Rehabilitation is a field of medicine where the concepts of science and technology are applied for the betterment of the condition of people with disability. Rehabilitation tries to shine some light on the existing capacities of the person and try to bring them to the optimal level. This can be done by the use of medical, social, vocational, and educational measures, either collectively or singularly.

As a consequence, this makes the life of the handicapped more productive. Rehabilitation engineering is a field of engineering that deals with the design and development of products or equipment that improves the state of disabled people.

Before diving deep into the concepts of preventive rehabilitation and the diagnosis of disability, let’s try to understand the difference between impairment, disability, and handicap.  

Impairment is the loss or abnormality encountered by any part of the individual, physiologically or psychologically. Disability is the restriction caused by the impairment to perform a certain activity that is considered within the normal range of a human being. The condition of being handicapped is the disadvantage faced by the person that prevents the fulfillment of a role that is considered normal.

For example, one who has cataracts has impaired eyesight (impairment). This affects the subject’s reading/motor activities (disability), thereby resulting in the exclusion from school (handicap).

According to WHO, there are 6 major types of handicaps,

  • Locomotor handicap (which forms 60 percent of all handicaps)
  • Visual handicap
  • Hearing and speech handicaps
  • Cardiopulmonary handicap
  • Intellectual handicap
  • Emotionally disturbed

Types of Disability

There are three types of disabilities depending on the origin of the same. They are, primary, secondary, and multiple disabilities.

Primary disabilities are the disabilities that are a direct consequence of a disease or a condition. For example, the inability to walk after a hip fracture comes under primary disability. Secondary disabilities are the disabilities that develop gradually that don’t exist during the occurrence of the primary disability.

For example, joint contracture in poliomyelitis, subluxation of the shoulder joint in hemiplegia, tendon-Achilles contracture in cerebral palsy, and pressure sores in paraplegia, etc, comes under secondary disabilities. The condition where there are more than two disabilities co-existing is called multiple disabilities.

For example, a child with cerebral palsy would probably have, in addition to delayed milestones and motor problems, damage to the part of the brain responsible for sight and hearing.

Need for rehabilitation

The interaction during pre-pathogenesis between the host agent and the surroundings, makes the patient go from a subclinical stage to a disease’s clinical manifestation. The subject descends the scale of health from good health to inadequate health due to sickness.

Either the patient receives effective treatment and recovers, or the patient may occasionally give in to the condition. Conversely, some diseases cause the patient to enter a zone of disability from which they require rehabilitation.

Phases of a medical treatment

There are three phases of a particular medical treatment,

  • Preventive care (to prevent the occurrence of the condition)
  • Curative care (to strive to cure the particular condition)
  • Rehabilitation (to aid in a better coping mechanism for the disability resulted due to a particular condition)

Prevention rehabilitation

Preventive rehabilitation deals with the quality of life. When there is a fall in the mortality levels, there is a rise in the morbidity levels. The field of rehabilitation deals with morbidity levels, i.e., the condition of suffering from a disease or medical condition.

There are three levels of prevention, namely the primary, secondary and tertiary. The following block diagram represents the different stages of the progression of a disease and where the prevention procedures can be applied. le

Levels of prevention

Below is the table that focuses on the target, aim, and example for the levels of prevention.

Levels of preventionTargetAimExample
PrimaryHealthy PopulationTo avoid the development of the diseasePublic awareness and vaccinations
SecondaryPopulation at risk To aid in the early diagnosis of the disease, thereby preventing the progression of the diseaseHealth check-ups
TertiaryThe sick peopleTo administer proper rehabilitation to the people with the diseaseRehabilitation services
Levels of prevention

Diagnosis of disability

During the process of diagnosis, the person is considered as a whole entity. This means that the physical, emotional, vocational, and social condition of the subject has to be thoroughly evaluated without leaving any aspect. The diagnosis of disability can be expressed as,

  • Disability evaluation: The amount of disability / the subject’s inability to do a certain task compared to what they were doing before the condition. It is calculated by having the patient undergo general physical, orthopedic, physiatry, and neurological exams in the rehabilitation facility.
  • Functional diagnosis: Rehabilitation specialists are taught to make a functional diagnosis in order to assess the patient’s remaining capacities and strengthen them.

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