Handicap care

Mr. Muthuukaruppan M.

Handicap & Disability Disadvantage for a given individual in his or her social

context, that limits or prevents the fulfillment of a role that is normal to an individual.

Any restriction or lack of ability to perform an activity in the manner normal to a individual.

Physical, cognitive, mental, sensory, emotional or combinations are noted.

Disability prevents subjects from being independent. Disabled persons are addressed “Differently Abled” persons.

Rehabilitation Enhance and restore functional ability and quality

of life to those with physical impairments or disabilities

Primary prevention, Secondary prevention & Tertiary prevention

Goal is to “Add life to years, not years to life”

WHO Identified 6 Handicap’s Locomotor handicap: paraplegias Hearing & speech handicap: loss of hearing & inability to

speak Cardiopulmonary handicap: respiratory & vascular

disorders Visual handicap: blindness Mental handicap: Conditions like Down’s syndrome,

dyslexias Emotionally disturbed

Primary disabilities are direct consequences of a disease. eg-spinal cord injury, stroke

Secondary disabilities are those which did not exist at the onset of primary disability but develop subsequently. eg-tight muscles, joints etc.

Result of Decreased Activity due to handicap

Rehabilitation Team Doctor Physiotherapist Occupationaltherapist Speech pathologist Prosthetist – Orthotist Rehabilitation nurse Psychologist Music or play therapist Biomedical engineer

Social worker Vocational counselor Special educator Government agencies

Delivery of Rehabilitation care

Institutional based care (IBR) Homes Day care centers Outpatient clinic Camps Community based rehabilitation (CBR)

Therapeutic exercises Strengthening exercises Balance training Coordination exercises Gait training Mobilization exercises Re-education exercises Massage techniques Relaxation exercises

Strengthening exercises:Set of exercises to improve the power of the muscle or muscle groupsFITT principle – frequency, intensity, time & typeTypes of contraction – concentric, eccentric or isometricPrecautions needed to be taken care.

Balance training:Procedures assisting in improving static & dynamic balance are used in training

Coordination exercises:For performing precise smooth and purposeful movement using multiple muscles and a stable postureVolition - Ability to start, maintain or stop an activity Perception – intact centers and areas in brain to retrieve the plans stored priorMotor plans in central nervous systemRepetitive exercises, precision & attention are important part of treatment

Gait training:Gait or human locomotion is a translatory progression of the body as a whole, produced by coordinated movements of body segments.Normal gait requires sensory inputs and proper muscular activity.Gait training can be given using assistive devices such as crutches, walkers, sticks etc.

Mobilization exercises:Mobilization is passive movement in such a manner or speed that the patient can stop the movement at his will.It helps in restoring or maintaining joint movement

Massage techniques:Manipulation of soft tissues and assisting in circulation of extremitiesAssists in treating pathological disorders.

Relaxation exercises:Relaxation is a state in which the muscles of the body are relatively free from tensionGeneral relaxation & Local relaxation

Reeducation exercises:Exercises taught to train a lost or new activity to muscle groups after various pathologies.Done in grades to increase the activity subsequently

Summary

Physical Activity/Exercise can improve disability and handicap

Improvement in quality of life

“Rehabilitation is clearly the only practical means of significantly improving function in Handicap patients”

George Kraft, MDThe Lancet, December 11, 1999