Pathway to Disability: The Nagi Model Courtney Hall, PT, PhD Atlanta VAMC Emory University

Pathway to Disability: The Nagi Model

Courtney Hall, PT, PhDCourtney Hall, PT, PhD

Atlanta VAMCAtlanta VAMC

Emory UniversityEmory University

Please Note:

Jane Gain is referred to as Joyce throughout this lecture.

Pathway to Disability:Nagi Model

Disease/Pathology

FunctionalLimitation

DisabilityImpairment

The Nagi Model Revised

Disease/Pathology


Disability

Lifestyle/Inactivity

Impairment

Disease/Pathology

Underlying pathologic condition that interferes with normal bodily function or structure

e.g., stroke, osteoarthritis

ImpairmentImpairment Loss or abnormality at the tissue,

organ, or body system level The physiological or psychological

consequences Impairment can be primary or

secondary to pathology e.g., sensory deficit or abnormal

muscle tone after a stroke

Functional Limitation

Restrictions in performance at the level of the whole person

e.g., limitations in gait following stroke

Disability

Limitations in performance of socially defined roles and tasks within a sociocultural and physical environment

Includes work, school, recreation, personal care

DisabilityNot all impairments or

functional limitations result in disability

Similar patterns of disability may result from different impairments and functional limitations

Measuring Disease and Lifestyle

Disease/Pathology


Disability


Impairment

Health/Activity Questionnaire

Gender: Male Female Age: 71

Have you ever been diagnosed as having any of the following conditions?

Heart attack Respiratory disease

Neuropathies Arthritis

Inner ear problems Depression

FALL PROOFTM PROGRAM

Health/Activity InformationHealth/Activity Information

Jane (Case Study 1)Jane (Case Study 1)

List all medications that you currently take:

Albuterol Allopurinol

Asthma Cort K-Dur

Lasix Beconase

Synthroid

How many times have you fallen within the past year? 2




In a typical week, how often do you leave your house? less than once/week 3-4 times/week 1-2 times/week most every day

Do you currently participate in regular physical exercise that causes an increase in breathing, heart rate, or perspiration?

Yes No If yes, how many days per week?




When you go for walks, which of the following best describes your walking pace:

Strolling (easy pace)

Average or normal

Fairly brisk (fast pace)

Do not go for walks on a regular basis




Measuring Impairment

Disease/Pathology


Disability


Impairment

Senior Fitness Test

M-CTSIB

Health Activity Questionnaire

Do you currently suffer any of the following symptoms in your legs or feet?

Numbness

Tingling

Arthritis

Swelling




Disease/Pathology


Disability


Impairment

BBS or FAB scale

50’ walk/ walkie-talkie

Measuring Functional Limitation

Do you use an assistive device for walking?

No Yes Type?




Disease/Pathology


Disability


Impairment

CPF Scale

Measuring Disability

Disability - Composite Physical Function Scale Jane (Case Study 1)

Take care of personal needs 2 1 0

Bathe yourself 2 1 0

Climb a flight of stairs 2 1 0

Walk outside 1-2 blocks 2 1 0

Do light household activities 2 1 0

Please indicate your ability to do each of the following:

Can Can do with Cannot

do difficulty or help do


Do own shopping 2 1 0

Walk 1/2 mile 2 1 0

Walk 1 mile 2 1 0

Lift and carry 10 pounds 2 1 0

Lift and carry 25 pounds 2 1 0





Do most heavy household chores 2 1 0

Do strenuous activities 2 1 0

CPF Score = 7/24 indicating low-functioning




Disability- Composite Physical Function Scale- Jan (Case Study 1)

Do you currently require household or nursing assistance to carry out daily activities?

No Yes If yes, please check the reason (s)?

a. Health problems b. Chronic pain c. Lack of strength or endurance d. Lack of flexibility or balance

Documents

Pathway to Disability: The Nagi Model Courtney Hall, PT, PhD Atlanta VAMC Emory University