Assessing injury-related movement difficulties: A method for analyzing the association between functional limitations
1National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD 20782, USA. mloeb@cdc.gov
Background:
The conceptualization of disability has shifted from a medical to a social model with a consequent focus away from impairments and toward activities and participation. The International Classification of Functioning, Disability and Health (ICF) provides a common point of reference and a common language in a developing disability discourse.
Objectives:
We sought to apply a model for the measurement of disability based on the activity and participation constructs of the ICF to persons with movement difficulty as a result of injury-related causes.
Methods:
Data from sample adults aged 18 years and over in the 2001-2006 National Health Interview Survey (NHIS) were used for analysis. Disability among adults with injury-related movement difficulty was assessed through measures of difficulty performing basic actions (movement, sensory, emotional, and/or cognitive functioning); and limitations of complex activities (defined through measures of self-care, social participation, and work participation). SUDAAN 9.0 was used in all analyses to account for the complex sampling design and weighting of the NHIS data.
Results:
Approximately 16% of noninstitutionalized adults who reported movement difficulty mentioned injury as a cause. On average, between 2001 and 2006, about 7.6 million adults had injury-related movement difficulty in the United States. Overall, 50% of adults who experienced injury-related movement difficulty also experienced some complex activity limitation.
Conclusions:
Using NHIS data, we have demonstrated the applicability of an approach using basic actions difficulty and complex activity limitations to measure functioning and participation in individuals with a specific type and cause of difficulty: injury-related movement difficulty. The operationalization of these constructs provides a possible tool to monitor progress toward the attainment of the equalization of opportunities among people with injury-related movement difficulty.
