International disability studies最新文献

The Vocational Rehabilitation Index (VRI) is an easily administered, seven-item, ordinally scaled assessment, developed from analysis of variables associated with early return to work in a representative sample of 194 persons who received compensation for injuries at work or in road traffic accidents. The VRI discriminates between persons who return to work and those who do not. It can be used to identify, amongst non-returners, those whose return to work might be assisted by referral to rehabilitation. It may also indicate the kind of assistance that would be most helpful.

A portable microprocessor-based device, the timer-logger-communicator (TLC), was adapted and connected to footswitches to monitor and record temporal gait parameters in 25 hemiplegic and 30 normal subjects. Controls walked at 1.36 m/s with symmetric gait. Hemiplegic subjects had a mean walking speed of 0.43 m/s, asymmetric gait, and varying proportions of time spent in each phase, consistent with previously reported gait parameters. Trends in objective gait measures more closely paralleled trends in functional ambulation classification than in Brunnstrom motor recovery stages. The TLC gait monitor is a useful instrument to measure temporal parameters of gait in the clinical setting.

A study has been made of lower limb amputation statistics from morbidity data from the State Health Departments in New South Wales, Queensland, and Western Australia. The incidence of lower limb amputation in these three States was 22.6 in 1981, 22.5 in 1983, and 23.6 in 1984. Incidence was lowest in New South Wales and highest in Western Australia. Below-knee amputation was more common than above-knee except in Western Australia in the years 1981 and 1983. Males had slightly more amputations than females. Incidence increased steadily with age, rising rapidly after 55 years. Vascular disease was the most common cause of major amputation. Of malignancies, skin cancers, both malignant melanoma and other forms, were causes of major and minor amputations in addition to bone malignancies. These three Australian States have a lower incidence of amputation than the United Kingdom or Finland.

A total of 2705 people aged 60 years and over were sent a postal questionnaire requesting information about the symptoms of four common conditions--exertional chest pain, chronic productive cough, breathlessness, and exertional pain in the calves. These were elicited using a standardized questionnaire. The effect of these symptoms on the dependence of those suffering them was assessed in relation to a series of activities associated with normal daily living. There was a consistent rank order in the activities that people were unable to perform for the different symptoms studied, but this order altered with increasing severity and multiple symptoms. There was a consistency about the activities which changed order. It is suggested that symptoms and their associated dependence need to be assessed in relation to each other, using simple scaling systems by professional service personnel, managers/, and planners, in order to bring together the therapeutic rehabilitative, and social aspects of health needs. These are felt to be vital before decisions about service development can be made.

A screening instrument for disabilities, based on the D Code of the ICIDH, has been constructed. It is intended for use in the daily routine of rehabilitation medicine. The instrument consists of 28 items in five ability categories. Disabilities as well as perceived problems related to each disability are described using a four-point scale. In this study the instrument was used to screen the functional status and perceived problems of 284 rehabilitation patients. The mean time needed for assignment was 3 min (range 1-6). Computer software was developed, which permitted easy comparison of disabilities versus the related problems in individuals and at group level.

Little work has been carried out on diabetes and disability. A questionnaire survey on the employment of people with diabetes aged 17-65 years was carried out in the UK. Data were also collected from a questionnaire sent to a random sample of employers. A comparison between those diabetic patients registered as disabled and those not so registered showed that men were more likely to be registered than women. The disabled group were also older, lower down the social scale, more likely to rent their house, to have left school before the age of 17 years, and to live in the north of the country. Significantly fewer disabled patients were currently working compared with those not registered as disabled (30% versus 65%, p less than 0.0001). Registered disabled patients who were working were no more likely to report having more than 20 days off sick in the last year compared with those patients not registered as disabled (7% versus 9%). Employers did not report adverse sickness absence rates for their registered disabled diabetic patients. People with diabetes who are registered as disabled can make good employees in a range of different occupations. Registering as disabled may improve employment opportunities for people with diabetes who are finding difficulty in obtaining suitable employment.

This paper investigates the reliability of six measures of impairment and disability related to mobility after stroke: the Rivermead Motor Assessment (RMA, gross function subsection); gait speed (over 5 and 10 m); the motricity index (leg scores only); functional ambulation categories; sitting to standing (by observation); and mobility categories. Twenty-five patients who had suffered a stroke 2-6 years earlier leaving them with mobility disability were seen as part of a home-based physiotherapy trial. Assessments were made by three people on three occasions over 5 weeks. All six measures were reliable in statistical terms. A variation in gait speed of up to 25% and a difference of 3 points in the RMA were the actual limits of reliability.

This paper draws on a unique longitudinal study, '70-year-old people in Gothenburg, Sweden', to augment available knowledge of the incidence of physical disability in an ageing cohort. Among women the incidence of mobility disability was 0.12 between age 70 and 75 years, and 0.19 from age 75 to 79 years. One in 10 males became mobility disabled from age 70 to 75 years while the risk increased to 0.18 between age 75 and 79 years. Cohort members disabled at age 70 years were at significantly increased risk of dying by age 79 years compared with their non-disabled counterparts. The data were consistent with other research revealing a substantial annual risk of disability or death for people in their eighth decade of life.

A study based on the WHO model of community-based rehabilitation in Guangzhou City, China, is described. Preliminary epidemiological data are reported, and compared with analogous data from Korea, Vietnam, Malaysia, Mexico, Indonesia, and Pakistan. Confidence levels for estimates of the prevalence of limb dysfunction, visual dysfunction, hearing and/or speech dysfunction, and mental retardation are also reported.

Until recently there has been little satisfactory information about people with disabilities in France, partly due to reluctance by those framing legislation to formulate a definition of handicap. A preliminary translation of the ICIDH in 1981 stimulated interest in the problem, and the National Technical Centre on Handicaps issued a definitive translation in 1988. The word 'handicap' caused difficulties in French as it approximates to the global term disablement. This report describes how the difficulties were surmounted, and how the National Technical Centre then proceeded to undertake activities to extend awareness of the ICIDH. The impact of the classification is reviewed, and applications in social administration, rehabilitation and geriatrics, epidemiological surveys, and education and training are discussed. In 1989 the National Centre was appointed as a WHO collaborating centre for the ICIDH, and future aims are described.