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Disability is a human reality that has been seen distinctively by different societies and cultures. The International Day of Persons with Disabilities, which is observed on December 3 every year, aims to promote the rights and well-being of PWD in all spheres of life and development. It also aims to increase the awareness of the situation in daily lives of persons with disabilities, considering every aspect of political, social, economic and cultural life.
Disability is a condition of the body, it’s not an illness. Long-term effects of the illness can be a disability. It can be present since birth, acquired during young and active years of life or during old age. It can be visible (physical disabilities) or invisible (mental and cognitive disabilities). It can be short-term like having a fractured arm and having limited mobility for a few weeks or long-term disability like cerebral palsy, Parkinson’s or stroke which is chronic and permanent.
There is no definitive definition of disability. It is a multidimensional, complex, dynamic and contested concept.
There are different models of how disability is categorised and understood: medical model, social model, human rights model, interactional model etc.
This considers that disability is caused directly by a disease, an injury, or some de-regulations in the bodily systems, which require treatment and rehabilitation. It does not take into account important roles of environmental and social barriers.
It identifies the systemic barriers, negative attitudes and exclusion by society (purposely or inadvertently) hinder the lifestyle of persons with disability. This model promotes the notion that while physical, sensory, intellectual, or psychological factors may cause individual functional limitation or participation restriction, these do not lead to disability, unless society fails to take account of and includes people regardless of their individual differences.
According to the World Health Organization (WHO), 15 percent of the people in the world are having some sort of disability, that’s nearly a 100 crore people worldwide. In India, as per 2011 Census, out of the 121 crore population, about 2.68 crore persons are ‘disabled’, which is 2.21 percent of the total population. The challenges persons with disabilities are facing every day is a profound one, especially after considering the aftereffects of Covid-19.
It can be done by not just creating awareness/addressing and fixing the problems/issues, but ensuring their participation, inclusiveness and equality, as well as providing legal protection.
The primary healthcare system plays a major role both as a provider and supporter. It engages with initiatives such as early identification of impairments and providing basic treatments, referrals to specialized services such as physical, occupational, and speech therapies, prosthetics and orthotics, and if required corrective surgeries.
Rehabilitation assists individuals who experience, or are likely to experience disability, to achieve and maintain optimal functioning in their daily activities and life.
Physiotherapists also play a distinctive role in helping those who acquire disabilities congenitally or early in life to develop maximal functioning, while rehabilitation assists individuals who experience loss/difficulty in doing a task to regain maximal functioning through interventions and compensatory strategies.
The habilitation/rehabilitation protocol is tailor-made according to individual needs. It is specific to the impairment and functional needs, involves single or multiple exercises and interventions, as well as takes into account all the phases of injury/disability – early/acute, post-acute and late/chronic stages.
Evidence shows that specific exercise protocols in a broad range of health conditions – including amputations, stroke, cerebral palsy, cystic fibrosis, frailness in elderly people, osteoarthritis in the knee and hip, heart disease and heart surgeries, fracture after an accident, low back pain – has contributed to increased strength, endurance, and flexibility of joints.