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Cad Saude Publica. 2009 Mar;25(3):475-83.

[Human functioning and disability: exploring the scope of the World Health Organization's international classification].

[Article in Portuguese]

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  • 1Escola de Educação Física, Fisioterapia e Terapia Ocupacional, Universidade Federal de Minas Gerais, Belo Horizonte, Brasil.


The theoretical discussion on disability is dichotomized according to the medical and social perspectives. The biomedical model focuses on impairment, disease, or physical abnormality and how these factors produce disability. The social approach suggests that the meaning of disability and impairment emerges from specific social and cultural contexts. The WHO created the International Classification of Functioning, Disability and Health (ICF), with a classification system and theoretical model based on the combination of the medical and social models and using a biopsychosocial approach to integrate the health dimensions. Despite the importance and immediacy of the ICF, some concepts were insufficiently detailed and justified and could lead to distinct interpretations. This essay proposes to describe the ICF model and analyze the scope of the biopsychosocial theory for exploring the relational nature of the 'disability' and 'impairment' categories, as well as the universal nature of the WHO proposal. One of the most positive aspects of the ICF is to highlight the interactive nature of disability and the division of the phenomenon into three dimensions, thus demonstrating the degree of complexity in the process of human functioning and disability.

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