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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-2 .

ACTIVITIES OF DAILY LIVING FORM

CODE ACTIVITIES
1 SELF-CARE
A FEEDING
1A - 1 Eating with finger
1A - 2 Cutting chapati with fingers
1A - 3 Eating rice with fingers
1A - 4 Eating western style (using fork, knife + spoon )
1A - 5 Eating rice with spoon
1A - 6 Drinking fluid from glass/cup
1A - 7 Eating on floor ( )
1A - 8 Eating on table
1A - 9 Can serve self solids
1A - 10 Can serve self liquids
B PERSONAL HYGIENE AND GROOMING
1B - 1 Hair-combing with 2 hands ( plating/bun )
1B - 2 Teeth-brushing teeth/dentures gargling (Applying Masheri )
1B - 3 Nail care - clean fingernails, toenails trimming
1B - 4 Shaving
1B - 5 Blowing nose
1B - 6 Applying make up
1B - 7 Toilet - Indian style squatting, getting up from squatting
1B - 8 Washing - pouring water
1B - 9 Bathing applying soap washing UE washing LE washing face
1B - 10 Care for menstrual periods
C DRESSING
1C - 1 Put on blouse/shirt
1C - 2 Remove blouse/shirt
1C - 3 Put on pyjama/trousers/dhoti
1C - 4 Remove pyjama/trousers/dhoti
1C - 5 Put on sari
1C - 6 Remove sari
1C - 7 Making sari pleats
1C - 8 Put on bra/baniyan
1C - 9 Remove bra/baniyan
1C - 10 Put on underwear/panty
1C - 11 Remove underwear/panty
1C - 12 Tie waist string/waist belt
1C - 13 Remove tie waist string/waist belt
1C - 14 Buttoning front/unbuttoning
1C - 15 Buttoning back/unbuttoning
1C - 16 Tie shoe laces/Velcro
1C - 17 Put on footwear
1C - 18 Remove footwear
1C - 19 Put on zippers/take off
1C - 20 Put on orthosis/remove (splints)
D OBJECT MANIPULATION (HAND ACTIVITIES)
1D - 1 Operate switches/doorbells
1D - 2 Remove, replace light buld/regulator
1D - 3 Plug in cord (3 pin, holder)
1D - 4 Operate locks + handles
1D - 5 Operate scissors
1D - 6 Handle money
1D - 7 Open + close doors/windows/drawer/refrigerator
1D - 8 Open cans/bottles/jars
1D - 9 Tie package
1D - 10 Sew (button, border)
1D - 11 Polish shoes
1D - 12 Sharpen pencil
1D - 13 Seal + open letter
1D - 14 Open box/dabba
1D - 15 Thread needle + make a knot
1D - 16 Cut with shears
E COMMUNICATION
1E - 1 Writing with pen/pencil
1E - 2 Use telephone
1E - 3 Handle own mail
1E - 4 Verbal
1E - 5 Read
1E - 6 Hold book/turn pages
1E - 7 Type
1E - 8 Any other ( sign language )
1F FUNCTIONAL MOBILITY
1F - 1 Carry objects during locomotion
1F - 2 Use public transport - Bus/Train
1F - 3 Drive automobile
1F - 4 Use mobility aids ( crutch, cane etc. )
2 WORK
A HOME MAKING TASKS
2A - 1 Sweeping with broom + use dust pan
2A - 2 Cleaning floor/mopping kitchen
2A - 3 Cleaning utensils
2A - 4 Carrying pail of water (bucket)
2A - 5 Handling light cleaning tools (brush)
2A - 6 Washing clothes
2A - 7 Wring out
2A - 8 Squeez dry
2A - 9 Ironing clothes
2A - 10 Clean bathroom/
2A - 11 Hanging up garments
2A - 12 Child care ( under 4 yrs.)
2A - 13 Bed making
2A - 14 Shopping + marketing
2B MEAL PREPARATION + SERVICE
2B - 1 Turn off gas/electric range (Mixer, oven, grinder, stove )
2B - 2 Light gas with match/lighter
2B - 3 Pour hot water from pan to cup
2B - 4 Peel vegetables, fruits
2B - 5 Cut up vegetables, fruits
2B - 6 Handle sharp tools safely
2B - 7 Break eggs
2B - 8 stir against resistance
2B - 9 Measure flour
2B - 10 Rolling chapatis
2B - 11 Open oven door/handle hot plate
2B - 12 Carry pan to oven + put in (turn chapati on hot plate etc. )
2B - 13 Remove hot pan from oven to table
2B - 14 Carry hot accessorise (casserole) to table (to serve)
2B - 15 Clear up table (floor)
2B - 16 Wipe up range + work areas
2B - 17 Handle pressure cooker
2B - 18 Grind on grinding stone
2C OCCUPATION (WORK HABITS AND ATTITUDES)
2C - 1 Standing for long time
2C - 2 Repetition
2C - 3 Heavy lifting
2C - 4 Working Barefooted
2C - 5 Working Bare Handed
2C - 6 Walking long distances
2C - 7 Precision work
2C - 8 Hot object handling
2C - 9 Prolonged holding (lifting)
2C - 10 Working long time in water
2C - 11 Strenous eye activities ( welding )
3 LEISURE SKILLS
3A - 1 Games
3A Hobbies/Habits
3B - 1 Crafts
3B - 2 TV/Radio use
3B - 3 Phonograph/tape recorder use
3B - 4 Smoking (Hand burns)
3A - 2 Play (children)
3C SPIRITUAL ACTIVITIES
3C - 1 Doing pooja
3C - 2 Attending temple/church/mosque

1 Dependent V/s Independent
2 Inappropriate ways of handling V/s Appropriate ways of handling combination of 1 and 2
D Dependent - 0
IIA Independent Inappropriate - 1
IA Independent Appropriate - 2

DEFINITIONS
Dependent - Patient is unable to do any part of the activity.
Independent Inappropriate - Patient is able to complete the activity with / without difficulty which may or will lead to reinforcement of abnormal porters or deformity predispose the body parts to ulcers etc. with such kind of performance of the activity. ( With or without adaptive equipment please mention splint, orthosis, or any other adaptive equipment used ).
Independent Appropriate - Patient is able to complete the activity with or without adaptive equipment. Two way of handling or performing the activity may or will not lead to deforming porters, ulcer or any other complications etc.

* If patient is not able to do the activity, who else can do it for the patient.
* NA - Not applicable.