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BACKGROUND: There is willingness in Europe to implement the use of a biopsychosocial model such as the International Classification of Functioning, Disability and Health (ICF) for assessing work incapacity. OBJECTIVE: A preliminary study was conducted to investigate the perceptions of medical advisers on the value of structuring clients’ biopsychosocial information in an ICF-based report. METHOD: A sample (n = 101) received a perception questionnaire after watching two comparative videos based on a clinical case. Questions relating to work incapacity were also asked. The data was analysed using quantitative methods. Comments were also collected. RESULTS: Before knowing the ICF-based report, 61.96% of the respondents believed a return to work seems possible by providing adapted work or a different job. There is an increase of 8.69 pp (p-value: 0.077) after reading the report. Opening up the initial sample to more insurance physicians (n = 119), the difference is more significant (p-value: 0.012). Also, 71.9% of respondents believe they have a better view of the client’s biopsychosocial situation after reading the report. Respondents recognise the clinical and diagnostic relevance of ICF but say it cannot be used at the moment for various reasons, such as the time required or the need for a multidisciplinary team and effective coordination. Older respondents are less enthusiastic about the appropriateness of using ICF. CONCLUSION: The respondents identify an added value in having a biopsychosocial based-report. After learning about the report, more physicians see opportunities for professional re-integration than before. The medical advisers and their team must be strengthened and receive a clear role in order to empower them.

RESUMO Objetivo: investigar a associação entre força de preensão manual e capacidade funcional de pessoas com diabetes. Método: estudo observacional de corte transversal com 168 participantes atendidos num ambulatório de Curitiba, Brasil, em 2019. Coletaram-se dados clínicos, sociodemográficos, socioeconômicos e aplicados os protocolos: World Health Organization Disability Assessment Schedule; Timed Up and Go e dinamometria. Para a análise, foram ajustados modelos de regressão linear múltipla para as variáveis dependentes relativas à capacidade funcional. Resultados: observou-se incapacidade leve, mobilidade funcional limítrofe, e maior correlação entre a escala de mobilidade funcional e força de preensão manual (r=-0,384; p < 0,01). A força de preensão manual com outras covariáveis explicaram menos de 30% da variabilidade funcional. Conclusão: esses resultados contribuem para a resolutividade da prática clínica na medida em que evidenciam que a força muscular e a capacidade funcional devem ser consideradas na avaliação do paciente de forma combinada, tornando-a mais clara e abrangente. ABSTRACT Objective: to investigate the association between handgrip strength and functional capacity in people with diabetes. Method: observational cross-sectional study with 168 participants seen at an outpatient clinic in Curitiba, Brazil, in 2019. Clinical, sociodemographic, and socioeconomic data were collected, and the following protocols were applied: World Health Organization Disability Assessment Schedule; Timed Up and Go; and dynamometry. For the analysis, multiple linear regression models were adjusted for the dependent variables related to functional capacity. Results: we observed mild disability, borderline functional mobility, and higher correlation between functional mobility scale and handgrip strength (r=-0.384; p < 0.01). Handgrip strength with other covariates explained less than 30% of the functional variability. Conclusion: these results contribute to the problem-solving of clinical practice in that they show that muscle strength and functional capacity should be considered in the evaluation of the patient in combination, making it clearer and more comprehensive. RESUMEN Objetivo: investigar la asociación entre la fuerza de prensión manual y la capacidad funcional en personas con diabetes. Método: estudio observacional transversal con 168 participantes atendidos en una clínica ambulatoria en Curitiba, Brasil, en 2019. Se recogieron datos clínicos, sociodemográficos y socioeconómicos, y se aplicaron los siguientes protocolos: World Health Organization Disability Assessment Schedule; Timed Up and Go y dinamometría. Para el análisis, se ajustaron modelos de regresión lineal múltiple para las variables dependientes relacionadas con la capacidad funcional. Resultados: se observó una discapacidad leve, una movilidad funcional limítrofe y una mayor correlación entre la escala de movilidad funcional y la fuerza de prensión manual (r=-0,384; p < 0,01). La fuerza de prensión manual con otras covariables explicó menos del 30% de la variabilidad funcional. Conclusión: estos resultados contribuyen a la resolución de la práctica clínica, ya que muestran que la fuerza muscular y la capacidad funcional deben considerarse en la evaluación del paciente de forma combinada, haciéndola más clara y completa.

The human immunodeficiency virus (HIV) is responsible for the compromise of the immune system and a high number of hospitalizations. Considering the biopsychosocial (BPS) context of the individual, the International Classification of Functioning, Disability and Health (ICF) provides the maximum description of a health condition and the impact of interventions and service delivery for the physiotherapeutic process. The aim of this study was to build and validate a physical therapy assessment and functional classification instrument based on the ICF for hospitalized members of the HIV community. This is an observational, cross-sectional, and descriptive study based on the analysis of demand, elaboration, and improvement of the instrument and its validation with the consensus of a experts committee of physical therapists; they evaluated 58 items and the classification codes resulted in 0.858 overall Kappa value=strong agreement between assessments, all statistically significant (p-value0.80. The constructed instrument is valid for the evaluation and functional classification in the ICF model for hospitalized members of the HIV community, contributing to the physical therapy clinical practice in the hospital environment. RESUMEN El virus de la inmunodeficiencia humana (VIH) es responsable del deterioro del sistema inmunitario y de un elevado número de hospitalizaciones. Considerando el contexto biopsicosocial (BPS) del individuo, el proceso fisioterapéutico cuenta con la Clasificación Internacional del Funcionamiento, de la Discapacidad y de la Salud (CIF), que brinda la máxima descripción de una condición de salud y el impacto de las intervenciones y prestación de servicios. El objetivo de este estudio es construir y validar un instrumento de evaluación fisioterapéutica y clasificación funcional basado en el CIF para pacientes VIH hospitalizados. Se trata de un estudio observacional, transversal y descriptivo, realizado desde el análisis de la demanda, desarrollo y perfeccionamiento del instrumento y su validación con el consenso de un comité de fisioterapeutas especialistas que evaluaron 58 ítems y los códigos de clasificación, lo que resultó un valor kappa global 0,858=fuerte concordancia entre las evaluaciones, todas estadísticamente significativas (p0,80. El instrumento construido presenta validez para la evaluación y clasificación funcional en el modelo CIF para pacientes con VIH hospitalizados, lo que contribuye a la práctica clínica fisioterapéutica en el ámbito hospitalario. RESUMO O vírus da imunodeficiência humana (HIV - human immunodeficiency virus) é responsável pelo comprometimento do sistema imune e por um elevado número de hospitalizações. Considerando o contexto biopsicossocial (BPS) do indivíduo, o processo fisioterapêutico dispõe da Classificação Internacional de Funcionalidade, Incapacidade e Saúde (CIF), que fornece a máxima descrição de uma condição de saúde e o impacto das intervenções e prestação de serviços. O objetivo deste estudo é construir e validar um instrumento de avaliação fisioterapêutica e classificação funcional baseada na CIF para os pacientes HIV hospitalizados. Trata-se de um estudo observacional, transversal e descritivo realizado a partir da análise de demanda, elaboração e aprimoramento do instrumento e sua validação com o consenso de um comitê de fisioterapeutas especialistas que avaliaram 58 itens e os códigos de classificação, resultando no valor kappa geral de 0,858=concordância forte entre as avaliações, todas estatisticamente significativas (p0,80. O instrumento construído apresenta validade para a avaliação e classificação funcional no modelo da CIF para os pacientes HIV hospitalizados, contribuindo para a prática clínica fisioterapêutica no ambiente hospitalar.

Objectives: to investigate how social support for the nuclear family, extended family and extra-family influences the functioning indexes of the mothers of the State of São Paulo. Methods: data collection took place via an online form, posted in maternity groups on social networks. A structured questionnaire was used to identify the profile of the puerperal woman and her support network, as well as WHODAS 2.0 to assess functioning. Results: support of husband/partner (p=0.012), other family members (p=0.001), friends/neighbors (p=0.003) were translated into better functioning of puerperal woman, while virtual support (p=0.043) was related to worse rates in the domains contemplated by WHODAS 2.0. Regarding health professionals, the result was not significant (p=0.721), indicating a low frequency for this type of support (12%). Conclusions: the presence of support acted positively on the functioning of women in the puerperium.

RATIONALE, AIMS AND OBJECTIVES: Myotonic dystrophy type 1 (DM1) is a progressive multisystem disorder that requires a special focus on the delivery of health and rehabilitation. The aim of the study was to identify the needs and interventions in patients with DM1 referred to a national rehabilitation hospital and to illustrate the needs and interventions in relation to predefined subgroups of disease classification.METHOD: Electronic medical records from the period 2000-2019 of a randomized sample of patients with DM1 (N = 193) were reviewed to identify rehabilitation needs and interventions. The sample was classified into four subgroups of disease classifications. The number of identified needs and interventions were presented as medians and range, and differences between subgroups were illustrated by Kruskal-Wallis one-way analysis of variance. The needs were categorized using the International Classification of Functioning, Disability and Health (ICF).RESULTS: A total of 2099 needs and 2103 interventions were registered. The most frequent needs were coordination of healthcare services (480) and employment and income (363), while the most frequent interventions were counselling (835) and follow-up (386). Patients with congenital DM1 had the most needs and interventions per person. In relation to the ICF, the most registered needs were environmental factors (880) and activity and participation (848).CONCLUSION: All subgroups of patients with DM1 had a substantial number of needs and interventions related to coordinating and navigating within the healthcare system. The subgroup of patients with congenital DM1 had the most needs and interventions compared to the other subgroups.

Background Within preventive Child Health Care (CHC), the 360°CHILD-profile has been developed. This digital tool visualises and theoretically orders holistic health data in line with the International Classification of Functioning, Disability and Health. It is anticipated that evaluating the effectiveness of the multifunctional 360°CHILD-profile within the preventive CHC-context is complex. Therefore, this study aimed at investigating the feasibility of RCT procedures and the applicability of potential outcome measures for assessing the accessibility and transfer of health information. Methods During the first introduction of the 360°CHILD-profile in CHC practice, a feasibility RCT with an explanatory-sequential mixed methods design was executed. CHC professionals (n=38) recruited parents (n=30) who visited the CHC for their child (age 0–16). Parents were randomised to “care as usual” (n=15) or “care as usual with, in addition, the availability of a personalised 360°CHILD-profile during 6 months” (n=15). Quantitative data on RCT feasibility were collected on recruitment, retention, response, compliance rates and outcome data on accessibility and transfer of health information (n=26). Subsequently, thirteen semi-structured interviews (5 parents, 8 CHC professionals) and a member check focus group (6 CHC professionals) were performed to further explore and gain a deeper understanding of quantitative findings. Results Integration of qualitative and quantitative data revealed that the recruitment of parents by CHC professionals was problematic and influenced by organisational factors. The used randomisation strategy, interventions and measurements were executable within the setting of this specific study. The outcome measures showed skewed outcome data in both groups and a low applicability to measure accessibility and transfer of health information. The study revealed points to reconsider regarding the randomisation and recruitment strategy and measures in the next steps. Conclusions This mixed methods feasibility study enabled us to gain a broad insight into the feasibility of executing an RCT within the CHC context. Trained research staff should recruit parents instead of CHC professionals. Measures, potentially for evaluating 360°CHILD-profile’s effectiveness, need further exploration and thorough piloting before proceeding with the evaluation process. Overall findings revealed that executing an RCT within the context of evaluating 360°CHILD-profile’s effectiveness in the CHC setting will be much more complex, time-consuming and costly than expected. Thereby, the CHC context requires a more complex randomisation strategy than executed during this feasibility study. Alternative designs including mixed methods research must be considered for the next phases of the downstream validation process. Trial registration NTR6909; https://trialsearch.who.int/.

