K28 Limited function/disability (k) (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] This guide aims to provide an overview of the symptoms, causes, diagnostic steps, possible interventions, and lifestyle modifications that can help manage limited function/disability.

Codes

• ICPC-2 Code: K28 Limited function/disability (k)^[2]
• ICD-10 Code: Z73.6 Limitation of activities due to disability^[3]

Symptoms

• Difficulty in performing daily activities^[4]
• Impaired mobility^[5]
• Muscle weakness^[6]
• Cognitive impairments^[7]
• Pain or  discomfort^[8]
• Fatigue^[9]

Causes

• Musculoskeletal disorders (e.g., arthritis, osteoporosis)^[10]
• Neurological conditions (e.g., stroke, multiple sclerosis)
• Traumatic injuries (e.g., spinal cord injury, traumatic brain injury)
• Chronic conditions (e.g., fibromyalgia, chronic fatigue syndrome)
• Age-related changes

Diagnostic Steps

Medical History

• Gather information about the patient’s medical conditions, including any chronic illnesses or injuries.
• Identify any risk factors that may contribute to limited function/disability.
• Assess the patient’s symptoms and their impact on daily activities.

Physical Examination

• Perform a thorough physical examination to assess muscle strength, range of motion, and coordination.
• Evaluate sensory function and reflexes.
• Assess posture and gait abnormalities.

Laboratory Tests

• Blood tests to assess for underlying medical conditions (e.g., inflammatory markers, thyroid function tests).
• Specialized assays to evaluate specific conditions (e.g., rheumatoid factor, antinuclear antibody test).

Diagnostic Imaging

• X-rays to assess for musculoskeletal abnormalities (e.g., fractures, joint degeneration).
• Ultrasound to evaluate soft tissue structures (e.g., tendons, ligaments).
• CT scans or MRIs to visualize internal structures (e.g., brain, spinal cord).

Other Tests

• Electromyography (EMG) to assess muscle function and nerve conduction.
• Cognitive assessments to evaluate cognitive impairments.
• Functional assessments to determine the impact of limited function/disability on daily activities.

Follow-up and Patient Education

• Schedule regular follow-up appointments to monitor the patient’s progress and adjust treatment plans if necessary.
• Provide education on managing symptoms, adapting daily activities, and utilizing assistive devices if needed.
• Offer resources and support groups for patients and their caregivers.

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, renal impairment.
   • Side effects: Upset stomach, increased risk of bleeding.
   • Severe side effects: Kidney damage, cardiovascular events.
   • Drug interactions: Anticoagulants, corticosteroids.
   • Warning: Prolonged use may increase the risk of adverse effects.
2. Muscle relaxants (e.g., Cyclobenzaprine, Methocarbamol):
   • Cost: Generic versions can be $10-$30/month.
   • Contraindications: Glaucoma, urinary retention.
   • Side effects: Drowsiness, dizziness.
   • Severe side effects: Allergic reactions, liver toxicity.
   • Drug interactions: Sedatives, opioids.
   • Warning: Avoid activities requiring mental alertness while taking these medications.
3. Antidepressants (e.g., Amitriptyline, Duloxetine):
   • Cost: Generic versions can be $10-$30/month.
   • Contraindications: Recent myocardial infarction, narrow-angle glaucoma.
   • Side effects: Dry mouth, drowsiness.
   • Severe side effects: Suicidal thoughts, serotonin syndrome.
   • Drug interactions: Monoamine oxidase inhibitors (MAOIs), other serotonergic drugs.
   • Warning: May take several weeks to achieve therapeutic effects.
4. Anticonvulsants (e.g., Gabapentin, Pregabalin):
   • Cost: Generic versions can be $10-$30/month.
   • Contraindications: Hypersensitivity to the drug.
   • Side effects: Dizziness, drowsiness.
   • Severe side effects: Suicidal thoughts, angioedema.
   • Drug interactions: Opioids, benzodiazepines.
   • Warning: May cause dependence and withdrawal symptoms with prolonged use.
5. Corticosteroids (e.g., Prednisone, Dexamethasone):
   • Cost: Generic versions can be $10-$30/month.
   • Contraindications: Active infections, systemic fungal infections.
   • Side effects: Increased appetite, weight gain.
   • Severe side effects: Adrenal suppression, osteoporosis.
   • Drug interactions: Nonsteroidal anti-inflammatory drugs (NSAIDs), anticoagulants.
   • Warning: Long-term use may require gradual tapering to avoid adrenal insufficiency.

