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Sobre deficiência motora

This is a question that has not yet received a consensual answer among the various responsible entities.

According to the World Health Organization, based on the International Classification of Functioning, Disability and Health, the functioning or disability of a person must take into account two fundamental aspects that are dynamically interconnected: health states (injuries, diseases, disorders, among others) and contextual factors (personal and environmental factors).

In other words, the term disability reflects the interaction between a person’s abilities and the conditions provided by the society in which he or she lives (which may impose more or less barriers in the face of each person’s limitations).

For more information on disability, see the Handbook for People with Motor Disabilities, developed to contextualize these and other disability-related issues.

Motor disability refers to the difficulty or even inability to move, control, or coordinate some type of motor movement. This disability can be transient or permanent and can be congenital or acquired through accident or disease.

There are various degrees of motor impairment that is as great as the level of movements affected.

Its main causes are:

  • Traffic Accidents
  • Brainstroke
  • Industrial Accidents
  • Gun accidents
  • Complications during
    childbirth
  • Dementia
  • Disease
  • Jumping or diving accidents

For more information about motor disability, spinal cord injury, and reduced mobility, or about research conducted in this area, see the Manual for People with Motor Disabilities, developed to clarify these and other related questions./vc_column_text]

To answer this question, let’s start by explaining a little bit how our body works.

It is the brain that commands our movements. Whenever we want to move a leg, an arm, or even blink, there is an order that comes from the brain and reaches the nerves and muscles in the area we want to move – making them move. This information circuit also works in reverse order. For example, if we step barefoot on something that causes us pain, this information is quickly sent to the brain, which in turn gives the order to lift our foot in order to stop the pain.

This information between the brain and other areas of the body is transmitted mainly through the spinal cord, which is covered by the spinal column.

When a spinal cord injury occurs, there is usually a major or minor cut in the spinal cord, preventing some or all of the information received or transmitted from passing through the area of injury.

The injury can be complete – there is a complete loss of the ability to control and sensitize the voluntary muscles below the injury – or incomplete – there is a more or less significant decrease in the ability to control movement and sensitivity, below the injury.

A person with reduced mobility is understood as any person whose mobility is conditioned due to aging, motherhood, a motor and/or cognitive impairment and/or any other cause that affects their mobility and requires special adaptation to their needs, either occasionally or for an indefinite period.

It is the possibility of using, with safety and autonomy, the spaces, urban equipment, transportation, systems, and means of communication, by the person with reduced mobility or disability.

The Central Nervous System is composed of two structures – the Brain and the Spinal Cord – and is responsible for the main functions of human behavior.

The Spinal Cord is a long, fragile, cylindrical-shaped structure (about 1 cm in diameter and 42 to 46 cm long) that extends from the base of the brain (brainstem), as an extension of the brainstem, to the bottom of the back (lumbar area). It is protected by a bony structure – the Vertebral Column – that surrounds it along its length.

The Spinal Cord has essentially two functions:

  1. Signal transmission – is responsible for conducting nerve impulses to and from the brain. It receives signals from organs and muscles and transmits them to the brain. In the opposite direction, the brain sends to the medulla, through axons, orders referring to the movement of muscles.
  2. Reflex activity – refers to the mechanism that allows a (non-conscious) motor response to a stimulus. This happens, for example, in the case of a stimulus that causes pain in which the response is prior to the arrival of information to the brain and consequent awareness. This response is called a reflex and is characterized by being a rapid, instantaneous and automatic response to a stimulus.

The spinal column is effectively the central pillar of the torso, consisting of a succession of bones, called vertebrae, surrounding the spinal cord. Being the central axis of the body it ends up having two fundamental mechanical requirements for its functions – rigidity and plasticity. In the neck region, it is located centrally, as it supports the head and should be as close as possible to its center of gravity. In the thorax region, it is situated in a more posterior position, due to the agglomeration of internal organs in this area and especially due to the heart. In the lumbar region it is again located in the center because there it has to support the entire weight of the torso.
Its main functions are:

  • Support the head and torso;
  • Protect the spinal cord (from the head to the pelvis);
  • Participate in all limb and torso movements;

Between the vertebrae are discs that are composed of cartilage and serve as shock absorbers for the spinal column. From the spinal cord and between the vertebrae come two strands of nerves, called spinal nerves. The spinal nerves contain the motor and sensory nerve fibers that allow the spinal cord and brain to communicate with the rest of the body.