Moždani udar, iako nastupa naglo, u svojoj biti je kronično stanje. Morbiditet i mortalitet od moždanog udara i dalje su vrlo visoki, a onima koji su preživjeli moždani udar, u pravilu, potrebna je akutna bolnička skrb, koja se zatim nastavlja kroz subakutnu rehabilitaciju i u konačnici reintegraciju u zajednicu. Rehabilitacija se provodi timskim interdisciplinarnim pristupom. Usprkos uloženim naporima, još uvijek postoji mnogo nezadovoljenih potreba preživjelih koji su doživjeli moždani udar, počevši od dostupnosti akutne bolničke skrbi, potom dostupnosti i organizacije subakutne rehabilitacije te u konačnici od mogućnosti reintegracije u zajednicu. Rehabilitacija bi trebala započeti tijekom akutne bolničke skrbi unutar prvih 24 do 48 sati kroz ranu mobilizaciju bolesnika. U subakutnoj fazi ishod rehabilitacije izravno ovisi o broju sati dnevno provedenih u rehabilitacijskom programu. Za uspješan ishod rehabilitacije važno je individualno procijeniti oštećenje i funkciju pomoću specifičnih mjernih instrumenata, postaviti individualizirane ciljeve i sukladno tome izraditi plan rehabilitacije te pratiti učinkovitost rehabilitacijskog programa. Primarni cilj rehabilitacije je uspostavljanje samostalnosti u obavljanju aktivnosti svakodnevnog života. U radu su pregledno prikazani tijek rehabilitacije nakon moždanog udara, primarna i sekundarna oštećenja tjelesnih funkcija i struktura nakon moždanog udara, kao i ograničenja aktivnosti koja iz njih proizlaze, te osnovni principi njihove rehabilitacije., A stroke occurs abruptly, but it is in its essence a chronic condition. The stroke morbidity and mortality are still very high, and those surviving the stroke,in general,require acute hospital care, which then continues through subacute rehabilitation and ultimately reintegration into the community. Rehabilitation is carried out through a team interdisciplinary approach. Despite the efforts, there are still a lot of unmet needs of survivors who have suffered a stroke, starting with the availability of acute hospital care and subsequently by the availability and organisation of subacute rehabilitation and ultimately by the possibility of reintegration into the community. Rehabilitation should start during acute hospital care within the first 24 to 48 hours through early patient mobilisation. In the subacute phase, the outcome of rehabilitation directly depends on the number of hours per day spent in the rehabilitation program. For a successful outcome of rehabilitation, it is important to individually assess the damage and function using specific measuring instruments, and set individualised goals, and design a rehabilitation plan accordingly, and monitor the efficiency of rehabilitation program. The primary objective of rehabilitation is to establish independence in carrying out the activities of daily life. In the article the course of stroke rehabilitation, the primary and secondary damage to physical functions and structures after stroke, as well as the resulting limitations of activities, and principles of their rehabilitation are given.

THESIS ABSTRACT Name, surame: Bc. Kateřina Marková Thesis supervisor: MUDr. Bc. Petra Sládková, Ph. D. Title of thesis: Functional assesment of activities and participations according to the International Classification of Functioning, Disability and Health in patients with central hemiparesis Abstract: Functional independence and social integration, which are the domains of occupational therapy, are essential for the successful rehabilitation of patients. The International Classification of Functioning, Disability and Health can provide a suitable framework for functional assessment, not only for occupational therapists. The main aim of this thesis is a determination of the functional picture of selected patients with central hemiparesis. The secondary objectives encompass firstly a verification of pre- established hypotheses, and secondly, an evaluation of the influence of the Day Hospital of the General University Hospital in Prague on the functional abilities of patients with central hemiparesis. Primary research methods comprise in particular a quantitative data analysis and comparison; however, a qualitative analysis of texts or description are also utilized. The research retrospectively evaluates the results of the assessment of activities and participation and environmental factors in patients with...

This thesis describes the results of the longitudinal Mixed Methods research project with the aim to develop and evaluate a new tool for visualizing and theoretically ordering personalized health information of a child’s health situation: the 360°CHILD-profile. Promising results were found on validity, reliability and usability of the 360°CHILD-profile for relevant stakeholders (parents, youth, professionals and policy-makers). On the other hand, the project revealed substantial (mostly organizational) barriers within the preventive Child Health Care with regard to the implementation and evaluation process. Findings provided insight in how to get ready for implementation and how to evaluate performance of the promising 360°CHILD-profile. The quick overview on holistic health data, this tool provides, is likely to be time saving and enables a comprehensible transfer of health information to parents and youth. Most importantly, the 360°CHILD-profile specifically is designed to intuitively guide thought processes in line with a more personalized and participative child health care.

Resumo Introdução O Work Rehabilitation Questionnaire (WORQ) é um instrumento internacional baseado na Classificação Internacional de Funcionalidade, Incapacidade e Saúde para avaliar a capacidade funcional em pessoas com deficiência para o trabalho. Objetivo Realizar adaptação transcultural e análise da confiabilidade para a população brasileira. Métodos A adaptação transcultural consistiu em tradução, síntese das traduções, retrotraduções, análise do comitê de juízes, pré-teste e teste piloto. Os resultados foram obtidos pelo cálculo da taxa de concordância para equivalência semântica, idiomática, experiencial e conceitual. A confiabilidade foi testada por análise de estabilidade, equivalência e consistência interna por meio do cálculo de α-Cronbach e Coeficiente de Correlação Intraclasse (ICC). Resultados Participaram da primeira etapa 05 tradutores, 08 juízes e 14 possíveis usuários no pré-teste. A taxa de concordância foi menor que 90% apenas na equivalência idiomática, resultando em ajustes ortográficos sem alterar o construto do instrumento. A confiabilidade foi testada em 34 trabalhadores com deficiência, idade média de 40,3 (±4,2) anos, ambos os sexos, funcionários de uma instituição de ensino de São Paulo inseridos pela lei de cotas (8.213/91). A Consistência Interna apresentou valores superiores a 80% em todos os domínios e foi maior que 90% para o escore total. Após 15 dias da primeira avaliação, foram sorteados 20 desses participantes para reavaliação. O ICC para estabilidade foi 82,5% (p=0,008) e equivalência foi 95,4% (p80% in all domains and was >90% for the total score. Fifteen days after the first assessment, 20 of these participants were randomly selected for reassessment. The ICC values for stability and equivalence were 82.5% (p=0.008) and 95.4% (p

Bakgrund: En akut akillesseneruptur (ATR) resulterar i begränsning av funktion som kan kvarstå under lång tid. I litteraturen finns ett flertal reliabla och valida utvärderingsinstrument som används vid funktionsbedömningar efter ATR. Då osäkerhet angående lämpligt val av tester inför återgång i aktivitet/idrott föreligger finns ett behov av tydliga riktlinjer i fråga om kliniskt relevanta utvärderingsinstrument. Syfte: Syftet med studien var att identifiera kliniskt relevanta fysioterapeutiska utvärderingsinstrument för bedömning av funktion hos personer med akillesseneruptur samt kartlägga dessa utifrån ett validitets och reliabilitetperspektiv. Metod: En kartläggande litteraturstudie. Litteratursökningen genomfördes i databaserna PubMed, Cinahl och PEDro mellan 2023-02-07 – 2023-02-15 utifrån inklusionskriterierna: vuxna individer med akut ATR, artiklar publicerade 2013-2023, observations- och randomiserade kontrollerade studier. Av identifierade utvärderingsinstrument valdes 15 ut, baserat på kriterierna: frekvens, klinisk användbarhet samt kategorisering enligt ramverket International Classification of Functioning, Disability and Health (ICF). Valda utvärderingsinstrument kategoriserades enligt ICF samt granskades avseende reliabilitet och validitet om denna data fanns tillgänglig. Resultat: Totalt inkluderades 15 olika utvärderingsinstrument, såväl objektiva som subjektiva, för granskning utifrån reliabilitet och validitet. Fem av dessa visade både god reliabilitet och validitet samt klinisk användbarhet. Inga diagnosspecifika utvärderingsinstrument inom ICF-kategorierna personlighetsfaktorer och omgivningsfaktorer identifierades. Slutsats: Achilles Tendon Resting Angle (ATRA), Achilles Tendon Total Rupture Score (ATRS), Foot and Ankle Outcomes Score (FAOS), Heel-Rise Endurence och Heel-Rise Height är fem tillförlitliga utvärderingsinstrumnet att använda i klinik. Inför återgång till aktivitet/idrott är det nödvändigt att komplettera med idrottsspecifika utvärderingsinstrument samt instrument som utvärderar psykologiska faktorer. Background: An acute achilles tendon rupture (ATR) results in limitations of function that remains for a long time. There are several reliabel and valid outcome measures used in functional evaluation after ATR presented in the litterature. Due to uncertainties regarding which appropriate outcome measures to use for return to activities/sports there is a need for clinical guidelines. Purpose: The purpose was to identify physiotherapeutic outcome measures for the evaluation of function in people with achilles tendon ruptures and to chart these from a perspecive of reliability and validity. Method: A scoping review. A litterature search were performed in the databases PubMed, Cinahl and PEDro between 2023-02-07 – 2023-02-15 based on the inclusion criteria: adults with acute ATR, articles published between 2013-2023, clinical trials and randomized controlled trials. From identified outcome measures 15 were selected based on the criteria frequency, clinical usability and categorized by the theoretical framework International Classification of Functioning, Disability and Health (ICF). Selected outcome measures were categorized according to ICF and reviewed for republicity of results, if this data was available. Results: 15 outcome measures, both objective and subjective, were included for evaluation regarding reliability and validity. Five of these proved good reliability, validity and clinical usability. In the ICF categories, personal factors and environmental factors, no diagnose specific outcome measures were identified. Conclusion: Achilles Tendon Resting Angle (ATRA), Achilles Tendon Total Rupture Score (ATRS), Foot and Ankle Outcomes Score (FAOS), Heel-Rise Endurence och Heel-Rise Height are five reliable outcome measures to use in clinical practice. Before return to activities/sports it is necessary to add sportspecific outcome measures and evaluation of psychological factors.

Background Multi-grip myoelectric hand prostheses (MHPs), with five movable and jointed fingers, have been developed to increase functionality. However, literature comparing MHPs with standard myoelectric hand prostheses (SHPs) is limited and inconclusive. To establish whether MHPs increase functionality, we compared MHPs with SHPs on all categories of the International Classification of Functioning, Disability, and Health-model (ICF-model). Methods MHP users (N = 14, 64.3% male, mean age = 48.6 years) performed physical measurements (i.e., Refined Clothespin Relocation Test (RCRT), Tray-test, Box and Blocks Test, Southampton Hand Assessment Procedure) with their MHP and an SHP to compare the joint angle coordination and functionality related to the ICF-categories ‘Body Function’ and ‘Activities’ (within-group comparisons). SHP users (N = 19, 68.4% male, mean age = 58.1 years) and MHP users completed questionnaires/scales (i.e., Orthotics and Prosthetics Users’ Survey—The Upper Extremity Functional Status Survey /OPUS–UEFS, Trinity Amputation and Prosthesis Experience Scales for upper extremity/TAPES-Upper, Research and Development-36/RAND-36, EQ-5D-5L, visual analogue scale/VAS, the Dutch version of the Quebec User Evaluation of Satisfaction with assistive technology/D-Quest, patient-reported outcome measure to assess the preferred usage features of upper limb prostheses/PUF-ULP) to compare user experiences and quality of life in the ICF-categories ‘Activities’, ‘Participation’, and ‘Environmental Factors’ (between-group comparisons). Results ‘Body Function’ and ‘Activities’: nearly all users of MHPs had similar joint angle coordination patterns with an MHP as when they used an SHP. The RCRT in the upward direction was performed slower in the MHP condition compared to the SHP condition. No other differences in functionality were found. ‘Participation’: MHP users had a lower EQ-5D-5L utility score; experienced more pain or limitations due to pain (i.e., measured with the RAND-36). ‘Environmental Factors’: MHPs scored better than SHPs on the VAS-item holding/shaking hands. The SHP scored better than the MHP on five VAS-items (i.e., noise, grip force, vulnerability, putting clothes on, physical effort to control) and the PUF-ULP. Conclusion MHPs did not show relevant differences in outcomes compared to SHPs on any of the ICF-categories. This underlines the importance of carefully considering whether the MHP is the most suitable option for an individual taking into account the additional costs of MHPs.

Numerous tests employed to predict cardiac and functional status are expensive and not widely accessible for a considerable number of patients, particularly those diagnosed with Chagas disease (CD) residing in remote and endemic regions. To date, there is no knowledge of studies that have validated instruments that address functionality in an expanded way, including the biopsychosocial factors in patients with CD. This study aims to evaluate the psychometric properties of the World Health Organization Disability Assessment Schedule (WHODAS 2.0), in its 12-item shortened version (WHODAS-12) when applied to patients with CD. This is a cross-sectional study of a prospective cohort that follows individuals with CD (SaMi-Trop). Data collection took place between October 2019 and March 2020. In the interviews, sociodemographic information, life habits, clinical information, and indicators of disability measured by WHODAS-12 were collected. Descriptive analysis, internal consistency and construct validity of the instrument were performed. A total of 628 patients with CD were interviewed, most were women (69.5%), their mean age was of 57 years, and most declared an average self-perception of health (43.4%). The 12 items of WHODAS-12 were distributed into three factors, which together account for 61% of the variance. The Kaiser–Meyer–Olkin (KMO) index was 0.90, indicating adequacy of the sample for factor analysis. The internal consistency of the global scale showed alpha = 0.87. The percentage of incapacity was 16.05%, indicating mild incapacity for the evaluated patients. WHODAS-12 is a valid and reliable measure to assess the disability of the Brazilian population with CD.

Background Assessing prognosis is challenging for many physicians in various medical fields. Research shows that physicians who perform disability assessments consider six areas when evaluating a prognosis: disease, treatment, course of the disease, external information, patient-related and physician-related aspects. We administered a questionnaire to evaluate how physicians rate the importance of these six prognosis areas during work disability evaluation and to explore what kind of support they would like during prognosis assessment. Methods Seventy-six physicians scored the importance of 23 prognostic aspects distributed over six prognosis areas. Participants scored the importance of each aspect both “in general” and from the perspective of a case vignette of a worker with a severe degenerative disease. The questionnaire also covered needs and suggestions for support during the evaluation of prognoses. Results Medical areas that are related to the disease, or the treatment or course of the disease, appeared important (scores of 7.0–9.0), with less differing opinions among participants (IQR 1.0–3.0). Corresponding verbatim remarks supported the importance of disease and treatment as prognostic aspects. In comparison, patient- and physician-related aspects scored somewhat lower, with more variability (range 4.0–8.0, with IQR 2.0–5.0 for patient- and physician-related considerations). Participants indicated a need for a tool or online database that includes prognostic aspects and prognostic evidence. Conclusions Despite some variation in scores, the physicians rated all six prognosis areas as important for work disability evaluations. This study provides suggested aids to prognosis assessment, including an online support tool based on evidence-based medicine features.

