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Claude Hamonet


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Disability situations, an original concept connecting disease,
disability and rehabilitation for assess and manage disabled persons

7th World Congress of the international society of Physical and
Rehabilitation Medicine. June 16-20, 2013, Beijing, China.


Claude Hamonet, Department of Medicine, University Paris-East, 94010 Creteil, France.
Jean-Michel Gracies, Department of Rehabilitation Medicine, University Paris-East, 94010 Creteil, France.



The debate on the definition of disability has been going round in circles for a long time. The lack of clear conceptualization, induced simplifications, misunderstandings and misinterpretations. The consequences are: the lack of reliable tools affects the assessment of disabled people needs and the correct measurement of effects of Rehabilitation. The WHO biomedical propositions (CIDIH I, CIDIH II, and, since 2001, ICF) initiated by P.H.N. Wood (1980) are useless tools for diagnose, defining and assessing disability. The use of inaccurate and ambivalent terms as “activities” adds to the already great confusion on a subject specifically requiring accurate words.

Material and methods

The concept of situations of disability is a new look for society and PRM. Disability Identification and Measurement System (DIMS) is an ergonomic and anthropologic approach of disability and an international proposal for the quantified identification of Disabilities with three levels:

Severity scale (dependence)
No hardship.
Hardship in a functional or situational realization.
Limitation in the realization, including usage of a medication, a technical (including animal) functional, situational.
A human aid is partially necessary.
The function or the tasks is impossible or must be totally compensated by other person.


Consequences for PMR practice: a best identification of disability, a method for identify the needs of the individual, a method to choose the best rehabilitation solution: technical aid, human aid, physiotherapy, occupational therapy, introduction of the human factor in Rehabilitation (subjectivity).


There are two pillars in Rehabilitation: subjectivity and environment (situations). “A disabled person is not a disabled one, but a person in a disabling situation.”


Cl. Hamonet: “Proposed methodology for applying the three-dimensional approach to the measurement and evaluation of the effects of diseases and traumatism”, Icidh International Network 1990, 3, 16–23.
Cl. Hamonet: “Assessing and managing handicap: an original concept”, 7th Congress of the Pan-Arab Association of Physical Medicine and Rehabilitation, Jeddah, Saudi Arabia, 9–11 March, 2013.

Key words

Disability, dependence, rehabilitation, assessment, inclusion.