R28 Limited function/disability (r) (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 interventions for limited function/disability.

Codes

• ICPC-2 Code: R28 Limited function/disability (r)
• ICD-10 Code: Z73.6 Limitation of activities due to disability

Symptoms

• Difficulty in performing daily activities^[2]
• Impaired mobility
• Cognitive impairments
• Muscle weakness
• Pain or discomfort
• Fatigue^[3]

Causes

• Chronic conditions such as arthritis, multiple sclerosis, or Parkinson’s disease^[4]
• Neurological disorders
• Traumatic injuries
• Genetic disorders
• Age-related degeneration
• Mental health conditions^[5]

Diagnostic Steps

Medical History

• Gather information about the patient’s medical conditions, including chronic illnesses, injuries, or neurological disorders.
• Identify any risk factors that may contribute to limited function/disability.
• Assess the patient’s symptoms and their impact on daily activities^[6].

Physical Examination

• Perform a comprehensive physical examination to assess muscle strength, range of motion, and coordination.
• Evaluate the patient’s gait and balance.
• Assess sensory function and reflexes.
• Look for any signs of deformities or abnormalities^[7].

Laboratory Tests

• Blood tests to assess for underlying medical conditions such as arthritis, vitamin deficiencies, or thyroid disorders.
• Genetic testing to identify any genetic disorders that may be causing limited function/disability.
• Assess inflammatory markers to rule out autoimmune conditions^[8].

Diagnostic Imaging

• X-rays to evaluate the structure and integrity of bones and joints.
• MRI or CT scans to assess for any abnormalities in the brain or spinal cord.
• Ultrasound to evaluate blood flow and identify any vascular abnormalities^[9].

Other Tests

• Electromyography (EMG) to assess muscle and nerve function.
• Cognitive assessments to evaluate cognitive impairments.
• Functional assessments to determine the impact of limited function/disability on daily activities^[10].

Follow-up and Patient Education

• Provide appropriate referrals to specialists such as physical therapists, occupational therapists, or neurologists.
• Educate the patient about their condition, treatment options, and lifestyle modifications.
• Schedule regular follow-up appointments to monitor progress and adjust treatment plans if necessary.

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, cardiovascular events.
   • Drug interactions: Blood thinners, ACE inhibitors.
   • Warning: Prolonged use may increase the risk of gastrointestinal bleeding.
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, alcohol.
   • Warning: May cause drowsiness, avoid driving or operating heavy machinery.
3. Antidepressants (e.g., Amitriptyline, Duloxetine):
   • Cost: Generic versions can be $10-$30/month.
   • Contraindications: Recent heart attack, narrow-angle glaucoma.
   • Side effects: Dry mouth, drowsiness.
   • Severe side effects: Suicidal thoughts, serotonin syndrome.
   • Drug interactions: MAO inhibitors, blood thinners.
   • Warning: May take several weeks to see the full effect.
4. Anticonvulsants (e.g., Gabapentin, Pregabalin):
   • Cost: Generic versions can be $10-$30/month.
   • Contraindications: Allergy to anticonvulsants, kidney disease.
   • Side effects: Dizziness, drowsiness.
   • Severe side effects: Suicidal thoughts, severe allergic reactions.
   • Drug interactions: Opioids, benzodiazepines.
   • Warning: May cause drowsiness, avoid driving or operating heavy machinery.
5. Corticosteroids (e.g., Prednisone, Dexamethasone):
   • Cost: Generic versions can be $10-$30/month.
   • Contraindications: Active infections, uncontrolled diabetes.
   • Side effects: Increased appetite, weight gain.
   • Severe side effects: Increased risk of infections, osteoporosis.
   • Drug interactions: NSAIDs, anticoagulants.
   • Warning: Prolonged use may require gradual tapering to avoid adrenal insufficiency.

Surgical Procedures:

• Joint replacement surgery: Replacing damaged joints with artificial joints to improve mobility and reduce pain. Cost: $20,000 to $50,000.
• Spinal fusion surgery: Joining two or more vertebrae to stabilize the spine and reduce pain. Cost: $50,000 to $100,000.

Alternative Interventions

• Acupuncture: May help reduce pain and improve overall well-being. Cost: $60-$120 per session.
• Chiropractic care: Manipulation of the spine to improve joint function and reduce pain. Cost: $30-$200 per session.
• Massage therapy: Manual manipulation of soft tissues to relieve muscle tension and improve circulation. Cost: $50-$100 per session.
• Yoga and meditation: Can help improve flexibility, strength, and mental well-being. Cost: Varies depending on the location and instructor.
• Assistive devices: Use of mobility aids such as canes, walkers, or wheelchairs to improve mobility and independence. Cost: Varies depending on the specific device.

Lifestyle Interventions

• Physical therapy: Customized exercise programs to improve strength, flexibility, and mobility. Cost: $50-$150 per session.
• Occupational therapy: Focuses on improving daily activities and functional independence. Cost: $50-$150 per session.
• Healthy diet: A well-balanced diet rich in fruits, vegetables, and lean proteins can support overall health and well-being. Cost: Varies depending on food choices.
• Regular exercise: Engaging in regular physical activity can improve strength, flexibility, and overall fitness. Cost: Varies depending on the chosen activity.
• Stress management techniques: Practices such as mindfulness, deep breathing, or relaxation exercises can help reduce stress and improve overall well-being. Cost: Varies depending on the chosen technique.

It is important to note that the cost ranges provided are approximate and may vary depending on the location and availability of the interventions. It is recommended to consult with healthcare professionals for personalized treatment options and cost estimates.

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 – R28 Limited function/disability (r) (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 (r) 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 (r). 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. Geneva: World Health Organization.
2. Verbrugge, L. M., & Jette, A. M. (1994). The disablement process. Social Science & Medicine, 38(1), 1-14.
3. Kroenke, K., Wood, D. R., Mangelsdorff, A. D., Meier, N. J., & Powell, J. B. (1988). Chronic fatigue in primary care: prevalence, patient characteristics, and outcome. JAMA, 260(7), 929-934.
4. Marrie, R. A., & Horwitz, R. I. (2010). Emerging effects of comorbidities on multiple sclerosis. The Lancet Neurology, 9(8), 820-828.
5. Prince, M., Patel, V., Saxena, S., Maj, M., Maselko, J., Phillips, M. R., & Rahman, A. (2007). No health without mental health. The Lancet, 370(9590), 859-877.
6. Guccione, A. A., Felson, D. T., Anderson, J. J., Anthony, J. M., Zhang, Y., Wilson, P. W., … & Kannel, W. B. (1994). The effects of specific medical conditions on the functional limitations of elders in the Framingham Study. American Journal of Public Health, 84(3), 351-358.
7. Tinetti, M. E., & Kumar, C. (2010). The patient who falls:”It’s always a trade-off”. JAMA, 303(3), 258-266.
8. Gabay, C., & Kushner, I. (1999). Acute-phase proteins and other systemic responses to inflammation. New England Journal of Medicine, 340(6), 448-454.
9. Bammer, R., Keeling, S. L., Augustin, M., Pruessmann, K. P., Wolf, C., & Stollberger, R. (2001). Improved diffusion‐weighted single‐shot echo‐planar imaging (EPI) in stroke using sensitivity encoding (SENSE). Magnetic Resonance in Medicine, 46(3), 548-554.
10. Jette, A. M., Haley, S. M., & Kooyoomjian, J. T. (2003). Are the ICF activity and participation dimensions distinct?. Journal of Rehabilitation Medicine, 35(3), 145-149.