Submitted by Nadir Basilio (nadirsb@uninove.br) on 2023-02-03T15:27:44Z No. of bitstreams: 1 Léia Cordeiro de Oliveira.pdf: 1043110 bytes, checksum: bccadca5743d81df127df35f7f461c8b (MD5) Made available in DSpace on 2023-02-03T15:27:44Z (GMT). No. of bitstreams: 1 Léia Cordeiro de Oliveira.pdf: 1043110 bytes, checksum: bccadca5743d81df127df35f7f461c8b (MD5) Previous issue date: 2022-12-01 BACKGROUND: The SATISPART-Stroke (SATIS-Stroke) is the most complete scale to assess satisfaction with activity and participation after stroke. However, its use was tested only through face-to-face interviews. OBJECTIVE: To verify the validity, reproducibility and feasibility of applying the SATIS-stroke by digital means. METHODS: Methodological study, with chronic stroke survivors, designed to validate two teleassessment modalities: self-completion of a digital form versus video call. In stage I, there was a face-to-face interview and two self-assessments, in which the participant completed the electronic form with the SATIS questions. Stage II took place 6-8 months after stage I, in which the SATIS-Stroke was replicated in person and via video call. The application order was randomized. RESULTS: A total of 95 participants were recruited, of which only 50 responded to the digital form (52.6% adherence). There were higher mean scores in the self-assessments by completing the digital form compared to the face-to-face assessment (mean difference (DM)= -0.36±0.93; p=0.009), however, with no difference between the scores of the self-assessments by completing the form. digital form. Excellent reliability was obtained in the test-retest of the self-assessment by completing the digital form (ICC2.1=0.77; 95%CI=0.60-0.87). In stage II, 50 individuals with stroke participated, with adequate reliability being observed when comparing face-to-face application vs. video call CCI2.1= 0.55; 95%CI: 0.21-0.74), with moderate correlation between the evaluation methods (r=0.43; p=0.02). Dispersion between assessments was within the limits of agreement. CONCLUSION: There was adequate validity and reliability in the assessment by digital means, with better adherence to assessment by video call. CONTEXTUALIZAÇÃO: A SATISPART-Stroke (SATIS-Stroke) é a escala mais completa para avaliar a satisfação de atividade e participação após Acidente Vascular Cerebral (AVC). Contudo, seu uso foi testado apenas por meio de entrevista presencial. OBJETIVO: Verificar a validade, reprodutibilidade e viabilidade da aplicação da SATIS-stroke por meios digitais. MÉTÓDOS: Estudo metodológico, com sobreviventes de AVC crônico, elaborado para validar duas modalidades de teleavaliação: autopreenchimento de formulário digital versus videochamada. Na etapa I houve entrevista presencial e duas autoavaliações, nas quais o participante realizava o autopreenchimento de formulário eletrônico com as perguntas da SATIS. A etapa II ocorreu após 6-8 meses da etapa I, na qual replicou-se a SATIS-Stroke presencialmente e por videochamada. A ordem de aplicação foi aleatorizada. RESULTADOS: Foram recrutados 95 participantes, destes, somente 50 indivíduos responderam ao formulário digital (adesão de 52,6%). Houve maiores médias de escores nas autoavaliações por preenchimento de formulário digital comparada à avaliação presencial (diferença das médias (DM)= -0,36±0,93; p=0,009), contudo, sem diferença entre as pontuações das autoavaliações por preenchimento de formulário digital. Excelente confiabilidade foi obtida no teste-reteste da autoavaliação por preenchimento de formulário digital (CCI2,1=0,77; 95%IC= 0,60-0,87). Na etapa II participaram 50 indivíduos com AVC, sendo observada adequada confiabilidade na comparação aplicação presencial vs videochamada CCI2,1= 0,55; IC95%: 0,21-0,74), com moderada correlação entre os métodos de avaliação (r=0.43; p=0,02). A dispersão entre as avaliações esteve dentro dos limites de concordância. CONCLUSÃO: Verificou-se adequada validade e confiabilidade na avaliação por meios digitais, com melhor adesão a avaliação por videochamada.

The International Classification of Functioning, Disability and Health (ICF) is a globally recognized classification for health components and health-related factors, which has been recommended by the World Health Organization for use in medical rehabilitation. In the practice of a rehabilitation doctor dealing with patients suffering from juvenile myoclonic epilepsy (JME), the ICF is used to establish a rehabilitation diagnosis and formulate the goal of rehabilitation, as well as to implement its basic principles. It provides better insight into a range of difficulties patients with JME might face at the level of personal health and in everyday life.

Aims To determine the most frequently utilized functional status assessment instruments for patients with brain tumors, compare their contents, using the International Classification of Functioning, Disability and Health (ICF), and their psychometric properties. Methods A scoping review was conducted to explore possible assessment instruments and summarize the evidence. A systematic literature search was performed for identification of the frequently used functional assessment tool in clinical trials in PubMed, ScienceDirect, and ProQuest databases. The content of most used instruments was linked to the ICF categories. The psychometric qualities of these assessment tools were systematically searched and analyzed. Results Nine most used assessment tools in clinical trials were identified. The most frequently used assessment instrument is the Karnofsky Performance Scale, which is developed for a general assessment of oncological patients. Out of four self-assessment tools, two were disease-specific (EORTC QLQ-BN20 and FACT-Br), EORTC QLQ-C30 has been shown good psychometric properties in patients with brain tumors as well as in patients with various oncological diseases, similar to the SF-36, it is used in patients with brain tumors as well as in patients with various diseases. The Functional Independence Measure and the Barthel Index were two objective assessment tools that described functioning, but two were neuropsychological tests (MMSE and Trial Making Test). Two hundred eighty-three meaningful concepts were identified and linked to 102 most relevant second-level categories covering all components of the ICF. Forty-nine studies reporting psychometric properties of those nine assessment tools were identified, indicating good reliability and validity for all the instruments. Conclusion Nine most frequently utilized functional status assessment instruments for patients with brain tumors represent all components of the ICF and have good psychometric properties. However, the choice of the tool depends on the clinical question posed and the aim of its use.

PURPOSE: The aim was to investigate how structured assessment of physical function can be performed in people with musculoskeletal disorders in arm-shoulder-hand. Specifically, we aimed to determine: • Which questionnaires are available for structured assessment of physical function in people with musculoskeletal disorders in arm-shoulder-hand? • What aspects of physical function do those questionnaires measure? • What are the psychometric properties of the questionnaires? MATERIALS AND METHODS: By means of a systematic review, questionnaires and psychometric tests of those were identified. ICF was used to categorise the content of the questionnaires, and the COSMIN checklist was used to assess the psychometric evaluations. RESULTS: Nine questionnaires were identified. Most items focused on activities rather than functions. Commonly, a couple of psychometric measurements had been tested, most often reported being adequate. Only one questionnaire had been tested for all aspects. Variation in scope and insufficient reports regarding validity and reliability make comparisons and decisions on use difficult both in clinical practice and for research purposes. CONCLUSIONS: The level of psychometric evaluation differs, and often only a few aspects of validity and reliability have been tested. The questionnaires address activity issues to a higher extent than function.IMPLICATIONS FOR REHABILITATIONThis review investigates the content and quality of nine ASH questionnaires.The questionnaires addressed activity issues to a higher extent than function.The level of psychometric testing of the questionnaires differed.DASH, Quick-DASH, and SPADI were the questionnaires that were most often evaluated with various psychometric tests, and with adequate results.

Objectives: The World Health Organization (WHO) recommended the International Classification of Functioning, Disability and Health (ICF) but its use in clinical practice is sparse. This study investigated the limitations and restrictions in the most relevant brief ICF core set categories for chronic low back pain (cLBP) as automatically predicted from routinely measured outcomes using a novel, validated mapping algorithm. Materials and Methods: Of 2718 cLBP patients recruited, data from 1541 (64% females) were available from before and at the end of 6 months comprehensive outpatient rehabilitation. Assessments included the Roland Morris Disability Questionnaire (RMDQ) and Pain Disability Index (PDI) questionnaires, the percentage of patients with predicted limitations and restrictions in important activity and participation ICF categories, bodily functional measurements, pain intensity, and anxiety/depression (EQ-5D). Results: At baseline, both the RMDQ and the PDI measures were within the third of the lowest disability scores whilst 80% of the patients had limitations with “maintaining a body position” and 30% with “walking” ICF categories. Intervention-associated gains in the maximum isometric lumbar extension and flexion strength and the lumbar range of motion were significant overall, but improvements in patients’ ICF limitations/restrictions varied. Anxiety/depression, lumbar range of motion, and extension strength all had a significant impact on the majority of the ICF categories, whereas flexion strength had none. Discussion: The rate of patients with predicted limitations/restrictions in activity/participation ICF core categories for cLBP partly mirrored disability levels and the impact of the body function scores on these limitations/restrictions in ICF categories was varied. Thus, assessing problems in the ICF activity/participation core categories is of relevance to clinical practice for both treatment goal setting and intervention planning. This may be achieved by computer-generated mapping without additional time burden.

BACKGROUND: Employment is an essential component of life as it provides income, sense of engagement and opportunities for personal development. Unemployment due to disability following an accident may have dramatic social and psychological consequences on individuals; it is thus fundamental to foster return to work of these persons. OBJECTIVE: The present work was aimed to develop a methodology determining suitable jobs for people living with disability after a job-related accident. METHODS: The Occupational Information Network (O*NET) taxonomy was combined with the International Classification of Functioning, Disability and Health (ICF) to match individual resources with specific job requirements. ICF Linking Rules were employed by two independent groups of researchers to associate ICF codes to O*NET skill and ability descriptors. RESULTS: O*NET descriptors were linked to 92 unique ICF codes. A “Criticality score” combining ICF and O*NET features to assess suitability of selected jobs for persons with disabilities was also proposed. CONCLUSIONS: The proposed methodology represents a novel instrument to support return to work; the capability to assess specific work-related facets through the lens of both the ICF model and O*NET taxonomy would conceivably provide vocational rehabilitation specialists and occupational therapists with a useful tool fostering job placement of workers with disability.

Introdução: A Classificação Internacional de Funcionalidade, Incapacidade e Saúde descreve a saúde e os estados relacionados a ela, sob a ótica de um modelo biopsicossocial. No Brasil, a utilização da ferramenta por terapeutas ocupacionais é regulamentada pelo conselho de classe, favorecendo a sua ampla utilização nos planejamentos terapêuticos. Objetivo: Identificar, por meio da literatura, como se dá a utilização da Classificação por terapeutas ocupacionais. Método: Trata-se de uma revisão integrativa de literatura. A busca na literatura foi realizada na Scientific Eletronic Library Online (SciELO), na Biblioteca Virtual da Saúde (BVS) e na PubMed tendo como critérios de seleção artigos publicados no período de 2010 a 2020, em português, inglês ou espanhol, e que se enquadre na temática do uso da Classificação pela Terapia Ocupacional. Resultado: Foram selecionados 67 artigos e estes foram categorizados em cinco grupos de acordo com a forma de uso. Dos componentes da ferramenta, o estudo identificou que 91% dos artigos utilizaram o componente Atividade e Participação, 73% utilizaram as Funções do Corpo, 52% utilizaram os Fatores Ambientais, 46% utilizaram as Estruturas do Corpo e doze 18% utilizaram os Fatores Pessoais. Conclusão: Os terapeutas ocupacionais têm utilizado a Classificação em sua prática profissional dentro das diversas possibilidades apresentadas pela Organização Mundial de Saúde, demonstrando que a ferramenta pode ser utilizada como auxiliar para a profissão. Introduction: The International Classification of Functioning, Disability and Health describes health and the states related to it, from the perspective of a biopsychosocial model. In Brazil, the use of the tool by occupational therapists is regulated by the class council, favoring its wide use in therapeutic planning. Objective: To identify, through the literature, how the Classification is used by occupational therapists. Method: This is an integrative literature review. The literature search was carried out in the Scientific Electronic Library Online (SciELO), in the Virtual Health Library (BVS) and in PubMed, having as selection criteria articles published between 2010 and 2020, in Portuguese, English or Spanish, and that were fits the theme of the use of Classification by Occupational Therapy. Result: 67 articles were selected and they were categorized into five groups according to the form of use. Of the components of the tool, the study identified that 91% of the articles used the Activity and Participation component, 73% used the Body Functions, 52% used the Environmental Factors, 46% used the Body Structures and twelve 18% used the Personal Factors. Conclusion: Occupational therapists have used the Classification in their professional practice within the various possibilities presented by the World Health Organization, demonstrating that the tool can be used as an auxiliary for the profession. Introducción: La Clasificación Internacional del Funcionamiento, la Discapacidad y la Salud describe la salud y los estados relacionados con ella, desde la perspectiva de un modelo biopsicosocial. En Brasil, el uso de la herramienta por parte de los terapeutas ocupacionales está regulado por el consejo de clase, favoreciendo su amplio uso en la planificación terapéutica. Objetivo: Identificar, a través de la literatura, cómo la Clasificación es utilizada por los terapeutas ocupacionales. Método: Esta es una revisión integradora de la literatura. La búsqueda bibliográfica se realizó en la Scientific Electronic Library Online (SciELO), en la Biblioteca Virtual en Salud (BVS) y en PubMed, teniendo como criterios de selección artículos publicados entre 2010 y 2020, en portugués, inglés o español, y que fueran aptos el tema del uso de la Clasificación por Terapia Ocupacional. Resultado: Se seleccionaron 67 artículos y se categorizaron en cinco grupos según la forma de uso. De los componentes de la herramienta, el estudio identificó que el 91% de los artículos utilizaba el componente Actividad y Participación, el 73% utilizaba las Funciones Corporales, el 52% utilizaba los Factores Ambientales, el 46% utilizaba las Estructuras Corporales y doce el 18% utilizaba el Personal factores. Conclusión: Los terapeutas ocupacionales han utilizado la Clasificación en su práctica profesional dentro de las diversas posibilidades presentadas por la Organización Mundial de la Salud, demostrando que la herramienta puede ser utilizada como auxiliar para la profesión.

