D28 Limited function/disability (d) (ICD-10:Z73.6)

Introduction

Limited function/disability refers to a condition where an individual experiences a decrease in their ability to perform daily activities due to physical or cognitive impairments^[1][2]. This guide aims to provide an overview of the symptoms, causes, diagnostic steps, possible interventions, and lifestyle interventions for limited function/disability.

Codes

• ICPC-2 Code: D28 Limited function/disability (d)^[3]
• ICD-10 Code: Z73.6 Limitation of activities due to disability^[4]

Symptoms

• Difficulty in performing daily activities^[5]
• Loss of coordination or balance^[6]
• Muscle weakness or stiffness^[7]
• Fatigue or lack of energy^[8]
• Cognitive impairments, such as memory loss or difficulty concentrating^[9]

Causes

• Chronic conditions, such as arthritis, multiple sclerosis, or Parkinson’s disease^[10]
• Neurological disorders, such as stroke or traumatic brain injury
• Musculoskeletal injuries or conditions, such as fractures or osteoarthritis
• Genetic or congenital disorders affecting physical or cognitive function
• Age-related changes and degenerative diseases

Diagnostic Steps

Medical History

• Gather information about the patient’s medical conditions, including chronic illnesses, injuries, or neurological disorders.
• Identify any risk factors, such as family history or exposure to toxins.
• Assess the patient’s symptoms and their impact on daily activities.

Physical Examination

• Perform a comprehensive physical examination to assess muscle strength, range of motion, coordination, and balance.
• Evaluate reflexes, sensation, and cognitive function.
• Look for any signs of musculoskeletal abnormalities or neurological deficits.

Laboratory Tests

• Blood tests: Measure markers of inflammation, assess organ function, and screen for underlying conditions, such as autoimmune diseases or metabolic disorders.
• Genetic testing: Identify any genetic mutations or abnormalities that may contribute to the limited function/disability.
• Neurological tests: Assess cognitive function, memory, and processing speed.

Diagnostic Imaging

• X-rays: Evaluate the structure and integrity of bones and joints.
• MRI (Magnetic Resonance Imaging): Visualize soft tissues, such as muscles, tendons, and ligaments, as well as the brain and spinal cord.
• CT scan (Computed Tomography): Provide detailed images of bones, blood vessels, and organs.
• Ultrasound: Assess blood flow, muscle function, and joint abnormalities.

Other Tests

• Electromyography (EMG): Measure electrical activity in muscles to assess nerve function and muscle response.
• Nerve conduction studies: Evaluate the speed and strength of electrical signals in nerves.
• Cognitive assessments: Assess memory, attention, and problem-solving abilities.

Follow-up and Patient Education

• Schedule regular follow-up appointments to monitor the progression of the condition and adjust treatment plans accordingly.
• Provide patient education on managing symptoms, adapting daily activities, and accessing support services or assistive devices.

Possible Interventions

Traditional Interventions

Medications:

Top 5 drugs for Limited function/disability:

1. Nonsteroidal anti-inflammatory drugs (NSAIDs) (e.g., Ibuprofen, Naproxen):
   • Cost: Generic versions can be $3-$20/month.
   • Contraindications: History of gastrointestinal bleeding, kidney disease.
   • Side effects: Upset stomach, increased risk of bleeding.
   • Severe side effects: Kidney damage, allergic reactions.
   • Drug interactions: Blood thinners, certain blood pressure medications.
   • Warning: Long-term use may increase the risk of cardiovascular events.
2. Muscle relaxants (e.g., Cyclobenzaprine, Baclofen):
   • Cost: Generic versions can be $4-$30/month.
   • Contraindications: Liver disease, history of seizures.
   • Side effects: Drowsiness, dizziness.
   • Severe side effects: Allergic reactions, hallucinations.
   • Drug interactions: Sedatives, alcohol.
   • Warning: May cause drowsiness, avoid driving or operating machinery.
3. Antidepressants (e.g., Amitriptyline, Duloxetine):
   • Cost: Generic versions can be $4-$30/month.
   • Contraindications: Recent heart attack, narrow-angle glaucoma.
   • Side effects: Dry mouth, drowsiness.
   • Severe side effects: Suicidal thoughts, serotonin syndrome.
   • Drug interactions: Monoamine oxidase inhibitors (MAOIs), certain pain medications.
   • Warning: May take several weeks to see the full effect.
4. Anticonvulsants (e.g., Gabapentin, Pregabalin):
   • Cost: Generic versions can be $4-$30/month.
   • Contraindications: Allergy to the medication.
   • Side effects: Dizziness, drowsiness.
   • Severe side effects: Suicidal thoughts, severe skin reactions.
   • Drug interactions: Opioids, certain antacids.
   • Warning: May cause drowsiness, avoid driving or operating machinery.
5. Cognitive enhancers (e.g., Donepezil, Rivastigmine):
   • Cost: Generic versions can be $10-$50/month.
   • Contraindications: Allergy to the medication.
   • Side effects: Nausea, diarrhea.
   • Severe side effects: Slow heart rate, seizures.
   • Drug interactions: Certain antidepressants, antipsychotics.
   • Warning: May take several weeks to see the full effect.