Tetraplegia and Quadriplegia have the same meaning, however in Europe the most used terminology is Tetraplegia while in America the term Quadriplegia is used more.

The word Quadraplegia results from the fusion of two words from two different languages – Latin and Greek. The word “Quadra” translated from Latin means four, while the Greek word “Plegia” means paralysis. Thus, when combined, we have the word “Quadraplegia.

Tetraplegia results from a spinal cord lesion above the first thoracic vertebra (T1), namely in the cervical area, and has as a consequence the total loss of movement and sensitivity (total or not) of the torso and upper and lower limbs.

Like the word Quadraplegia, it also derives from Latin and Greek. In this situation the injury occurs below the first thoracic vertebra (T1). The degree of paraplegia depends on the area where the injury occurred – thoracic, lumbar or sacral – so the consequences can range from a total loss of movement from the thoracic area to the lower limbs, or only paralysis of the leg movements.

Despite advances in the emergency treatment and rehabilitation of spinal cord injuries, methods for reducing the extent of the injury and restoring function are still limited. The immediate treatment for spinal cord injury includes techniques to relieve spinal cord compression and to ensure stabilization of the spine, corticosteroid therapy to minimize cellular damage, and others.

The consequences associated with spinal cord injury depend on the degree of severity of the injury, as well as the segment of the spinal cord that was injured and the type of fibers that were affected. Most people who suffer an injury of this nature recover some functions between the first week and six months after the injury, but spontaneous recovery decreases sharply after this period. It should be noted that a good rehabilitation plan minimizes (in the long term) some of the consequences of the injury.

Due to the complexity of the CNS, spinal cord repair cannot be viewed with simplicity. For many decades, the inability to regenerate CNS cells was considered a “law of nature” and as such, spinal cord injuries were considered irreversible.

Currently, despite the advances in medicine and the fact that clinical trials of spinal cord regeneration are already being performed in animals, researchers must wait for sufficiently consistent results before considering clinical trials in humans. It must also be demonstrated that spinal cord regeneration in animals can be repeated in several laboratories, and that cell transplantation works in larger, chronic injuries.

Despite the hopeful and satisfactory results, this whole process takes time and experience, so it is unlikely that human cell transplantation will be available in the immediate future.

There could be a lot to lose. First and foremost, whatever spinal cord function you still have, and even your life is in danger. Experimental cell grafts performed without the necessary safety and efficacy have proven that they can lead to very serious side effects – chronic pain, or paralysis, among others.

On the other hand, there are also many other considerations to be taken into account, such as the high cost of surgical procedures and their associated risks, the potential for post-operative complications, in addition to the ethical issues that all these procedures raise in a society.

Sobre acessibilidades

Promoting accessibility and direct or indirect non-discrimination is a fundamental element in people’s quality of life, and an indispensable means for exercising the rights that are conferred to any member of a democratic society under the rule of law.

Legislation:

  • Decree-Law nº125/2017, of October 4: APPROVES THE REGIME OF ACCESSIBILITY TO BUILDINGS AND ESTABLISHMENTS RECEIVING PUBLIC, PUBLIC WAYS AND HOUSING BUILDINGS, introducing changes to Decree-Law nº 163/2006. It confers to the International Standard Proportion the supervision of the compliance with the duties imposed to the entities of the central public administration and public institutes in matters of accessibility, as well as the institution of administrative offence proceedings in case those entities do not comply with the accessibility norms, and to the Inspectorate General of Finances the duties imposed to the local administration.
  • Decree-Law No. 163/2006, August 8: REGIME OF ACCESSIBILITY TO BUILDINGS AND ESTABLISHMENTS RECEIVING PUBLIC, PUBLIC WAYS AND HOUSING BUILDINGS
  • Law No. 46/2006, of August 28: LAW PROHIBITS AND PUNISHES DISCRIMINATION ON GROUNDS OF DISABILITY AND EXISTENCE OF AGGREED HEALTH RISK
  1. The National Institute for Rehabilitation has the mission of promoting accessibility in national buildings and monuments, central public administration entities, and public institutes;
  2. The Inspectorate General of Finance is the entity with the power to inspect and to sanction the violation of the duties that the law imposes on local government entities (such as municipalities and county councils) in terms of accessibility;
  3. The Directorate-General of Cultural Heritage is the entity that issues opinions on compliance with technical accessibility standards in buildings of special historical and architectural interest.

