W28 Limited function/disability (w) (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: W28 Limited function/disability (w)^[2]
• ICD-10 Code: Z73.6 Limitation of activities due to disability^[3]

Symptoms

• Difficulty in performing daily activities
• Decreased mobility
• Impaired coordination
• Muscle weakness
• Cognitive impairments^[4]

Causes

• Chronic medical conditions (e.g., arthritis, stroke, multiple sclerosis)
• Neurological disorders (e.g., Parkinson’s disease, Alzheimer’s disease)
• Musculoskeletal injuries (e.g., fractures, spinal cord injuries)
• Developmental disabilities (e.g., cerebral palsy, Down syndrome)
• Mental health conditions (e.g., depression, anxiety disorders)^[5]

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^[6].

Physical Examination

• Perform a comprehensive physical examination to assess muscle strength, range of motion, and coordination.
• Evaluate sensory function and reflexes.
• Assess cognitive function and mental status^[7].

Laboratory Tests

• Blood tests to assess for underlying medical conditions (e.g., complete blood count, thyroid function tests).
• Specialized assays to measure specific biomarkers related to certain conditions (e.g., serum creatinine for kidney function)^[8].

Diagnostic Imaging

• X-rays to evaluate bone structure and detect fractures or joint abnormalities.
• Ultrasound to assess soft tissue injuries or abnormalities.
• CT scans or MRIs to visualize the brain, spinal cord, or other internal structures^[9].

Other Tests

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

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, preventing complications, and accessing support services^[1].

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, Methocarbamol):
   • Cost: Generic versions can be $10-$30/month.
   • Contraindications: Glaucoma, urinary retention.
   • Side effects: Drowsiness, dizziness.
   • Severe side effects: Severe allergic reactions, liver toxicity.
   • Drug interactions: Sedatives, alcohol.
   • 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 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 achieve full therapeutic effect.
4. Anticonvulsants (e.g., Gabapentin, Pregabalin):
   • Cost: Generic versions can be $10-$30/month.
   • Contraindications: Allergy to the medication, kidney disease.
   • Side effects: Dizziness, drowsiness.
   • Severe side effects: Suicidal thoughts, severe allergic reactions.
   • Drug interactions: Opioids, certain antacids.
   • Warning: May cause dependence or withdrawal symptoms with long-term use.
5. Cognitive enhancers (e.g., Donepezil, Rivastigmine):
   • Cost: Generic versions can be $10-$50/month.
   • Contraindications: Allergy to the medication, severe liver disease.
   • Side effects: Nausea, diarrhea.
   • Severe side effects: Slow heart rate, seizures.
   • Drug interactions: Certain antidepressants, antipsychotics.
   • Warning: Regular monitoring of liver function may be required.

Alternative Drugs:

• Opioids (e.g., Oxycodone, Hydrocodone): Used for severe pain management but should be used with caution due to the risk of dependence and addiction.
• Antianxiety medications (e.g., Lorazepam, Alprazolam): May be prescribed for patients with anxiety-related symptoms.
• Antipsychotics (e.g., Risperidone, Quetiapine): Used for managing behavioral symptoms in certain conditions.

Surgical Procedures:

• Joint replacement surgery: Replacing damaged joints with artificial ones to improve mobility and reduce pain. Cost: $20,000 to $50,000 per joint.
• Spinal fusion surgery: Joining two or more vertebrae to stabilize the spine and reduce pain. Cost: $50,000 to $100,000.
• Deep brain stimulation: Implanting electrodes in the brain to help manage movement disorders. Cost: $30,000 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 and joints to improve mobility and reduce pain. Cost: $50-$200 per session.
• Physical therapy: Exercises and techniques to improve strength, flexibility, and mobility. Cost: $50-$150 per session.
• Occupational therapy: Strategies and adaptations to improve daily activities and independence. Cost: $50-$150 per session.
• Assistive devices: Use of mobility aids (e.g., canes, walkers, wheelchairs) to improve function. Cost: Varies depending on the specific device.

Lifestyle Interventions

• Regular exercise: Engaging in physical activity tailored to individual abilities and limitations. Cost: Varies (e.g., gym membership, equipment).
• Healthy diet: Consuming a balanced diet rich in fruits, vegetables, whole grains, and lean proteins. Cost: Varies depending on food choices.
• Stress management techniques: Practicing relaxation techniques, mindfulness, or meditation. Cost: Free or minimal cost.
• Sleep hygiene: Establishing a regular sleep routine and creating a sleep-friendly environment. Cost: Free or minimal cost.
• Social support: Engaging in social activities and seeking support from family, friends, or support groups. Cost: Varies depending on activities.

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 – W28 Limited function/disability (w) (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 (w) 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 (w). 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. Mayo Clinic. (2021). Disability and health: Overview. Retrieved from https://www.mayoclinic.org/diseases-conditions/disability/symptoms-causes/syc-20352935
2. World Health Organization. (2019). International Classification of Primary Care, Second edition (ICPC-2). Retrieved from https://www.who.int/standards/classifications/other-classifications/international-classification-of-primary-care
3. World Health Organization. (2019). International Statistical Classification of Diseases and Related Health Problems (ICD-10). Retrieved from https://icd.who.int/browse10/2019/en
4. National Institute on Disability, Independent Living, and Rehabilitation Research. (2020). Disability Statistics. Retrieved from https://www.nidilrr.acl.gov/stats/disability-statistics
5. Centers for Disease Control and Prevention. (2020). Disability and Health Promotion. Retrieved from https://www.cdc.gov/ncbddd/disabilityandhealth/index.html
6. American Academy of Family Physicians. (2021). Disability Evaluation. Retrieved from https://www.aafp.org/afp/topicModules/viewTopicModule.htm?topicModuleId=89
7. National Institute of Neurological Disorders and Stroke. (2021). Neurological Diagnostic Tests and Procedures. Retrieved from https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Neurological-Diagnostic-Tests-and-Procedures-Fact
8. American Association for Clinical Chemistry. (2021). Lab Tests Online. Retrieved from https://labtestsonline.org/
9. Radiological Society of North America. (2021). RadiologyInfo.org. Retrieved from https://www.radiologyinfo.org/
10. American Occupational Therapy Association. (2021). Occupational Therapy Practice Framework: Domain and Process. Retrieved from https://www.aota.org/practice/practice-essentials/framework