Browse the corpus

Disability changes dramatically the life of those who suffer any disabling condition, but also for the patient's relatives and persons close to them. Management of dressing disability should be global, including medical, psychological, social, political, and economical. The measures to approach the problems derived from disability vary from simple measures to very complex and global strategies that must be taken by the governments. They should include disease prevention, doctors and allied professional training, rehabilitation, occupational therapists interventions, caring strategies, and sociopolitical initiatives. Regarding dressing disability, above all, it is important to highlight the importance of a multidisciplinary approach, especially rehabilitation and occupational therapy interventions. Firstly, rehabilitation primarily focuses on maintaining and improve the physical condition, which enhances the quality of life, socialization, and can have positive effects on certain diseases, delaying its development.[12] On the other hand, occupational therapy focuses on assisting people and caregivers; it is a discipline whose main goal is helping the patient through educational advice, compensatory strategies, activity modifications, and environmental accommodations to achieve the highest level of independence and optimum level of function.[13] Some interventions try to help to adapt to the new life of the disabled people and their careers. As more global, for instance, modifying clothes and shoes (open back shirts; slip-on shoes; snaps, magnets or velcro instead of buttons;  zippers, etc.), furthermore, some assistive devices like shoe horns or button hooks, which are very useful for people with damaged fine mobility or decreased range of movements. In patients with hemiplegia/hemiparesis and other conditions causing weakness and dressing disability, it is of major importance to teach and advise the patients and careers about how to get dressed. It is useful to sit down to gain the support and stability of the body.

Some interventions try to help to adapt to the new life of the disabled people and their careers. As more global, for instance, modifying clothes and shoes (open back shirts; slip-on shoes; snaps, magnets or velcro instead of buttons;  zippers, etc.), furthermore, some assistive devices like shoe horns or button hooks, which are very useful for people with damaged fine mobility or decreased range of movements. In patients with hemiplegia/hemiparesis and other conditions causing weakness and dressing disability, it is of major importance to teach and advise the patients and careers about how to get dressed. It is useful to sit down to gain the support and stability of the body. Specific instructions should be given depending on the garment. In the case of a shirt, it should be unbuttoned, the damaged or weaker arm should go first into the sleeve, using the stronger arm to help; then, the shirt should be adjusted from the back again with the stronger arm to place it into the other sleeve, the better hand should fasten the garment. In the case of a pullover and similar garments that go over the head, the method is similar, with the damaged arm being placed firstly into the sleeve, and then use the better arm to place the neck opening over the head, and finish placing the better arm into the other sleeve. For trousers, the weaker leg should be placed over the stronger one so as to put it into the trouser leg, after that, it is easier to put the better leg into the other trouser leg, the stronger or both arms are of great help to make these maneuvres; then, depending on the balance, we can advise the patient to stand up or lie down in the bed to finish pulling the trousers up over the hips. Finally, In the case of socks, it may be useful placing the foot on a stool or crossing one leg over the other, then, using the better hand, the sock can be placed into the weaker foot first. To undress requires the reverse of the steps mentioned above. From a more concrete point of view, occupational therapy makes a specific work though differents interventions in the more disabling diseases. All these strategies become essential to achieve and maintain optimal functioning.[14] Some of these interventions are: Optimizing the day structure and routine, to handle in a better way the time and energy, improving cognition and feelings.

From a more concrete point of view, occupational therapy makes a specific work though differents interventions in the more disabling diseases. All these strategies become essential to achieve and maintain optimal functioning.[14] Some of these interventions are: Optimizing the day structure and routine, to handle in a better way the time and energy, improving cognition and feelings. Education and coaching can motivate the patients to participate in adapting and to apply self-management with an active role. This point is especially important in the OT interventions for children with disabilities, with the purpose of driving them to improve developing their personal independence, and participation in their daily life roles. In this sense, this intervention can be named the backward chaining, an effective intervention to teach complex behavior involving multiple steps in a sequence giving up the assistance gradually from the last step to the first.[15][16] The patient needs strategies for motor complex sequences, such as manual activities, like dressing or doing handworks. These strategies are carried out in the following steps: the therapist observes the patient during the activity to analyze which components are limited. After that, the therapist helps the patient recognizing the activity and selecting the most optimal movement components. The sequence of components has to be summarized in key phrases, preferably supported by visuals (auditory cues can also help). Then the patient is guided in the performance the steps aloud (motor imagery has a positive influence) to integrate it.[17] Psychological care should always be a consideration in this group of people. Disability results in a condition where an individual has fewer opportunities for favorable contact with their social environment. This isolation has a negative influence on mental health and well-being and should also be managed accordingly in multidisciplinary teams, with patients, families, psychologists, and doctors.[18]