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Our aim was to determine impairments in physical functions, activity limitations, and participation restrictions with the International Classification of Functioning, Disability and Health version for Children and Youth (ICF-CY) framework in children with acute lymphoblastic leukemia (ALL) receiving treatment. Physical functions were assessed in terms of pain level, fatigue level, handgrip strength, and motor proficiency. Fine motor activities and lower extremity performance were assessed to determine activity limitations. Participation was assessed with a patient-reported questionnaire. Thirty children with ALL (mean age: 8.45 ± 3.33 years) were included. Pain and fatigue level were mild. Poor handgrip strength was found; their mean handgrip strength was 60% of the normative. Fifty-six percent of the children had below-average motor performance. Participation scores were considerably high, except for sport and physical functioning sub-score. Participation level was positively associated with bilateral coordination and duration after diagnosis, while negatively correlated with pain and fatigue level (p ˂ 0.05). Conclusion: The ICF-CY-based evaluation was useful to understand children's limitations in everyday life. Children with ALL need supportive interventions during treatments in terms of physical functioning and participation in activities. Children with ALL with higher pain and fatigue, poor bilateral coordination, and who were in earlier period after diagnosis had higher risk for participation restriction. What is Known: • Children with ALL had physical functioning limitations on treatments. • Participation restrictions were described in children with ALL off treatment. What is New: • The ICY-CY-based health and functioning evaluation allows health care professionals to globally determine limitations of everyday life in children with ALL on treatment. • Impairments in physical functions, pain severity, fatigue severity, and duration after diagnosis are associated with participation to everyday life in children with ALL on treatment. [ABSTRACT FROM AUTHOR]

Background: The validity, reliability, and accuracy of the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) for face-to-face assessment in the stroke population are well established. However, the validity and reliability of WHODAS 2.0 through tele-assessment remain uncertain. OBJECTIVE: To assess the reliability, agreement, internal consistency, criterion and discriminant validity of WHODAS 2.0 when administered through video calls., Methods: A longitudinal methodological study included fifty individuals with chronic stroke. Both in-person and video call assessments were conducted, and their sequence was randomized. The reliability was determined using the Intraclass Correlation Coefficient (ICC2,1). Measurement errors were assessed using the standard error of measurement (SEM) and smallest detectable change (SDC). Internal consistency was assessed using Cronbach's α. Criterion validity was determined by conducting Pearson's correlation coefficient analysis between in-person and video call assessments. Discriminant validity was examined using the Receiver Operating Characteristic (ROC) curve to distinguish disability levels, with the Modified Rankin Scale as the reference standard., Results: The participants had a mean age of 56.10 ± 10.8 years, with an equal distribution of genders. Adequate reliability was observed between the two methods (ICC2,1 = 0.88; 95% CI = 0.79-0.93; p  < 0.001), and internal consistency was also adequate (Cronbach's α = 0.88). The criterion validity revealed a strong correlation ( r  = 0.78; p  < 0.001). Discriminant validity demonstrated satisfactory accuracy in distinguishing disability levels via video call (AUC = 0.67; p  = 0.04)., Discussion: This study offers evidence supporting the validity and reliability of the WHODAS 2.0 assessment through video call. Teleassessment using WHODAS 2.0 proves suitable for individuals who have had a stroke, enabling remote evaluation and care.

