Abstract
In patients with severe motor and intellectual disabilities, we investigated the principles of rehabilitation programs for the long term. According to the impairment and disability model of WHO (1980), the impairment level and its relationship to other clinical factors of 92 institutionalized patients were examined. Firstly, results showed that the teenage group revealed more severe impairment and suffered more frequently from pre-and perinatal disturbances (including prematurity) than other older age groups. These findings may reflect the recent noticeable advances in perinatal medicine. Secondly, deformity of the skeleton began in their 20s in some patients, and the significant correlations between each impairment component decreased in older groups. Thirdly, the multivariable analysis between sitting ability and impairment elements revealed that the level of motor and cognition abilities in a teenage group still reflect their individual developmental history during early life, but little in older groups. These evidences suggest that the fundamental factors that affect impairment levels may change their make-up by their 20s at latest.
