To evaluate the Comprehensive International Classification of Functioning, Disability and Health (ICF) Core Set for multiple sclerosis with regard to the Brief ICF Core Set for multiple sclerosis.
...Descriptive cross-sectional single-centre study.
A total of 151 participants (99 females/52 males, mean age 49 years) referred for work ability assessment.
Data were collected from clinical recordings and by telephone interview.
Among 33 Body Functions, 14 were impaired in over 60% of the participants, and 6 in over 75%. These 6 most impaired functions were related to exercise tolerance (b455), urination (b620), muscle power (b730), motor reflex (b750), control of voluntary movement (b760) and gait pattern (b770). Among 54 Activities and Participation categories, 8 were impaired in over 60% of the participants, and 3 were impaired in over 75%. The latter activities were related to walking (d450), moving around (d455) and moving around using equipment (d465). Among the 36 Environmental categories, most were facilitators, except for temperature (e2250) and employment (e590). The latter category was both a facilitator and a barrier.
These results suggest additional categories that should be included into the Brief ICF Core Set, to improve its representation of the complex disability of multiple sclerosis.
The International Classification of Functioning, Disability and Health (ICF) is part of the Family of International Classifications of the World Health Organization (WHO) and acts as a tool for ...describing and organizing information about the functioning and disability of people with and without disabilities, providing a language standard. Marajó is a region with infrastructure peculiarities and disabled people who face very specific and little-known challenges there.
Classify the mobility of people with physical disabilities in the Marajó archipelago according to the ICF.
Cross-sectional study, with a quantitative approach, referring to the activity profile of physical PCD residents in the municipalities of Marajó. The subjects were selected by convenience through the dissemination of the action in Basic Health Units visited by the group of the “Abrace o Marajó'' Project between August 2021 and January 2022. The participants underwent a structured interview where they answered an adapted checklist, based on the ICF biopsychosocial model, which provides a standardized language. The ICF data used are related to the “activity and participation” domains, with a focus on mobility.
The study included 51 physically disabled persons, with a predominance of age between 40 and 59 years (39.22%), men (54.90%), browns/mulattoes (62.75%). Most respondents had mobility problems, with 88.24% having difficulty walking (d450), 84.31% having difficulty lifting and carrying objects (d430), 78.43% having difficulty using transportation (d470), 64.71% using some locomotion device (d465), and 41.18% with impaired fine use of the hands (d440). These data suggest that the mobility deficit combined with the lack of accessibility may be one of the factors that most interfere with the lives of these participants, as it limits and/or restricts their participation in daily activities.
Disabled persons residing in Marajó have several limitations and/or restrictions on participation in day-to-day activities related to lack of mobility, the main limitations are those with the highest percentages, that is, walking, lifting, and carrying objects, and using means of transport. In this regard, it is vital to adopt public policies aimed at improving the infrastructure of streets and sidewalks in order to facilitate access for this population, thus promoting an increase in the level of activity and participation.
This study can contribute to the visibility of the needs of disabled persons who live in Marajó and the implementation of public policies to assist this population, as well as to understand their main difficulties and what accessibility measures can bring more autonomy.
Rehabilitation services are increasingly targeting involvement in daily life. Within the ICF this is referred to as participation. Questions regarding its conceptualization have been raised and a ...consensus is lacking.
In a first phase a critical review of the literature was performed to detect recurring conceptual problems in applying participation and to detect how researchers deal with these. This leaded in the second phase to a systematic review to identify how participation measures are operationalized.
Phase 1 resulted in possible solutions to overcome 4 recurring key-limitations: (1) how to deal with ambiguity and vagueness about the term itself, (2) how to differentiate between activity and participation (3) what is the current empirical knowledge about the subjective aspects of participation (4) what are the different ways to measure participation. Phase 2 resulted in 18 instruments operationalising participation in different ways: (a) unidimensional; the frequency of performing activities (b) unidimensional; the limitations in experiencing participation when performing activities (c) multidimensional; multiple subjective dimensions when performing activities and (d) multidimensional: objective and subjective dimensions.
Notwithstanding an increasing body-of-knowledge some issues still remain blurred and specifically how participation is measured is subject to debate. This leads to difficulties to use participation in clinical practice. However: insight in current body-of-knowledge and awareness of shortcomings might inspire professionals aiming it's application.
To classify short-term and long-term rehabilitation goals and analyse how they capture functioning in a biopsychosocial International Classification of Functioning, Disability and Health (ICF) ...perspective.
A retrospective study was conducted at two specialised outpatient multidisciplinary rehabilitation centres for polio survivors and accident victims. Rehabilitation goals extracted from patient journals were linked to the ICF according to linking rules.
One hundred patients were included. Four hundred and eighty-seven short-term and long-term rehabilitation goals were linked to the ICF. Fifty-seven per cent were linked to Activity and Participation, 22% to Body Functions, 1% to Body Structure, 4% to Environmental Factors, 4% to Personal Factors, whereas 11% were not defined and 1% was not covered. The identified categories covered all ICF domains. The most frequent categories for short-term goals were d450 "Walking" and d570 "Looking after one's health." For long-term goals, d850 "Remunerative Employment" and d920 "Recreation and Leisure" were the most frequent.