Decree Law No. 125/2017, of October 4, states that Commissions for the Promotion of Accessibility will be created. These committees will evaluate accessibility in buildings and spaces:

  • of the State
  • of local authorities
  • of public institutes that are personalized services or public funds.

Technical teams will also be created in each ministry to promote accessibility. These teams have the duty to enforce the technical standards of accessibility in the buildings of each ministry. These teams must report to the International Standard Proportion on their activities.

After 10 years after the publication of the 9th article of law number 163/2006, from August 28th, and despite the fact that there are no systemized data that would allow us to accurately analyze the results obtained in the implementation of accessibility at a national level, it is undeniable that we have, today, a more accessible territory. Despite the progress achieved, an expressive set of buildings, spaces and installations that do not satisfy accessibility conditions still exists in the national edified patrimony.

The effects of the international economic crisis and the economic and financial assistance program that the country was forced to comply with resulted in disinvestment in this area. Other factors, however, must be taken into consideration, namely the fact that cultural and attitude barriers to diversity and difference, particularly towards people with disabilities, still exist in society in general.

Decree-Law 163/2006, August 8, as amended by Decree-Law 136/2014, September 9, stipulated a 10-year deadline for adapting facilities, buildings, establishments, public facilities and equipment for public use and the public highway to technical accessibility standards, which ended on February 8, 2017. However, the national commitment to promote an inclusive society in which everyone can access all resources under equal conditions remains unchanged, a goal for which the removal of persistent architectural barriers will be essential.

However, article 9 of Decree-Law 163/2006, of August 28th, stipulates the following:

  • The spaces referred to in nº 1 and 2 of article 2 of the Decree-Law, whose construction began prior to August 22, 1997, must be adapted within a period of 10 years, counting from the date of commencement of Decree-Law 163/2006, of August 28 (2016);
  • The spaces mentioned in nº 1 and 2 of article 2 of the Decree-Law, whose construction started after August 22nd 1997, must be adapted within a period of 5 years, counting from the date of entry into force of Decree-Law n.º 163/2006, from August 28th (2011);
  • Spaces that are in conformity with the dispositions of Decree Law n.º 123/97, from May 22nd, later revoked by Decree Law n.º 163/2006, from August 28th, are exempt from complying with the technical norms attached to the decree law.
  • After the deadlines established in the previous numbers have elapsed, the nonconformity of the buildings and establishments referred to in them with the technical accessibility norms is sanctioned under the terms applicable to new buildings and establishments.

However, there are several exceptions, which are mentioned in articles 10 and 11 of the Decree-Law, of which we highlight some examples: works that are disproportionately difficult or require disproportionate or unavailable financial means; cases where cultural and historical heritage may be affected, among others. For more information please consult the Decree Law by clicking here.

According to article 18 of Decree-Law 163/2006, of 28 August, administrative offences are punishable by a fine of between €250.00 and €3,740.98, in the case of natural persons, and of €500.00 and €44,891.81, when the offender is a legal person. In case of negligence, the maximum amounts provided for in the preceding paragraph are €1,870.49 and €22,445.91, respectively.

It is up to the State and its various entities to certify the accessibility of public and private spaces, in accordance with Decree-Law no. 163/2006, of August 28.

Law 32/2012, of August 14, approved measures aimed at speeding up and boosting urban rehabilitation, changing articles 1424 to 1426 of the Civil Code, regarding the Horizontal Property regime, namely by attributing to the joint owners who have a disabled person in their household, the right to make the following innovations, upon prior notice to the administrator, 15 days in advance, and observing the technical accessibility standards set forth in specific legislation:

a) Placing access ramps;

b) Placing elevator platforms, when there is no elevator with door and cabin dimensions that allow its use by a person in a wheelchair;

It is important to note that only the owners who install the access ramps and elevator platforms will participate in the expenses related to the access ramps and elevator platforms when they are installed as mentioned above. However, any owner can, at any time, participate in the benefits by paying his/her share of the execution and maintenance expenses.

