key: cord-341778-v2n8ez0t
authors: Bayen, Eleonore; Stefanescu, François; Robert, Hélène; Weil-Chounlamountry, Agnès; Villain, Marie; Gouriou, Clémentine; Gueorguieva, Sofia; Picq, Christine; Bruguière, Pascale; Pradat-Diehl, Pascale
title: Will participation restrictions related to the COVID-19 lockdown boost inclusivity?
date: 2020-04-29
journal: Ann Phys Rehabil Med
DOI: 10.1016/j.rehab.2020.04.004
sha: 
doc_id: 341778
cord_uid: v2n8ez0t

nan

restrictions for a long time, whatever their impairment (e.g., motor, cognitive-behavioral, respiratory) and disease (e.g., traumatic spine and brain injury, stroke). The International Classification of Functioning, Disability and Health (ICF) from the World Health Organization (WHO) provides a structuring framework to understand disability 1 . In this biopsychosocial model, disability involves dysfunction in one or more of 3 different levels due to a given health condition: first, impairments (e.g., hemiplegia); second, activity limitations (e.g., inability to walk outside); and third, participation restrictions (e.g., not being able to perform a professional or social community activity). Importantly, the ICF points out how environmental factors (e.g., a wheelchair-accessible area or a dementia-friendly society) can be either facilitators or barriers to the everyday life functioning and social integration of the person. Thus, people living with a disability are used to developing adaptive behaviors to cope and lower the social and physical barriers they encounter in their environment. Because the disability stems from the interaction between the features of a person and the features of the overall context in which the person lives, it has the potential to evolve.

The present social lockdown context has immersed half of the planet in a disability situation (as defined in the WHO model), thus inverting individuals' usual perspectives of capacity, growth and performance. Participation restrictions have become the norm in nations and on a global scale as opposed to being the fate of a minority of excluded groups who experience stigma. Healthy individuals are currently walking their individual psychological paths and developing coping strategies based on the conviction that these enforced restrictions are temporary and reversible (e.g., not being able to access their workplace or enjoy a walk in a park). But fear, frustration and isolation have also placed trapped citizens of the world in the shoes of those living with a long-term disability. The context of collective resilience enables us reflect on the life of those of us who endure a permanent lockdown situation due to severe health conditions or socioeconomic vulnerabilities (e.g., forced migration and poverty). The COVID-19 war has brought human and economic suffering and a heavy death toll. Yet, it also has some positive solidarity and brotherhood counterparts: a major unexpected counterpart could be boosting inclusivity at local, regional, national and planetary levels because citizens are becoming more conscious of handicap. Being more inclusive means stepping up to dismantle barriers (as defined by the ICF) that are physical and mental obstacles to welcome each person whatever their situation. Weeks of confinement have been training our brains to be empathetic and disabled-friendly and to think universal. As many others, physicians of physical and rehabilitation medicine are humbly trying to alleviate the disability situations in people's life. We believe that massive quarantines stand as an opportunity to sustainably educate societies about handicap. Thus, we hope that the lockdown experience will help redesign social justice in our ecosystems and pave the road for more inclusivity in post-COVID societies.

None declared.

World Health Organization. The International Classification of Functioning, Disability and Health. Geneva: World Health Organization