Initial evidence supports the reliability of the Participation Measurement Scale (PM-Scale) in Brazil, but further exploration of its psychometric properties is needed for Brazilian stroke survivors. The aim of the study is to analyze the reliability, convergent validity, internal consistency, and accuracy of the PM-Scale Brazil. A methodological study involved three assessments over intervals of 7-14 days. Reliability was evaluated through the Intraclass Correlation Coefficient. Convergent validity was assessed using Spearman's correlation coefficient to evaluate the alignment of the PM-Scale Brazil with the SATIS-Stroke. Internal consistency was assessed through Cronbach's α. Accuracy was estimated by calculating the area under the receiver operating characteristic curve. The study involved 110 stroke survivors, revealing adequate intra-rater and inter-rater reliability. A significant weak correlation was observed between the PM-Scale and SATIS-Stroke. Internal consistency and accuracy were adequate. The PM-Scale Brazil demonstrates good reliability, internal consistency, and sensitivity. However, its weak correlation with SATIS-Stroke suggests limited convergent validity., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Objectives: The objectives of this study were to identify contextual factors as barriers or facilitators of osteoarthritis management in urban- and rural-dwelling seniors by applying the World Health Organization’s International Classification of Functioning, Disability and Health (ICF). Design: Secondary analysis was performed on interview transcripts from urban- (n ​= ​11) and rural-dwelling (n ​= ​9) seniors living with osteoarthritis in Canada. Meaningful concepts were linked to ICF codes (Environmental Factors) according to established linking rules. Unclassified content (including Personal Factors) was subjected to qualitative content analysis. Results: A total of 481 and 410 meaningful concepts were identified in interview transcripts from urban and rural groups, respectively. For Environmental Factors, the majority of meaningful concepts linked to “Environmental Factors”, then “Activities and Participation”, and then “Body Functions” in the ICF. The most frequently linked codes were “e355 Health professionals”, “e5801 Health systems”, “e5800 Health services”, and “e398 Support and relationships, other specified”. The most salient barrier and facilitator to osteoarthritis management reflected in our results were “e5801 Health systems” and “e398 Support and relationships, other specified”, respectively, for both urban and rural groups. For Personal Factors, qualitative content analysis of unclassified content revealed 3 key themes including (1) Coping Strategies; (2) Age of Osteoarthritis Diagnosis; and (3) Individual Circumstances. Conclusion: Beyond physical limitations, community-dwelling seniors with osteoarthritis encounter a wide range of biopsychosocial factors that can impact disease management. Applying the ICF, we identify “Environmental Factors” as a significant contextual factor impacting osteoarthritis management in both urban and rural communities.

Background: Accidental falls could have severe and far-reaching consequences for older adults, their families and society at large. Healthcare practitioners’ (HCPs) perspectives on fall risk factors in older adults could assist in reducing and even preventing falls. Currently, no universal tool exists for this purpose. The World Health Organization’s globally accepted International Classification of Functioning, Disability and Health (ICF) was used. Aim: This study aimed to (1) describe the perspectives of HCPs on fall risk factors in older adults in South Africa and (2) link these factors to the ICF. Setting: Eighteen HCPs participated in two focus groups. Methods: Using a qualitative research design, an inductive thematic analysis allowed for the identification of important themes, which were linked to the ICF. Results: The factors mentioned by participants were categorised into 38 themes, which were linked to 142 ICF codes, of which 43% (n = 61) were linked to the Body Function category, 23% (n = 32) to the Environmental Factors category, 18% (n = 26) to the Body Structure category and 16% (n = 23) to the Activities and Participation category. HCPs revealed two relevant factors that were not captured in existing fall risk assessment tools (FRATs), namely ‘muscle-power functions’ and ‘mobility-of-joint functions’, which directly relate to the ability to execute mobility activities. Combining HCPs’ perspectives with other stakeholders and with literature provides a holistic picture of fall risk factors in older adults.

ABSTRACT Purpose: The aim of this study was to identify the most typical and relevant categories of the International Classification of Functioning, Disability and Health (ICF) for patients with 22q11.2 Deletion Syndrome. Methods: Based on the Delphi technique an expert survey through e-mail was performed among health professionals’ specialists in the 22q11.2DS. Data were collected in 2 rounds. Answers were analysed for the degree of consensus. Results: 7 Experts recruited through e-mail distribution lists of professional organizations and personal networks participated in the study. Categories in all ICF components that were considered typical and/or relevant by at least 80% of the responders were added to a pilot ICF instrument for children with 22q11.2DS, with a total of 145 ICF categories. Conclusion: a list of ICF categories that are considered relevant and typical for 22q11.2DS condition by international experts was created. This is an important step towards identifying ICF Core Sets for chronic paediatric conditions in Brazil.

Abstract Introduction: the biopsychosocial (BPS) model from the perspective of the International Classification of Functioning (ICF) agrees with the current theories regarding child development. They state the interdependence between the individual's relations, environment and received stimuli. The early interventions, particularly in the aquatic environment (AE), present gaps concerning their systematization, above all in their being in accordance with the ICF. Objectives: to describe an ICF-based aquatic early intervention program, named KITE, for the neuropsychomotor development (NPMD) of typical, at-risk and/or delayed babies 4 to 18 months old. Methods: the KITE is a program systematized on the AE, centered on the family and the daycare environment; it takes place twice a week, lasting for 4 weeks, in 45- to 60-minute sessions. The assessments and interventions are systematized by following the ICF. For the main outcome on the NPMD, the Alberta Infant Motor Scale (AIMS) and the Denver Developmental Screening Test II (DDST-II) are used, and as the secondary outcome on the stimulation received, quality of life and aquatic skills, the Affordances in the Home Environment for Motor Development - Infant Scale (AHEMD-IS), the Pediatric Quality of Life Inventory (PedsQL™) and the Aquatic Functional Assessment Scale – Baby (AFAS Baby) are used, respectively. Conclusion: This study has presented tools for the application of a clinical trial through the KITE for the NPMD of babies, systematized and based on the BPS perspective of the ICF, and discussed according to the neuroplastic evidence of the child development.

