The International Classification of Functioning, Disability and Health to map leprosy-related disability in rural and remote areas in Indonesia

Abstract

The International Classification of Function, Disability and Health (ICF - WHO, 2001) recognizes several dimensions of disability, such as body structure and function (and impairment thereof), activity (and activity restrictions) and participation (and participation restriction) and their interactions with contextual factor (personal and environmental). In this study, we map and analyse the relationship between the components of ICF in leprosy patients from two rural areas in Indonesia: Lewoleba (East Nusa Tenggara) and Likupang (North Minahasa). This study was a part of a community outreach program by the KATAMATAKU team from Universitas Indonesia. The body structure was graded using the WHO hand and feet disability grade and the number of enlarged nerves, whilst the body function was measured by the Jebsen Taylor Hand Function Test (JTT) and Timed-up and Go (TUG). Activity limitation and participation restriction were measured using the Screening Activity Limitation Safety Awareness (SALSA) Scale and Participation Scale (P-scale), respectively. There were 177 leprosy patients from the two regions and 150 patients with complete data were included in the analysis. We found 82% subjects with multibacillary leprosy, 10.67% subjects with grade 2 WHO hand disability, and 9.33% subjects with grade 2 WHO foot disability. Assessment using SALSA Scale showed 29.33% of subjects with limitation activity and 11.33% with participation restriction. Age was shown to have positive correlations with SALSA, JTT, and TUG. Inter-dimensional analysis showed that the SALSA scale had significant positive correlations with the number of nerve enlargement, P-scale, JTT, and TUG. SALSA scores of grade 2 WHO hand and foot disability were also significantly higher than grade 1 and 0. Participation scale also had a positive correlation with JTT but not TUG. Hand disability seemed to affect societal participation whilst foot did not. We used the ICF to describe and analyse dimensions of leprosy-related disability in Indonesia.

Comparison of McKenzie and Isometric Exercises on Neck Functions of Computer Users with Forward Head Posture

“…2,13,14 Restoring the ideal cranio-cervical posture through improved postural awareness, an ergonomic work environment, therapeutic exercises, motor learning, or particular manual treatment techniques is the key to managing FHP. 15 Therapeutic exercises are an effective intervention in reducing head and neck symptoms and disability. 16 6,9,17 The purpose of the McKenzie exercise, a form of self-therapeutic training, is to stretch, rehabilitate, and improve neck flexor flexibility.…”