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Fréz AR, Alouche SR, Binda AC, Nunes Cabral CM. Content validity of the International Classification of Functioning, Disability and Health core set for knee dysfunction: a Delphi study. Physiother Theory Pract 2024; 40:110-117. [PMID: 35837751 DOI: 10.1080/09593985.2022.2101037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 07/07/2022] [Indexed: 10/17/2022]
Abstract
OBJECTIVE To assess the content validity of the preliminary core set for knee dysfunction based on the opinion of experts. DESIGN A panel of 180 experts in knee disorders or on the use of the International Classification of Functioning, Disability, and Health for musculoskeletal conditions was invited for this Delphi study. The experts gave their opinion on whether to include the categories of the preliminary core set for knee dysfunction in a more comprehensive core set, using a six-item Likert scale. Kappa coefficient was used to analyze the agreement between the experts, and a consensus of 75% among responses was considered acceptable. RESULTS Nineteen experts participated in all rounds. Of the 24 categories from the preliminary core set for knee dysfunction, 15 remained in the comprehensive core set and one category was further detailed into three new categories. Seven new categories were included. Thus, the comprehensive core set for knee dysfunction was composed of 25 categories with an agreement of 81.5% among responses and a Kappa value of 0.63. CONCLUSION After validation by experts, the comprehensive core set for knee dysfunction was composed of 25 categories that can be used to assess the functioning of patients with knee dysfunction.
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Affiliation(s)
- Andersom Ricardo Fréz
- Physical Therapy Department, Universidade Estadual do Centro-Oeste, Guarapuava, Brazil
- Master's and Doctoral Program in Physical Therapy, Universidade Cidade de São Paulo, São Paulo, Brazil
| | - Sandra Regina Alouche
- Master's and Doctoral Program in Physical Therapy, Universidade Cidade de São Paulo, São Paulo, Brazil
| | - Aline Cristiane Binda
- Physical Therapy Department, Universidade Estadual do Centro-Oeste, Guarapuava, Brazil
- Master's and Doctoral Program in Physical Therapy, Universidade Cidade de São Paulo, São Paulo, Brazil
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Geng BF, Feng C, Liu SG, Jiang ZL, Lin F. Haemophilia item bank based on International Classification of Functioning, Disability and Health: a systematic review. Hematology 2023; 28:2191077. [PMID: 36946880 DOI: 10.1080/16078454.2023.2191077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Haemophilia comprises a continuum of blood disorders that often include joint and muscular dysfunction, which may lead to a constellation of activity limitations and participation restrictions. However, there is scant research incorporating functional assessment scales into the common language provided by the International Classification of Functioning, Disability and Health (ICF). This study aims to identify the ICF categories to include in an item bank of functioning aspects relevant for haemophilia. DESIGN AND METHODS A systematic search was carried out in July 2021 based on the PubMed MEDLINE, CLINICAL, and Cochrane databases for qualified articles, investigating haemophilia-specific scales and the scales recommended by the World Federation of Haemophilia (WFH) linked to ICF categories between 2001 and 2021. Well-trained healthcare professionals in the haemophilia field and ICF evaluation conducted group discussions to determine the ICF items for haemophilia. RESULTS A total of 112 out of 176 items measuring function were collected for the haemophilia ICF item bank, including 32 items for body function (b), 45 items for activity and participation (d), 27 items for environmental factors (e), and 8 items for body structure(s). INTERPRETATION AND CONCLUSIONS We recommend that future haemophilia research use the haemophilia-specific ICF item bank, which could capture a whole spectrum of functional measurements and facilitate multidisciplinary and worldwide communication. This study also indicates that further development and analysis of the psychometric properties of the 112 haemophilia-related ICF items is warranted.
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Affiliation(s)
- Bao-Feng Geng
- Department of Rehabilitation Medicine, Sir Run Run Hospital, Nanjing Medical University, Nanjing, People's Republic of China
| | - Chun Feng
- The Center of Rehabilitation Therapy, The First Rehabilitation Hospital of Shanghai, Rehabilitation Hospital Affiliated to Tongji University, Shanghai, People's Republic of China
| | - Shou-Guo Liu
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, People's Republic of China
| | - Zhong-Li Jiang
- Department of Rehabilitation Medicine, Sir Run Run Hospital, Nanjing Medical University, Nanjing, People's Republic of China
| | - Feng Lin
- Department of Rehabilitation Medicine, Sir Run Run Hospital, Nanjing Medical University, Nanjing, People's Republic of China
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, People's Republic of China
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Hernández-Lázaro H, Jiménez-Del Barrio S, Ceballos-Laita L, Lahuerta-Martin S, Medrano-de-la-Fuente R, Hernando-Garijo I, Mingo-Gómez MT. Multicentre cross-sectional study assessing content validity of the International Classification of Functioning, disability and health core set for post-acute musculoskeletal conditions in primary care physiotherapy services. J Rehabil Med 2023; 55:jrm11950. [PMID: 37974517 PMCID: PMC10666063 DOI: 10.2340/jrm.v55.11950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 09/20/2023] [Indexed: 11/19/2023] Open
Abstract
OBJECTIVE To assess content validity of the comprehensive International Classification of Functioning, Disability and Health (ICF) Core Set for post-acute musculoskeletal conditions in primary care physiotherapy services. DESIGN Multicentre cross-sectional study. SUBJECTS Patients with musculoskeletal disorders referred to primary care physiotherapy services. METHODS Structured interviews were conducted using categories from the ICF Core Set, and their relevance was assessed using a visual analogue scale. An ICF category had to represent a problem for at least 5% of the sample in order to be validated. RESULTS The study sample comprised 274 patients. All categories in the ICF Core Set were confirmed. Body functions related to pain and movement were the most commonly impaired, with ICF categories "b280 Sensation of pain" and "b710 Mobility of joint functions" having the highest prevalence (87.2% and 84.7%, respectively). Activity limitations and participation restrictions were concentrated in chapters "d4 Mobility" (63.5% for "d430 Lifting and carrying objects") and "d2 General tasks and demands" (59.5% for "d240 Handling stress and other psychological demands"). The most relevant environmental factors were "e225 Climate" (55.8%) and "e580 Health services, systems and policies" (39.4%). CONCLUSION The ICF Core Set for post-acute musculoskeletal conditions shows appropriate content validity for primary care physiotherapy services.
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Affiliation(s)
- Héctor Hernández-Lázaro
- Ólvega Primary Care Physiotherapy Unit, Soria Health Care Management, Castilla y León Regional Health Administration (SACYL), Ólvega (Soria), Spain
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Hernández-Lázaro H, Mingo-Gómez MT, Jiménez-Del-Barrio S, Rodríguez-Fernández AI, Areso-Bóveda PB, Ceballos-Laita L. Validation of the International Classification of Functioning, Disability, and Health (ICF) core set for post-acute musculoskeletal conditions in a primary care physiotherapy setting from the perspective of patients using focus groups. Disabil Rehabil 2023:1-8. [PMID: 37667886 DOI: 10.1080/09638288.2023.2251392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 08/15/2023] [Accepted: 08/18/2023] [Indexed: 09/06/2023]
Abstract
PURPOSE To validate the comprehensive ICF core set for post-acute musculoskeletal conditions from the perspective of patients in a primary care physiotherapy setting. MATERIALS AND METHODS A qualitative study was conducted with patients suffering from musculoskeletal problems. A phenomenological approach based on focus groups was used to identify the most relevant aspects related to physical therapy care in their condition. The data were analyzed using a meaning condensation procedure, identifying relevant themes and concepts. The identified concepts were linked to the ICF and compared to the ICF core set for post-acute musculoskeletal conditions. RESULTS Forty-three patients were included in eight focus groups. A total of 1281 relevant concepts were extracted and related to 156 ICF second-level entities. Entities in the ICF core set for post-acute musculoskeletal conditions were 95.7% confirmed. Eighty-nine additional second-level ICF entities were identified. CONCLUSIONS Entities in the ICF core set for post-acute musculoskeletal conditions are relevant to patients seen in primary care physical therapy units. However, there are areas of functioning related to community health care not covered by this ICF-based tool.IMPLICATIONS OF REHABILITATIONAn ICF-based framework is feasible for the assessment of musculoskeletal conditions.Post-acute musculoskeletal ICF core set was confirmed in patient focus groups.Additional ICF categories emerged for a primary care physical therapy setting.Community features of functioning could be addressed by a tailored ICF core set.
