GOOD MORNING…

LOCOMOTOR DISABILITY
EVALUATION

Disability evaluation of:

• Upper limb
• Lower limb
• Trunk
• Dwarfism
• Amputation
• Neurological conditions
• Cardiopulmonary conditions
DISABILITY EVALUATION FOR
NEUROLOGICAL CONDITIONS
 DISABILITY EVALUATION FOR
NEUROLOGICAL CONDITIONS
• Assessment of neurological conditions is not the assessment of the
disease/ pathology but the assessment of its clinical manifestations

• Has to be done after six months after the onset of disease

 DISABILITY EVALUATION FOR
NEUROLOGICAL CONDITIONS
• Altered sensorium
• Cranial nerve disability
• Sensory system disability
• Motor system disability
• Bladder disability
• Fits & epilepsy
• Ataxia
 DISABILITY EVALUATION FOR
NEUROLOGICAL CONDITIONS

• Altered sensorium – 100 %

Type of cranial nerve PPI
involvement

Motor cranial nerve 20 % for each nerve

Sensory cranial nerve 10 % for each nerve

• Sensory system

Type of sensory involvement PPI

Anaesthesia 10% for each limb

Hypoaesthesia
Paraesthesia
For involvement of 25%
hand/hands
Foot/feet
• Motor system disability

Neurological PPI
involvement
Mild 25 %
Moderate 50 %
Severe 75 %
 Bladder involvement PPI

Mild ( Hesitancy/ frequency) 25 %

Moderate (Precipitancy) 50 %

Severe (occasional but recurrent 75 %

incontinence)
Very severe (Retention/ total incontinence) 100 %
Frequency/ severity of convulsion PPI

Mild occurrence of 1 convulsion Nil

Moderate 1 -5 convulsions/ month 25 %

On medication

Severe 6 – 10 convulsions/ month 50 %

Very severe more than 10 fits/ month 75 %

Frequency/ severity of ataxia PPI

Mild – detected on examination 25 %

Moderate 50 %

Severe 75 %

Very severe 100 %

DISABILITY EVALUATION OF THE
CARDIOPULMONARY SYSTEM
 DISABILITY EVALUATION OF THE
CARDIOPULMONARY SYSTEM

• Modified New York Heart Association subjective

classification should be used to assess the functional
disability

• Should be done after full medical, surgical &

rehabilitative treatment available because most of the
diseases are potentially treatable
Group 0 A patient with cardiopulmonary disease who is asymptomatic Nil

Group 1 A patient with cardio-pulmonary disease who has mild restriction 20%
(25%) of his ordinary physical activities

Group 2 A patient with cardiopulmonary disease who has 25-50% restriction 40 %

of his ordinary physical activity

Group 3 A patient with cardiopulmonary disease who becomes symptomatic 60 %

during less than ordinary physical activity so that his ordinary
physical activities are 50-75% restricted

Group 4 A patient with cardiopulmonary disease who is symptomatic on 80 %

mildest exertion so that his ordinary physical activities are severely
or completely restricted (75-100%)

Group 5 A patient with cardiopulmonary disease who gets intermittent 100%

symptoms at rest
 DISABILITY EVALUATION

• Mental retardation

• Visual disability

• Speech & hearing disability

• Locomotor disability

• Multiple disabilities
 SHORTCOMINGS

• It evaluates impairment

• Assesses only physical dimension

• Complex calculation

• Evaluation of TMJ is not there

 SHORTCOMINGS

• Evaluation of ROM & strength of MTP & IP joints are

totally omitted

• Only scoliosis in non-traumatic trunk condition

• Disability evaluation of neurological conditions are

more of subjective
 ?..
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 REFERENCE

• Ministry of Social Justice and Empowerment

https://enabled.in/wp/guidelines-for-various-disabilities-and-procedure-
for-certification/
 DISABILITY
EVALUATION
Assignment
• A 25 year old right dominant male patient sustained fracture of right
humerus 2 months ago. Patients current status is described below.

• Calculate the disability % and mention whether he is eligible for

disability certificate.
 Right left
ROM Shoulder Flex-Extn 140* Full
IR- ER Full Full
Add-Abd 90* Full
Elbow Flex-Extn 100* Full
Pron-Supn Full Full
Wrist Flex-Extn Full Full
Rad-Ulnar Full Full
Dev
Muscle Normal in the available range
strength
Coordinated Overhead activities Affected Normal
activities Combing & plaiting Affected Normal
Remaining all activities are
not affected