MODEL
The Nature of Physical Therapy
Physical Therapy is providing services to people and populations to develop, maintain and restore maximum
movement and functional ability throughout the lifespan.
Physical therapy includes the provision of services in circumstances where movement and function are threatened by the process of ageing or that of injury or disease.
Full and functional movement are at the heart of what it means to be healthy.
Pelayanan Fisioterapi ditujukan kepada perorangan dan masyarakat
Lingkup pelayanan Fisioterapi adalah Mengembangkan, memelihara,
dan
memulihkan
Yang menjadi bidang garapan Fisioterapi adalah (maksimilisasi) Gerak
dan (kemampuan) Fungsi
Sehat yang dimaksud oleh Fisioterapi adalah keadaan gerakan penuh
dan
Apakah yang dikerjakan
Fisioterapi
Physical therapy is concerned with identifying and maximizing movement potential, within the spheres of promotion, prevention, treatment and rehabilitation. Physical therapy involves the interaction between physical therapist, patients or clients, families and care givers, in a process of assessing movement potential and in establishing agreed upon goals and objectives using knowledge and skills unique to physical therapists.Fisioterapi mengenali dan memaksimalkan potensi gerak yang berhubungan dengan lingkup promosi, prevensi, penyembuhan dan pemulihan.
…...Fisioterapi
The physical therapists' distinctive view of the
body and its movement needs and potential is
central to determining a diagnosis and an
intervention strategy and is consistent whatever
the setting in which practice is undertaken. These
settings will vary in relation to whether physical
therapy is concerned with health
promotion:
prevention, treatment or rehabilitation.
Fisioterapis secara khusus memandang tubuh dan kebutuhan potensi gerak merupakan pusat penentuan diagnosis dan strategi intervensi dan konsiten dengan bentuk apapun dimana praktek fisioterapi dilakukan.
KEPMENKES 1363
Fisioterapi adalah bentuk pelayanan
kesehatan yang ditujukan kepada
individu dan atau kelompok untuk
mengembangkan,
memelihara
dan
memulihkan gerak dan fungsi tubuh
sepanjang daur kehidupan dengan
menggunakan
penanganan
secara
DEFINISI FISIOTERAPI
•
Pelayanan kepada individu dan
masyarakat
•
Mengembangkan, memelihara,
memulihkan gerak dan fungsi
•
Sepanjang daur kehidupan
Nagi Model
berdasarkan pada konsep
•
penyakit atau aktif patologi,
•
impairtment,
•
keterbatasan fungsi,
Nagi model
penyakit /
aktif patologi,
impairtment
keterbatasan
fungsi,
(Functional
limitation )
Nagi model
•
aktif patologi adalah interruption/ berhentinya atau interference
proses normal dan usaha organisme secara simultan untuk
memperbaikinya sendiri ke keadaan normal dengan mobilisasi
defense tubuh dan mekanisme coping,
•
impairtment adalah hilangnya atau abnormalitas anatomi,
fisiologikal, mental atau psikologikal atau fungsi;
•
keterbatasan fungsi atau restriksi kemampuan untuk melakukan
tindakan fisik, tugas atau efisiensi aktifitas, harapan khusus, atau
kompeten pada tingkat semua organisme dan person;
•
disability adalah ketidakmampuan untuk melakukan atau
keterbatasan dalam melakukan tindakan, tugas, aktifitas yang
biasanya diharapkan dalam peran social khusus untuk individu atau
diharapkan untk status person atau peran dalam konteks
WHO
•
Pada tahun 1980, World Health Organization
(WHO) dikembangkan suatu model
disablement alternative.
•
Dalam WHO International Clasification of
World Health Organization
Disability model
penyakit /
disease
impairtment
Ketidak
WHO MODEL
•
desease/penyakit
didefenisikan sebagai perubahan patologi yang ditunjukkan
sebagai suatu kondisi kesehatan yang berubah atau attribute status kesehatan
individu yang akan membawa pada suatu distress, interference dengan aktifitas
sehari-hari atau kontak dengan pelayanan kesehatan
.
•
Impairtment
didefenisikan sebagai perubahan abnormal pada tingkat molecular,
selular dan jaringan melalui struktur dan fungsi abnormal pada tingkat organ;
•
disability
restriction atau kurangnya kemampuan untuk melakukan aktifitas
umum dengan cara yang normal;
NCMRR (1992 )
•
National Center For Medical
Rehabilitation and Research
(NCMRR) mempublikasikan
suatu model disablement yang
diambil dari Model Nagi dan
NCMRR (1992 )
•
patofisiologi,
•
impairtment,
•
keterbatasan fungsi,
•
disability dan
NCMRR
•
Model NCMRR menolak konotasi
negative dari bentuk “handicap” dan
diusulkan untuk menggantinya
dengan bentuk “keterbatasan
societal” untuk menghitung
keterbatasan – imposed by society -
membatasi kemampuan orang untuk
berpartisipasi secara independent
(IOM)
•
Pada tahun 1991, Institute Of
Medicine (IOM) menempatkan
keempat model disablement untuk
menekankan prevention, diusulkan
bahwa disability mungkin dicegah
melalui control resiko fisik dan
resiko factor lingkungan social
Health condition
Environmental
factors Personal factors Body functions/
Body structures Activities Participation
Health condition
Environmental factors
Personal factors Body functions/
Body structures Activities Participation 1. The ICF integrative bio-psycho-social model of functioning and
disability
A health condition is an umbrella term for disease, disorder, injury or trauma.
