Handicap care Mr. Muthuukaruppan M.

Handicap & DisabilityDisadvantage 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.

RehabilitationEnhance and restore functional ability and quality of life to those with physical impairments or disabilitiesPrimary prevention, Secondary prevention & Tertiary preventionGoal is to Add life to years, not years to life

WHO Identified 6 HandicapsLocomotor handicap: paraplegiasHearing & speech handicap: loss of hearing & inability to speakCardiopulmonary handicap: respiratory & vascular disordersVisual handicap: blindnessMental handicap: Conditions like Downs syndrome, dyslexiasEmotionally disturbed

Primary disabilities are direct consequences of a disease. eg-spinal cord injury, strokeSecondary 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 TeamDoctorPhysiotherapistOccupationaltherapistSpeech pathologistProsthetist OrthotistRehabilitation nursePsychologistMusic or play therapistBiomedical engineer

Social workerVocational counselorSpecial educatorGovernment agencies

Delivery of Rehabilitation careInstitutional based care (IBR)HomesDay care centersOutpatient clinicCampsCommunity based rehabilitation (CBR)

Therapeutic exercisesStrengthening exercisesBalance trainingCoordination exercisesGait trainingMobilization exercisesRe-education exercisesMassage techniquesRelaxation 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 movementMassage 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 relaxationReeducation exercises:Exercises taught to train a lost or new activity to muscle groups after various pathologies.Done in grades to increase the activity subsequently

SummaryPhysical Activity/Exercise can improve disability and handicapImprovement in quality of life

Rehabilitation is clearly the only practical means of significantly improving function in Handicap patientsGeorge Kraft, MDThe Lancet, December 11, 1999

**We know from extensive research, mostly from cardiac rehabilitation, that inactivity causes deconditioning and those who are deconditioned tend to be less active.

In addition, we know that the inactivity can cause physical impairment and psychological disturbances such as depression and decreased self-esteem. This vicious circle can cause significant problems with overall health and places individuals at greater risk for cardiovascular diseases.*