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Affiliation(s)
- Héctor Hernández-Lázaro
- Ólvega Primary Care Physiotherapy Unit, Soria Health Care Management, Regional Health Administration of Castilla y León (SACYL), Ólvega, Spain
- Faculty of Health Sciences, University of Valladolid, Soria, Spain
| | - Maria Teresa Mingo-Gómez
- Faculty of Health Sciences, University of Valladolid, Soria, Spain
- Clinical Research in Health Sciences Group, University of Valladolid, Soria, Spain
| | - Sandra Jiménez-Del-Barrio
- Faculty of Health Sciences, University of Valladolid, Soria, Spain
- Clinical Research in Health Sciences Group, University of Valladolid, Soria, Spain
| | - Ana Isabel Rodríguez-Fernández
- Cervera de Pisuerga Primary Care Physiotherapy Unit, Palencia Health Care Management, Regional Health Administration of Castilla y León (SACYL), Cervera de Pisuerga, Spain
| | - Paula Begoña Areso-Bóveda
- Burgos Centro Primary Care Physiotherapy Unit, Burgos Primary Health Care Management, Regional Health Administration of Castilla y León (SACYL), Burgos, Spain
| | - Luis Ceballos-Laita
- Faculty of Health Sciences, University of Valladolid, Soria, Spain
- Clinical Research in Health Sciences Group, University of Valladolid, Soria, Spain
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Hernández-Lázaro H, Mingo-Gómez MT, Jiménez-del-Barrio S, Lahuerta-Martín S, Hernando-Garijo I, Medrano-de-la-Fuente R, Ceballos-Laita L. Researcher's Perspective on Musculoskeletal Conditions in Primary Care Physiotherapy Units through the International Classification of Functioning, Disability, and Health (ICF): A Scoping Review. Biomedicines 2023; 11:biomedicines11020290. [PMID: 36830831 PMCID: PMC9953260 DOI: 10.3390/biomedicines11020290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 01/13/2023] [Accepted: 01/18/2023] [Indexed: 01/26/2023] Open
Abstract
(1) Background: Musculoskeletal disorders are the second cause of disability in the world. The International Classification of Functioning Disability and Health (ICF) is a tool for systematically describing functioning. Outcome measures for musculoskeletal disorders and functioning concepts embedded in them have not been described under the ICF paradigm. The objective of this scoping review was to identify ICF categories representing the researcher's perspective and to compare them with the ICF core set for post-acute musculoskeletal conditions. (2) Methods: This review was conducted as follows: (a) literature search using MEDLINE/PubMed, CINAHL, Web of Science, and Scopus databases; (b) study selection applying inclusion criteria (PICOS): musculoskeletal conditions in primary care, application of physiotherapy as a treatment, outcome measures related to functioning, and experimental or observational studies conducted in Western countries during the last 10 years; (c) extraction of relevant concepts; (d) linkage to the ICF; (e) frequency analysis; and (f) comparison with the ICF core set. (3) Results: From 540 studies identified, a total of 51 were included, and 108 outcome measures were extracted. In the ICF linking process, 147 ICF categories were identified. Analysis of data showed that 84.2% of the categories in the ICF core set for post-acute musculoskeletal conditions can be covered by the outcome measures analyzed. Sixty-eight relevant additional ICF categories were identified. (4) Conclusion: Outcome measures analyzed partially represent the ICF core set taken as a reference. The identification of additional categories calls into question the applicability of this core set in primary care physiotherapy units.
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Affiliation(s)
- Héctor Hernández-Lázaro
- Faculty of Health Sciences, University of Valladolid, 42004 Soria, Spain
- Clinical Research in Health Sciences Group, University of Valladolid, 42004 Soria, Spain
- Ólvega Primary Care Health Center (Soria, Spain), Soria Health Care Management, Castilla y León Regional Health Management (SACYL), 47007 Valladolid, Spain
| | - María Teresa Mingo-Gómez
- Faculty of Health Sciences, University of Valladolid, 42004 Soria, Spain
- Clinical Research in Health Sciences Group, University of Valladolid, 42004 Soria, Spain
| | - Sandra Jiménez-del-Barrio
- Faculty of Health Sciences, University of Valladolid, 42004 Soria, Spain
- Clinical Research in Health Sciences Group, University of Valladolid, 42004 Soria, Spain
- Correspondence:
| | | | - Ignacio Hernando-Garijo
- Faculty of Health Sciences, University of Valladolid, 42004 Soria, Spain
- Clinical Research in Health Sciences Group, University of Valladolid, 42004 Soria, Spain
| | - Ricardo Medrano-de-la-Fuente
- Faculty of Health Sciences, University of Valladolid, 42004 Soria, Spain
- Clinical Research in Health Sciences Group, University of Valladolid, 42004 Soria, Spain
| | - Luis Ceballos-Laita
- Faculty of Health Sciences, University of Valladolid, 42004 Soria, Spain
- Clinical Research in Health Sciences Group, University of Valladolid, 42004 Soria, Spain
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Selb M, Nicol R, Hartvigsen J, Segerer W, Côté P. An ICF-based assessment schedule to facilitate the assessment and reporting of functioning in manual medicine - low back pain as a case in point. Disabil Rehabil 2022; 44:8339-8348. [PMID: 34919452 DOI: 10.1080/09638288.2021.2012842] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
PURPOSE This paper outlines the first steps toward developing the ICF-based assessment schedule for manual medicine with a focus on low back pain (LBP). It reports on the results of a consensus process to develop the default and optional versions of the set of ICF categories (ManMed Set) the assessment schedule should cover, and gives insight in expert input toward building a toolbox of instruments for assessing the ManMed Set categories. METHODS A scoping review and qualitative study were conducted, each resulting in a list of ICF categories. These categories, along with the categories of the ICF Generic-30 Set, Comprehensive ICF Core Set for LBP, and from an existing Delphi study, served as the starting point for an established consensus process to decide on the ManMed Set. RESULTS After alternating plenary and working group sessions, an iterative ranking process and cut-off calculation, the multi-professional and international group of 20 experts in manual medicine included 23 categories in the default ManMed version (16 + the ICF Generic-7 Set categories) and 25 in the optional version. CONCLUSIONS Their development is a major step toward developing an assessment schedule that can be employed in standardizing the assessment and reporting of functioning in manual medicine, initially of LBP patients.Implications for rehabilitationThe ICF assessment schedule for manual medicine has potential use in supporting rehabilitation practice, such as for planning interventions, defining rehabilitation goals, and measuring and documenting functioning outcomes.It can be used to promote interdisciplinary coordination of care and facilitate communication between members of a multidisciplinary rehabilitation team within manual medicine and beyond.The ICF assessment schedule for manual medicine can facilitate rehabilitation and manual medicine research by providing evidence for optimizing rehabilitation practice.