The study showed challenges in capturing all aspects of biopsychosocial functioning in rehabilitation goals, particularly Contextual Factors. This study indicates that rehabilitation goals capture capacity rather than performance. Further research could highlight if functioning is captured in the rehabilitation plan, and in this way include both capacity and performance.
Implications for rehabilitation
Health professionals in a post-acute or long-term rehabilitation setting should pay attention to capacity and performance when rehabilitation goals are set.
The rehabilitation plan should contain goals and a description of patient's contextual factors and both should be equally valued and combined in a description of functioning.
In a post-acute or long-term rehabilitation setting short-term and long-term goals are affected by the context. A longer rehabilitation intervention lead to goals linked to activity and participation.
Choosing the most appropriate patient‐reported outcome measure (PROM) for a clinical study is essential in order to achieve trustworthy results. This choice will depend on (a) the objective of the ...study and hence the research question; (b) the choice of a theoretical framework, such as the World Health Organization's International Classification of Functioning, Disability, and Health (ICF); (c) whether there currently is a PROM that possesses high content validity and high construct validity for the specific patient group and objective, and if not; (d) the decision on whether to use a suboptimal PROM or develop and validate a new PROM. This paper presents the steps that should be followed in order to assess the relevance of PROMs and suggests ways to enhance the choice depending on the goal of the study.
Autism spectrum disorder (ASD) is characterized by impairments in many functional areas requiring long-term interventions to promote autonomy. This study aims to map The Sensory Profile™ 2 (SP-2), ...one of the most widely used assessment tools in children with ASD, with the International Classification of Functioning, Disability and Health for Children and Youth (ICF-CY), developed by the World Health Organization (WHO). This will allow the identification of the functional dimensions covered by this instrument and the comparison with the ICF shortlist proposed for autism (ICF Core Set ICF-CS). The deductive content analysis described in the ICF Linking Rules was followed, along with a systematized process including statistical and reasoning techniques that could contribute to the improvement of ICF linking studies (Cohen's Kappa and percentage of agreement). 218 codes were identified, 71% of them were codes related to the body functions chapters, mainly linked to perceptual functions (b160), emotional functions (b152), and temperament and personality functions (b126). Concerning activities and participation chapters (29%) the most frequently used codes were: focusing attention (d160), carrying out daily routine (d230), and walking (d450). Even though the SP-2 items do not assess most of the functional features regarded as essential in the ASD ICF-CS, SP-2 encompasses a majority of problems concerning body functions. This instrument may be considered as part of a multidimensional assessment approach, to complement other sources that are more likely to assess activity and participation dimensions and guide a functional intervention.
Purpose: Pain is prevalent and affects functioning and quality of life of children with cerebral palsy (CP). However, pain in CP is under recognized. The International Classification of Functioning, ...Disabiity and Health (ICF) guides the selection of comprehensive chronic pain assessment tools. Our objectives were to identify measures addressing pain in children with CP, characterize the content of each measure using the ICF, and identify gaps and overlaps.
Materials and methods: Measures were identified from: (1) a systematic review of outcome measures (1998-2012) and (2) a scan of chronic pain measures (2013-2015). Included measures were those published in English, used in children and youth with CP, and contained an item/domain addressing pain. Constructs of the measures were linked to the ICF.
Results: Overall, 31 measures addressing chronic pain in CP were included. Considerable variability was found in the degree to which their content represented the ICF. Most of pain measures address pain intensity and pain location (body functions) as opposed to functional impact of pain (activities and participation).
Conclusions: Functional dimensions are poorly represented in pain measures. Our findings may guide the selection of measures for research and clinical needs for comprehensive chronic pain management in children with CP.
Implications for Rehabilitation
Chronic pain is prevalent among children with cerebral palsy and significantly interfere with functional activities.
To effectively manage chronic pain in children with cerebral palsy, measures capturing functional-based information need to be part of routine chronic pain assessment.
Nowadays, one of the fastest growing technique is an Insulated Concrete Form (ICF). It has advantages like cost-effective, less maintenance, soundproof, energy-efficient, waterproof and ...disaster-resistant. ICF wall panels are made by interlocking Fibre Cement Board (FCB) sheet which poured in placed concrete. In this study, the behaviour of the ICF wall panel under axial compression is examined with experimental and analytical methods. ICF wall panels cast with various thickness and dense FCB are tested under axial compression. ICF panels with 1.2gm3/cm dense FCB with changing width of 6mm and 10mm were casted for experimental analysis. The experiments were carried out in an universal testing machine with the capacity of 600 kN. The maximum peak load of 540 kN is observed in FCB of 10mm thick and the maximum displacement of 13mm is observed in FCB80 at the peak load. An analytical investigation is carried with Euler’s crippling load equation and an average variation of 12% is observed between analytical and experimental results. It is concluded that the ICF system of construction provides desirable plastic behaviour against axial compressive loading. Hence ICF is recommended for construction to get the maximum benefits of the wall while it reaches ultimate strain.
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