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Need a print out of the Original Article published in Indian Journal of Occupational Therapy


Leprosy & ADL

Worked with ALERT - INDIA, for 6 months on an assignment of Assessment of ADL status in Leprosy patients with WHO grade II deformities

Presented a paper at the XXXVII Annual National Conference EMCON - 2000 - of the A.I.O.T.A. at Mumbai on Assessment of ADL in Leprosy patients with WHO grade II deformities



Until now little is known about disability in leprosy as opposed to impairment. This may partly be due to a lack of awareness that disability is actually something separate from impairment. Another reason may be the absence of a suitable tool to measure disability. We are not aware of the existence of many standardised assessment instruments for disability, used with persons affected by leprosy. Many disability scales are available in Western countries, but none appeared suitable for use with people living in a developing country like India. Where females wear Sari and males use Dhoti, where eating rice with fingers is one at the hallmark of becoming independent.

Also females are not aware of washing machine or dish washer. Also male and female labour workers at construction sites are still working barefooted and barehanded without any protective device when normal and even after affected by Leprosy.

Taking into consideration above mentioned factors factors ADL-evaluation scale was designed, which was an interview based assessment of ADL, appropriate for persons living in our country. The structure of ADL-assessment scale was based on the Activity (Disability) classification of the draft of the ICIDH -II


ICIDH defines impairment and disability as follows. (WHO 1980)
Impairment : Any loss or abnormality of psychological physiological or anatomical structure or function.

Disability : Any restriction or lack of ability (resulting from impairment) to perform an activity in the manner of within the range considered normal for a human being.

Deformity may be defined as visible impairment

In 1997, a draft of the revised edition of the ICIDH was published : the ICIDH -2 In this revised classification, the terms disability and handicap were replaced by the more initiative and positive terms activities (of daily living) and (social) participation.Problems in these areas are described as activity limitation and participation restriction.(Besides providing a uniform language for the area of prevention of impairment and disability, it offers a client oriented framework for rehabilitation). Also according to above definitions, we will therefore refer to the WHO disability grade AS the WHO impairment grade.