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Affiliation(s)
- Melissa Selb
- ICF Research Branch, Nottwil, Switzerland.,Swiss Paraplegic Research, Nottwil, Switzerland
| | | | - Jan Hartvigsen
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.,Chiropractic Knowledge Hub, Odense, Denmark
| | | | - Pierre Côté
- Faculty of Health Sciences, Ontario Tech University, Oshawa, Ontario, Canada.,Institute for Disability and Rehabilitation Research, Ontario Tech University and CMCC, Oshawa, Ontario, Canada
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Hernandez-Lazaro H, Mingo-Gómez MT, Ceballos-Laita L, Medrano-de-la-Fuente R, Jimenez-Del Barrio S. Validation of the international classification of functioning, disability, and health (ICF) core sets for musculoskeletal conditions in a primary health care setting from physiotherapists' perspective using the Delphi method. Disabil Rehabil 2022:1-11. [PMID: 35830343 DOI: 10.1080/09638288.2022.2096128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
PURPOSE To analyze the possibilities of using ICF core sets for musculoskeletal conditions in primary care physiotherapy units of the Health Service of "Castilla y León" (Spain). METHODS A three-round Delphi study was conducted by physiotherapists working in a primary care setting. The data obtained were linked to second-level ICF categories and their relevance was assessed by the participants. The most relevant categories were compared with those present in the existing ICF core sets for musculoskeletal conditions. RESULTS Eighty-four physiotherapists participated in the survey. The consensus was reached for 45 ICF categories and 5 personal factors after the survey. Thirty-five of these categories were present in the Comprehensive Core Set for post-acute Musculoskeletal Conditions. In addition, 35 categories present in the core set were not considered relevant from the participants' perspective. CONCLUSIONS Physiotherapists mainly considered movement-related categories as relevant. The ICF core set for post-acute musculoskeletal conditions comprises many of these categories and can therefore be taken as a basis for the adoption of ICF in the clinical context. RELEVANCE Primary care physiotherapists should be aware of the advantages of using ICF in their clinical settings.Implications for RehabilitationThis study shows which body functions and structures, activities and participation, environmental factors, and personal characteristics are relevant from primary care physiotherapists' perspective assessing persons with musculoskeletal conditions.The Comprehensive ICF Core Set for Subacute Musculoskeletal Conditions includes most of the categories identified in this study, but they need to be refined to fully represent the primary care physiotherapists' perspective.The results of this study support the use of the Comprehensive ICF Core Set for Subacute Musculoskeletal Conditions as a basis for operationalizing ICF in this clinical setting.
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Affiliation(s)
- Hector Hernandez-Lazaro
- Ólvega Primary Care Health Center. Surgery, Ophthalmology, Otorhinolaryngology and Physical Therapy Department, University of Valladolid, Valladolid, Spain.,Castille and Leon Health Service, Soria, Spain
| | - Maria Teresa Mingo-Gómez
- Clinical Research in Health Sciences Group. Department of Surgery, Ophthalmology, Otorhinolaryngology and Physical Therapy, University of Valladolid, Valladolid, Spain
| | - Luis Ceballos-Laita
- Clinical Research in Health Sciences Group. Department of Surgery, Ophthalmology, Otorhinolaryngology and Physical Therapy, University of Valladolid, Valladolid, Spain
| | - Ricardo Medrano-de-la-Fuente
- Clinical Research in Health Sciences Group. Department of Surgery, Ophthalmology, Otorhinolaryngology and Physical Therapy, University of Valladolid, Valladolid, Spain
| | - Sandra Jimenez-Del Barrio
- Clinical Research in Health Sciences Group. Department of Surgery, Ophthalmology, Otorhinolaryngology and Physical Therapy, University of Valladolid, Valladolid, Spain
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Pathak A, Abbott HJ, Sharma S, Ribeiro DC, Heinemann AW. Content validity of the Brief and Comprehensive ICF Core Sets for common disabling conditions in a developing country. Int J Rehabil Res 2021; 44:159-165. [PMID: 33960972 DOI: 10.1097/mrr.0000000000000470] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The International Classification of Functioning, Disability and Health (ICF) features associated tools, the Brief and Comprehensive ICF Core Sets. These are designed to be universally applicable, but have limited evidence of content validity (i.e. comprehensiveness and relevance) in low income, non-Western countries. In this cross-sectional study, we aimed to assess the content validity of the ICF Core Sets in Nepal. We interviewed 161 participants with stroke, spinal cord injury (SCI), chronic obstructive pulmonary disease (COPD), and musculoskeletal conditions and asked them to identify activities they had difficulty performing due to their health condition. We mapped 544 participant responses to the ICF and assessed if these ICF categories were represented in the respective ICF core sets. The Comprehensive Core Sets for stroke, COPD, SCI, and musculoskeletal conditions contained more items identified by participants than the respective Brief Core Sets (e.g., 89% vs. 26% in stroke). Among ICF categories that represented at least 5% of participants' responses, the Brief Core Sets covered 40%-71% of participants' responses whereas the Comprehensive Core Sets covered 67%-100% of responses. This is the first study to evaluate the content validity of the ICF Brief and Comprehensive core sets in Nepali individuals with stroke, SCI, MSK conditions, and COPD. The Comprehensive Core Sets for stroke, COPD, and SCI have adequate content validity for use in clinical practice and research in Nepal; the Brief Core Sets may not adequately meet local and individual needs unless supplemented with additional ICF categories.
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Affiliation(s)
- Anupa Pathak
- Centre for Musculoskeletal Outcomes Research (CMOR), Department of Surgical Sciences, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Haxby J Abbott
- Centre for Musculoskeletal Outcomes Research (CMOR), Department of Surgical Sciences, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Saurab Sharma
- Centre for Musculoskeletal Outcomes Research (CMOR), Department of Surgical Sciences, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
- Department of Physiotherapy, Kathmandu University School of Medical Sciences, Dhulikhel, Nepal
| | - Daniel Cury Ribeiro
- Centre for Health, Activity, and Rehabilitation Research (CHARR), School of Physiotherapy, University of Otago, Dunedin, New Zealand
| | - Allen W Heinemann
- Department of Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine
- Center for Rehabilitation Outcomes Research, Shirley Ryan AbilityLab, Chicago, Illinois, USA
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Anttila H, Tallqvist S, Muñoz M, Leppäjoki-Tiistola S, Mäkitie O, Hiekkala S. Towards an ICF-based self-report questionnaire for people with skeletal dysplasia to study health, functioning, disability and accessibility. Orphanet J Rare Dis 2021; 16:236. [PMID: 34022932 PMCID: PMC8141148 DOI: 10.1186/s13023-021-01857-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 05/06/2021] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Little is known about the spectrum of everyday challenges that people with skeletal dysplasia face because of their health and functioning. We aimed to identify factors related to health, functioning and disability in people with skeletal dysplasia, and their challenges with accessibility in order to form a self-reported questionnaire for national data collection. The comprehensive musculoskeletal post-acute core set of the International Classification of Functioning, Disability and Health (ICF) was used as a framework. METHODS An iterative, participatory and qualitative process was used to formulate a questionnaire. Items were searched from Patient-Reported Outcomes Measurement Information System and from other self-report instruments, additional items were formulated using ICF linking rules. Expert panels from the target population assessed the face and content validity in thematic interviews. RESULTS The questionnaire demonstrated its relevance, comprehensiveness and feasibility for people with skeletal dysplasia. The ICF linkages showed the contents' correspondence to the construct. Expert panels added 15 categories and one on chapter level to the core set and confirmed content validity. The final survey covers 86 ICF categories and 173 ICF-linked items that were grouped to 33 questions. CONCLUSIONS The content of the questionnaire proved to be sufficiently valid for people with skeletal dysplasia. It can be used to explore their health, functioning, disability and accessibility to develop care and rehabilitation policies, to plan services and to provide information to various parties involved.
