[The contribution of the new scale for assessing disability].

Problem: The assessment of disability and its management is complex and problematic. With a view to ensuring equality of opportunity between disabled people and others, a new law adopted in August 2005 proposed a new method for assessing disability is applicable on a wider scale by GPs.

Aim: Assessing the contribution of the new scale for assessing disability in patients suffering from debilitating diseases, to verify compliance in Tunisia.

Methods: Cross-sectional study on 60 hemiplegic, paraplegic and post traumatic head injuries. The patients underwent clinical evaluation and a functional assessment. The assessment tools used were: the classification of the American Spinal Injury Association, the Barthel Index, Glasgow Outcome Scale, Functional Independence Measure, the Health Assessement Questionnaire and the Social Function-36. Patients were also evaluated with the new scale of disability.

Results: concerning paraplegic patients, limitation of activity concerned mobility, maintenance staff, domestic life, social relationships, community life and major areas of life. On the hemiplegic, areas related to communication, mobility, maintenance staff, domestic life, social relationships, community life and major areas of life have been affected. We have noted a correlation between the new scale and the Barthel Index. Regarding traumatic brain injury, the areas most affected were those related to mobility, maintenance staff, domestic life and the major areas of life. A correlation was found between the new scale and the Functional Independence Measure in three populations, as well as the quality of life that has been correlated with disability. Disability was observed in 90% of paraplegics, 80% and 50% of hemiplegic patients with severe brain injury. The handicap was the heaviest seen in traumatic brain injury patients with a frequency of 20%.

Conclusion: The new scale for assessing disability has reproduced disability and special needs of paraplegic patients, stroke patients and traumatic brain injury.