Definition of physical disability
Refers to the incompleteness of a person’s limbs or paralysis or deformity of limbs or body, resulting in varying degrees of functional loss or dysfunction of the human movement system.
What does physical disability include?
(1) The upper or lower limbs are amputated or congenitally mutilated due to trauma or disease;
(2) The upper or lower limbs are mutilated due to trauma or disease; Deformity or dysfunction caused by trauma, lesions or developmental abnormalities;
(3) Deformity or dysfunction of the spine caused by trauma, lesions or developmental abnormalities;
(4) Functional disorders of the trunk or limbs caused by trauma, lesions or developmental abnormalities of the central and peripheral nerves.
Grading of physical disabilities
Based on the comprehensive consideration of the number of disabilities in the human movement system, the level of the disabled part and the degree of functional impairment, the grades of physical disability are divided based on functional impairment. .
(1) First-level physical disability:
1 Quadriplegia: paraplegia of the lower limbs, inability to move independently in both hip joints; hemiplegia, complete loss of unilateral limb function.
2. Amputation of limbs at different parts or congenital missing limbs; amputation or missing limbs of a single whole arm (or whole leg) and both lower legs (or forearms); amputation of both upper arms and single thigh (or lower leg) or Missing limbs; amputation of both arms (or legs) or missing limbs.
3. Severe functional impairment of both upper limbs; severe functional impairment of three limbs.
(2) Secondary physical disability:
1 Hemiplegia or paraplegia of both lower limbs, with only a little function of the residual limbs retained.
2. Amputation or missing limbs of both upper limbs (upper arms or forearms) or both thighs; amputation or missing limbs of one whole leg (or whole arm) and one upper arm (or thigh); amputation or missing limbs of three limbs at different parts. Missing limbs.
3 Severe functional impairment of two limbs; moderate functional impairment of three limbs.
(3) Third-level physical disability:
1. Amputation or missing limbs of both lower legs; amputation or missing limb of one limb at the forearm, thigh and upper part.
2. Severe functional impairment of one limb; moderate functional impairment of both limbs.
3 Both thumbs are accompanied by index finger (or middle finger) defects.
(4) Level 4 physical disability:
1 Single lower leg amputation or missing limb.
2. Moderate functional impairment of one limb; mild functional impairment of both limbs.
3 The spine (including cervical spine) is ankylosed; the kyphosis deformity is greater than 70 degrees; the scoliosis is greater than 45 degrees.
4 The lower limbs are unequal in length, with a gap greater than five centimeters.
5 Unilateral thumb is accompanied by index finger (or middle finger) defect; the thumb is retained on one side, and the remaining four fingers are amputated or missing.
Note:
The following situations do not fall within the scope of physical disability:
(1) Those who retain the thumb and index finger (or middle finger) but lose the other three fingers.
(2) Those who retain the heel but lose the front half of the foot.
(3) Those whose lower limbs are unequal in length and the gap is less than five centimeters. ]
(4) A hunchback of less than 70 degrees or scoliosis of less than 45 degrees.
Overall functional evaluation of physically disabled people
From the overall perspective of a disabled person, in order to achieve activities of daily living (Activities of Daily Living, without rehabilitation measures) (referred to as ADL) to evaluate different abilities.
Daily living activities are divided into eight items, namely: sitting, standing, walking, dressing, washing, eating, defecating, and writing. If you can achieve an item, it will be counted as one point; if you have difficulty in achieving it, it will be counted as 0-5 points; if you cannot achieve it, it will be counted as 0 points.
According to this, four levels are divided, and the list is as follows:
Level score
Level 1 physical disability is completely unable to achieve daily life activities 0 to 2
Level 2 Physical disability is basically unable to realize activities of daily living 3 to 4
Level 3 physical disability can partially realize activities of daily living 5 to 6
Level 4 physical disability is basically able to realize activities of daily living 7～8
By applying for a disability certificate, you can enjoy many benefits from the state, such as assistance for the disabled, tuition exemptions, employment arrangements, free rural cooperative medical care or urban residents’ medical insurance, and you can apply for taxes and fees when opening a store. Reductions and exemptions, etc., depend on the relevant policies of the local government.
Training methods for physical disabilities
Commonly used rehabilitation training methods for cerebral palsy in children
Cerebral palsy in children is caused by the part of the brain that controls movement before birth, after birth or in infancy. Tissues are damaged, resulting in difficulty with body movement and positioning due to loss of muscle control. Once cerebral palsy in children is diagnosed by a medical institution, rehabilitation training should be carried out as soon as possible. The first is the correct holding posture, that is, the child's legs are straddling the waist of the rehabilitation staff. In order to strengthen the control of the child's head, the child can be placed in a prone position with both hands supporting the head and chest, or the upper limbs can be extended while the child is lying on the back, and the child can be slowly pulled from the supine position to a sitting position. When children sit on the bed, they should be induced to reach forward and sideways to retrieve objects, and protective reactions in all directions will gradually appear to enhance the stability of the sitting position.