Introduction: Illness in workers and the configuration of health care services for this population constitute a major public health challenge in Brazil. Objectives: To evaluate factors associated with the activities and participation components of functioning in workers seen in primary care. Methods: This was a cross-sectional study of 111 workers who completed a sociodemographic, occupational, and health questionnaire, as well as the World Health Organization Disability Assessment Schedule 2.0. Results were analyzed using descriptive methods, the Mann-Whitney U test, and Spearman correlation coefficients. Results: Most workers were women (63.1%), with a mean age of 36.54 years, single (48.6%), with secondary education (33.3%), and a sedentary lifestyle (68.5%). Over 70% rated their health as “very good/good,” were actively employed, and reported difficulties on at least one item of the World Health Organization Disability Assessment Schedule. Carrying out household activities, working, standing up, learning new tasks, and dealing with strangers were the items most frequently associated with mild/moderate disability. Walking for long distances, feeling emotionally affected, and engaging in community activities were the items for which the most severe/extreme difficulties were reported. Functioning was associated with education (p = 0.009), occupational status (p = 0.000), and perceived health (p = 0.000). The results indicated that less-educated individuals who were not actively working and had poor perceived health had the highest levels of disability. Conclusions: Our results identified several functional difficulties in the working population. Interdisciplinary strategies are needed to address the activity limitations and restrictions to participation in workers seen in primary care.

Introduction: Contemporary occupational diseases are increasingly expressed by function disorders, which include voice disorders, forcing workers to request a leave of absence from work and leading to an incapacity to perform their work activities. Teachers have the higher prevalence of vocal disorders among the professionals who use their voices professionally, which is reported as the second cause of teaching work absences in Brazil. Objectiv: To analyze the environment and organization aspects of the teaching work associated with the development of voice disorder of teachers, according to the International Classification of Functioning, Disability and Health (ICF). Method: This study consisted of two steps. Initially, an integrative bibliographic review was performed to search for references related to the topic in the LILACS, MEDLINE and SCIELO databases, using the health descriptors "voice disorders" and "teachers". Then, the selected articles were read in full in order to identify the work factors associated with the voice disorder and compared with the theoretical framework of the ICF, in order to identify possible indicators of loss of functioning and capacity for teaching work resulting from voice disorders. Results: The presence of dust and noise were the most prevalent environment aspects. In turn, the high demand for work and the lack of autonomy to perform the work were identified as factors related to the organization of the work of the teaching work, as well as stress at work and the presence of situations of violence at school as the most reported work absences. Conclusion: As shown, the factors of teaching work described impact all components of functioning and lead to the incapacity of the teacher to work. The use of the ICF may contribute to systematize and quantify, in a standardized way, the loss of functioning and work capacity resulting from voice disorders, in addition to assisting in the development of public health promotion policies and in the prevention of vocal disorders in teachers. Resumen Introducción: Las enfermedades ocupacionales contemporáneas se expresan cada vez más en trastornos funcionales, que incluyen trastornos de la voz, y que obligan a los trabajadores a solicitar una excedencia del trabajo, provocando la incapacidad para realizar sus actividades laborales. Los docentes tienen la mayor prevalencia de trastornos vocales entre aquellos que usan su voz profesionalmente, lo que se reporta como la segunda causa de ausencias laborales docentes en Brasil. Objetivo: Analizar los aspectos ambientales y organizativos de la labor docente asociados al desarrollo del trastorno de la voz de los docentes, según la Clasificación Internacional de Funcionamiento, Discapacidad y Salud (CIF). Método: Este estudio consta de dos pasos. Inicialmente se realizó una revisión bibliográfica integradora para buscar referencias relacionadas con el tema en las bases de datos Lilacs, Medline y SciELO, utilizando los descriptores de salud "trastornos de la voz" y "docentes". Luego, se leyeron íntegramente los artículos seleccionados con el fin de identificar los factores laborales asociados al trastorno de la voz y se compararon con el marco teórico de la CIF, con el fin de identificar posibles indicadores de pérdida de funcionamiento y capacidad para el trabajo docente derivados de los trastornos de la voz. Resultados: La presencia de polvo y ruido fueron los aspectos ambientales más prevalentes. A su vez, la alta demanda de trabajo y la falta de autonomía para realizarlo fueron identificados como factores relacionados con la organización del trabajo de la labor docente, así como el estrés en el trabajo y la presencia de situaciones de violencia en la escuela como las ausencias laborales más reportadas. Conclusión: Como se muestra, los factores del trabajo docente descritos impactan todos los componentes del funcionamiento y conducen a la incapacidad del maestro para trabajar. El uso de la CIF puede contribuir a sistematizar y cuantificar, de manera estandarizada, la pérdida de funcionamiento y capacidad laboral derivada de los trastornos de la voz, además de ayudar en el desarrollo de políticas de promoción de la salud pública y en la prevención de los trastornos vocales en los docentes.

Line Preede,1– 3 Helene L Soberg,1,4 Håkon Dalen,2 Astrid Nyquist,2 Reidun Jahnsen,2,3 Martin Saebu,2 Erik Bautz-Holter,1,3 Cecilie Røe1,3 1Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway; 2Beitostølen Healthsports Centre, Beitostølen, Norway; 3Faculty of Medicine, University of Oslo, Oslo, Norway; 4Faculty of Health Sciences, Oslo Metropolitan University, Oslo, NorwayCorrespondence: Line Preede Haneholmveien 216, Sandefjord, 3231, NorwayTel +47 930 56 136Email line.preede@studmed.uio.noPurpose: To explore the goal-setting process carried out at a rehabilitation facility providing adapted physical activity, by 1) identifying goals set by individuals with chronic disabilities, 2) comparing these goals to the negotiated goals set in collaboration with the rehabilitation team and 3) assessing goal achievement and its association with self-reported functioning after 12 months.Methods: A prospective observational study where adults (18– 67 years) admitted to Beitostølen Healthsports Centre (n=151) reported mental and physical functioning measured by the Medical Outcomes Study 12-item Short-Form Health Survey (SF-12) administered at baseline (eight weeks before rehabilitation), admission, discharge and follow-up 12 months after rehabilitation. The participants provided their individual goals for rehabilitation in the admission questionnaire. Individual goals were compared to negotiated goals set by the participants and the rehabilitation team together as part of the goal-setting process at the facility. The goals were linked to The International Classification of Functioning, Disability and Health (ICF) for comparison. Goal achievement was assessed on a 10-point numeric rating scale (NRS) in the discharge questionnaire. The association between SF-12 physical and mental functioning at long-term follow-up and goal achievement was explored.Results: The 293 individual goals and the 407 negotiated goals were most frequently linked to the ICF-component Body Functions. When comparing negotiated to individual goals, negotiated goals were more frequently linked to activities and participation. Goals to wide to be linked to the ICF were less frequent. For 76% of the participants, content of individual goals was captured in negotiated goals. Goal achievement with NRS scores ≥ 9 points was reported by 66% of the included participants. Goal achievement was a significant predictor for long-term mental functioning (p=0.04).Conclusion: Collaboration between participants and health professionals resulted in more specific goals directed towards the activities and participation component. Goal achievement predicted long-term mental functioning following rehabilitation.Keywords: adapted physical activity, disability, rehabilitation, participation, goal-setting, international classification of functioning, disability and health

Yongmei Zhang,1,* Xiaoxuan Meng,1,* Yuehao Shen,2,* Jiajia Xie,2 Xi Yu,3 Qiaoshuo Wang,4 Lan Wang1 1School of Nursing, Tianjin Medical University, Tianjin, People’s Republic of China; 2Department of Respiratory Care, General Hospital of Tianjin Medical University, Tianjin, People’s Republic of China; 3Department of Respiratory Care, Tianjin First Center Hospital, Tianjin, People’s Republic of China; 4Department of Cardiac Care, Tianjin Chest Hospital, Tianjin, People’s Republic of China*These authors contributed equally to this workCorrespondence: Lan WangSchool of Nursing, Tianjin Medical University, 22 Qi Xiang Tai Road, Heping District, Tianjin, 300070, People’s Republic of ChinaTel +86 22 83336913Fax +86 22 83336900Email wangl0423@tmu.edu.cnPurpose: To analyze the reliability and validity of the Brief international classification of functioning, disability and health (ICF) core set for chronic obstructive pulmonary disease (COPD).Patients and Methods: A cross-sectional study was conducted in four tertiary hospitals in Tianjin, China. A total of 100 patients with COPD were selected to evaluate functioning and disability involving body functions, body structures, activities and participation as well as environmental factors of the Brief ICF core set for COPD. Internal consistency was calculated by Cronbach’s α. Content validity was examined using the content validity index (CVI), scale-level CVI/universal agreement, and scale-level CVI/average agreement (S-CVI/Ave). In addition, construct validity and convergent validity were also examined.Results: The Brief ICF core set for COPD had a high internal consistency, 0.873 for the total scale, with values of 0.750, 0.640, and 0.843 for body functions, body structures, and activity and participation, respectively. The content validity was calculated by the CVI, scale-level CVI/universal agreement, and S-CVI/Ave at values of 0.80– 1, 0.929, and 0.986, respectively. Meanwhile, the ICF core set for COPD had good convergent validity, correlating with the mMRC dyspnea score (r=0.690, P< 0.01), and there were significant correlations between the ICF core set for COPD and COPD clinical severity grade (r=0.363, P< 0.01). A four-factor model of functions and disability in the Brief ICF core set for COPD had the best fit according to confirmatory factor analysis (CFA).Conclusion: The Brief ICF core set for COPD is a reliable and valid convenient instrument for assessing comprehensive problems in the functioning of patients with COPD, which can be used to design and to evaluate rehabilitation strategies.Keywords: international classification of functioning, disability and health, chronic obstructive pulmonary disease, reliability, validity

To present the process used to develop the low back pain (LBP) assessment tool including evaluation of the initial content validity of the tool. The development process comprised the elements: definition of construct and content, literature search, item generation, needs assessment, piloting, adaptations, design, and technical production. The LBP assessment tool was developed to assess the construct “functioning and disability” as defined by the International Classification of Functioning, Disability and Health (ICF). Involvement of patients and health professionals was essential. The elements were collapsed into five steps. In total, 18 patients and 12 health professionals contributed to the content and the design of the tool. The LBP assessment tool covered all ICF components shared among 63 ICF categories. This study presents the process used to develop the LBP assessment tool, which is the first tool to address all ICF components and integrate biopsychosocial perspectives provided by patients and health professionals in the same tool. Initial evaluation of content validity showed adequate reflection of the construct “functioning and disability”. Further work on the way will evaluate comprehensiveness, acceptability, and degree of implementation of the LBP assessment tool to strengthen its use for clinical practice.Implications for RehabilitationA biopsychosocial and patients-centred approach is a strong foundation for identifying the many relevant aspects related to low back pain (LBP).Responding to a lack of tools to support a biopsychosocial and patients-centred approach the LBP assessment tool was developed using a robust, multi-step process with involvement of patients and health professionals.The LBP assessment tool is a strong candidate for a user-friendly tool to facilitate use of the International Classification of Functioning, Disability and Health in routine clinical practice. A biopsychosocial and patients-centred approach is a strong foundation for identifying the many relevant aspects related to low back pain (LBP). Responding to a lack of tools to support a biopsychosocial and patients-centred approach the LBP assessment tool was developed using a robust, multi-step process with involvement of patients and health professionals. The LBP assessment tool is a strong candidate for a user-friendly tool to facilitate use of the International Classification of Functioning, Disability and Health in routine clinical practice.