A health condition may also include other circumstances, such as ageing, stress, pregnancy, congenital anomaly, or genetic
predisposition
Health conditions may be coded using the ICD-10.
Health condition
Environmental factors
Personal factors Body functions/
Body structures Activities Participation 1. The ICF integrative bio-psycho-social model of functioning and
disability
Body functions are physiological functions of body systems, including psychological functions
Body structures are anatomical parts of the body, such as organs, limbs and their components
Impairments are problems in body functions or structure such as a significant deviation or loss
Health condition
Environmental factors
Personal factors Body functions/
Body structures Activities Participation
Tetraplegia G83.5
1. The ICF integrative bio-psycho-social model of functioning and disability
Physical Therapist:
Beside Mr. Wun‘s complete problems in the lower extremity, he has partial
deficits of muscle power in the arms. Due to his loss of movement in his legs, he demonstrates stiffness in the
muscles and reduced mobility in the ankle joints. As a consequence of the loss of muscle power he has also
problems with his respiratory functions
Health condition Environmental factors Personal factors Body functions/ Body structures Activities Participation Tetraplegia G83.5 muscle power in the arms
movement in his legs stiffness in the muscles mobility in the ankle joints
respiratory functions
1. The ICF integrative bio-psycho-social model of functioning and disability
Health condition
Environmental factors
Personal factors
Activities Participatio n
Activity is the execution of a task or action by an individual
Participation is involvement in a life situation.
Activity limitations are difficulties an individual may have in executing activities
Participation restrictions are problems an individual may experience in involvement in life situation
Tetraplegia G83.5
movements in his legs stiffness in the muscles muscle power in the arms
mobility in the ankle joints respiratory functions
1. The ICF integrative bio-psycho-social model of functioning and disability
„ My problems in daily living are that I need much more time for eating, and I can‘t go to the toilet. To maintain sitting is difficult, I always need my arms to prop up. I can‘t go out to meet my friends, but I still communicate to them by phone or E-Mail.
I also started to
work on the computer, doing translations from English to Thai ….“ Health condition Environmental factors Personal factors Activities Participatio n Tetraplegia G83.5 eating maintain sitting
meet my friends
work on the computer
go to the toilet
movements in his legs stiffness in the muscles muscle power in the arms
mobility in the ankle joints respiratory functions
1. The ICF integrative bio-psycho-social model of functioning and disability
Health condition
Environmental
factors Personal factors
Activities Participation Environmental factors make up the physical, social and attitudinal environment in which people live and conduct their lives.
These factors are external to individuals and can have a positive or negative influence on the individual’s performance as a member of society, on the individual’s capacity to execute actions or tasks, or on individual’s body function or structure
Tetraplegia G83.5
movements in his legs stiffness in the muscles muscle power in the arms
mobility in the ancle joints respiratory functions
eating
maintain sitting
go to the toilet meet my friendswork on the computer
1. The ICF integrative bio-psycho-social model of functioning and disability
„My wheelchair is very heavy, that makes it difficult for me to move it. Most of the buildings outside are not adapted for disabled. The streets are full of obstacles; impossible to overcome.
The support of my mother is most important for me, additionally we have two housekeepers who help me all the time.
My health insurance pays for all my hospital stays, that helps also.
Health condition Environmental factors Personal factors Activities Participatio n Tetraplegia G83.5
movements in his legs stiffness in the muscles muscle power in the arms
mobility in the ancle joints respiratory functions
eating
maintain sitting
go to the toilet meet my friends work on the computer
wheelchair is very heavy buildings
streets are full of obstacles
support of my mother housekeepers
health insurance
1. The ICF integrative bio-psycho-social model of functioning and disability
Health condition
Environmental
factors Personal factors
Activities Participatio n
Personal factors are the particular background of an individual’s life and living, and comprises features of the individual that are not part of a health condition or health state.
These factors may include gender, race, age, other health conditions, fitness, lifestyle, habits, coping styles, social background, education, profession, past and current experience,…
Tetraplegia G83.5
movements in his legs stiffness in the muscles muscle power in the arms
mobility in the ancle joints respiratory functions
eating
maintain sitting
go to the toilet meet my friendswork on the computer
housekeepers wheelchair buildings
streets are full of obstacles support of my mother health insurance
1. The ICF integrative bio-psycho-social model of functioning and disability
Medical Doctor:
„Mr Wun is 24 years old, he finalized his university degree for engeneering last year. Although his disease is severe he is motivated to improve his situation.
Health condition
Environmental
factors Personal factors
Activities Participatio n
Tetraplegia G83.5
movements in his legs stiffness in the muscles muscle power in the arms
mobility in the ancle joints respiratory functions
eating
maintain sitting
go to the toilet meet my friendswork on the computer
housekeepers wheelchair buildings
streets are full of obstacles support of my mother health insurance
motivated engeneering
university degree 24 years old
1. The ICF integrative bio-psycho-social model of functioning and disability