For children who cannot roll over, when they are lying on their back, flex the lower limb on the rolling side and assist the flexed leg to drive the body to rotate, or hold the upper limb on the rolling side to extend and adduct it to drive the trunk to turn over. Learning to crawl is one of the prerequisites for walking. Children need to stretch their upper limbs for support, and support their lower limbs with their knees so that their trunk and thighs are at 90°. After the posture remains stable, toys with loud sounds and bright colors can be placed in front of the child to induce them to reach forward and grab alternately. At the same time, the soles of the child's feet can be pushed forward to assist them in moving forward. For children whose heels cannot touch the ground when standing, the trainer can hold the heels with four fingers when they are lying on their backs, press the palms toward the soles of the feet, and dorsiflex the instep toward the calf. The angle between the instep and the calf should be as small as possible. 90°.
You can also wear foot and ankle orthotics to help correct pointed feet, stabilize ankle joints, and better train for standing and walking. Some children make fists with both hands and cannot grasp objects. Trainers should insist on doing passive finger stretching activities and abduct their thumbs so that other fingers can be easily stretched. Along with sports training, language training should also be strengthened. Use brightly colored toys to attract children's attention and strive to imitate the trainer's vocalizations and pronunciation. Create a good speech environment and correct abnormal pronunciation in a timely manner. When the muscle tension of the limbs is significantly increased or the involuntary movement of the limbs hinders the child's activities, antispasmodic or athetosis-controlling drugs may be considered, such as diazepam, lyolexol, amtan, madopa, etc. Traditional Chinese medicine massage can reduce the tension of spastic muscles and expand the range of motion of limb joints; acupuncture can use scalp acupuncture in the movement and language areas to improve the function of these areas.
Commonly used rehabilitation training methods for hemiplegia
In addition to necessary drug intervention, the main rehabilitation training methods for hemiplegia include: exercise therapy, occupational therapy, speech therapy, psychotherapy, culture and sports treatment, traditional physical therapy, traditional medicine of the motherland, etc. Exercise therapy: It is a general term for treatment methods that improve movement disorders through active movement and passive movement. The main contents include joint mobility training, muscle strength training, posture correction training and neurophysiological therapy. About 80% of patients with cerebrovascular disease have varying degrees of movement disorders, mainly hemiplegic spasticity, which is the spasticity pattern we often see in which the upper limbs are flexed and the lower limbs are straightened. During the bedridden period of cerebrovascular disease, body position transformation, passive movement, maintaining good limb positions, and sitting up training are mainly carried out to reduce complications such as pressure ulcers and joint contractures, and lay a solid foundation for future rehabilitation training; during the out-of-bed period, sitting training should be performed , balance training, standing training, etc. to improve the patient's limb function; during the walking period, walking training is mainly used to improve gait.
In order to prevent residual limb edema and promote residual limb maturity, the residual limb should be patted to thicken the skin of the residual limb, improve the tolerance of the residual limb, and prepare for the installation of prostheses. At the same time, targeted rehabilitation training should be carried out according to different parts of the amputation: patients with thigh amputation mainly perform hip muscle strength training and prevent deformity. The specific method is: the patient lies prone and extends his thigh to train hip muscle strength, and lifts his leg upward while lying down. , train the outer thigh muscle strength. Pay attention to maintaining the normal position of the hip joint, and do not sit for a long time to prevent hip flexion deformity. Patients with lower leg amputation mainly train the knee muscle strength and perform knee extension and knee flexion strength training of the affected limb. Pay attention to maintaining the straight position of the knee joint and preventing flexion deformity of the knee joint. Patients after upper limb amputation should first perform handed-hand exchange training to complete activities of daily living with the unaffected upper limb. And move the shoulder and elbow joints and other joints to strengthen the remaining muscles. After installing a prosthetic limb, you must first learn how to put on and take off the prosthetic limb skillfully, and then train to use the prosthetic limb. Lower limb prosthetic training starts from standing balance, to walking with crutches or walkers, to walking independently and adapting to walking training and protective training on various road surfaces. Upper limb prosthetic training mainly includes opening and closing hands, elbow flexion, elbow locking, elbow unlocking, holding and moving objects, putting on and taking off clothes in daily life, opening doors, writing, making phone calls, etc.
Disability Level Subsidy Standards
Article 1, General Provisions
In order to improve the welfare subsidy system for disabled people and help disabled people and their families who cannot take care of themselves to improve care Conditions, these interim measures are formulated in accordance with the "Law of the People's Republic of China on the Protection of Disabled Persons" and the "Beijing Municipal Measures for the Implementation of the "Law of the People's Republic of China on the Protection of Disabled Persons".
Article 2. Subsidy Scope
The subsidy objects of this interim measure are those who have household registration in this city and hold the "Disability Certificate of the People's Republic of China" (hereinafter referred to as the "Disability Certificate"). Witnesses"), disabled people who cannot take care of themselves.
Among them, "unable to take care of themselves" means that disabled people have difficulties in taking care of themselves in daily life and require the care or supervision of others for part or most of their lives.
