van Brakel W H, Anderson A M
Indian J Lepr. 1997 Oct-Dec;69(4):361-76.
This paper describes the results of a survey aimed at studying the relationship between impairment and disability in leprosy. Persons affected by leprosy attending the Green Pastures Hospital, Pokhara, or one of the field clinics in the Western Region of Nepal visited during the study period were interviewed using a standardized questionnaire. Two hundred and sixty-nine subjects were included in the study. For the analysis, 'disability', was defined as activities being done with 'much difficulty', 'only with help' or being 'impossible'. The most commonly affected indoor activities were cutting nails (22%), washing clothes (16%), using scissors (17%) and tying a knot (18%). Among the outdoor activities, cutting grass, digging, harvesting, threshing and milking a cow or buffalo were the most commonly affected (22%-26%). Sensory impairment of the thumb and/or index finger at the 2 g level was a very significant risk factor for disability activities involving the hand(s). Muscle weakness of the thumb and mobile clawing of the fingers had a strong association with disability in several activities. Sensory impairment of the sole was the strongest determinant of disability in activities involving the lower limb. We recommend that efforts should be made to include disability as a standard activity for monitoring and evaluation of rehabilitation, both for individuals and on programme level.
本文描述了一项旨在研究麻风病损伤与残疾之间关系的调查结果。在研究期间，对前往博卡拉绿草地医院或尼泊尔西部地区的其中一家现场诊所就诊的麻风病患者，使用标准化问卷进行了访谈。共有269名受试者纳入研究。在分析中，“残疾”被定义为进行活动时“非常困难”、“仅在他人帮助下”或“无法进行”。最常受影响的室内活动是剪指甲（22%）、洗衣服（16%）、使用剪刀（17%）和打结（18%）。在户外活动中，割草、挖掘、收割、脱粒以及给奶牛或水牛挤奶受影响最为常见（22%-26%）。拇指和/或食指在2克水平的感觉障碍是涉及手部残疾活动的一个非常显著的风险因素。拇指肌肉无力和手指的活动爪形与多项活动中的残疾有很强的关联。足底感觉障碍是涉及下肢活动残疾的最强决定因素。我们建议应努力将残疾作为监测和评估康复的一项标准活动，无论是针对个体还是项目层面。
