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Purpose The International Classification of Functioning, Disability and Health (ICF) Comprehensive Core Set for Vocational Rehabilitation (CSVR) is a shortlist of functioning domains developed for use with people of working age that experience limitation in their work-related functional capacity. Functional capacity can be measured by, for example, Spinal Function Sort pictorial questionnaire and Functional Capacity Evaluation tests such as the: Complete Minnesota Dexterity Test, grip strength test, pushing, pulling, progressive iso-inertial lifting and carrying. However, these tests have not yet been linked to the CSVR. The objective of this study was to evaluate the extent to which the Spinal Function Sort and Functional Capacity Evaluation tests could be mapped to the ICF categories of the CSVR. Methods Two raters independently performed the linking of the Spinal Function Sort and the Functional Capacity Evaluation related tests to the CSVR according to established ICF linking rules. If an item could not accurately be linked to a CSVR category, the item was linked to the most fitting ICF category. Disagreements were resolved in a consensus meeting. Interrater agreement between raters was expressed in percentage agreement. Results The Spinal Function Sort and Functional Capacity Evaluation tests described a total of 39 unique ICF categories, out of which only six (15%) came from the CSVR. Interrater agreement ranged between 17 and 91%. Conclusions The study found six categories including vestibular functions, muscle power functions, writing, lifting and carrying objects, fine hand use and hand and arm use within the CSVR using the Spinal Function Sort and The Complete Minnesota Dexterity Test. With the rest of the items, the CSVR was considered too broad.

Background: Young patients with stroke are typically the economic support of their families and societies, and their return to work (RTW) is crucial to maintaining their quality of life. However, the identification of RTW-related factors of different aspects is complicated and a systematic analysis of these factors is lacking., Aim: The aim of this study was to develop a core set from the International Classification of Functioning, Disability and Health (ICF) for return to work (RTW) among patients with stroke., Design: Three-round Delphi-based consensus., Setting: University-based hospital., Population: Thirty experts in stroke-related domains from different institutions., Methods: A five-point Likert Scale was used to rate the importance of each item. Consensus of ratings was analyzed using Spearman's rho and semi-interquartile range indices. The International Classification of Functioning, Disability and Health core set for return to work among patients with stroke was based on a high level of consensus and a mean score of ≥4.0 in the third round of the Delphi., Results: The ICF core set comprised 58 categories distributed as follows: 16 body function, 30 activities and participation, 10 environmental factor, and 2 personal factors., Conclusions: Our ICF core set for RTW among patients with stroke can inform effective rehabilitation strategies and goal setting for RTW among patients with stroke. However, further validation is warranted., Clinical Rehabilitation Impact: ICF core set could provide information on rehabilitation strategies setting for RTW of stroke patients.

Purpose: To develop a set of quality indicators (QIs) for managing the International Classification of Functioning, Disability, and Health-based disability evaluation system in Taiwan. Method: Using a three-round Delphi exercise, 20 representatives from the social welfare associations for people with disability completed the consensus process. Questionnaire 1 comprised 52 potentially important factors relevant to good services for persons with disabilities in the system. An additional nine items were added to questionnaires 2 and 3. The responders rated the importance of each item using a 5-point Likert scale. The set of QIs for managing the system comprised items that obtained high consensus and a mean score ≥4.5 found in round 3. Results: Those QIs included a composite of measures about a comfortable and barrier-free assessment room, on-site assistance (being important for client access and safety), client's privacy, rights protection, and satisfaction, convenient service, attitude of staff (towards client centeredness), accuracy of report (system effectiveness), and competent staff (system efficiency). Spearman's rho (mean ± standard deviation) of round 3 was 0.79 ± 0.09, and Cronbach's α = 0.90. Conclusions: This set of QIs is suitable for managing the system serving people with disabilities. It is feasible in practice and scientifically acceptable, but further validation is needed.Implications for rehabilitationWith this study, we were able to develop a set of quality indicators for managing the International Classification of Functioning, Disability and Health-based disability evaluation system.The set of quality indicators included a composite of measures about a comfortable and barrier-free assessment room and on-site assistance; client's privacy, rights protection, and satisfaction, convenient service, attitude of staff; accuracy of report, and competent staff.These quality indicators foster client-centeredness, access, safety, system effectiveness and efficiency, feasibility, and science; and are relevant to managing a system that is intended to serve people with disabilities.