To evaluate comprehensiveness and acceptability of the patient-reported outcome instrument (PRO-LBP) and the clinician-reported outcome instrument (ClinRO-LBP) included in the low back pain (LBP) assessment tool. Second, to assess degree of implementation after three months. Feasibility-testing, training of health professionals, field-testing, and a feedback meeting was undertaken. Field-testing provided data to evaluate comprehensiveness, acceptability, and degree of implementation. Feasibility-testing and training of health professionals revealed that the LBP assessment tool was usable and ready for field-testing. In total, 152 patients participated in the field-testing of whom 95% considered the PRO-LBP comprehensive and 59% found it acceptable. Health professionals found the ClinRO-LBP comprehensive and acceptable. The feedback meeting revealed that the LBP assessment tool broadened the health professionals’ approach to functioning and facilitated a consultation based on the patient perspective. The degree of implementation reached 79%. The PRO-LBP and the ClinRO-LBP covered key concepts of LBP and were found acceptable by patients and health professionals. Despite the reduced degree of implementation after three months the LBP assessment tool allowed the health professionals to apply a biopsychosocial and patient-centred approach. Future research should investigate whether the LBP assessment can enhance patient-centred care.Implications for rehabilitationThe low back pain (LBP) assessment tool is the first evidence-based tangible tool to cover biopsychosocial aspects related to LBP as defined by the International Classification of Functioning, Disability and Health (ICF).The LBP assessment tool allowed health professionals to apply a biopsychosocial and patients-centred approach and has the potential to be used in rehabilitation planning.Awareness to continuous facilitation and training of health professionals is important to facilitate and maintain implementation of new procedures into routine clinical practice. The low back pain (LBP) assessment tool is the first evidence-based tangible tool to cover biopsychosocial aspects related to LBP as defined by the International Classification of Functioning, Disability and Health (ICF). The LBP assessment tool allowed health professionals to apply a biopsychosocial and patients-centred approach and has the potential to be used in rehabilitation planning. Awareness to continuous facilitation and training of health professionals is important to facilitate and maintain implementation of new procedures into routine clinical practice.

To facilitate the interaction between the health professional and the patient, a framework to guide the rehabilitation process is needed. This framework would encompass three interwoven aspects: the rehabilitation management plan, Individual Rehabilitation Project (IRP), and rehabilitation cycle(s). All three framework aspects focus on the patient and on the aim of rehabilitation, i.e. to optimize a person's functioning across the continuum of care. An IRP is a multi-element, person-centered rehabilitation management scheme, in which rehabilitation is generally provided by a multiprofessional team under the leadership of a physical and rehabilitation medicine (PRM) physician, working in an interdisciplinary manner and together with the patient (or proxy). A reference system for operationalizing functioning and standardizing the process is the International Classification of Functioning, Disability and Health (ICF) - for assessing functioning needs, defining rehabilitation goals and outcomes. The objective of this paper is to present the IRP as a framework for rehabilitation in Europe (EUR-IRP). The specific aims are: 1) to introduce the IRP; and 2) to describe the framework components, elements and variables of the IRP. Demonstration projects (case studies) using the EUR-IRP will be conducted. The present paper presents the efforts to date for developing the EUR-IRP, a key part of the action plan of the PRM Section and Board of the European Union of Medical Specialists to implement the ICF systemwide across the care continuum. This paper serves as another step to bring together practice, science and governance in calling for contribution from rehabilitation clinicians and researchers and professional societies in PRM and beyond.

BACKGROUND: This international, multi-center cross-sectional study is one of the preparatory studies in the development of the International Classification of Functioning, Disability and Health (ICF) Core Sets for adults with cerebral palsy (CP) to describe their functioning and health.OBJECTIVE: To identify the most common problems in functioning of adults with CP presenting in healthcare services, and facilitating and hindering environmental factors, using the ICF as a reference.METHODS: Participants were adults with CP who visited healthcare services in the Netherlands, Sweden, Thailand, and the United States. Structured interviews were performed using an adapted version of the generic ICF checklist 2.1a (106 categories) to rate the participant's functioning and the impact of environmental factors. Descriptive statistics were used for frequency analysis.RESULTS: In total, 101 participants were included, of whom 69 without intellectual disability (mean age ± SD of 38.4 ± 14.7 y; 85.5% with spastic type of CP; Gross Motor Function Classification System (GMFCS) levels I-V) and 32 with intellectual disability (mean age ± SD of 25.0 ± 6.4 y; 71.9% with spastic type of CP; GMFCS levels I-V). A total of 104 ICF categories in the ICF checklist were frequently present in adults with CP: 27 body functions, 4 body structures, 53 activities and participation, and 20 environmental factors.CONCLUSIONS: The most common problems of adults with CP presenting in healthcare services are diverse and highly prevalent. The study results add the clinical perspective on relevant categories of functioning to the basis for developing the ICF Core Sets for adults with CP.

The concept of functional disability is aligned with the biopsycho-social model of disability. However, there are reasons why the antiquated measurement of medical impairment continues to be in use. We propose solutions for a fairer process using the International Classification of Functioning, Disability, and Health (ICF) at the level of the medical boards augmented by telemedicine and artificial intelligence (AI). The proposed technologies (Level 1 and Level 2 AI) need to be tried in pilot projects. It will accomplish two goals, the first being the measurement of disability and not merely the impairment. Second, and perhaps more importantly, making the process more transparent in creating a “just” society.

Objectives To identify factors which may influence mobility and could be considered during the evaluation of mobility in individuals with acquired brain injury (ABI) following qualitative focus groups with both clinicians and individuals with ABI, to assess their needs and preferences in order to individualize their care management plans. Methods Five focus groups were held, three with clinicians from 3 rehabilitation sites of CRIR (CRDM: n = 4; IURDPM: n = 3; JRH: n = 10) and two with individuals with ABI from one rehabilitation site (CRDM) (individuals with stroke: n = 5; individuals with TBI: n = 5). Focus group discussions were transcribed and analyzed using inductive and deductive thematic content approaches. Results Four themes were identified: considering mobility holistically and individual needs, preferences, and unique experiences; assessment and intervention guidelines; support network; and uncertainty about symptoms and recovery. Using the ten-rule International Classification, Functioning, Disability, and Health framework linking process, codes were categorized into Body Functions Activity and Participation, and Environmental Factors exploring the prominent domains that mostly identify factors influencing mobility. Conclusions Comprehensive measurement of mobility remains an ongoing challenge owing to multiple contributing factors, ranging from personal and psychosocial factors to the influence of a myriad of environmental and community considerations. Preparing individuals with ABI for community mobility can be substantially improved if healthcare professionals employ communicative tools to facilitate shared decision making with patients and to deliver patient-centred rehabilitation care.

Introduction: Health systems worldwide are challenged to address the health-care needs of persons with COVID-19. After the immediate need to mitigate the spread of COVID-19 and scale up relevant health-care capacities, one major challenge has emerged – scaling up rehabilitation to address the functioning limitations experienced by COVID-19 patients/survivors. To meet this challenge, the International Society of Physical and Rehabilitation Medicine (ISPRM) endeavors to develop a tool for the assessment and reporting of functioning of COVID-19 patients/survivors – “ClinFIT COVID- 19” to assist health professionals to optimally address patients' health-care needs. The first step in the development process is identifying the International Classification of Functioning, Disability, and Health (ICF) categories that ClinFIT COVID-19 should cover for acute, postacute, and long-term settings. Methods: The multistep process to develop the ClinFIT COVID-19 category list involved the development of a proposed list of ICF categories, a survey of ISPRM members worldwide about the proposed category list, and a postsurvey consultation with the ISPRM ClinFIT Task Force. Results: The final category list for the acute care context contains the seven categories provided to the survey participants (energy/drive functions, sleep, emotional functions, pain, exercise tolerance functions, carrying out daily routine, and walking) plus six categories related to respiration, mobility, and cognition. The postacute and long-term care versions also contain the seven categories plus additional categories relevant for the specific context. The postacute version contains 15 categories and the long-term 16 categories. Conclusions: To advance the next steps, the leaders of ISPRM and the Task Force call national and international societies of rehabilitation professionals to join this coordinated effort.

The research substantiates the role of clinical psychologists in the system of comprehensive rehabilitation within the conditions of bio-psychosocial model of rehabilitation. Practical experience and the analysis of scientific literature made it possible to describe peculiarities of modern complex rehabilitation and the problems experienced by clinical psychologists. The authors determined difficulties and characteristics of professional work of rehabilitation psychologist within modern legal terrain. One problem is the lack of professional standard for the profession of clinical psychologist. The other problem is the inconsistency in the use of terms denoting professional specifics. Тhe paper focuses on the specificity of psychodiagnostic and rehabilitative work of a psychologist in the light of changing theoretical basis of rehabilitation and the transition from the International Classification of Disability Disorders and Social Insufficiency to the International Classification of Functioning, Disability, and Health. The authors showed the discrepancy between the theoretical approaches of domestic and foreign psychology to the assessment of mental disorders. New professional tasks of the psychologist are defined taking into account multidisciplinary orientation of rehabilitation process. The paper describes the problems of professional training of clinical psychologists and specifies new educational tasks are specified proceeding from the modern approach to rehabilitation. Positive dynamics in the solution of the declared problem can be found in new legislative initiatives, development of General clinical recommendations for rehabilitation psychologists, scientific publications on psychological rehabilitation, update of educational programs for training clinical psychologists.

The widely accepted model of prevention, including primary, secondary and tertiary prevention, focuses predominantly on diseases. The WHO provides a comprehensive model of health conceptualized on the basis of the International Classification of Functioning, Disability and Health (ICF). This paper develops a conceptual description of prevention aimed at functioning on the basis of the ICF model. Starting from the ICF-based conceptual descriptions of rehabilitation as a health strategy, a conceptual description of functioning prevention has been developed. Prevention aiming at functioning is the health strategy that applies approaches to avoid or reduce risks of impairing bodily functions and structures, activity limitations and participation restrictions; to strengthen the resources of the person; to optimize capacity and performance; to prevent impairments of bodily functions and structures; to prevent activity limitations and participation restrictions; to reduce contextual risk factors and barriers, including personal and environmental factors; to promote and strengthen contextual facilitators, with the goal of enabling people with impairments and people at risk of disability; and to maintain or improve the level of functioning in interactions with the environment. The proposed concept widens the scope of prevention to all aspects of functioning, including contextual factors.

In combination with appropriate data processing algorithms, wearable inertial sensors enable the measurement of motor activities in children's and adolescents' habitual environments after rehabilitation. However, existing algorithms were predominantly designed for adult patients, and their outcomes might not be relevant for a pediatric population. In this study, we identified the needs of pediatric rehabilitation to create the basis for developing new algorithms that derive clinically relevant outcomes for children and adolescents with neuromotor impairments. We conducted an international survey with health professionals of pediatric neurorehabilitation centers, provided them a list of 34 outcome measures currently used in the literature, and asked them to rate the clinical relevance of these measures for a pediatric population. The survey was completed by 62 therapists, 16 doctors, and 9 nurses of 16 different pediatric neurorehabilitation centers from Switzerland, Germany, and Austria. They had an average work experience of 13 +/- 10 years. The most relevant outcome measures were the duration of lying, sitting, and standing positions; the amount of active selfpropulsion during wheeling periods; the hand use laterality; and the duration, distance, and speed of walking periods. The health profession, work experience, and workplace had a minimal impact on the priorities of health professionals. Eventually, we complemented the survey findings with the family priorities of a previous study to provide developers with the clinically most relevant outcomes to monitor everyday life motor activities of children and adolescents with neuromotor impairments., Frontiers in Rehabilitation Sciences, 3, ISSN:2673-6861

Hintergrund: Trotz bestehender Gesetze zum barrierefreien Bauen bestehen in der Schweiz Barrieren für Personen im Rollstuhl. Diese führen dazu, dass Einschränkungen in der Partizipation am täglichen Leben bestehen. Ziel: Ziel dieser Arbeit ist es herauszufinden, wie und welche Barrieren die Partizipation einer Person im Rollstuhl beeinflussen. Zudem werden Handlungsempfehlungen für die Ergotherapie erarbeitet, die Therapeutinnen und Therapeuten zur Unterstützung von Personen im Roll-stuhl befähigen. Methode: Im Rahmen einer Fallanalyse wurde der Proband mit Paraplegie beobachtet und offen und teilstrukturiert befragt. Die Daten wurden in Form der Inhaltsanalyse nach Mayring analysiert. Ergebnisse: Die Ergebnisse werden im System der internationalen Klassifikation der Funktionsfähigkeit, Behinderung und Gesundheit aufgelistet. Sie zeigen, wie Barrieren, hilfreiche Faktoren und Strategien in verschiedenen Lebensbereichen auf die Partizipation von Personen im Rollstuhl einwirken. Schlussfolgerung: Es gibt viele Ansatzpunkte, um die Partizipation von Personen im Roll-stuhl zu verbessern. Ein wesentlicher Faktor ist die Veränderung der gesellschaftlichen Ein-stellung. Hierbei kann die Ergotherapie einen Einfluss darauf haben, Personen im Rollstuhl in ihrer Partizipation zu unterstützen.