Alternative Drugs :

• Acetaminophen: Over-the-counter pain reliever that can be used for mild to moderate pain.
• Tricyclic antidepressants (e.g., Nortriptyline): Can be used for neuropathic pain.
• Antiepileptic drugs (e.g., Carbamazepine): May be effective for certain types of nerve pain.
• Benzodiazepines (e.g., Diazepam): Can help with muscle spasms and anxiety.
• Topical analgesics (e.g., Lidocaine patches): Provide localized pain relief.

Surgical Procedures:

• Joint replacement surgery: Replaces damaged joints with artificial implants. Cost: $20,000 to $50,000 per joint.
• Spinal fusion surgery: Fuses two or more vertebrae to stabilize the spine. Cost: $50,000 to $100,000.
• Decompression surgery: Relieves pressure on nerves or the spinal cord. Cost: $30,000 to $80,000.
• Neurostimulation: Implants a device to deliver electrical impulses to nerves for pain relief. Cost: $20,000 to $50,000.

Alternative Interventions

• Physical therapy: Helps improve mobility, strength, and flexibility. Cost: $50-$150 per session.
• Occupational therapy: Focuses on improving daily activities and functional independence. Cost: $50-$150 per session.
• Chiropractic care: Manipulates the spine to alleviate pain and improve function. Cost: $50-$200 per session.
• Acupuncture: May help reduce pain and improve overall well-being. Cost: $60-$120 per session.
• Massage therapy: Provides relaxation and pain relief. Cost: $50-$100 per session.

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.
• Weight management: Maintaining a healthy weight can reduce stress on joints and improve mobility. Cost: Varies (e.g., diet programs, weight loss supplements).
• Assistive devices: Can help with mobility and performing daily activities. Cost: Varies depending on the device (e.g., canes, walkers, wheelchair).
• Stress management: Techniques such as meditation, deep breathing, and relaxation exercises can help manage stress and improve overall well-being. Cost: Varies (e.g., self-help books, meditation apps).

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 – K28 Limited function/disability (k) (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 (k) 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 (k). 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. World Health Organization. (2001). International Classification of Functioning, Disability and Health: ICF. World Health Organization.
2. WONCA International Classification Committee. (1998). ICPC-2: International Classification of Primary Care. Oxford University Press, USA.
3. World Health Organization. (2019). International statistical classification of diseases and related health problems (11th ed.).
4. Verbrugge, L. M., & Jette, A. M. (1994). The disablement process. Social science & medicine, 38(1), 1-14.
5. Guralnik, J. M., Ferrucci, L., Simonsick, E. M., Salive, M. E., & Wallace, R. B. (1995). Lower-extremity function in persons over the age of 70 years as a predictor of subsequent disability. New England Journal of Medicine, 332(9), 556-562.
6. Rantanen, T., Guralnik, J. M., Foley, D., Masaki, K., Leveille, S., Curb, J. D., & White, L. (1999). Midlife hand grip strength as a predictor of old age disability. Jama, 281(6), 558-560.
7. Plassman, B. L., Langa, K. M., Fisher, G. G., Heeringa, S. G., Weir, D. R., Ofstedal, M. B., … & Wallace, R. B. (2008). Prevalence of cognitive impairment without dementia in the United States. Annals of internal medicine, 148(6), 427-434.
8. Blyth, F. M., March, L. M., Brnabic, A. J., Jorm, L. R., Williamson, M., & Cousins, M. J. (2001). Chronic pain in Australia: a prevalence study. Pain, 89(2-3), 127-134.
9. Loge, J. H., & Kaasa, S. (1998). Short form 36 (SF-36) health survey: normative data from the general Norwegian population. Scandinavian journal of social medicine, 26(4), 250-258.
10. Woolf, A. D., & Pfleger, B. (2003). Burden of major musculoskeletal conditions. Bulletin of the World Health Organization, 81, 646-656.