THE IMPAIRMENT AND DISABILITY OF PATIENTS WITH SEVERE MOTOR AND INTELLECTUAL DISORDERS.

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For the patients with severe motor and intellectual disorders, we investigated the principles of rahabilitation programs for a long term. According to the impairment and disability model of WHO (1980), the impairments and ADLs and its relationship to other clinical factors of 92 institutionalized patients were examined.Results based on the impairment level showed that, firstly, the teen-age group revealed more severe impairment and suffered more frequently from pre-and peri-natal disturbances than the other older-age groups. These findings may reflect the recent noticeable advance in perinatal medicine. Secondly, deformity of skeletons began at age of 20s in some patients, and the significant correlations between each impairment component decreased in elder groups. Thirdly the multiple variable analysis between the sitting ability and the impairment elements revealed that the level of motor and cognition abilities in a teen-age group still reflect their individual developmental history … More during the early life, but little in elder groups.Results based on the disability level revealed that, firstly, abilities of ADL in most patients of the teen-age group were severely disturbed. Secondly, we founded that in the age-groups older than 20s patients with high ADL level decreased and patients with very low ADL level increased, and also noticed that the number of significant correlations between each ADL component decreased in elder groups. And lastly the multiple variable analysis of the sitting ADL ability revealed to be composed either of the congenital motor and intellectual ability, or of the acquired learning one.Therefore, in most patients with severe motor and intellectual disorders, we should aim to help them to maximize their internal ability till 20s, and thereafter it may be reasonable that we should change the strategy of the long term rehabilitation program both to maintain their acquired ADL and to protect against the progress of secondary and age-related impairment. Less