RESUMO Objetivo analisar e comparar o grau de incapacidade cervical em cantoras disfônicas e em cantoras sem queixas vocais autorreferidas. Método estudo observacional analítico transversal. Participaram do estudo 32 cantoras sem queixas vocais e 30 cantoras com diagnóstico fonoaudiológico e otorrinolaringológico de disfonia. Para as cantoras sem queixas vocais foram utilizados dois questionários aplicados virtualmente via GoogleForms, sendo um questionário composto por três perguntas referentes às queixas vocais e como cada cantora percebia sua voz de falada e de forma cantada e a Escala Funcional de Incapacidade do Pescoço de Copenhagen (EFIPC). Os dados referentes às cantoras disfônicas foram extraídos de um banco de dados previamente coletado por uma equipe de pesquisadores no Observatório de Saúde Funcional em Fonoaudiologia da Universidade Federal de Minas Gerais e a diferença na metodologia de coleta de dados entre os dois grupos deu-se devido às restrições apresentadas pela pandemia causada pelo coronavírus. Para a comparação entre os dois grupos, foi utilizado o teste Mann-Whitney e foi considerado um nível de significância de 5%. Resultados Houve diferença significativa entre os grupos (p=0,0001), demonstrando que as cantoras disfônicas sofrem mais com dores e desconfortos cervicais do que as cantoras sem queixas vocais. Conclusão cantoras disfônicas apresentam mais dor e desconforto cervical do que as cantoras sem queixas vocais, caracterizando uma maior incapacidade cervical. ABSTRACT Purpose To analyze and compare the degree of cervical disability in singers with dysphonia and in singers without self-reported vocal complaints. Methods A cross-sectional observational analysis. Sixty-two singers participated in the study: Thirty-two singers without vocal complaints and 30 singers with a speech-language pathology and otorhinolaryngological diagnosis of dysphonia. For singers without vocal complaints, two questionnaires were applied via Google Forms: A three-question questionnaire regarding vocal complaints and how each singer perceived their speaking and singing voice, and the Copenhagen Neck Functional Disability Scale (CNFDS). Data on singers with dysphonia were extracted from a database previously collected by a team of researchers at the speech-language pathology department of the Federal University of Minas Gerais. The difference in data collection methodology between the two groups was due to restrictions presented by the coronavirus pandemic. The Mann-Whitney test was used to compare the two groups, at a significance level of 5%. Results There was a significant difference between the groups (p=0.0001), demonstrating that singers with dysphonia suffered more from cervical pain and discomfort than singers without vocal complaints. Conclusion Singers with dysphonia have more cervical pain and discomfort than singers without vocal complaints, thus presenting with greater cervical disability.

Введение. Определена связь метаболического синдрома с развитием эндогенного стресса через динамику половых гормонов, показан патогенез стресса, зависящий от повышенной продукции центральных и периферических стрессорных гормонов в ответ на гормональный дисбаланс. Определена значимость программно-аппаратных комплексов в диагностике, в частности, системы интегрального мониторинга «Симона 111», регистрирующая состояние гемодинамики и через систему показателей обеспечивающая значения стрессоустойчивости. Показаны возможности коррекции эндогенного стресса транскраниальной электростимуляцией и серотонином. Цель исследования определить эффективность применения транскраниальной электростимуляцией и серотонином в лечении эндогенного стресса у женщин репродуктивного возраста с метаболическим синдромом. Материал и методы исследования. В исследовании приняло участие 20 женщин репродуктивного возраста с метаболическим синдромом, средний возраст которых 39,9 лет. Выделены 2 группы: I группа (n=10) женщины с бесплодием в анамнезе, без эффекта от вспомогательных репродуктивных технологий; II группа (n=10) -женщины с метаболическим синдромом и нарушением менструального цикла. У всех женщин в анамнезе COVID-19 легкого и среднетяжелого течения болезни, лечившихся в амбулаторных условиях. Использовались оценочные критерии Международной классификации функционирования. Нарушения гемодинамики, оценка стрессоустойчивости и эффективности лечебных мероприятий осуществлялись на системе интегрального мониторинга «Симона 111». Изучались показатели содержания глюкозы, серотонина в крови, общего анализа крови, липидов, ферментов печени. Лечение заключалось в проведении транскраниальной электростимуляции и электрофореза серотонина адипината при помощи физиотерапевтических аппаратов линейки «Трансаир». Для обработки цифровых данных использовали программу Statistica 11.0 (StatSoft Inc., США) для Windows. Проверка нормального распределения осуществлялась с помощью W-критерия Шапиро-Уилка. Результаты и их обсуждение. Разработан алгоритм обследования и введения пациенток репродуктивного возраста с метаболическим синдромом. Показана эффективность использования транскраниальной электростимуляции и электрофореза серотонина адипината при коррекции проявлений эндогенного стресса у женщин с метаболическим синдромом. Заключение. Обоснованный алгоритм обследования женщин целесообразно использовать при метаболическом синдроме в репродуктивном возрасте у женщин. Транскраниальную электростимуляцию и электрофорез серотонина адипината необходимо включить в стандарты лечения метаболического синдрома в репродуктивном возрасте женщин., Introduction. The relationship between the metabolic syndrome and the development of endogenous stress through the dynamics of sex hormones was determined. The pathogenesis of stress was shown, depending on the increased production of central and peripheral stress hormones in response to hormonal imbalance. The significance of software and hardware systems in diagnostics, in particular, the Simona 111 integrated monitoring system, which registers the state of hemodynamics and provides stress resistance values through a system of indicators, is determined. The possibilities of correction of endogenous stress by transcranial electrical stimulation and serotonin are shown. The research purpose is to determine the effectiveness of transcranial electrical stimulation and serotonin in the treatment of endogenous stress in women of reproductive age with metabolic syndrome. Material and research methods. The study involved 20 women of reproductive age with metabolic syndrome, whose average age was 39.9 years. There were 2 groups: the 1 group (n=10) women with a history of infertility, without the effect of assisted reproductive technologies; the 2 group (n=10) women with metabolic syndrome and menstrual irregularities. All women had a history of mild to moderate COVID-19 treated on an outpatient basis. The evaluation criteria of the International Classification of Functioning were used. Hemodynamic disorders, assessment of stress resistance and effectiveness of therapeutic measures were carried out on the Simona 111 integrated monitoring system. The indicators of glucose, serotonin in the blood, complete blood count, lipids, liver enzymes were studied. The treatment consisted of transcranial electrical stimulation and electrophoresis of serotonin adipinate using physiotherapy devices of the Transair line. Digital data were processed using the Statistica 11.0 program (StatSoft Inc., USA) for Windows. Normal distribution was tested using the Shapiro-Wilk W test. Results and its discussion. An algorithm for the examination and introduction of patients of reproductive age with metabolic syndrome has been developed. The efficiency of using transcranial electrical stimulation and electrophoresis of serotonin adipinate in the correction of manifestations of endogenous stress in women with metabolic syndrome was shown. Conclusion. It is advisable to use the substantiated algorithm for examining women of reproductive age with metabolic syndrome. Transcranial electrical stimulation and electrophoresis of serotonin adipinate should be included in the standards of treatment of metabolic syndrome in women of reproductive age.

Objectives: to construct and validate an instrument for assessing the functionality of individuals with schistosomiasis. Methods: methodological study, developed in three stages: 1) construction of the instrument and its association with categories of the International Classification of Functionality, which the study used to elaborate the questions; 2) validation of content, performed by judges experts in the subject; 3) application of the instrument by the test-retest technique in the population with schistosomiasis in 14 days. The study used the correlation coefficient kappa to calculate the degree of agreement between the judges kappa. Results: in its final version, the instrument consists of 27 items, 9 of which are from the Body functions component, 6 from Body structures, 4 from Activity and participation, and 8 from Environmental factors. Conclusions: the constructed instrument has a biopsychosocial approach, considering four components of the ICF, besides presenting good validity and interobserver reliability. RESUMEN Objetivos: construir y validar instrumento de evaluación del funcionamiento de individuos con esquistosomiasis. Métodos: estudio metodológico, desarrollado en tres etapas: 1) Construcción del instrumento y su asociación con categorías de la Clasificación Internacional del Funcionamiento, que fueron usadas para elaborar las preguntas; 2) Validez de contenido, realizada por jueces especialistas en la temática; 3) Aplicación del instrumento por la técnica de test-retest en la población con esquistosomiasis en el intervalo de 14 días. Para cálculo del grado de concordancia entre los jueces, se utilizó el coeficiente de correlación kappa. Resultados: en su versión final, el instrumento se constituyó por 27 ítems, siendo 9 del componente de Funciones del cuerpo, 6 de Estructuras del cuerpo, 4 de Actividad y participación y 8 de Factores ambientales. Fue considerado válido y confiable. Conclusiones: el instrumento construido tiene abordaje biopsicosocial, considerando cuatro componentes de la CIF, además de presentar buena validez y confiabilidad interobservador. RESUMO Objetivos: construir e validar um instrumento de avaliação da funcionalidade de indivíduos com esquistossomose. Métodos: estudo metodológico, desenvolvido em três etapas: 1) Construção do instrumento e associação deste com categorias da Classificação Internacional de Funcionalidade, que foram usadas para elaborar as perguntas; 2) Validação de conteúdo, realizada por juízes especialistas na temática; 3) Aplicação do instrumento pela técnica de teste-reteste na população com esquistossomose no intervalo de 14 dias. Para o cálculo do grau de concordância entre os juízes, utilizou-se o coeficiente de correlação kappa. Resultados: em sua versão final, o instrumento constitui-se por 27 itens, sendo 9 do componente de Funções do corpo, 6 de Estruturas do corpo, 4 de Atividade e participação e 8 de Fatores ambientais. Foi considerado válido e confiável. Conclusões: o instrumento construído tem abordagem biopsicossocial, considerando quatro componentes da CIF, além de apresentar boa validade e confiabilidade interobservador.

Se presenta la creación de un cuestionario para la evaluación de factores ambientales relevantes en el déficit visual, basado en el capítulo de barreras ambientales de la Clasificación Internacional del Funcionamiento, la Discapacidad y la Salud de la Organización Mundial de la Salud. El cues- tionario, denominado BAC-DV, tiene dos partes: un inventario de barreras físicas y tecnológicas y un cuestionario de actitudes. La selección inicial del contenido se realizó a partir de análisis de narrativas de entrevistas, revisión de la literatura y juicio de expertos. Se realizaron dos estudios empíricos. En el primero se calculó la fiabilidad de las dos partes y se eliminaron algunas preguntas poco representativas. El segundo estudio se centró en el inventario de barreras físicas y tecnológicas y permitió obtener su estructura, así como estudiar las características de los ítems. El inventario de barreras tiene cinco escalas: Exteriores, Interiores, Productos de la vida cotidiana, Tecnología de la información y comunicación y Obstáculos. El cuestionario de actitudes tiene tres escalas: Prejuicio, Condescendencia y Discriminación. Son necesarios estudios posteriores de validez y estructura, pero se puede afirmar que BAC-DV tiene validez de contenido y consistencia interna y es una aportación novedosa en la rehabilitación de la discapacidad visual. The creation of a questionnaire for the assessment of environmental factors relevant to visual impairment is presented, based on the chapter on environmental barriers of the International Classification of Functioning, Disability, and Health of the World Health Organisation. The questionnaire, called BAC-DV, has two parts: an inventory of physical and technological barriers, and a questionnaire on attitudes. The initial selection of the content was based on analyses of interview narratives, reviews of the relevant literature and expert judgement. Two empirical studies were conducted. In the first, the reliability of the two parts was assessed and some unrepresentative questions were eliminated. The second study focused on the inventory of physical and technological barriers and allowed their structure to be obtained, as well as studying the characteristics of the items. The barrier inventory has five scales: Outdoor, Indoor, Everyday Products, Information and Communication Technology, and Obstacles. The attitudes questionnaire has three scales: Prejudice, Condescension, and Discrimination. Further validity and structure studies are needed, but it may be affirmed that the BAC-DV has valid content and internal consistency, and is an original contribution to the visual impairment rehabilitation.

Se presenta la creación de un cuestionario para la evaluación de factores ambientales relevantes en el déficit visual, basado en el capítulo de barreras ambientales de la Clasificación Internacional del Funcionamiento, la Discapacidad y la Salud de la Organización Mundial de la Salud. El cues- tionario, denominado BAC-DV, tiene dos partes: un inventario de barreras físicas y tecnológicas y un cuestionario de actitudes. La selección inicial del contenido se realizó a partir de análisis de narrativas de entrevistas, revisión de la literatura y juicio de expertos. Se realizaron dos estudios empíricos. En el primero se calculó la fiabilidad de las dos partes y se eliminaron algunas preguntas poco representativas. El segundo estudio se centró en el inventario de barreras físicas y tecnológicas y permitió obtener su estructura, así como estudiar las características de los ítems. El inventario de barreras tiene cinco escalas: Exteriores, Interiores, Productos de la vida cotidiana, Tecnología de la información y comunicación y Obstáculos. El cuestionario de actitudes tiene tres escalas: Prejuicio, Condescendencia y Discriminación. Son necesarios estudios posteriores de validez y estructura, pero se puede afirmar que BAC-DV tiene validez de contenido y consistencia interna y es una aportación novedosa en la rehabilitación de la discapacidad visual. The creation of a questionnaire for the assessment of environmental factors relevant to visual impairment is presented, based on the chapter on environmental barriers of the International Classification of Functioning, Disability, and Health of the World Health Organisation. The questionnaire, called BAC-DV, has two parts: an inventory of physical and technological barriers, and a questionnaire on attitudes. The initial selection of the content was based on analyses of interview narratives, reviews of the relevant literature and expert judgement. Two empirical studies were conducted. In the first, the reliability of the two parts was assessed and some unrepresentative questions were eliminated. The second study focused on the inventory of physical and technological barriers and allowed their structure to be obtained, as well as studying the characteristics of the items. The barrier inventory has five scales: Outdoor, Indoor, Everyday Products, Information and Communication Technology, and Obstacles. The attitudes questionnaire has three scales: Prejudice, Condescension, and Discrimination. Further validity and structure studies are needed, but it may be affirmed that the BAC-DV has valid content and internal consistency, and is an original contribution to the visual impairment rehabilitation.

