Disability Reconsidered: The Paradox of Physical Therapy

Abstract

The purposes of this perspective article are: (1) to explore models of disability from the perspective of the academic discipline of disability studies (DS), (2) to consider the paradox of improving functional capacities while valuing disability as diversity, (3) to identify how physical therapy's use of the International Classification of Functioning, Disability and Health (ICF) disablement model intersects with various disability models, and (4) to apply this broader understanding of disability to physical therapist practice, education, and research. The DS literature has been critical of rehabilitation professionals, particularly targeting the medical model of disability. In contrast, advocates for a social model of disability recognize disability as diversity. It is paradoxical for physical therapy to simultaneously work to ameliorate disability while celebrating it as diversity. The ICF biopsychosocial disablement model offers a mechanism to practice within this paradox and suggests that it is no longer sufficient to conceptualize disability as a purely individual matter that requires attention in isolation from the impact of the larger society.

Exploring disability through the lens of moral experience

“…In line with the International Classification of Function, Disability and Health (ICF) model, 6 such an approach can illuminate questions of social participation for individuals with an impairment, and draw attention to how environmental and contextual features influence everyday experiences. Our focus on moral experience and disability also integrates well with recent contributions calling for increased attention by physical therapists to narratives and meaning-making in relation to ethics of clinical practice, 7,8 the importance of better understanding the lived experiences of disabled persons, 9 and further incorporation of social justice and health equity concerns as therapists consider the social determinants of health and their relationship with disability. 10 Before presenting our conceptualization of moral experience, we will underline the two principal sources of inspiration for this project: hermeneutics and anthropology.…”

A Research Agenda for Documenting Disability Status within Healthcare Organizations to Address Disparities in Care

“…The authors of the ACS questions report using the World Health Organization's framework of disability: the International Classification of Functioning, Disability and Health (ICF; U.S. Census Bureau, ). This framework is becoming widely used in the United States and is the recommended disability framework of the IOM (Institute of Medicine, ; Roush & Sharby, ). The ICF is a multilevel, complex framework that takes into account the individual and the environment in which he or she lives (World Health Organization, ).…”

“…The ICF is a multilevel, complex framework that takes into account the individual and the environment in which he or she lives (World Health Organization, ). In this framework, disability is viewed as a result of impairments in body functions and structures, and limitations in activities and participation, with environmental and personal factors influencing the impairments and limitations (Roush & Sharby, ; World Health Organization, ).…”

Untitled

“…Census Bureau, 2007). This framework is becoming widely used in the United States and is the recommended disability framework of the IOM (Institute of Medicine, 2006;Roush & Sharby, 2011). The ICF is a multilevel, complex framework that takes into account the individual and the environment in which he or she lives (World Health Organization, 2001).…”

“…The ICF is a multilevel, complex framework that takes into account the individual and the environment in which he or she lives (World Health Organization, 2001). In this framework, disability is viewed as a result of impairments in body functions and structures, and limitations in activities and participation, with environmental and personal factors influencing the impairments and limitations (Roush & Sharby, 2011;World Health Organization, 2001).…”