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Affiliation(s)
- Heidi Anttila
- Public Health and Welfare Department, Knowledge Management and Co-Creation Unit, Finnish Institute for Health and Welfare, Mannerheimintie 166, 01270, Helsinki, Finland.
| | | | - Minna Muñoz
- Validia Ltd, Validia Rehabilitation, Nordenskiöldinkatu 18 B, 00250, Helsinki, Finland
| | - Sanna Leppäjoki-Tiistola
- Lyhytkasvuiset - Kortväxta ry (Finnish Association for People with Restricted Growth and for Their Families), PO Box 14, 02601, Espoo, Finland
- Finnish Association of People With Physical Disabilities, Mannerheimintie 107, 00280, Helsinki, Finland
| | - Outi Mäkitie
- Children's Hospital, University of Helsinki and Helsinki University Hospital, P.O. Box 63, 00014, Helsinki, Finland
- Folkhälsan Institute of Genetics, Helsinki, Finland
| | - Sinikka Hiekkala
- Validia Ltd, Validia Rehabilitation, Nordenskiöldinkatu 18 B, 00250, Helsinki, Finland
- Finnish Association of People With Physical Disabilities, Mannerheimintie 107, 00280, Helsinki, Finland
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Fréz AR, Alouche SR, Binda AC, Vieira GW, Bueno BAM, Cabral CMN. Development of a Core Set for Knee Dysfunction Based on the International Classification of Functioning, Disability and Health: A Cross-sectional Study. Arch Phys Med Rehabil 2020; 102:571-581. [PMID: 33278366 DOI: 10.1016/j.apmr.2020.10.139] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Accepted: 10/28/2020] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To develop an International Classification of Functioning, Disability and Health core set for patients with knee dysfunction. DESIGN Cross-sectional study. SETTING The study was conducted at all levels of care (general community, primary care units, rehabilitation clinics/centers, hospital). PARTICIPANTS Participants (N=388) with knee dysfunction with or without clinical diagnosis of knee pathology, with or without complaint of pain, with or without instability, and/or with or without knee movement restriction of any type. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Participants were assessed using the core sets for acute and postacute musculoskeletal conditions, the subjective form from the International Knee Documentation Committee scale, the self-report of general health and functionality, and the general health and functionality classified by the researcher. To identify the categories that best explain knee dysfunction, linear regression analyses were performed. RESULTS Twenty-four categories were identified from the 75 core set categories for acute and postacute musculoskeletal conditions. Eleven categories belong to the component body functions, 3 represent body structures, 7 represent activities and participation, and 3 represent environmental factors. CONCLUSIONS A core set for knee dysfunction that can be used at all levels of health care was proposed, which offers a system for disability assessment related to knee dysfunction, including environmental and social factors. These factors are important for a broad assessment because they include the multiple aspects of functionality, usually not considered in other knee dysfunction assessment instruments. Further analysis of the content and construct validity of the core set is required.
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Affiliation(s)
- Andersom Ricardo Fréz
- Physical Therapy Department, Universidade Estadual do Centro-Oeste, Guarapuava, Paraná; Master's and Doctoral Program in Physical Therapy, Universidade Cidade de São Paulo, São Paulo, Brazil.
| | - Sandra Regina Alouche
- Master's and Doctoral Program in Physical Therapy, Universidade Cidade de São Paulo, São Paulo, Brazil
| | - Aline Cristiane Binda
- Physical Therapy Department, Universidade Estadual do Centro-Oeste, Guarapuava, Paraná
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Oliveira LRD, Macedo APFDS, Buchalla CM, Scatena JHG. Evolution of disability in traffic accident victims in rehabilitation, characterized by the International Classification of Functioning, Disability and Health (ICF). FISIOTERAPIA EM MOVIMENTO 2017. [DOI: 10.1590/1980-5918.030.002.ao07] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Abstract Introduction: The International Classification of Functioning, Disability and Health (ICF) enables monitoring of the clinical evolution of a patient. Objective: This study aimed to characterize the evolution of disabilities in patients undergoing physical therapy following traffic accidents, using the ICF. Methods: A longitudinal study of 53 accident victims was conducted between April and October 2010, in a rehabilitation unit in the capital of Mato Grosso State, Brazil. Data from physical therapy evaluation were collected in 2 stages and coded by the ICF. Results: The average time between evaluation and reevaluation was 73.4 days. The evolution of functional impairment demonstrated a reduction in the number of patients with deficits, except for muscle tone functions. On initial evaluation, 90.6% had difficulty with sensory functions and pain, varying from mild to complete, decreasing to 67.9% on reevaluation, with pain still mostly present. Almost all patients (96.2%) had a disability of neuromusculoskeletal and movement related functions on initial assessment, with a decrease to 15.7% of patients on reevaluation. The greatest improvements were observed in the categories of muscle strength (36.7%) and gait pattern (30.6%). On reevaluation, improvement was also observed regarding perceived impairment of body structures, especially for those with severe and complete disability. Conclusion: The study confirmed a reduction in the percentage of patients with some form of disability, and positive development in functional capacity. The use of ICF enabled evaluation of physical disabilities and monitoring of the evolution of patients undergoing physical therapy.
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Prodinger B, Cieza A, Oberhauser C, Bickenbach J, Üstün TB, Chatterji S, Stucki G. Toward the International Classification of Functioning, Disability and Health (ICF) Rehabilitation Set: A Minimal Generic Set of Domains for Rehabilitation as a Health Strategy. Arch Phys Med Rehabil 2016; 97:875-84. [DOI: 10.1016/j.apmr.2015.12.030] [Citation(s) in RCA: 80] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2015] [Revised: 12/22/2015] [Accepted: 12/24/2015] [Indexed: 11/29/2022]
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Towards the development of an outcome instrument for spinal trauma: an international survey of spinal surgeons. Spine (Phila Pa 1976) 2015; 40:E91-6. [PMID: 25575093 DOI: 10.1097/brs.0000000000000684] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN International web-based survey. OBJECTIVE To identify the most relevant aspects of human function and health status from the perspective of health care professionals involved in the treatment of spinal trauma patients. SUMMARY OF BACKGROUND DATA There is no universally accepted outcome instrument available that is specifically designed or validated for spinal trauma patients, contributing to controversies related to the optimal treatment and evaluation of many types of spinal injuries. Therefore, the AOSpine Knowledge Forum Trauma aims to develop such an instrument using the International Classification of Functioning, Disability, and Health (ICF) as its basis. METHODS Experts from the 5 AOSpine International world regions were asked to give their opinion on the relevance of a compilation of 143 ICF categories for spinal trauma patients on a 3-point scale: "not relevant," "probably relevant," or "definitely relevant." The responses were analyzed using frequency analysis. Possible differences in responses between the 5 world regions were analyzed with the Fisher exact test and descriptive statistics. RESULTS Of the 895 invited AOSpine International members, 150 (16.8%) participated in this study. A total of 13 (9.1%) ICF categories were identified as definitely relevant by more than 80% of the participants. Most of these categories were related to the ICF component "activities and participation" (n = 8), followed by "body functions" (n = 4), and "body structures" (n = 1). Only some minor regional differences were observed in the pattern of answers. CONCLUSION More than 80% of an international group of health care professionals experienced in the clinical care of adult spinal trauma patients indicated 13 of 143 ICF categories as definitely relevant to measure outcomes after spinal trauma. This study creates an evidence base to define a core set of ICF categories for outcome measurement in adult spinal trauma patients.
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Bölte S, de Schipper E, Holtmann M, Karande S, de Vries PJ, Selb M, Tannock R. Development of ICF Core Sets to standardize assessment of functioning and impairment in ADHD: the path ahead. Eur Child Adolesc Psychiatry 2014; 23:1139-48. [PMID: 24337412 PMCID: PMC4246121 DOI: 10.1007/s00787-013-0496-5] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2013] [Accepted: 11/09/2013] [Indexed: 11/06/2022]
Abstract
In the study of health and quality of life in attention deficit/hyperactivity disorder (ADHD), it is of paramount importance to include assessment of functioning. The International Classification of Functioning, Disability and Health (ICF) provides a comprehensive, universally accepted framework for the description of functioning in relation to health conditions. In this paper, the authors outline the process to develop ICF Core Sets for ADHD. ICF Core Sets are subgroups of ICF categories selected to capture the aspects of functioning that are most likely to be affected in specific disorders. The ICF categories that will be included in the ICF Core Sets for ADHD will be determined at an ICF Core Set Consensus Conference, wherein evidence from four preliminary studies (a systematic review, an expert survey, a patient and caregiver qualitative study, and a clinical cross-sectional study) will be integrated. Comprehensive and Brief ICF Core Sets for ADHD will be developed with the goal of providing useful standards for research and clinical practice, and to generate a common language for the description of functioning in ADHD in different areas of life and across the lifespan.
