What is a physical disability?
A physical disability is characterized by a limited ability to move, to perform manual tasks, or to control certain parts of the body.
Multiple realities
From reduced physical endurance to paralysis, physical disability encompasses a wide range of motor impairments. Those affecting children and young people form a heterogeneous group that can be classified into four categories according to the nature of the impairment:
- motor impairments of cerebral origin;
- motor impairments of spinal origin;
- motor impairments of neuromuscular origin;
- motor impairments of osteoarticular origin.
Cerebral origin
These impairments result either from very early damage to brain structures, leading to cerebral palsy, or from later damage caused by a traumatic brain injury, a stroke, or a brain tumor.
Once established, neurological impairments are non-progressive. They may cause disturbances in muscle tone, automatic regulation of movement, and voluntary motor control. Muscles and the skeleton are not directly affected, but they may undergo secondary deformities related to growth.
Spinal origin
Spinal cord injuries, caused by trauma or disease affecting the spinal cord, lead to disorders in the transmission of motor and sensory nerve impulses. The higher the level of spinal injury, the more severe the paralysis of the limbs.
A distinction is made between tetraplegia (impairment of all four limbs) and paraplegia (impairment of the lower limbs). Sphincter disorders and sensory impairments are characteristic of these injuries. Spina bifida is classified within this category.
Neuromuscular origin
This category includes several dozen conditions, most of them of genetic origin, such as muscular dystrophies (myopathies) or spinal muscular atrophy. These are progressive diseases characterized by a gradual loss of muscle strength and leading to various disorders, including orthopedic deformities, swallowing difficulties, digestive disorders, respiratory insufficiency, and sometimes cardiac involvement.
Osteoarticular origin
This category includes motor impairments caused by congenital malformations (absence or abnormality of a limb), rheumatic conditions (such as rheumatoid arthritis), spinal deformities (scoliosis), or abnormalities in bone formation (osteogenesis imperfecta). It also includes musculoskeletal disorders, which most commonly affect the back and upper limbs. Frequently observed conditions include low back pain, neck pain, carpal tunnel syndrome, rotator cuff syndrome of the shoulder, and lateral epicondylitis of the elbow.
Associated disorders
Learning difficulties in children and adolescents with motor function impairments are much more often related to associated disorders than to the physical impairment itself.
Neuropsychological disorders may arise due to very early brain damage (as in cerebral palsy) or following a traumatic brain injury with loss of previously acquired functions. These difficulties are never an expression of intellectual disability. They may include, for example, difficulties in performing gestures (dyspraxia), visuospatial disorders, or difficulties in mastering written or spoken language.
