Concepts of disability: the Activity Space Model.

This paper describes a new conceptual framework for functional assessment, the Activity Space Model (ASM). According to this model, functional impairments may lead to restrictions in an individual's activity space, a multidimensional space that represents human potential for activity. For each elementary ability, restrictions in the corresponding dimension of the activity space can be evaluated by deriving a difficulty curve that depicts the relationship between the level of performance and the psychophysical cost of activity. The effect of disease on daily functioning is explained in terms of a tradeoff between the psychophysical cost and the value of each act of behavior to the disabled individual. These two constructs are measured on the same scale and expressed in units of difficulty. The location of each task within the activity space in relation to the difficulty curve determines whether it will be performed or avoided at a given point in time. The ASM has both theoretical and practical implications. It offers a new, integrated perspective on disability and suggests new strategies for developing and evaluating functional assessment measures.

[1]  D L Patrick,et al.  Measurement of health status in the 1990s. , 1990, Annual review of public health.

[2]  M. Sussman,et al.  SOCIOLOGY AND REHABILITATION , 1967 .

[3]  A R Feinstein,et al.  Scientific and clinical problems in indexes of functional disability. , 1986, Annals of internal medicine.

[4]  Irving Kirsch,et al.  Response expectancy as a determinant of experience and behavior. , 1985 .

[5]  I. McDowell,et al.  Measuring health: A guide to rating scales and questionnaires, 3rd ed. , 2006 .

[6]  Gordon Waddell,et al.  Clinical assessment and interpretation of abnormal illness behaviour in low back pain , 1989, Pain.

[7]  I. K. Zola,et al.  Disability Statistics, What We Count and What It Tells Us , 1993 .

[8]  R. G. Williams,et al.  Theories and measurement in disability. , 1979, Journal of epidemiology and community health.

[9]  D. Sullivan,et al.  Disability components for an index of health. , 1971, Vital and health statistics. Series 2, Data evaluation and methods research.

[10]  Rosalie A. Kane,et al.  Assessing the Elderly: A Practical Guide to Measurement , 1981 .

[11]  S. Katz,et al.  STUDIES OF ILLNESS IN THE AGED. THE INDEX OF ADL: A STANDARDIZED MEASURE OF BIOLOGICAL AND PSYCHOSOCIAL FUNCTION. , 1963, JAMA.

[12]  E M Badley,et al.  Patterns of disability related to joint involvement in rheumatoid arthritis. , 1979, Rheumatology and rehabilitation.

[13]  Jette Am,et al.  Functional capacity evaluation: an empirical approach. , 1980 .

[14]  Wilson Rw,et al.  Preliminary analysis of O.E.C.D. disability on the pretest of the post census disability survey. , 1981 .

[15]  A. Bandura Self-efficacy: toward a unifying theory of behavioral change. , 1977, Psychological review.

[16]  G. Borg Perceived exertion as an indicator of somatic stress. , 2019, Scandinavian journal of rehabilitation medicine.

[17]  H. Kessler,et al.  Disability--determination and evaluation, , 1970 .

[18]  P Tugwell,et al.  Methodological considerations in functional assessment. , 1987, The Journal of rheumatology. Supplement.

[19]  David K. Ahern,et al.  Expectancies and functional impairment in chronic low back pain , 1988, Pain.

[20]  D. Duckworth,et al.  The Classification and Measurement of Disablement , 1980 .

[21]  H. Holman,et al.  Measurement of patient outcome in arthritis. , 1980, Arthritis and rheumatism.

[22]  E M Badley,et al.  An introduction to the concepts and classifications of the international classification of impairments, disabilities, and handicaps. , 1993, Disability and rehabilitation.

[23]  S. Katz Studies of illness in the aged , 1963 .

[24]  Norman K. Denzin,et al.  Disability and rehabilitation : legal, clinical, and self-concepts and measurements , 1971 .

[25]  C. Wallace,et al.  Functional assessment in rehabilitation. , 1986, Schizophrenia bulletin.

[26]  R. Hébert,et al.  The Functional Autonomy Measurement System (SMAF): description and validation of an instrument for the measurement of handicaps. , 1988, Age and ageing.

[27]  R. G. Williams,et al.  Disability: a model and measurement technique. , 1976, British journal of preventive & social medicine.

[28]  J R Morris,et al.  The Sickness Impact Profile: Conceptual Formulation and Methodology for the Development of a Health Status Measure , 1976, International journal of health services : planning, administration, evaluation.

[29]  Peter Freebody,et al.  Research report No. 10 , 1991 .

[30]  P. Gertman,et al.  Measuring health status in arthritis. The arthritis impact measurement scales. , 1980, Arthritis and rheumatism.

[31]  Carl V. Granger,et al.  Functional assessment in rehabilitation medicine , 1993 .

[32]  H. Philips Avoidance behaviour and its role in sustaining chronic pain. , 1987, Behaviour research and therapy.

[33]  J L Cutler,et al.  The definition and measurement of disability. , 1974, Social science & medicine.

[34]  S. Soraci,et al.  Assessment of patient satisfaction in activities of daily living using a modified Stanford Health Assessment Questionnaire. , 1983, Arthritis and rheumatism.

[35]  Andrew M. Pope,et al.  Disability in America: Toward a National Agenda for Prevention. Summary and Recommendations. , 1991 .

[36]  R. Deyo,et al.  Barriers to the Use of Health Status Measures in Clinical Investigation, Patient Care, and Policy Research , 1989, Medical care.