From the Guidelines
A functional impairment is a limitation that significantly affects a person's ability to perform essential daily activities or fulfill expected roles in their life, as seen in patients with post-intensive care syndrome (PICS) who experience new or increased impairments of physical, cognitive, and/or psychological functions that outlast their hospital stay 1.
Definition and Causes
Functional impairments can affect various aspects of an individual's life, including physical capabilities, cognitive functions, emotional regulation, or social interactions. These impairments may result from different causes, such as physical illness, mental health conditions, developmental disorders, injuries, or aging processes. In the context of PICS, functional impairments can manifest as cognitive impairments (e.g., delirium, deficits of attention, memory, executive functions, and visuospatial perception), psychological impairments (e.g., depression, anxiety disorders, and post-traumatic stress disorder), or physical impairments (e.g., intensive care unit-acquired weakness, neuromuscular functions of swallowing, breathing, mobility, and personal autonomy) 1.
Assessment and Impact
Healthcare providers often assess functional impairments using standardized tools to determine appropriate treatments, accommodations, or support services. Understanding a person's specific functional impairments is crucial for developing effective rehabilitation plans, determining disability benefits eligibility, or creating appropriate workplace or educational accommodations. The severity of functional impairments can range from mild difficulties that require minimal accommodations to profound limitations necessitating extensive support. In patients with PICS, the reported prevalence of functional impairments varies, with 64% and 56% of ICU survivors impaired in at least one of the three levels of function at 3 and 12 months after discharge, respectively 1.
Key Considerations
- Functional impairments can have a significant impact on a person's quality of life, morbidity, and mortality.
- Early identification and assessment of functional impairments are essential for providing appropriate support and rehabilitation.
- A multidisciplinary and multiprofessional approach is necessary for addressing the complex needs of individuals with functional impairments, particularly those with PICS 1.
- The development of guidelines for rehabilitation, such as the one proposed for patients with PICS, can help promote clinical decisions and standards of care to improve outcomes and quality of life for affected individuals 1.
From the Research
Definition of Functional Impairment
- Functional impairment refers to a loss or limitation of physical, mental, or sensory function that affects an individual's ability to perform daily activities and maintain independence 2.
- In the context of spinal cord injury (SCI), functional impairment can result in severe motor and sensory deficits that impact personal and social behaviors 2.
Causes of Functional Impairment
- Spinal cord injury (SCI) is a common cause of functional impairment, affecting an estimated three million people worldwide, with approximately 180,000 new cases reported each year 2.
- Stroke is another condition that can lead to functional impairment, with many survivors experiencing spasticity and other motor deficits that affect their ability to perform daily activities 3.
Effects of Functional Impairment
- Functional impairment can have a significant impact on an individual's quality of life, affecting their ability to perform daily activities, maintain independence, and participate in social and recreational activities 2, 3.
- Spasticity, a common complication of SCI and stroke, can further exacerbate functional impairment, making it difficult for individuals to control their muscle tone and perform everyday tasks 3, 4, 5, 6.
Treatment of Functional Impairment
- Various treatments are available to manage functional impairment, including pharmacological interventions such as baclofen, which can help reduce spasticity and improve motor function 3, 4, 2, 5, 6.
- Other treatments, such as spinal cord stimulation and intrathecal baclofen therapy, may also be effective in managing severe spasticity and improving functional outcomes in individuals with SCI 6.