BACKGROUND A deeper understanding of how contextual factors affect the ability to participate in the life area of work and employment despite chronic musculoskeletal pain is needed as a basis for interprofessional rehabilitation programs. OBJECTIVE To investigate which contextual factors influence rehabilitation program clients' ability to participate in the life area of work and employment, and how they do this. METHODS Nested case study using a realist evaluation framework of interprofessional interventions. Qualitative content analysis of problem-centered interviews to identify influential context-mechanism-outcome configurations. RESULTS We identified several important context-mechanism-outcome configurations. In the pre-interventional phase, socioeconomic and environmental factors affected two mechanisms, "exhaustion" and "discrimination". In the intra-interventional phase, the social skills of health professionals and opportunities for discussion with peers affected the ability of program participants to engage with program content. In the post-intervention phase, volitional competences of the social system affected the sustainable application of program content in everyday life. CONCLUSION The identified context-mechanism-outcome configurations shows that the ability to participate in the life area of work is interdependent with the ability to participate in other areas of life. In practice and research, assessment and treatment should be carried out based on this understanding.

Bakgrund Femoroacetabulär impingement (FAI) syndrom är en allt vanligare rörelserelaterad funktionsnedsättning i höften, relaterat till en prematur kontakt mellan proximalafemur och acetabulum. Fysioterapi har visat god effekt vid behandlingen av FAI men aktuell forskning är begränsad och konsensus kring bästa behandlingsmetod saknas. Syfte Identifiera och kategorisera vilka fysioterapeutiska interventioner som används vid behandlingen av femoroacetabulär impingement (FAI), hur interventionerna utvärderas och presentera effekten av dessa interventioner. Metod Kartläggande litteraturöversikt. I februari 2022 genomfördes en elektronisk sökning efter vetenskapliga originalstudier från 2012, i databaserna PubMed, CINAHL och PEDRO. Totalt 1672 studier granskades varav 23 inkluderades. Huvudtyper av interventioner identifieras och kategoriserades med stöd av ICF-ramverket utifrån avsett syfte. Resultat Ur 23 inkluderade studier identifierades 36 huvudtyper av interventioner. Av dessaka tegoriseras 25 interventioner under ICF komponenten kroppsfunktioner. Hälften av interventionerna kategoriseras under neuromuskuloskeletala och rörelserelaterade funktioner. Av totalt 33 olika patientrapporterade utfallsmått (PROM) utgjorde iHOT-33, mHHS och NAHS de tre vanligast förekommande. Minst ett av de rekommenderade utfallsmåtten iHOT-12/-33, HAGOS och HOS användes i 70% av studierna. Alla inkluderade randomiserade kontrollerade studier visar signifikanta förbättringar vid användandet av fysioterapeutiska interventioner för FAI avseende PROM vid uppföljning jämfört baslinjen. Slutsats Utformningen av fysioterapeutiska interventioner vid FAI varierar, även om majoriteten syftar till att påverka neuromuskuloskeletala och rörelserelaterade funktioner. Det är möjligt att utifrån interventionens syfte klassificera interventioner vid FAI enligt ICF-ramverket. Rekommenderade diagnosspecifika PROM används i relativt hög utsträckning, till skillnad från de rekommenderade livskvalitetsmåtten. Studien belyser i likhet med tidigare forskning, bristen på konsensus gällande den fysioterapeutiska behandlingen vid FAI. Background Femoroacetabular impingement (FAI) syndrome is an increasingly prevalent movement related disability in the hip, related to premature contact between the femur and acetabulum. Physiotherapy has shown efficacy in treating FAI, but research is limited and shows a lack of consensus regarding best conservative care. Purpose This study aims to identify and categorize the type of physiotherapeutic interventions used in treating FAI, present the effects of these interventions and to map the use of outcome measures. Methods Scoping review. In February 2022 an electronic search was conducted across the databases PubMed, CINAHL and PEDRO. A total of 1672 studies were identified of which 23 met eligibility. Main types of interventions were identified and classified based on aim using the ICF-framework. Results A total of 36 main types of interventions were identified. Out of these, 25 could be categorized under the ICF-component body functions and 18 under neuromusculoskeletal and movement-related functions. Out of 33 total PROMs, iHOT-33, mHHS and NAHS saw most use. At least one of the recommended PROMs was used in 70% of the studies. Included RCT: s show significant improvement on a variety of outcome scores. Conclusion Interventions treating FAI varies, with most targeting neuromusculoskeletal and movement-related functions. Categorization based on the aim of interventions is possible using the ICF-framework. Recommended hip-specific outcome measures are used to a greater extent compared to the more general quality of life measures. This study, in accordance with earlier research, illustrates the lack of consensus regarding the physiotherapeutic care of FAI.

Submitted by Nadir Basilio (nadirsb@uninove.br) on 2022-02-21T21:24:29Z No. of bitstreams: 1 Heyriane Martins Dos Santos.pdf: 2610434 bytes, checksum: c6961bc334daca0b077a97e266b09a70 (MD5) Made available in DSpace on 2022-02-21T21:24:29Z (GMT). No. of bitstreams: 1 Heyriane Martins Dos Santos.pdf: 2610434 bytes, checksum: c6961bc334daca0b077a97e266b09a70 (MD5) Previous issue date: 2021-12-13 Introduction: According to the International Classification of Functioning, Disability and Health (ICF), the environment is associated with the state of human disability and functionality, however, few studies seek to analyze the influence of the environment on disability after stroke. Objectives: Study 1- identify how environmental barriers and facilitators relate to disability after stroke. Study 2-identify the main biopsychosocial predictors associated with the level of disability after stroke according to the ICF biopsychosocial model. Methods: Both studies are exploratory cross-sectional analytical, in which individuals with chronic stroke were evaluated. Disability was considered the dependent variable, being assessed by the World Health Disability Assessment Schedule (WHODAS-2.0). In Study 1, the independent variable was the environment, assessed using the Measure of the Quality of the Environment (MQE). Multiple linear regression was used to estimate the impact of the environment on disability after stroke. In Study 2, the independent variables were determined using the ICF biopsychosocial model: the personal factors considered were: age, sex and income. For bodily functions, the emotional function (Geriatric Depression Scale (GDS)) was considered, and whether the dominant upper limb was affected by stroke. For the activity and participation component, satisfaction in carrying out activities and participation, locomotion, and manual skill were considered, assessed by Satispart Stroke (SATIS-Stroke), Locomotion ability for adults (ABILOCO) and manual ability for adults with upper limb impairment (ABILHAND), respectively; in addition to considering the return to work. For the environmental factors, the environmental facilitators and obstacles that were assessed by the MQE were considered. Binary logistic regression for likelihood ratio was used. Results: Study 1- the main barriers were those related to the physical environment. It was observed that the barrier environment was a predictor of general disability [F(1.73) = 4.24; R2=0.06; β = -0.23; t = -2.06; p=0.04] and predictor of participation [F(1.73) = 10.45; R2=0.13; β = -0.35; t = -3.23; p = 0.01]. Environmental enablers did not correlate with disability. Study 2 -It identified that satisfaction in activities and participation (OR = 0.17; 95%CI 0.03-0.80, p=0.02) and income (OR = 1.96; 95%CI 1.03-3.71, p=0.03) proved to be independent predictors of disability. Conclusion: The physical environment was identified as a barrier, being a predictor of disability after a stroke. When performing the analysis based on the biopsychosocial model, the environment continued to be a factor associated with disability, however, related to the lack of access to health services. Low income and decreased satisfaction in carrying out activities and participation were also factors associated with disability after stroke. Variables related to bodily functions were not related to disability. Introdução: De acordo com a Classificação Internacional de Funcionalidade, Incapacidade e Saúde (CIF) o ambiente está associado ao estado de incapacidade e funcionalidade humana, entretanto, poucos estudos buscam analisar a influência do ambiente na incapacidade após AVC. Objetivo: Estudo 1- identificar como as barreiras e os facilitadores ambientais se relacionam com a incapacidade após AVC. Estudo 2- identificar os principais preditores biopsicossociais associados ao nível de incapacidade após AVC segundo o modelo biopsicossocial da CIF. Métodos: Ambos os estudos são analíticos exploratórios de corte transversal, no qual avaliou-se indivíduos com AVC crônico. A incapacidade foi considerada a variável dependente, sendo avaliada pelo World Health Disability Assessment Schedule (WHODAS-2.0). No Estudo 1, a variável independente foi o ambiente, avaliado por meio do Measure of the Quality of the Environment (MQE). A regressão linear múltipla foi utilizada para estimar o impacto do ambiente sobre a incapacidade após AVC. No Estudo 2, as variáveis independentes foram determinadas por meio do modelo biopsicossocial da CIF: os fatores pessoais considerados foram: idade, sexo e renda. Para as funções corporais considerou-se a função emocional (Geriatric Depression Scale (GDS)) e, se o membro superior dominante foi acometido pelo AVC. Para o componente atividade e participação considerou-se a satisfação na execução das atividades e participação, a locomoção, e a habilidade manual, avaliadas pela Satispart Stroke (SATIS-Stroke), Locomotion ability for adults (ABILOCO) e manual ability for adults with upper limb impairment (ABILHAND), respectivamente; além de se considerar o retorno ao trabalho. Para os fatores ambientais considerou-se os facilitadores e obstáculos ambientais que foram avaliados pelo MQE. Foi utilizada a regressão logística binária por razão de verossimilhança. Resultados: Estudo 1- as principais barreiras foram as relacionadas ao ambiente físico. Observou-se que o ambiente barreira foi preditor de incapacidade geral [F(1.73) = 4.24; R2=0.06; β = -0.23; t = -2.06; p=0.04] e preditor da participação [F(1.73) = 10.45; R2=0.13; β = -0.35; t = -3.23; p = 0.01]. Os facilitadores ambientais não se correlacionaram com a incapacidade. Estudo 2 - a satisfação nas atividades e participação (OR = 0,17; IC95% 0,03-0,80, p=0,02) e a renda (OR = 1,96; IC95% 1,03-3,71, p=0,03) se mostraram preditoras independentes da incapacidade. Conclusão: O ambiente físico foi identificado como barreira, sendo inicialmente, associado ao estado de incapacidade após AVC. Ao realizar a análise baseada no modelo biopsicossocial, observou-se que a baixa renda e a diminuição da satisfação da execução das atividades e participação foram fatores associados à incapacidade após AVC, contudo, nesta na análise final o ambiente não esteve associado à incapacidade. As variáveis relacionadas às funções corporais não apresentaram relação com a incapacidade.