Specific scope: visually and physically disabled persons with disability levels of Level 1 and 2, intellectual and mental disabled persons with disabilities of Level 1, 2 and 3, and persons with disabilities of Level 1 and 2. Multiple disabilities among hearing and speech disabled people.
Beijing’s subsidy standards for disabled people and suspension of nursing subsidies
List of designated medical institutions for medical diagnosis of disabled people in Beijing and details of their evaluation standards
Article 3. Subsidy standards
(1) For those with multiple disabilities among those with visual, physical, intellectual, and mental disabilities whose disability level is Level 1 and those with intellectual and mental disabilities whose disability level is Level 2, the subsidy shall be based on the subsidy rate per person per person. A monthly nursing subsidy of 300 yuan is provided.
(2) For visually and physically disabled persons with a disability level of Level 2, intellectual and mental disabled persons with a disability level of Level 2 and 3, and hearing and speech persons with a disability level of Level 1 and 2. Persons with multiple disabilities among the disabled will be provided with a nursing subsidy at the standard of 100 yuan per person per month.
Article 4. Application Approval Procedure
(1) For persons with disabilities who meet the application conditions, they or their guardians should hold the "Disability Certificate", "ID Card", " Please go to the neighborhood (village) committee where your household registration is located and fill in the "Beijing Disabled Persons' Care Subsidy Application Approval Form" (Appendix 1, hereinafter referred to as the "Application Form") Approval Form"), which shall be submitted by the neighborhood (village) committee to the street (township) Disabled Persons' Federation for review.
(2) The street (township) Disabled Persons' Federation will review the application within 10 working days from the date it receives the "Application Approval Form" and relevant supporting materials. Those who meet the application conditions after review should sign and stamp the "Application Approval Form" and submit it to the district (county) Disabled Persons' Federation for approval; if the application does not meet the application conditions, the applicant must be informed in a timely manner and their materials must be returned.
(3) The district (county) Disabled Persons' Federation will make an approval decision within 7 working days from the date of receiving the "Application Approval Form" and relevant supporting materials, and feedback the approval status to the street (Township) Disabled Persons' Federation.
For disabled persons who have passed the examination and approval, the street (township) Disabled Persons' Federation will issue to them the "Beijing Disabled Persons' Nursing Subsidy Receipt Certificate" (Annex 2, hereinafter referred to as the "Certificate"); for those who have not passed the examination and approval, the street (township) Disabled Persons' Federation will issue them The Disabled Persons' Federation informs the applicant and returns his/her materials.
Article 5 Fund Guarantee
The funds required for nursing subsidies shall be borne by the district (county) finance. The district (county) finance, Disabled Persons' Federation and other departments must negotiate and determine the budget arrangements and allocation methods of subsidy funds to ensure that subsidy funds are paid in full and in a timely manner.
Nursing subsidy funds are calculated from the month following the date of application by the disabled person and are transferred through the bank.
Article 6 Annual Review System
Nursing subsidies for disabled persons shall be subject to a semi-annual review system. Disabled persons who enjoy nursing subsidies should go to the street (township) in January and July every year with the original copies of the "Disabled Person's Certificate", "ID Card", "Household Registration Book" and "Receipt Certificate" by themselves or their guardians. The Disabled Persons' Federation handles the review procedures for continuing to enjoy nursing subsidies.
For details on Article 7, please see the first link: Suspension of nursing subsidies for disabled people in Beijing
Article 8 Household registration transfer
Disabled persons enjoying nursing subsidies If a person's household registration is transferred within the administrative area of ??this city, he or she should go to the street (township) Disabled Persons' Federation with the "Household Registration Book" and "Receipt Certificate" to apply and go through the district (county) Disabled Persons' Federation to handle the nursing subsidy transfer procedures (see attachment 3 for the transfer form);
If the household registration of a disabled person who enjoys nursing subsidies moves within the district or county, he or she must go to the street (township) Disabled Persons' Federation to handle the nursing subsidy transfer procedures with the "Household Registration Book" and "Receipt Certificate";
The transfer-out place will stop issuing nursing subsidy funds starting from the month after the transfer procedures are completed, and the transfer-in place will stop issuing nursing subsidy funds from the month the transfer-out place stops issuing funds.
Article 9 Policy Cohesion
Subsidies under this Interim Measures and other nursing subsidy policies cannot be enjoyed repeatedly.
Article 10 Management and Supervision
Disabled persons and their families who receive nursing subsidies should actively improve their nursing conditions. Guardians should effectively perform guardianship responsibilities in accordance with the law.
Nursing subsidy handling agencies must adhere to the principles of openness, fairness and impartiality, conduct strict audits, strengthen the management and monitoring of nursing subsidy funds, and accept the supervision and inspection of financial and auditing departments.
If it is confirmed that there has been any malpractice, false reporting, false claims, withholding, misappropriation, fraud, or indiscriminate issuance of subsidy funds, the relevant personnel will be held accountable for their administrative and legal responsibilities in accordance with the law, and all funds issued will be recovered. Subsidy funds.
Article 11 The Municipal Disabled Persons’ Federation is responsible for the interpretation of these interim measures.
Article 12 These interim measures will be implemented from July 1, 2015.