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Affiliation(s)
- Sven Bölte
- Neuropsychiatric Unit, Department of Women’s and Children’s Health, Center of Neurodevelopmental Disorders (KIND), Stockholm, Sweden
- Division of Child and Adolescent Psychiatry, Stockholm County Council, Stockholm, Sweden
| | - Elles de Schipper
- Neuropsychiatric Unit, Department of Women’s and Children’s Health, Center of Neurodevelopmental Disorders (KIND), Stockholm, Sweden
| | - Martin Holtmann
- LWL-University Hospital for Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Ruhr University Bochum, Hamm, Germany
| | - Sunil Karande
- Learning Disability Clinic, Department of Pediatrics, Seth G.S. Medical College & K.E.M. Hospital, Mumbai, India
| | - Petrus J. de Vries
- Division of Child and Adolescent Psychiatry, University of Cape Town, Cape Town, South Africa
| | - Melissa Selb
- ICF Research Branch in cooperation with the WHO Collaborating Centre for the Family of International Classifications in Germany (at DIMDI), Nottwil, Switzerland
- Swiss Paraplegic Research (SPF), Nottwil, Switzerland
| | - Rosemary Tannock
- Neurosciences and Mental Health Research Program, The Hospital for Sick Children, University of Toronto, Toronto, Canada
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Poltawski L, Abraham C, Forster A, Goodwin VA, Kilbride C, Taylor RS, Dean S. Synthesising practice guidelines for the development of community-based exercise programmes after stroke. Implement Sci 2013; 8:115. [PMID: 24079302 PMCID: PMC3851241 DOI: 10.1186/1748-5908-8-115] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2013] [Accepted: 09/28/2013] [Indexed: 12/02/2022] Open
Abstract
Background Multiple guidelines are often available to inform practice in complex interventions. Guidance implementation may be facilitated if it is tailored to particular clinical issues and contexts. It should also aim to specify all elements of interventions that may mediate and modify effectiveness, including both their content and delivery. We conducted a focused synthesis of recommendations from stroke practice guidelines to produce a structured and comprehensive account to facilitate the development of community-based exercise programmes after stroke. Methods Published stroke clinical practice guidelines were searched for recommendations relevant to the content and delivery of community-based exercise interventions after stroke. These were synthesised using a framework based on target intervention outcomes, personal and programme proximal objectives, and recommended strategies. Results Nineteen guidelines were included in the synthesis (STRIDES; STroke Rehabilitation Intervention-Development Evidence Synthesis). Eight target outcomes, 14 proximal objectives, and 94 recommended strategies were identified. The synthesis was structured to present best practice recommendations in a format that could be used by intervention programme developers. It addresses both programme content and context, including personal factors, service standards and delivery issues. Some recommendations relating to content, and many relating to delivery and other contextual issues, were based on low level evidence or expert opinion. Where opinion varied, the synthesis indicates the range of best practice options suggested in guidelines. Conclusions The synthesis may assist implementation of best practice by providing a structured intervention description that focuses on a particular clinical application, addresses practical issues involved in programme development and provision, and illustrates the range of best-practice options available to users where robust evidence is lacking. The synthesis approach could be applied to other areas of stroke rehabilitation or to other complex interventions.
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Affiliation(s)
- Leon Poltawski
- University of Exeter Medical School, Veysey Building, Salmon Pool Lane, Exeter EX2 4SG, UK.
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Author response. Phys Ther 2013; 93:1004-5. [PMID: 23977696 DOI: 10.2522/ptj.2013.93.7.1004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
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Yen TH, Liou TH, Chang KH, Wu NN, Chou LC, Chen HC. Systematic review of ICF core set from 2001 to 2012. Disabil Rehabil 2013; 36:177-84. [DOI: 10.3109/09638288.2013.782359] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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Randström KB, Asplund K, Svedlund M. Impact of environmental factors in home rehabilitation--a qualitative study from the perspective of older persons using the International Classification of Functioning, Disability and Health to describe facilitators and barriers. Disabil Rehabil 2011; 34:779-87. [PMID: 22004413 DOI: 10.3109/09638288.2011.619621] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE The aim of this study was to explore older people's experience of environmental factors that impact on their activity and participation in home rehabilitation. METHOD Older people aged between 68 and 93 years and receiving home rehabilitation were interviewed. A qualitative content analysis was performed on the interview text using the predetermined structure of the International Classification of Functioning, Disability and Health (ICF) environmental domain. The text was linked to the closest ICF category. RESULTS The results identified environmental facilitators and barriers that influenced activity and participation among older people receiving home rehabilitation. Approaches that provided a facilitative environment were access to assistive products and technologies, alterations to the physical environment, social support and relationships, and adjusted health and social care services. CONCLUSIONS A qualitative study using ICF-listed environmental factors contributed a holistic view of facilitators and barriers in home rehabilitation for older people. Awareness of the importance of the impact of the social environment on activities and participation could improve home rehabilitation services for older people. The study represents an important step towards a holistic approach using the ICF, which aims to enable all health care professionals to describe, plan and evaluate rehabilitation services together with older people across the health and social care sectors.
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Riberto M. Core sets da Classificação Internacional de Funcionalidade, Incapacidade e Saúde. Rev Bras Enferm 2011; 64:938-46. [DOI: 10.1590/s0034-71672011000500021] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2011] [Accepted: 09/06/2011] [Indexed: 11/21/2022] Open
Abstract
A Classificação Internacional de Funcionalidade, Incapacidade e Saúde (CIF) propõe um modelo de entendimento da funcionalidade humana que integra aspectos biomédicos, sociais e pessoais, além de homogeneizar a terminologia que descreve as condições incapacitantes relacionadas à saúde. Todavia, em virtude de sua complexidade e da grande quantidade de aspectos contemplados, foi necessário desenvolver instrumentos práticos baseados nela. Os core sets da CIF são conjuntos de categorias da CIF que descrevem a funcionalidade de pessoas com determinadas condições de saúde. Eles vêm sendo desenvolvidos em processos de consenso com representação multiprofissional e internacional. Os core sets podem ser resumidos ou abrangentes, conforme o uso por apenas um ou mais profissionais. Seu uso permite ao profissional de saúde avaliar aspectos não contemplados por qualquer outro instrumento de avaliação funcional, como os fatores ambientais.
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Kostanjsek N, Escorpizo R, Boonen A, Walsh NE, Üstün TB, Stucki G. Assessing the impact of musculoskeletal health conditions using the International Classification of Functioning, Disability and Health. Disabil Rehabil 2011; 33:1281-97. [DOI: 10.3109/09638288.2010.526165] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Brehm M, Bus SA, Harlaar J, Nollet F. A candidate core set of outcome measures based on the International Classification of Functioning, Disability and Health for clinical studies on lower limb orthoses. Prosthet Orthot Int 2011; 35:269-77. [PMID: 21937572 DOI: 10.1177/0309364611413496] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Although many core sets of measurement concepts have been published in the literature, this has not been done for the field of lower limb orthoses. OBJECTIVES This paper provides an overview of the measurement concepts that are relevant in lower limb orthotic evaluations, and it proposes a candidate Core Set of outcome measures to be used in clinical studies on ankle-foot orthoses (AFOs) and knee-ankle-foot orthoses (KAFOs). STUDY DESIGN Literature review. METHODS The International Classification of Functioning, Disability and Health (ICF) was used as framework to select relevant concepts. RESULTS AND CONCLUSION Measurement concepts covering all ICF levels of functioning were identified as relevant for the Core Set, including functions of the joints and bones (b710-b729), muscle functions (b730-b749), gait pattern functions (b770), walking (b450), moving around in different locations (d460), and daily-life functioning (d5-d9). Further validation of this candidate Core Set through a formal decision-making process is needed to obtain consensus among experts in the field. Based on such a consensus, the next step will be to systematically review the literature and identify those measurement instruments that are best suited to assess the proposed concepts, based on their psychometric properties in a given sample and context. Thereafter, we suggest that this ICF Core Set of measurement instruments should be applied in orthotic studies on AFOs and KAFOs in ambulatory patients with gait problems. CLINICAL RELEVANCE Although many ICF Core Sets have been published, this has not been done for the field of lower limb orthoses. We feel that such a Core Set is urgently needed, to enable comparison of results, and establish evidence on the efficacy of orthotic treatment, which will improve patient care.
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Affiliation(s)
- Merel Brehm
- Department of Rehabilitation Medicine, Academic Medical Center, University of Amsterdam, The Netherlands.
