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Impairment, disability, and handicap.

V Mooney

    Clinical Orthopaedics and Related Research
    |August 1, 1987
    PubMed
    Summary
    This summary is machine-generated.

    Orthopedic surgeons struggle to separate impairment from disability due to challenges in measuring dynamic musculoskeletal function. Future efforts should focus on objective, dynamic assessments of musculoskeletal handicap, similar to sports medicine return-to-play criteria.

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    Area of Science:

    • Orthopedics
    • Musculoskeletal Medicine
    • Rehabilitation Science

    Background:

    • Current orthopedic practice faces challenges in differentiating between impairment and disability.
    • Measuring dynamic function is difficult, as in-office range-of-motion tests do not fully represent an extremity's or spine's functional potential.
    • Disability definitions are subjectively influenced by the physician-patient relationship and external factors like insurance or legal involvement.

    Purpose of the Study:

    • To highlight the limitations in current methods of assessing orthopedic impairment and disability.
    • To advocate for a shift in focus from 'disability' to 'musculoskeletal handicap' and from 'impairment' to 'dynamic function'.
    • To propose the development of standardized, objective methods for measuring dynamic musculoskeletal function.

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    Main Methods:

    • The abstract discusses conceptual limitations and proposes future directions rather than detailing specific experimental methods.
    • It suggests drawing parallels with sports medicine's approach to assessing an athlete's readiness to return to sport.
    • Emphasizes the need for dynamic, quantifiable measurements of function.

    Main Results:

    • The abstract does not present empirical results but outlines a critical analysis of current assessment paradigms.
    • It identifies a clear need for improved methodologies in musculoskeletal assessment.
    • Suggests that current methods are inadequate for accurately reflecting an individual's true functional capacity.

    Conclusions:

    • Orthopedic surgeons must develop better methods to measure dynamic musculoskeletal function to accurately assess disability.
    • A future focus on 'musculoskeletal handicap' and objective, dynamic function measurement is recommended.
    • Development of standardized, objective measurement tools is crucial for the musculoskeletal system, analogous to biochemical standards in visceral organ systems.