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Purpose: People may suffer from diseases and a variety of health conditions, but a full understanding of the experience of their health condition also requires comprehensive information about the impact of the disease or the health condition on the person. This article operationalises the impacts of health conditions as classified in the International Classification of Diseases (ICD) in terms of the concept of functioning as found in the International Classification of Functioning, Disability and Health (ICF). It identifies a set of ICF categories as the functioning properties - to describe the impact of health conditions generically across health conditions to be jointly used with the ICD., Method: The ICF categories to characterise the functioning properties of any health condition have been selected from three main generic health profile instruments: The World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0), the World Health Survey (WHS) Questionnaire and a list of candidate categories of the generic ICF core set., Results: A set of ICF categories to describe the impact of a health condition is presented according to specific functioning domains., Conclusions: The joint use of the ICD and the ICF through the list of functioning properties and in the context of ICD-11 development captures the valuable synergy of the two classifications. It enhances patient management, intervention design and the reporting of health. It also enables us to distinguish severity of disease from its impacts. The ICD-ICF joint use creates a shared formal representation across the continuum of care for health information system implementation.

Purpose: To propose the joint use of the International Classification of Diseases (ICD) and the International Classification of Functioning, Disability and Health (ICF) and to illustrate this proposal using musculoskeletal (MSK) conditions., Method: In light of the MSK conditions as classified in the ICD, categories from existing ICF core sets for MSK conditions were pooled to specify functioning. Another approach was to consider other categories from measures or instruments already linked in the literature., Results: ICF Categories have been pooled from six core sets for MSK conditions, two specific care settings, one MSK clinical trial setting and eight instrument linkage papers., Conclusions: The ICD-ICF joint use would be able to capture the impact of a health condition by taking into account the disease and functioning status which would facilitate clinical care. Therefore, there is reasonable ground to demonstrate the operational linkage and complementary role of the ICD and the ICF in the context of the ICD revision.

Background and Purpose: To identify the contents of a documentation template in The Guide to Physical Therapist Practice using the International Classification of Functioning, Disability, and Health (ICF) Core Sets for rheumatoid arthritis, osteoarthritis, and low back pain (LBP) as reference., Methods: Concepts were identified from items of an outpatient documentation template and mapped to the ICF using established linking rules. The ICF categories that were linked were compared with existing arthritis and LBP Core Sets., Results: Based on the ICF, the template had the highest number (29%) of linked categories under Activities and participation while Body structures had the least (17%). ICF categories in the arthritis and LBP Core Sets had a 37-55% match with the ICF categories found in the template. We found 164 concepts that were not classified or not defined and 37 as personal factors., Conclusions: The arthritis and LBP Core Sets were reflected in the contents of the template. ICF categories in the Core Sets were reflected in the template (demonstrating up to 55% match). Potential integration of ICF in documentation templates could be explored and examined in the future to enhance clinical encounters and multidisciplinary communication., (Copyright © 2010 John Wiley & Sons, Ltd.)

The American Physical Therapy Association (APTA) has endorsed the International Classification of Functioning, Disability and Health (ICF) as a framework to be integrated into physical therapist practice. The ICF is a universal and inclusive platform for the understanding of health and disability and a comprehensive classification system for describing functioning. The APTA's Guide to Physical Therapist Practice was designed to guide patient management, given the different settings and health conditions that physical therapists encounter in their daily clinical practice. However, physical therapists may be unclear as to how to concretely apply the ICF in their clinical practice and to translate the application in a way that is meaningful to them and to their patients. This perspective article proposes ways to integrate the ICF and the Guide to Physical Therapist Practice to facilitate clinical documentation by physical therapists.

Background and Purpose: Physical therapists require a comprehensive assessment of a patient's functioning status to address multiple problems in patients with severe conditions. The International Classification of Functioning, Disability and Health (ICF) is the universally accepted conceptual model for the description of functioning. Documentation tools have been developed based on ICF Core Sets to be used in multidisciplinary rehabilitation management and specifically by physical therapists. The purposes of this case report are: (1) to apply ICF-based documentation tools to the care of a patient with spinal cord injury and (2) to illustrate the use of ICF-based documentation tools during multidisciplinary patient management., Case Description: The patient was a 22-year-old man with tetraplegia (C2 level) who was 5 months postinjury. The report describes the integration of the ICF-based documentation tools into the patient's examination, evaluation, prognosis, diagnosis, and intervention while he participated in a multidisciplinary rehabilitation program for 2 months., Outcomes: The patient's comprehensive functioning status at the beginning of the program, the rehabilitation goals, the intervention plan, and his improvements in functioning following rehabilitation and the according goal achievement were illustrated with physical therapy-specific and multidisciplinary ICF-based documentation tools., Discussion: This case report illustrates how the ICF-based documentation template for physical therapists summarizes all relevant information to aid the physical therapist's patient management and how ICF-based documentation tools for multidisciplinary care complement one another and thus can be used to enhance multidisciplinary patient management. In addition, the ICF assists in clarifying clinician roles as part of a multidisciplinary team. The case report demonstrates that the ICF can be a viable framework both for physical therapy and multidisciplinary management and for clinical documentation.