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Pettersson I, Pettersson V, Frisk M. ICF from an occupational therapy perspective in adult care: an integrative literature review. Scand J Occup Ther 2011; 19:260-73. [DOI: 10.3109/11038128.2011.557087] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Escorpizo R, Ekholm J, Gmünder HP, Cieza A, Kostanjsek N, Stucki G. Developing a Core Set to describe functioning in vocational rehabilitation using the international classification of functioning, disability, and health (ICF). JOURNAL OF OCCUPATIONAL REHABILITATION 2010; 20:502-511. [PMID: 20514511 DOI: 10.1007/s10926-010-9241-9] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
INTRODUCTION The consequences of accidents, injuries, and health conditions that prevent workers from engaging in employment are prevailing issues in the area of work disability. Vocational rehabilitation (VR) programs aim to facilitate return-to-work process but there is no universal description of functioning for patients who participate in VR. Our objective is to develop a Core Set for VR based on the international classification of functioning, disability, and health (ICF). An ICF Core Set is a short list of ICF categories with alphanumeric codes relevant to a health condition or a health-related event. METHODS Development process consists of three phases. First is the preparatory phase which consists of four parallel studies: (1) systematic review of the literature, (2) worldwide survey of experts, (3) cross-sectional study, and (4) focus group interview. Patients with various health conditions are to be recruited from five VR centers located in Switzerland and Germany. The second phase is a consensus conference where findings from the preparatory phase will be presented followed by a multi-stage consensus process to determine the ICF categories that will comprise the Core Set for VR. The final phase consists of validation studies in several health conditions and settings. CONCLUSIONS We expect the first version of the ICF Core Set for VR to be completed in 2010. The Core Set can serve as a guide in the evaluation of patients and in planning appropriate intervention within VR programs. This Core Set could also provide a standard and common language among clinicians, researchers, insurers, and policymakers in the implementation of successful VR.
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Affiliation(s)
- Reuben Escorpizo
- Department of Health Sciences and Health Policy, University of Lucerne, Lucerne, Switzerland.
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Cerniauskaite M, Quintas R, Boldt C, Raggi A, Cieza A, Bickenbach JE, Leonardi M. Systematic literature review on ICF from 2001 to 2009: its use, implementation and operationalisation. Disabil Rehabil 2010; 33:281-309. [PMID: 21073361 DOI: 10.3109/09638288.2010.529235] [Citation(s) in RCA: 162] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
PURPOSE To present a systematic literature review on the state of the art of the utilisation of the International Classification of Functioning, Disability and Health (ICF) since its release in 2001. METHOD The search was conducted through EMBASE, MEDLINE and PsychInfo covering the period between 2001 and December 2009. Papers were included if ICF was mentioned in title or abstract. Papers focussing on the ICF-CY and clinical research on children and youth only were excluded. Papers were assigned to six different groups covering the wide scenario of ICF application. RESULTS A total of 672 papers, coming from 34 countries and 211 different journals, were included in the analysis. The majority of publications (30.8%) were conceptual papers or papers reporting clinical and rehabilitation studies (25.9%). One-third of the papers were published in 2008 and 2009. CONCLUSIONS The ICF contributed to the development of research on functioning and on disability in clinical, rehabilitation as well as in several other contexts, such as disability eligibility and employment. Diffusion of ICF research and use in a great variety of fields and scientific journals is a proof that a cultural change and a new conceptualisation of functioning and disability is happening.
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Affiliation(s)
- Milda Cerniauskaite
- Neurology, Public Health and Disability Unit-Scientific Directorate, Neurological Institute C. Besta IRCCS Foundation, Milan, Italy
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Stadhouder A, Buckens CFM, Holtslag HR, Öner FC. Are existing outcome instruments suitable for assessment of spinal trauma patients? J Neurosurg Spine 2010; 13:638-47. [DOI: 10.3171/2010.5.spine09128] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Object
Valid outcome assessment tools specific for spinal trauma patients are necessary to establish the efficacy of different treatment options. So far, no validated specific outcome measures are available for this patient population. The purpose of this study was to assess the current state of outcome measurement in spinal trauma patients and to address the question of whether this group is adequately served by current disease-specific and generic health-related quality-of-life instruments.
Methods
A number of widely used outcome measures deemed most appropriate were reviewed, and their applicability to spinal trauma outcome discussed. An overview of recent movements in the theoretical foundations of outcome assessment, as it pertains to spinal trauma patients has been attempted, along with a discussion of domains important for spinal trauma.
Commonly used outcome measures that are recommended for use in trauma patients were reviewed from the perspective of spinal trauma. The authors further sought to select a number of spine trauma–relevant domains from the WHO's comprehensive International Classification of Functioning, Disability and Health (ICF) as a benchmark for assessing the content coverage of the commonly used outcome measurements reviewed.
Results
The study showed that there are no psychometrically validated outcome measurements for the spinal trauma population and there are no commonly used outcome measures that provide adequate content coverage for spinal trauma domains.
Conclusions
Spinal trauma patients are currently followed either as a subset of the polytrauma population in the acute and early postacute setting or as a subset of neurological injury in the long-term revalidation medicine setting.
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Affiliation(s)
| | | | - Herman R. Holtslag
- 2Rehabilitation & Sports Medicine, University Medical Center Utrecht, The Netherlands
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Creating an interface between the International Classification of Functioning, Disability and Health and physical therapist practice. Phys Ther 2010; 90:1053-63. [PMID: 20448104 DOI: 10.2522/ptj.20090326] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The American Physical Therapy Association (APTA) has endorsed the International Classification of Functioning, Disability and Health (ICF) as a framework to be integrated into physical therapist practice. The ICF is a universal and inclusive platform for the understanding of health and disability and a comprehensive classification system for describing functioning. The APTA's Guide to Physical Therapist Practice was designed to guide patient management, given the different settings and health conditions that physical therapists encounter in their daily clinical practice. However, physical therapists may be unclear as to how to concretely apply the ICF in their clinical practice and to translate the application in a way that is meaningful to them and to their patients. This perspective article proposes ways to integrate the ICF and the Guide to Physical Therapist Practice to facilitate clinical documentation by physical therapists.
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Comparison of the ICF core set for cardiopulmonary conditions in the acute hospital setting among different types of transplant patients. Int J Rehabil Res 2010; 33:325-31. [PMID: 20571411 DOI: 10.1097/mrr.0b013e32833ba58a] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
To compare the functioning profiles of patients receiving different types of organ transplants using the International Classification of Functioning, Disability, and Health. The patients (n =102) were enrolled between days 5 and 10 after discharge following receipt of an organ transplant,and assessed for sociodemographic variables, the Functional Independence Measure and Barthel Index, and the International Classification of Functioning, Disability,and Health core set for cardiopulmonary conditions in the acute hospital, augmented with three additional categories.Analysis was conducted by grouping the patients as follows: (1) kidney transplants; (2) all other kinds of transplants. Functional Independence Measure/Barthel Index scores were significantly higher in group 1 compared with group 2. Prevalences of 30% or greater for any impairment were noted for seven b factors, one s factor,and one d factor in group 1, whereas the corresponding numbers for group 2 were 14, 2, and 8, respectively. When prevalences of 30% or greater were calculated for severe or total impairment for all factors, there were none for group 1, but six factors for group 2. For the six factors, the prevalence difference between the groups was significant in five after a full Bonferroni correction (P < 0.000002). The factors with the highest barriers were e110 (products or substances for personal consumption, 36%) and e120(products and technology for personal use in daily living,42%) in group 2 (both significant with P < 0.000001 when compared with the respective prevalences in group 1).Although exercise seems to be the most needed rehabilitation function for kidney transplant patients, other transplant patients will require considerably more rehabilitation intervention.