Alternative Drugs:

• Botulinum toxin injections: Used to reduce muscle stiffness and spasticity. Cost: $500-$1,000 per treatment.
• NMDA receptor antagonists (e.g., Memantine): Used to manage cognitive impairments. Cost: $50-$200/month.
• Dopamine agonists (e.g., Pramipexole): Used to manage movement disorders. Cost: $50-$200/month.
• Antipsychotics (e.g., Risperidone): Used to manage behavioral symptoms. Cost: $10-$100/month.
• Antianxiety medications (e.g., Lorazepam): Used to manage anxiety or agitation. Cost: $4-$30/month.

Surgical Procedures:

• Joint replacement surgery: Replaces damaged joints with artificial implants. Cost: $20,000 to $50,000 per joint.
• Spinal fusion: Joins two or more vertebrae to stabilize the spine. Cost: $50,000 to $100,000.
• Deep brain stimulation: Implants electrodes in the brain to manage movement disorders. Cost: $50,000 to $100,000.

Alternative Interventions

• Physical therapy: Helps improve strength, flexibility, and coordination. Cost: $50-$150 per session.
• Occupational therapy: Focuses on improving daily activities and functional independence. Cost: $50-$150 per session.
• Speech therapy: Aids in improving speech and swallowing abilities. Cost: $50-$150 per session.
• Acupuncture: May help reduce pain and improve overall well-being. Cost: $60-$120 per session.
• Assistive devices: Can include mobility aids, adaptive equipment, or communication devices. Cost: Varies depending on the specific device.

Lifestyle Interventions

• Exercise: Regular physical activity can improve strength, flexibility, and overall function. Cost: Varies (e.g., gym membership, home exercise equipment).
• Healthy diet: A balanced diet rich in nutrients can support overall health and well-being. Cost: Varies depending on food choices.
• Stress management: Techniques such as meditation, deep breathing, or yoga can help reduce stress and improve mental well-being. Cost: Varies (e.g., self-guided practices, classes).
• Sleep hygiene: Establishing a regular sleep routine and creating a sleep-friendly environment can improve sleep quality. Cost: Varies (e.g., comfortable bedding, relaxation techniques).
• Social support: Engaging in social activities and seeking support from friends, family, or support groups can improve emotional well-being. Cost: Varies (e.g., community events, support group fees).

It is important to note that the cost ranges provided are approximate and may vary depending on the location and availability of the interventions.

Mirari Cold Plasma Alternative Intervention

Understanding Mirari Cold Plasma

• Safe and Non-Invasive Treatment: Mirari Cold Plasma is a safe and non-invasive treatment option for various skin conditions. It does not require incisions, minimizing the risk of scarring, bleeding, or tissue damage.
• Efficient Extraction of Foreign Bodies: Mirari Cold Plasma facilitates the removal of foreign bodies from the skin by degrading and dissociating organic matter, allowing easier access and extraction.
• Pain Reduction and Comfort: Mirari Cold Plasma has a local analgesic effect, providing pain relief during the treatment, making it more comfortable for the patient.
• Reduced Risk of Infection: Mirari Cold Plasma has antimicrobial properties, effectively killing bacteria and reducing the risk of infection.
• Accelerated Healing and Minimal Scarring: Mirari Cold Plasma stimulates wound healing and tissue regeneration, reducing healing time and minimizing the formation of scars.

Mirari Cold Plasma Prescription

Video instructions for using Mirari Cold Plasma Device – D28 Limited function/disability (d) (ICD-10:Z73.6)

Localized (0) Sacrum (1) Prostate & Uterus (2) Kidney, Liver & Spleen (3) Heart, Bile & Pancreas (4) Lungs (5) Throat, Lymphatic & Thyroid (6) Neuro system & ENT (7)

Use the Mirari Cold Plasma device to treat Limited function/disability (d) effectively.