Background: Worker productivity outcome is essential in examining the rehabilitation of workers with arthritis and other musculoskeletal conditions. There is great variation in the contents of worker productivity questionnaires. The International Classification of Functioning Disability and Health (ICF) offers the possibility to serve as a reference to describe and compare the contents of these questionnaires., Methods: A literature review identified published self-report worker productivity questionnaires. All meaningful concepts were identified and linked to the corresponding ICF category according to established rules., Results: Eighteen questionnaires were identified which contained a total of 519 meaningful concepts and which were linked to 64 unique 2nd level ICF categories. All questionnaires addressed Activities and Participation, thirteen (72%) addressed Body Functions, seven (39%) addressed Environmental Factors, seven (39%) addressed Personal Factors and only one questionnaire (6%) for Body Structures component. Overall, Work Role Functioning (WRF) questionnaire addressed the most number of different categories while Quantity and Quality method contained only one ICF category. The Rheumatoid Arthritis-Work Instability Scale had the highest number of categories for Body Functions, the Work Activity Limitations Scale and WRF had the most number of categories for Activities and Participation. The Health and Labour Questionnaire had the highest number of categories referring to unpaid work participation. The Health and Work Questionnaire was the only that included contextualization of both Environmental and Personal Factors., Conclusion: Self-report worker productivity questionnaires differed largely in their contents. This content analysis study could guide us in selecting an appropriate questionnaire for a specific study question.

At OMERACT 8 in May 2006 in Malta, the International Classification of Functioning, Disability and Health (ICF) was introduced as a universal model and a universal classification to describe human functioning. The potential usefulness of the ICF for the OMERACT process was highlighted and reported in a position paper following the OMERACT 8 meeting. Since then representatives of several OMERACT working groups with an interest in the ICF joined an OMERACT-ICF reference group. Most members had experience with the ICF and worked further to integrate the ICF into OMERACT. We describe the main roles of the ICF in the OMERACT process and the challenges when practice confronts theory.

Worker productivity is a combination of time off work (absenteeism) due to an illness and time at work but with reduced levels of productivity while at work (also known as presenteeism). Both can be gathered with a focus on application as a cost indicator and/or as an outcome state for intervention studies. We review the OMERACT worker productivity groups' progress in evaluating measures of worker productivity for use in arthritis using the OMERACT filter. Attendees at OMERACT 9 strongly endorsed the importance of work as an outcome in arthritis. Consensus was reached (94% endorsement) for fielding a broader array of indicators of absenteeism. Twenty-one measures of at-work productivity loss, ranging from single item indicators to multidimensional scales, were reviewed for measurement properties. No set of at-work productivity measures was endorsed because of variability in the concepts captured, and the need for a better framework for the measurement of worker productivity that also incorporates contextual issues such as job demands and other paid and unpaid life responsibilities. Progress has been made in this area, revealing an ambivalent set of results that directed us back to the need to further define and then contextualize the measurement of worker productivity.

This study seeks to elucidate the effects of the cycle time of a pick-and-place task on muscle activity, grip force, posture, and perception-based measures (discomfort and difficulty). Six healthy adults (3 males, 3 females) participated. A 4 x 2 repeated measures design was used with cycle time (1, 2, 5, and 10s) and grip (power and chuck) as independent variables. The task consists of repetitively picking a 0.7 kg part and placing it into a bin. A reduction in cycle time (CT) resulted in both a decrease of task time and physical rest time (p<0.001). The physiological muscle rest was much lower than the physical rest time (p<0.05). An increase in static muscle loading (p<0.01), grip force (p<0.001), and discomfort (p<0.001) were also observed. These results suggest that a pace threshold (between 2 and 5s for this task) is reached at a higher CT than that defined by the ability to perform the task.

Arthritis is a leading cause of work disability and makes up a significant amount of the socioeconomic cost and health burden to the working age population. We discuss the measurement of worker productivity: that is, absenteeism and presenteeism. Absenteeism refers to the time missed from work due to health reasons and presenteeism refers to the time of impaired performance while at work due to health reasons resulting in productivity loss. While the term absenteeism is commonly used and has several definitions by itself, the current arthritis literature lacks the use of presenteeism as a work outcome measure in describing health states of the workers and for economic costing. Due to advanced medical management and job accommodations that allow workers to stay at work, absenteeism alone may not be enough to give us a complete picture of worker productivity. From our review, we found that the conceptualization and measurement of absenteeism and presenteeism differ. Our research agenda was to carry forward a work outcome measurement that can be used for cost calculation and that can determine levels or states of productivity loss so we can accurately measure the influence of arthritis and advance arthritis care. We recognize the need to perform psychometric testing of work outcome measures and to improve our ability to identify transitions (i.e., move in and out of a productivity state over time) made by workers with arthritis.