The symbol of accessibility must be in a proper plate which is obtained from the licensing entities, being that in this point the Decree-Law doesn’t explicit if the licensing entity in question is the one which licenses the works (ex.: Municipal Councils, in the case of private buildings) or if it is the one which licenses the functioning (depends on the type of establishment).

The Municipal Councils are the licensing entities par excellence. All licensing projects have to go through them. The remaining entities mentioned jointly in article 14 of Decree-Law 163/2006 are related to public or local entities.

Incentivos à contratação de pessoas com deficiência

When an entity intends to hire a person with a disability, the main concern it should take into account is whether the worker needs any job adaptation. After this analysis, the entity should draw up a job description in order to determine the tasks to be performed.

It should be noted that people with disabilities still have many abilities that are compatible with various types of jobs.

  1. For example, if a person with paraplegia (no mobility in the lower limbs), who is in a wheelchair, has to do most of his or her work using a computer, there is no reason why this person should not be as productive as other non-disabled people.The only requirements for this person to be able to work in a company are related to the surroundings: the building must be accessible and there may need to be an adapted bathroom, but this is not always necessary, it depends on the type of motor disability. This is just one example. There are many others!

Doubts about how to deal with disability often arise, due to lack of knowledge, or lack of experience in daily contact with people with disabilities. We recommend consulting specific information for human resources managers on this area.

Diversity within a company is a positive factor in the work environment. To have an inclusive company is to be giving an opportunity to people who have ability, also contributing to make other employees aware of the ability of people with disabilities.

However, if the company considers that there should be training in order to better understand the situation and give more knowledge to the other employees, it should invest in this aspect.

The company’s human resources policy must define openness to diversity and recognize this area as strategic. If this commitment is assumed by the top managers and they get involved in this process, recognizing the importance of integrating people with disabilities, the practices at the human resources management level will be more effective.

Yes, there is the Inclusive Employer Brand which is intended to promote the public recognition and distinction of open and inclusive management practices, developed by employers, regarding people with disabilities, being awarded every 2 years, in uneven years.

This recognition is given to entities that implement an inclusive job market in the areas of recruitment, maintenance, accessibility, and service with the community.

For more information, see www.iefp.pt or call 300 010 001.

Yes, there is the Adaptation of Workplaces and Elimination of Barriers measure which consists of financial support granted by IEFP in order to ensure the necessary conditions for the person with disabilities to be able to access the workplace and perform their duties.

Workplace adaptation aims at adapting the equipment, utensils and furniture used in the workplace. It is aimed at unemployed people registered at the Job Center or at workers who become disabled during their working life. Applicants to internship programs financed by IEFP or recipients of the Supported Employment in the Open Market can also benefit from this measure.

In the case of fixed-term or open-ended employment contracts or the Open Market Supported Employment Measure, the non-refundable allowance will be up to 16 times the IAS. In the case of internships financed by the IEFP, the value of the non-refundable subsidy is up to 8 times the IAS.

The Elimination of Architectural Barriers aims to eliminate physical obstacles that might hinder workers’ access or mobility within their facilities. This support can only be granted to facilities that were built before February 2007. It is aimed at unemployed people registered with the IEFP or who acquire a disability in the course of their professional life. Candidates of the Supported Employment Measure in the Open Market are also targeted. The value of the support cannot exceed 50% of the value of the work up to a limit of 16 times the IAS.

Both measures require an open ended or fixed term Employment Contract with an initial minimum duration of 1 year.

Yes, support products consist of financial aid to people with disabilities for the purchase, adaptation or repair of products, devices, equipment or technical systems of specialized production or available on the market that are indispensable to prevent, compensate, attenuate or neutralize activity limitations and participation restrictions that impair, make it difficult or impossible to access and attend vocational training or obtain and maintain employment and career progression.