WARNING: MIRARI COLD PLASMA IS DESIGNED FOR THE HUMAN BODY WITHOUT ANY ARTIFICIAL OR THIRD PARTY PRODUCTS. USE OF OTHER PRODUCTS IN COMBINATION WITH MIRARI COLD PLASMA MAY CAUSE UNPREDICTABLE EFFECTS, HARM OR INJURY. PLEASE CONSULT A MEDICAL PROFESSIONAL BEFORE COMBINING ANY OTHER PRODUCTS WITH USE OF MIRARI.

Step 1: Cleanse the Skin

• Start by cleaning the affected area of the skin with a gentle cleanser or mild soap and water. Gently pat the area dry with a clean towel.

Step 2: Prepare the Mirari Cold Plasma device

• Ensure that the Mirari Cold Plasma device is fully charged or has fresh batteries as per the manufacturer’s instructions. Make sure the device is clean and in good working condition.
• Switch on the Mirari device using the power button or by following the specific instructions provided with the device.
• Some Mirari devices may have adjustable settings for intensity or treatment duration. Follow the manufacturer’s instructions to select the appropriate settings based on your needs and the recommended guidelines.

Step 3: Apply the Device

• Place the Mirari device in direct contact with the affected area of the skin. Gently glide or hold the device over the skin surface, ensuring even coverage of the area experiencing.
• Slowly move the Mirari device in a circular motion or follow a specific pattern as indicated in the user manual. This helps ensure thorough treatment coverage.

Step 4: Monitor and Assess:

• Keep track of your progress and evaluate the effectiveness of the Mirari device in managing your Limited function/disability (d). If you have any concerns or notice any adverse reactions, consult with your health care professional.

Note

This guide is for informational purposes only and should not replace the advice of a medical professional. Always consult with your healthcare provider or a qualified medical professional for personal advice, diagnosis, or treatment. Do not solely rely on the information presented here for decisions about your health. Use of this information is at your own risk. The authors of this guide, nor any associated entities or platforms, are not responsible for any potential adverse effects or outcomes based on the content.

Mirari Cold Plasma System Disclaimer

• Purpose: The Mirari Cold Plasma System is a Class 2 medical device designed for use by trained healthcare professionals. It is registered for use in Thailand and Vietnam. It is not intended for use outside of these locations.
• Informational Use: The content and information provided with the device are for educational and informational purposes only. They are not a substitute for professional medical advice or care.
• Variable Outcomes: While the device is approved for specific uses, individual outcomes can differ. We do not assert or guarantee specific medical outcomes.
• Consultation: Prior to utilizing the device or making decisions based on its content, it is essential to consult with a Certified Mirari Tele-Therapist and your medical healthcare provider regarding specific protocols.
• Liability: By using this device, users are acknowledging and accepting all potential risks. Neither the manufacturer nor the distributor will be held accountable for any adverse reactions, injuries, or damages stemming from its use.
• Geographical Availability: This device has received approval for designated purposes by the Thai and Vietnam FDA. As of now, outside of Thailand and Vietnam, the Mirari Cold Plasma System is not available for purchase or use.

References

1. Intellectual disability: Definition, symptoms, treatment, and more. (n.d.). Retrieved from https://www.medicalnewstoday.com/articles/intellectual-disability
2. Clinical Characteristics of Intellectual Disabilities – NCBI. (n.d.). Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK332877/
3. ICPC-2 Code: D28 Limited function/disability (D) – RxReasoner. (n.d.). Retrieved from https://www.rxreasoner.com/icpc2codes/D28
4. Z73.6 – Limitation of activities due to disability | ICD-10-CM. (n.d.). Retrieved from https://www.icd10data.com/ICD10CM/Codes/Z00-Z99/Z69-Z76/Z73-/Z73.6
5. Intellectual Disability Signs, Symptoms, & Causes. (n.d.). Retrieved from https://www.millcreekbehavioralhealth.com/development-disorders/intellectual-disability/symptoms-signs-causes/
6. Intellectual disability: Definition, symptoms, treatment, and more. (n.d.). Retrieved from https://www.medicalnewstoday.com/articles/intellectual-disability
7. Clinical Characteristics of Intellectual Disabilities – NCBI. (n.d.). Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK332877/
8. Intellectual Disability Signs, Symptoms, & Causes. (n.d.). Retrieved from https://www.millcreekbehavioralhealth.com/development-disorders/intellectual-disability/symptoms-signs-causes/
9. Intellectual disability: Definition, symptoms, treatment, and more. (n.d.). Retrieved from https://www.medicalnewstoday.com/articles/intellectual-disability
10. Clinical Characteristics of Intellectual Disabilities – NCBI. (n.d.). Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK332877/