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Allet L, Bürge E, Monnin D. ICF: Clinical relevance for physiotherapy? A critical review. ACTA ACUST UNITED AC 2009. [DOI: 10.1080/14038190802315941] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Maini M, Nocentini U, Prevedini A, Giardini A, Muscolo E. An Italian experience in the ICF implementation in rehabilitation: Preliminary theoretical and practical considerations. Disabil Rehabil 2009; 30:1146-52. [DOI: 10.1080/09638280701478397] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Kohler F, Cieza A, Stucki G, Geertzen J, Burger H, Dillon MP, Schiappacasse C, Esquenazi A, Kistenberg RS, Kostanjsek N. Developing Core Sets for persons following amputation based on the International Classification of Functioning, Disability and Health as a way to specify functioning. Prosthet Orthot Int 2009; 33:117-29. [PMID: 19367515 DOI: 10.1080/03093640802652029] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Amputation is a common late stage sequel of peripheral vascular disease and diabetes or a sequel of accidental trauma, civil unrest and landmines. The functional impairments affect many facets of life including but not limited to: Mobility; activities of daily living; body image and sexuality. Classification, measurement and comparison of the consequences of amputations has been impeded by the limited availability of internationally, multiculturally standardized instruments in the amputee setting. The introduction of the International Classification of Functioning, Disability and Health (ICF) by the World Health Assembly in May 2001 provides a globally accepted framework and classification system to describe, assess and compare function and disability. In order to facilitate the use of the ICF in everyday clinical practice and research, ICF core sets have been developed that focus on specific aspects of function typically associated with a particular disability. The objective of this paper is to outline the development process for the ICF core sets for persons following amputation. The ICF core sets are designed to translate the benefits of the ICF into clinical routine. The ICF core sets will be defined at a Consensus conference which will integrate evidence from preparatory studies, namely: (a) a systematic literature review regarding the outcome measures of clinical trails and observational studies, (b) semi-structured patient interviews, (c) international experts participating in an internet-based survey, and (d) cross-sectional, multi-center studies for clinical applicability. To validate the ICF core sets field-testing will follow. Invitation for participation: The development of ICF Core Sets is an inclusive and open process. Anyone who wishes to actively participate in this process is invited to do so.
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Affiliation(s)
- Friedbert Kohler
- Department of Rehabilitation Medicine, Braeside Hospital, Wetherill Park, Australia.
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Mease PJ. Assessing the Impact of Psoriatic Arthritis on Patient Function and Quality of Life: Lessons Learned from Other Rheumatologic Conditions. Semin Arthritis Rheum 2009; 38:320-35. [DOI: 10.1016/j.semarthrit.2008.01.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2007] [Revised: 11/20/2007] [Accepted: 01/05/2008] [Indexed: 11/28/2022]
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Dixon D, Johnston M, McQueen M, Court-Brown C. The Disabilities of the Arm, Shoulder and Hand Questionnaire (DASH) can measure the impairment, activity limitations and participation restriction constructs from the International Classification of Functioning, Disability and Health (ICF). BMC Musculoskelet Disord 2008; 9:114. [PMID: 18715495 PMCID: PMC2533660 DOI: 10.1186/1471-2474-9-114] [Citation(s) in RCA: 86] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2008] [Accepted: 08/20/2008] [Indexed: 11/10/2022] Open
Abstract
Background The International Classification of Functioning, Disability and Health (ICF) model of the consequences of disease identifies three health outcomes, impairment, activity limitations and participation restrictions. However, few orthopaedic health outcome measures were developed with reference to the ICF. This study examined the ability of a valid and frequently used measure of upper limb function, namely the Disabilities of the Arm, Shoulder and Hand Questionnaire (DASH), to operationalise the ICF. Methods Twenty-four judges used the method of Discriminant Content Validation to allocate the 38 items of the DASH to the theoretical definition of one or more ICF outcome. One-sample t-tests classified each item as measuring, impairment, activity limitations, participation restrictions, or a combination thereof. Results The DASH contains items able to measure each of the three ICF outcomes with discriminant validity. The DASH contains five pure impairment items, 19 pure activity limitations items and three participation restriction items. In addition, seven items measured both activity limitations and participation restrictions. Conclusion The DASH can measure the three health outcomes identified by the ICF. Consequently the DASH could be used to examine the impact of trauma and subsequent interventions on each health outcome in the absence of measurement confound.
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Affiliation(s)
- Diane Dixon
- Department of Psychology, University of Stirling, Stirling, Scotland, UK.
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Mueller M, Boldt C, Grill E, Strobl R, Stucki G. Identification of ICF categories relevant for nursing in the situation of acute and early post-acute rehabilitation. BMC Nurs 2008; 7:3. [PMID: 18282288 PMCID: PMC2276191 DOI: 10.1186/1472-6955-7-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2007] [Accepted: 02/18/2008] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND The recovery of patients after an acute episode of illness or injury depends both on adequate medical treatment and on the early identification of needs for rehabilitation care. The process of early beginning rehabilitation requires efficient communication both between health professionals and the patient in order to effectively address all rehabilitation goals. The currently used nursing taxonomies, however, are not intended for interdisciplinary use and thus may not contribute to efficient rehabilitation management and an optimal patient outcome. The ICF might be the missing link in this communication process. The objective of this study was to identify the categories of the International Classification of Functioning, Disability and Health (ICF) categories relevant for nursing care in the situation of acute and early post-acute rehabilitation. METHODS First, in a consensus process, "Leistungserfassung in der Pflege" (LEP) nursing interventions relevant for the situation of acute and early post-acute rehabilitation were selected. Second, in an integrated two-step linking process, two nursing experts derived goals of LEP nursing interventions from their practical knowledge and selected corresponding ICF categories most relevant for patients in acute and post-acute rehabilitation (ICF Core Sets). RESULTS Eighty-seven percent of ICF Core Set categories could be linked to goals of at least one nursing intervention variable of LEP. The ICF categories most frequently linked with LEP nursing interventions were respiration functions, experience of self and time functions and focusing attention. Thirteen percent of ICF Core Set categories could not be linked with LEP nursing interventions. The LEP nursing interventions which were linked with the highest number of different ICF-categories of all were "therapeutic intervention", "patient-nurse communication/information giving" and "mobilising". CONCLUSION The ICF Core Sets for the acute hospital and early post-acute rehabilitation facilities are highly relevant for rehabilitation nursing. Linking nursing interventions with ICF Core Set categories is a feasible way to analyse nursing. Using the ICF Core Sets to describe goals of nursing interventions both facilitates inter-professional communication and respects patient's needs. The ICF may thus be a useful framework to set nursing intervention goals.
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Affiliation(s)
- Martin Mueller
- ICF Research Branch, WHO FIC Collaborating Center (DIMDI), Institute for Health and Rehabilitation Sciences, Ludwig-Maximilians-Universität, Munich, Germany
| | - Christine Boldt
- Swiss Paraplegic Research, Guido A Zaech Institute, Nottwil, Switzerland
| | - Eva Grill
- ICF Research Branch, WHO FIC Collaborating Center (DIMDI), Institute for Health and Rehabilitation Sciences, Ludwig-Maximilians-Universität, Munich, Germany
| | - Ralf Strobl
- ICF Research Branch, WHO FIC Collaborating Center (DIMDI), Institute for Health and Rehabilitation Sciences, Ludwig-Maximilians-Universität, Munich, Germany
| | - Gerold Stucki
- ICF Research Branch, WHO FIC Collaborating Center (DIMDI), Institute for Health and Rehabilitation Sciences, Ludwig-Maximilians-Universität, Munich, Germany
- Swiss Paraplegic Research, Guido A Zaech Institute, Nottwil, Switzerland
- Department of Physical Medicine and Rehabilitation, University Hospital Munich, Ludwig-Maximilians-Universität, Munich, Germany
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Braun J, Zochling J, Grill E, Liman W, Stucki G. Die Internationale Klassifikation für Funktionsfähigkeit, Behinderung und Gesundheit und ihre Bedeutung für die Rheumatologie. Z Rheumatol 2007; 66:603-6, 608-10. [PMID: 17704927 DOI: 10.1007/s00393-007-0188-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The international classification of functioning, disability and health (ICF) has been developed by the World Health Organization (WHO) to describe health and handicaps in more detail in order to allow better classification and registration. The ICF comprises the disease, structure, functioning, activity and participation as well as corresponding factors related to the individual and the environment. By this means an integrated concept and assessment of biologic, individual and social aspects of health is attained. The ICF represents an essential addition to the international classification of diagnoses (ICD) and procedures (OPS). The ICF consists of two interelated parts. The first part that describes functioning and disability contains two components: one related to the body (functioning and structure) and one related to activity and participation. The second part describes the context factors (related to the environment and the individual). Body functions are the physical and mental functions of the organism. Body structures are the anatomically defined parts of the body. Activity describes how a task is solved or how an action can be performed and participation is the way in which an individual is involved in the environment and society. The ICF categories make the classification of all aspects of functioning and health in individuals easier and independent of diseases or specific assessment instruments. However, since there are more than 1,400 categories, the ICF cannot be used in daily practice in this form. Therefore, attempts are made to identify those parts of the ICF that are relevant for specific patients, situations and disease states or activities. These are the so-called ICF core sets. This article attempts to give an overview on the ICF, to provide an insight into recent work on the ICF related to musculoskeletal and rheumatic diseases and, finally, to describe how an ICF core set for patients with acute arthritis was made possible by means of a successful multicenter cooperative effort.