The IEFP co-participation in the cost of acquisition, adaptation or repair of support products corresponds to 100% of the cost when this is not co-participated by the health system or subsystem or insurance company of which the person is a beneficiary, or to the difference between the cost of acquisition, repair or adaptation and the co-participation amount to which the person is entitled, through the health system or subsystem of which the person is a beneficiary or the respective insurance company.

For more information, see http://www.iefp.pt/ or call 300 010 001.

Employers who enter into an open-ended employment contract with a person with a disability – provided that the person has a capacity for work of less than 80% of the normal capacity required of a non-disabled worker, performing the same duties – are entitled to a reduction in the contribution rate.

The employer now pays 11.9% on the employee’s wages for the duration of the employment contract. The employee pays 11% (paid by the employer) – total rate: 22.9%.

For further information contact Social Security (300 502 502) or consult the Practical Guide on “Redução de Taxa Contributiva – Trabalhadores com Deficiência“.

It is aimed at people with disabilities and natural or legal entities, of a private nature, with or without profit.

The internship lasts 12 months and the grants vary according to the qualifications (evaluated by the National Qualifications Framework), and are subject to income tax and Social Security contributions (TSU).

  • Qualification 1 and 2: 1 times the IAS *
  • Qualification 3: 1.2 times the IAS
  • Qualification 4: 1.3 times the IAS
  • Qualification 5: 1.4 times the IAS
  • Qualification 6, 7 and 8: 1.65 times the IAS

* IAS (Social Support Index) – 419,22€

IEFP co-participation: 95% co-participation for private entities that employ 10 or less collaborators and that have never joined the measure; 80% co-participation for the remaining cases.

For more informations, click here or call 300 010 001.

An Insertion Employment Contract (CEI) consists in the performance, by the unemployed, of socially useful work within the scope of projects promoted by public or private, non-profit collective entities.

This measure has a maximum duration of 12 months.

The Employment Integration Contract (CEI) is aimed at unemployed people registered with the IEFP receiving unemployment benefits or unemployment social benefits. To these subsidies is added a monthly grant corresponding to 20% of the IAS, food subsidy and transportation expenses.

The Insertion Employment Contract + (CEI+) is aimed at unemployed people registered with the IEFP who do not benefit from unemployment benefits or who benefit from the Social Integration Income. The grant awarded to beneficiaries corresponds to the IAS, the food subsidy and transport costs. The IEFP contribution is 100% in the case of private non-profit entities and 90% in the case of public or private entities in the local business sector.

The “Employment Contract” measure consists of financial support for employers who enter into fixed-term or open-ended Employment Contracts. In the case of fixed-term contracts, the IEFP support corresponds to 110% of the IAS for three months. For permanent contracts, the support comprises 110% of the IAS, granted for 9 months.

At the moment, a 5% quota is stipulated for the public and local administration (DL 29/ 2001 of February 3rd), whereby the person with disability must have a disability equal to or greater than 60%.

We advise you to register at the Job Center in your area of residence and in the project for the professional integration of people with motor disability “Talent has no limits” through this form.

We also advise you to have an up-to-date Curriculum Vitae, to search by your own means and never give up!

Informações úteis

The IMTT, makes available on-line, the request of a parking card for people with disabilities. To use this service, you must be already registered on the finance site.

This service is in the ONLINE SERVICES area – https://servicos.imtt.pt

You must select the private zone, and then authenticate. The password to be used for authentication should be the same as the one you use in the finance site. If this is the first time you are using the IMTT site, you will need to fill out a form with personal data.

It is always necessary to check the box to authorize IMTT to read your data.

Then, in the service area selection, choose Miscellaneous/Other and then choose Parking Permit Requests for People with Disabilities.

To complete the request you must send via CTT the copy of the Multipurpose Certificate.

For clarifications regarding this service you can contact IMTT’s services: email: sois@imtt.pt | telefone: 217949000 | fax: 217973777

The Provedoria de Justiça makes available the Disabled Citizen’s Hotline- 800 208 462 -, which is free and open every working day from 9:30 am to 5:30 pm.

This line aims to clarify doubts and solve questions presented by people with disabilities and other people or institutions related to this area and who want to be informed about this subject.

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