Purpose The purposes of this study were to provide an outline of the existing literature on operationalization of the International Classification of Functioning, Disability and Health (ICF) within vocational rehabilitation (VR) and to explore the ICF utility within VR. Methods The process was undertaken in five stages according to a framework of scoping review. Screening and extraction of data were done by two independent reviewers, and data was summarized according to content analysis. Results Fifty papers (25 qualitative and 25 quantitative) were included. The operationalization of the ICF was described in four different ways: In total 18 (36%) papers described use of the ICF for structuring information, 8 (15%) for linking information to ICF, 12 (24%) for analysis of results, and 12 (24%) for development of a model. In total 15 (29%) papers described VR interventions involving stakeholders, whereas 32 (62%) were reviews. Forty of the papers described all the ICF components. Conclusions The review revealed use of the ICF within the field VR in 50 papers, and in various settings. The ICF framework was most often operationalized for structuring or linking information of functioning. A majority of papers were reviews and involved researchers only, whereas different stakeholders and VR professionals were involved in the interventions. In 40 papers all the ICF components were described, and the ICF was considered a useful tool to inform the VR professionals´ assessment of functioning. However, more research within VR is needed to standardize and ease the use of the ICF.

Purpose: To explore the perceptions and attitudes among people with disabilities towards the newly implemented International Classification of Functioning, Disability and Health-based disability evaluation system (the new system) in Taiwan., Method: Using a self-administered questionnaire, we conducted a nationwide survey. The questionnaire focused on the domains of quality, satisfaction, and revision of the new system. In total, 1073 persons (age, ≥18 years) with disabilities or their primary caregivers, who experienced both the old and the new system, responded to the questionnaire., Results: Most participants were satisfied with the new system overall (58.7%) and the subscale of quality of structure (91.3%) and quality of outcome (63.6%). However, only 20.5% of the participants were favourable to the quality of process. The probability of being satisfied with the system overall was low for the quality of process subscale (adjusted odds ratio range, 0.3 ∼ 0.4) and its item of long interval (0.2 ∼ 0.6). Contrariwise, the probability was high for the other subscales (3.9 ∼ 13.7) and the item of identifying needs (21.9 ∼ 23.4)., Conclusions: Persons with disabilities and their primary caregivers have positive attitudes towards the new system. It is important to simplify the assessment tools and procedures to improve the system's quality of process and facilitate its usability. IMPLICATIONS FOR REHABILITATION Persons with disabilities have positive attitudes towards the newly implemented International Classification of Functioning, Disability, and Health-based disability evaluation system in Taiwan. The system that provides comprehensive information about functioning and disability of persons with disabilities is able to capture the difficulties and needs of those individuals in their daily lives. The system hence helps people to mitigate the effects of disability and guide rehabilitation. The assessment items and processes of the system, however, were perceived to be complicated, time-consuming, and inconvenient. Simplifying the assessment items and processes, such as developing a short form version of the assessment tool and increasing the service time, may facilitate the usability of the system.

Background: The Comprehensive ICF Core Set for vocational rehabilitation (VR) is a list of essential categories on functioning based on the World Health Organization (WHO) International Classification of Functioning, Disability and Health (ICF), which describes a standard for interdisciplinary assessment, documentation, and communication in VR., Objective: The aim of this study was to examine the content validity of the Comprehensive ICF Core Set for VR from the perspective of physical therapists., Design: A 3-round email survey was performed using the Delphi method., Methods: A convenience sample of international physical therapists working in VR with work experience of ≥2 years were asked to identify aspects they consider as relevant when evaluating or treating clients in VR. Responses were linked to the ICF categories and compared with the Comprehensive ICF Core Set for VR., Results: Sixty-two physical therapists from all 6 WHO world regions responded with 3,917 statements that were subsequently linked to 338 ICF categories. Fifteen (17%) of the 90 categories in the Comprehensive ICF Core Set for VR were confirmed by the physical therapists in the sample. Twenty-two additional ICF categories were identified that were not included in the Comprehensive ICF Core Set for VR., Limitations: Vocational rehabilitation in physical therapy is not well defined in every country and might have resulted in the small sample size. Therefore, the results cannot be generalized to all physical therapists practicing in VR., Conclusion: The content validity of the ICF Core Set for VR is insufficient from solely a physical therapist perspective. The results of this study could be used to define a physical therapy-specific set of ICF categories to develop and guide physical therapist clinical practice in VR., (© 2016 American Physical Therapy Association.)