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Affiliation(s)
- J Braun
- Rheumazentrum Ruhrgebiet, Landgrafenstrasse 15, 44652 Herne, Deutschland.
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Biering-Sørensen F, Scheuringer M, Baumberger M, Charlifue SW, Post MWM, Montero F, Kostanjsek N, Stucki G. Developing core sets for persons with spinal cord injuries based on the International Classification of Functioning, Disability and Health as a way to specify functioning. Spinal Cord 2006; 44:541-6. [PMID: 16955074 DOI: 10.1038/sj.sc.3101918] [Citation(s) in RCA: 82] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE The objective of this paper is to outline the proposed development process for the ICF Core Sets for Spinal Cord Injury (SCI) and to invite clinical and consumer experts to actively participate in this process. ICF Core Sets are selections of categories of the International Classification of Functioning, Disability and Health (ICF) that are relevant to persons with a specific condition or in a specific setting. METHOD The project is a cooperation between the ICF Research Branch of the World Health Organization (WHO) Collaboration Centre of the Family of International Classifications (DIMDI, Germany), the Classification, Assessment and Terminology (CAT) team and the Disability and Rehabilitation (DAR) team at WHO, the International Spinal Cord Society (ISCoS) and International Society for Physical and Rehabilitation Medicine (ISPRM) and partner institutions across the world. The project will consist of four worldwide studies to be conducted from 2006 to 2007 with a proposed ICF Core Set Consensus Conference to be held in 2007. ICF categories relevant for SCI are to be identified by means of (I) an empirical study, (II) a systematic review of outcomes and measures used in SCI research (III) an expert survey and (IV) focus groups and semistructured interviews with persons with SCI. Consensus about items that have to be part of a Comprehensive and of a Brief ICF Core Set for SCI will be reached in a final ICF Core Set Consensus Conference. Subsequent field testing will be necessary to validate this first version of ICF Core Sets for SCI. INVITATION FOR PARTICIPATION The development of ICF Core Sets is an inclusive and open process. Anyone who wishes to actively participate in this process is invited to contact the project coordinator (Monika.Scheuringer@med.uni-muenchen.de or http://www.icf-research-branch.org/research/spinalcord-injuries.htm). Individuals, institutions and associations can be formally associated as partners of the project.
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Affiliation(s)
- F Biering-Sørensen
- Clinic for Spinal Cord Injuries, The Neuroscience Centre, Rigshospitalet, Copenhagen University hospital, Copenhagen, Denmark
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Abstract
PURPOSE OF REVIEW Disability (activity limitation) is an important and common health outcome for patients with osteoarthritis, making accurate measures essential. This paper explores self-report measures of activity limitation associated with osteoarthritis and reports on recent conceptual advances that impact on the measurement of activity limitation. RECENT FINDINGS The Western Ontario and McMaster Universities Osteoarthritis Index and the Short Form-36, the most commonly used measures to assess activity limitation, continue to be validated in osteoarthritis. There has been little consensus, however, about which measure to use across different types of osteoarthritis. While new measures have been developed to assess activity limitation, it remains unclear whether or not these are an improvement over existing measures. The International Classification of Functioning, Disability and Health is becoming an important consideration. Commonly used measures do not map directly onto individual constructs of this classification, however a new measure for Japanese people with knee osteoarthritis was developed based on these constructs. SUMMARY There have been significant developments in the conceptual approach to measuring activity limitation. Measures are needed that operationalize activity limitation as defined by the International Classification of Functioning, Disability and Health (within or ideally across cultures), providing a common underlying construct for measures and hence facilitating comparability across studies.
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Affiliation(s)
- Beth Pollard
- School of Psychology, University of Aberdeen, William Guild Building, Aberdeen, UK.
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Finger ME, Cieza A, Stoll J, Stucki G, Huber EO. Identification of intervention categories for physical therapy, based on the international classification of functioning, disability and health: a Delphi exercise. Phys Ther 2006; 86:1203-20. [PMID: 16959669 DOI: 10.2522/ptj.20050134] [Citation(s) in RCA: 62] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
BACKGROUND AND PURPOSE Disability or limitations in human functioning are universal experiences that concern all people. Physical therapists aim to improve functioning and prevent disability. With the approval of the new International Classification of Functioning, Disability and Health (ICF), we can now rely on a globally recognized framework and classification to be used in different health care situations by all health care professionals in multidisciplinary teams. The objective of this study was to identify ICF categories that describe the most relevant and common patient problems managed by physical therapists in acute, rehabilitation, and community health care situations taking into account 3 major groups of health conditions: musculoskeletal, neurological, and internal. SUBJECTS The subjects were physical therapists who were identified as possible participants by the heads of physical therapy departments who were members of the Swiss Association of Physical Therapy Department Heads or who were recruited from the membership of the Swiss Association of Physiotherapy. METHODS A consensus-building, 3-round, electronic-mail survey with 9 groups of physical therapists was conducted using the Delphi technique. RESULTS Two hundred sixty-three physical therapists participated in at least one round of the Delphi exercise. They had consensus levels of 80% or higher for categories in all ICF components (Body Functions, Body Structures, Activities and Participation, and Environmental Factors 1 and 2). DISCUSSION AND CONCLUSION This study is a first step toward identifying a list of intervention categories relevant for physical therapy according to the ICF. The ICF, designed as a common language for multidisciplinary use, is also a very helpful framework for defining the core competence for the physical therapy profession.
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Grill E, Stucki G, Scheuringer M, Melvin J. Validation of International Classification of Functioning, Disability, and Health (ICF) Core Sets for Early Postacute Rehabilitation Facilities. Am J Phys Med Rehabil 2006; 85:640-9. [PMID: 16865018 DOI: 10.1097/01.phm.0000228537.17239.7f] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Short lists of International Classification of Functioning, Disability, and Health (ICF) categories, ICF Core Sets, have been developed as reference standards for clinical practice and research. The objective of this study was to validate the ICF Core Sets for early postacute rehabilitation facilities against the measures most commonly used in early postacute rehabilitation, the FIM instrument, the Functional Assessment Measure, and the Barthel index. DESIGN Linking study matching the concepts of three commonly used outcome measures to corresponding ICF categories. RESULTS Corresponding ICF categories could be found for all of the items of the FIM instrument + Functional Assessment Measure and Barthel index. The 40 items of these three measures were linked to 33 different ICF categories. Four items could be linked to ICF categories that were not part of any of the Postacute ICF Core Sets. CONCLUSIONS The Postacute ICF Core Sets cover the concepts of the most frequently used measures in early postacute rehabilitation. Yet, many aspects of human functioning are not measured by the FIM instrument + Functional Assessment Measure and the Barthel index. If this information is considered relevant, these items would have to be added by using supplementary measures. Our comparison demonstrates the benefit of using a common language when comparing items using different wordings and concepts.
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Affiliation(s)
- Eva Grill
- ICF Research Branch, WHO FIC Collaborating Center (DIMDI), Institute for Health and Rehabilitation Sciences, Munich, Germany
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