Submitted by Nadir Basilio (nadirsb@uninove.br) on 2022-02-21T20:56:18Z No. of bitstreams: 1 Gabriela Santos Pereira.pdf: 2967815 bytes, checksum: 8fc53db269972b3608d69a7a3d124428 (MD5) Made available in DSpace on 2022-02-21T20:56:18Z (GMT). No. of bitstreams: 1 Gabriela Santos Pereira.pdf: 2967815 bytes, checksum: 8fc53db269972b3608d69a7a3d124428 (MD5) Previous issue date: 2021-12-10 INTRODUCTION: The Participation Measure Scale (PM-Scale) was developed to assess participation in individuals after stroke and has shown adequate measurement properties. However, PM-Scale is only available in French and English versions. OBJECTIVES: 1. Transculturally translate and adapt the PM-Scale into Brazilian Portuguese; 2. test its reproducibility, convergent validity and diagnostic capability; 3. measure item and response scoring patterns using the Rasch model; 4. link the PM-Scale concepts with those of the CIF. METHODS: Methodological study. The translation process followed standardized guidelines that consisted of six phases. Three evaluations were carried out, with an interval of seven to 14 days. The first evaluation consisted of the application of 22 items from the PM-Scale, in addition to the application of the SATIS-Stroke and SS-QOL. In the two subsequent evaluations, the PM-Scale evaluation was repeated in order to analyze its reproducibility. All scales were applied in the form of an interview, by two trained professionals. Reproducibility was assessed using the Intraclass Correlation Coefficient (ICC2.1) and the Bland-Altman plot. Convergent validity was analyzed using Spearman's correlation coefficient. The Rasch model was used to analyze the validity of item and response scoring patterns. Accuracy was estimated based on the area under the ROC (Receiver Operating Characteristic) curve with a 95% confidence interval and considering sensitivity and specificity. For all analyses, a significance level of (p < 0.05) was considered. The linking of the PM-Scale concepts with the CIF was conducted through specific and updated linkage rules. RESULTS: 110 individuals participated in the study, with a mean age of 57.02±11.50. Excellent intra- and inter-rater reliability was observed (ICC = 0.87; 95% CI: 0.81-0.91 and ICC = 0.77; 95% CI: 0.66-0.84). When analyzing the agreement, the Bland-Altman plots showed a relatively skewed distribution around the midline in both comparisons. There was a significant correlation between PM-Scale and SATIS-Stroke (rs=0.38, p 1.3 et 1.3 et 1,3 et 1,3 et

Submitted by Nadir Basilio (nadirsb@uninove.br) on 2021-11-08T21:05:21Z No. of bitstreams: 1 Michele Lacerda de Andrade.pdf: 1907960 bytes, checksum: 286560cb3bb3c86f01fe27e7cac16d9f (MD5) Made available in DSpace on 2021-11-08T21:05:21Z (GMT). No. of bitstreams: 1 Michele Lacerda de Andrade.pdf: 1907960 bytes, checksum: 286560cb3bb3c86f01fe27e7cac16d9f (MD5) Previous issue date: 2021-10-06 Objective: To characterize social participation and identify the predictors of social participation in adults with Down Syndrome (DS). Methodology: Cross-sectional study, 60 adult individuals with DS, 28.27±7.25 years old, were evaluated. To characterize social participation, the Assessment of Life Habits (Life-H 3.1) was applied. To identify the predictors of social participation, instruments associated with the Body Function and Structure, activity, environmental and personal factors components of the ICF biopsychosocial model were chosen. These instruments were the Body Mass Index (BMI), the Mini Mental State Examination (MMSE) for mental function, the Stand up and sit down test to assess lower limb muscle strength, the 8 foot up and go test (8-FUGT) to assess functional mobility, Measure of the Quality of the Environment (MQE) and age. Data analysis: To characterize the sample and social participation, a descriptive analysis was performed and to identify the predictors, the Multiple Linear Regression analysis was used. Results: The Life-H total score shows that individuals present a moderate restriction in Social participation, being the best performance in items involving Daily Activities, and presented a greater restriction in the Employment, Education and Responsibilities domains, which are within the Roles Social. Three variables were found to predict social participation, with 8-TUGT being the best predictor, followed by MEEN and the Sit and Stand Test. Conclusion: This study showed that individuals with DS have a greater restriction in Social Participation in activities involving Social Roles. The best predictors influencing Social Participation were functional mobility, cognition and lower limb muscle strength. Objetivo: Caracterizar a participação social e identificar quais são os preditores da participação social em adultos com Síndrome Down (SD). Metodologia: Estudo transversal, foram avaliados 60 indivíduos adultos com SD, 28.27±7.25 anos. Para caracterização da participação social foi aplicado o Assessment of Life Habits (Life-H 3.1). Para identificar os preditores da participação social foram escolhidos instrumentos associados aos componentes Função e Estrutura do Corpo, atividade, fatores ambientais e fatores pessoais do modelo biopsicossocial da CIF. Estes instrumentos foram o índice de Massa Corporal (IMC), o Mini-exame do estado mental (MEEM) para a função mental, o Teste de levantar e sentar da cadeira para avaliar a força muscular de membros inferiores, o 8 foot up and go test (8-FUGT) para avaliar a mobilidade funcional, o Measure of the Quality of the Enviroment (MQE) e a idade. Análise de dados: Para caracterização da amostra e da participação social foi realizada uma análise descritiva e para identificação dos preditores foi usada a análise de Regressão Linear Múltipla. Resultados: O score total do Life-H mostra que os indivíduos apresentam uma restrição moderada na participação Social, sendo a melhor atuação nos itens que envolvem Atividades Diárias, e apresentaram uma maior restrição nos domínios Emprego, Educação e Responsabilidades, que estão dentro dos Papeis Sociais. Foram encontradas 3 variáveis preditoras da participação social, sendo o 8-TUGT a melhor variável preditora, seguida pelo MEEN e do Teste de Sentar e Levantar. Conclusão: Este estudo expôs que os indivíduos com SD possuem uma maior restrição na Participação Social em atividades que envolvem Papeis Socias. Os melhores preditores que influenciam na Participação Social foram a mobilidade funcional, a cognição e a força muscular de membros inferiores.

Objective: To know the experiences of elderly people with Human Immunodeficiency Syndrome subsidized by complexity. Method: A qualitative multiple case study, conducted in Rio Grande do Sul, Brazil, in 2015, with eight elderly people, using a form based on the International Classification of Functioning, Disability and Health. The analysis was based on three strategies Analytical: general, theoretical and descriptive. Results: Seven women and one man were interviewed; Aged between 60 and 72 years. They acquired the virus through sexual intercourse with partner / husband. They underwent diagnostic examination after routine medical consultation, presented symptom of the disease or discovered companion serology. They had difficulty accepting the serological condition, not revealing the diagnosis and presenting disappointment in the relationships and prejudice with the serological condition. Conclusion: It was verified the relevance of knowing the cases of the elderly with the Human Immunodeficiency Syndrome to elaborate actions appropriate to the needs of these elderly people. Objetivo: Proponer cuidados de enfermería (gerontotecnologías) y acciones ecosistémicas dirigidas a personas mayores con VIH/SIDA. Método: Estudio de caso cualitativo realizado en un servicio de referencia de VIH/SIDA de un hospital universitario de Rio Grande do Sul, Brasil, en 2015, con ocho personas mayores, mediante la aplicación de un formulario basado en la Clasificación Internacional del Funcionamiento, de la Discapacidad y de la Salud. El análisis siguió las proposiciones del estudio de caso en tres estrategias analíticas:general, teórica y descriptiva. Resultados principales: Los ancianos investigados eran siete mujeres y un hombre; tenían entre 60 y 72 años; tres eran solteros, cuatro eran jubilados con ingresos de hasta un salario mínimo, todos los ancianos tenían hijos. Los cuidados de enfermería se guiaron por la CIF como gerontotecnología ligera, presentada a través de tablas: Alteraciones de la salud y cuidados complejos de enfermería propuestos a los ancianos con VIH / Sida basados en la CIF, y las Acciones Ecosistémicas propuestas a los ancianos investigados con VIH/Sida. Conclusión: Los cuidados presentados se basaron en la autonomía, el respeto, la ausencia de preconceptos /tabus, considerando la individualidad/sexualidad de la persona ídem y la complejidad de este fenómeno con implicaciones emocionales, espirituales, culturales y sociales. Por ello, es necesario contemplar los cuidados de enfermería de forma adecuada a las necesidades de la persona mayor con VIH / sida y sus implicaciones emocionales, espirituales, culturales y sociales. Objetivo: Conhecer as vivências de pessoas idosas com Síndrome da Imunodeficiência Humana subsidiadas pela complexidade. Método: Estudo de caso múltiplo qualitativo, realizado no Rio Grande do Sul, Brasil, em 2015, com oito pessoas idosas, por meio de aplicação de formulário embasado na Classificação Internacional de Funcionalidade, Incapacidade e Saúde. A análise baseou-se em três estratégias analíticas: geral, teórica e descritiva. Resultados: Entrevistou-se sete mulheres e um homem; com idade entre 60 e 72 anos. Adquiriram o vírus por meio de relação sexual com companheiro/marido. Realizaram exame diagnóstico após consulta médica de rotina, apresentaram sintoma da doença ou descobriram a sorologia do companheiro. Tiveram dificuldade em aceitar a condição sorológica, não revelando o diagnóstico e apresentando desapontamento nos relacionamentos e preconceito com a condição sorológica. Conclusão: Verificou-se a relevância de conhecer os casos dos idosos com a Síndrome da Imunodeficiência Humana para elaborar ações adequadas às necessidades destes idosos.

Resumo Introdução A Técnica Delphi é utilizada para estabelecer consenso sobre determinado assunto, em áreas que precisam de construção, validação, revisão ou melhor exploração de conhecimentos e métodos de intervenção. Objetivo Apresentar as contribuições da Técnica Delphi como estratégia de validação de um instrumento em Terapia Ocupacional para avaliar adolescentes e adultos com deficiência visual. Método Pesquisa quali-quantitativa, exploratória e descritiva, com emprego da Técnica Delphi para validação do instrumento. Foi constituído um painel de especialistas por amostragem não probabilística por acessibilidade. Os questionários de opinião sobre a avaliação e a avaliação propriamente dita foram enviados na mesma data para todos os participantes. Utilizou-se exclusivamente o meio eletrônico como mecanismo de envio e recepção dos documentos. A análise dos dados transcorreu na coleta, tendo em vista que a rodada seguinte tinha início apenas após a análise do questionário anterior. Para obtenção do consenso, o resultado da rodada deveria apresentar IVCtotal≥0,90, IVCitem≥0,78 e estabilidade nas sugestões dos participantes. Resultados Foi formado um painel com 8 especialistas, realizadas três rodadas da Técnica, com duração total de 12 meses. Na terceira e última rodada, o IVCtotal=0,97 e não houve sugestões que provocassem alterações na avaliação, sendo considerada válida. Conclusão A Técnica Delphi se mostrou vantajosa por permitir sua realização online e anônima entre os participantes, possibilitando a participação de profissionais com expertises heterogêneas, que contribuíram e permitiram o estabelecimento do consenso quanto ao conteúdo, estrutura, linguagem, organização e a necessidade de itens para uma avaliação terapêutica ocupacional na área da deficiência visual, resultando em sua validação. Abstract Introduction The Delphi Technique is used to establish consensus on a given subject, in areas that still need construction, validation, revision, or better exploration of knowledge and intervention methods. Objective To show the contributions of the Delphi Technique as a validation strategy for an Occupational Therapy assessment for visually impaired persons. Method Quali-quantitative research, descriptive and exploratory, using the Delphi Technique as a validation strategy for the assessment. A non-probabilistic accessibility sample was constituted for the composition of a panel of experts. The questionnaires and the Assessment were sent, by e-mail, on the same date to all participants. An electronic device was exclusively used as a mechanism for sending and receiving documents. Data analysis took place during the collection, considering that the next round started only after analyzing the data from the previous questionnaire. To achieve consensus, the result of the round should have CVItotal≥0.90 and CVIitem≥0.78 and stability in the participants' suggestions. Results A panel was formed with 8 experts, held three rounds of the Technique, with a total duration of 12 months. In the third and last round, the CVItotal=0.97, and there were no suggestions that would cause changes in the Assessment. Therefore, it was considered valid. Conclusion The Delphi Technique proved to be advantageous allowing its online and anonymous performance among the participants, permitting the participation of professionals with heterogeneous expertise, who contributed and granted the establishment of consensus regarding the content, structure, language, organization, and the need for items for an Occupational Therapy assessment in visual impairment field, resulting in its validation.

Resumen Introducción: Los seres humanos expresan sus dimensiones biológica, psicológica y social en las capacidades para realizar diferentes actividades cotidianas y participar socialmente, de acuerdo con las oportunidades brindadas en el contexto en que viven. Objetivo: Establecer la relación entre los determinantes sociales de la salud y el funcionamiento humano -desde los componentes “actividad” y “participación”- en personas con enfermedad cerebrovascular de San Juan de Pasto (Colombia). Metodología: Estudio de corte, con una muestra intencional de 98 personas con diagnóstico de enfermedad cerebrovascular, mayores de 18 años, con mínimo 6 meses de evolución de la lesión, sin déficit cognitivo ni de lenguaje, usuarios de instituciones de salud y centros especializados de la ciudad de Pasto. Se utilizó un instrumento para valorar los determinantes sociales de la salud de personas con esta enfermedad y otro que permitió evaluar su actividad y participación. Resultados: Se encontraron correlaciones significativas entre el estrato socioeconómico, la condición de vivienda y el consumo de medicamentos, con la limitación en la actividad y la restricción en la participación (p

Ankylosing spondylitis is a chronic, gradually progressive inflammatory disease characterized by lesions of the sacroiliac joints and / or spine, which can occur with simultaneous lesions of the enthesis and peripheral joints, leading to early disability and a decrease in the quality of life of patients, mainly young age. The international society for evaluation of spondylarthritis (ASAS) recommended a combination of nonpharmacological and pharmacological methods in the treatment and rehabilitation of patients with ankylosing spondylitis for the longest possible preservation of the quality of life of patients, which requires a multidisciplinary therapeutic approach.Currently, in many European countries, the international classification of functioning, disability and health (IСF) is used as a universal approach to the assessment of human health. The IСF classifies the different areas of each patient’s life that are health-related and affect health, thus describing changes in their physical functioning and psychological well-being. It helps to introduce multidisciplinary, patient-centered, problem-oriented rehabilitation care into the real work of clinics.The IСF shows a broader and more meaningful picture of the patient’s health, which allows the multidisciplinary team to consider the patient from different perspectives — biological, personal and social. Using the IСF in the process of complex therapy and rehabilitation of patients with ankylosing spondylitis, a multidisciplinary team can achieve a more complete coherence of views in the treatment of patients with ankylosing spondylitis, which is very important in achieving the success of therapy of this category of patients.