Background and Purpose: The International Classification of Functioning, Disability and Health (ICF) of the World Health Organization was developed as a common framework to understand health and to describe the impact of health condition on functioning. The purpose of this paper is to summarize the literature on the use of the ICF in physical therapy practice and research., Methods: We performed a scoping-narrative review and searched for relevant English language articles from 2001 to 2012 in multiple databases that included MEDLINE, PsycINFO, PubMed and Physiotherapy Evidence Database. Our keywords for the search consisted of ['physical therapy' OR 'physiotherapy'] AND ['ICF']. All types of articles were considered., Results: We found 268 articles; out of which, 79 were reviewed. The years with most publications were 2011 (n = 16), 2008 (n = 15) and 2010 and 2012 (both with n = 13). Publications mostly came from the United States with 27% of the articles. The journal Physical Therapy leads with almost a third of ICF-related physical therapy publications. The ICF has been mostly used in studies of musculoskeletal and neuromuscular conditions. We found a wide array of application of the ICF in research, clinical practice and teaching (classroom and clinical education). Emerging topics included using the ICF in resource allocation and prevention and wellness., Conclusion: The use of the ICF in physical therapy practice and research is promising and continues to evolve. With recent developments in ICF-based measurement and integration in assessment tools for use in the clinics, research and teaching, the need to show the added value of using the ICF in practice and research remains., (Copyright © 2013 John Wiley & Sons, Ltd.)

International Classification of Functioning, Disability and Health (ICF) Core Sets are purpose-tailored shortlists of ICF categories from the whole ICF classification for describing functioning and disability. Although the 34 ICF Core Sets developed up to now already cover many health conditions, there may still be a need to develop additional ICF Core Sets that tackle other health conditions and address other purposes. This paper provides a detailed description of the standard process for developing ICF Core Sets that will serve as a guide for future ICF Core Set development projects. ICF Core Sets are developed by means of a three-phase, multi-method scientific process. The process involves four preparatory studies - an empirical multicentre study, a systematic literature review, a qualitative study and an expert survey. The results of the preparatory studies serve as the starting point for a structured decision-making and consensus process at an international conference, during which participating experts decide on the ICF categories to be included in the Comprehensive and Brief ICF Core Sets. The first version of the ICF Core Set may necessitate modifications for specific applications and implementation in specific settings.

The definition of disability had been unclear until the International Classification of Functioning, Disability, and Health was promulgated in 2001 by the World Health Organization (WHO). Disability is a critical but relatively neglected public-health concern. We conducted this study to measure disabilities by using the WHO Disability Assessment Schedule 2.0 (WHODAS 2.0) and identify the factors that contribute to disabilities. We obtained and analyzed the data on people who applied to Taiwan's disability registration system between September 2012 and August 2013. A total of 158,174 cases were selected for this study. Among the people included in this study, 53% were male, and the females were on average 3 years older than the males. More males than females were of a low socioeconomic status, but the rate of employment was higher among the males than among the females. Age, sex, place of residence, and types and severity of impairment were all determined to be factors that independently contributed to disability. This study has demonstrated that disability can be measured and compared using WHODAS 2.0. Increasing the public-health attention devoted to disability and identifying the factors associated with disability can promote independence and social participation in people with disabilities.

Purpose: To explore the environmental effects on the disabilities of people post stroke and to search for the best probabilistic cut-off value of the WHO Disability Assessment Schedule second edition (WHODAS 2.0) scores to predict people post stroke experiencing an access barrier to the International Classification of Functioning, Disability and Health category e120 products and technology for personal indoor and outdoor mobility and transportation (PMT)., Method: We analyzed data of 162 younger (aged 18-64 years) and 202 older (aged ≥65 years) people post stroke from the databank of persons with disability between June 1, 2011 and February 29, 2012. All participants rated each WHODAS 2.0 item with environmental intervention (performance score) and without any intervention (capacity score). We used the paired capacity-performance score difference to assess the whole environmental effects on the participants' disability, evaluated each participant's access barrier to PMT (negative PMT), and used a receiver-operating characteristic curve to predict patients having a negative PMT., Results: The whole environment acted as a barrier on mobility and self-care in >10 % of older people post stroke. Older patients having a summary index performance score of ≥78.8 points and younger patients having an index of ≥56.0 points were likely to experience a negative PMT. Older patients who have an access to PMT were possible to improve their daily activities performance, and younger patients could report less disability., Conclusions: An environmental support to improve the PMT accessibility is important for people post stroke to reduce their disability.

Objective: To present the International Classification of Functioning, Disability and Health (ICF) as a standard in disability evaluation and to discuss the usefulness and challenges of the ICF when applied in disability evaluation., Conclusions: Disability evaluation can be described and measured using the ICF and ICF-related tools such as the Generic Set, ICF Core Sets specific to health conditions or settings, and measurement instruments that have been linked to the ICF. Wide implementation of the ICF in disability evaluation, specifically in work disability and social security, is needed along with education on the ICF of those in occupational medicine, work rehabilitation, disability adjudication, policy and legislation, and government agencies. The ICF can be used to provide disability criteria in determining functional and work capacity and as a reference framework and a language of disability to help facilitate a common ground of understanding.