Background: Stroke is a cardiovascular disease with the highest prevalence worldwide, with impact on the functionality of survivors. Objective: To identify the Score Set of the International Classification of Functioning, Disability and Health (ICF) for people after stroke. Material and Methods: The research question was performed according to the Joanna Briges Institute (JBI) recommendations and PICo framework (Population, Interest phenomenon, Context). Each dimension of the PICo contributed to the definition of inclusion criteria, namely Population (P) Person after stroke; Interest phenomenon (I) Score set ICF; Context (Co) Community. The electronic research was done in the Medline, SciELO, virtual health library and EBSCO databases, between 2013 and 2017 Results: Of the identified articles 11 were selected and 160 ICF codes were identified, which characterize the functionality of people after stroke. Of these 160 codes, it was verified that 21, divided by 3 ICF categories, presented a frequency greater than or equal to 50%. Conclusions: The ICF score set for people after stroke is distributed as follows: 6 Body Functions (29%), 13 Activity and Participation (61%) and 2 Environmental Factors (10%).

Abstract Objective The objective of this study was to identify the perspective of the specialists about functioning in women with cervical cancer (CC). Methods A study was conducted with specialists using the Delphi methodology. The specialist contacts were found in oncology organizations and associations, as well as in a referral hospital in the treatment of CC. The questions that the experts answered covered the biopsychosocial domains of the International Classification of Functioning, Disability and Health (ICF). Results Twenty-five specialists participated in the study. The experts’ responses generated 485 significant concepts. The categories that presented the highest frequencies of reporting by the specialists were health services, systems and policies; structure of the reproductive system; health professionals and sexual function. Conclusion Regarding the perception of the specialists, this study concluded that 24 categories of ICF are the most relevant in the context of functioning in women with CC. The results suggest that the biopsychosocial perspective was incorporated in the experts’ perceptions about the functioning phenomenon in women with CC in Brazil.

The International Classification of Functioning, Disability and Health (referred to as the ICF) is the World Health Organization's framework for health. It can be used to identify goals that capture all aspects of a person's life and to inform clinical goal-setting processes. This review aims to report how healthcare providers are using the ICF framework to support goal-setting practices in pediatric rehabilitation services. A rapid review was conducted using scoping review principles in the following databases: CINAHL, Medline and PsycINFO. Key terms included: "ICF", "goal-setting" and "pediatrics". Sixteen studies met the inclusion criteria. Three main themes emerged about the use of the ICF in pediatric rehabilitation: 1) match the content of goals to the ICF domains; 2) implement with existing tools for goal-setting; and 3) inform the development of new tools for goal-setting. Healthcare providers often use a combination of goal-setting tools. The SMART approach is used to frame goals, while the Canadian Occupational Performance Measure and Goal Attainment Scale have been used to document and evaluate goals. The ICF framework can be used with current goal-setting practices and offers a common lens and language with which to facilitate collaborative goal-setting with families and healthcare providers. The International Classification of Functioning, Disability and Health (ICF) provides a common framework and language to support collaborative goal-setting between families and healthcare providers Despite the opportunity for the ICF to be used as a framework with goal-setting approaches, to date the ICF has mainly been used to match the content of goals to ICF domains for documentation purposes The ICF should be incorporated into the established clinical routines in order to promote its use among healthcare providers The ICF can be used with existing goal-setting tools in clinical practice and to inform the ongoing development of new tools to support the goal-setting process in family-centred services [ABSTRACT FROM AUTHOR]

WHODAS 2.0 is a unified scale to measuring disability across diseases, countries, and cultures. The objective was to explore the available evidence on the psychometric properties of 12-item self-administered WHODAS 2.0 among a general population and people with non-acute physical causes of disability. Five databases Medline, Embase, Web of Science, Scopus, and PsycINFO were searched for papers related to the validity, reliability, responsiveness, minimal clinically important difference or minimal detectable change of 12-item self-administered WHODAS 2.0. In order to avoid missing any potentially relevant studies, the search clauses were left as generic as possible and the refining search was conducted manually. As the review was focusing on chronic physical disorders and general adult population, major psychiatric diagnoses, acute traumas, other acute conditions (e.g., postpartum or pregnancy), hearing loss, progressive neurological disorders, and age <19 years were excluded. The relevancy of the studies was assessed by two independent reviewers. The 14 out of 191 observational studies were considered relevant. The sample sizes varied from 80 up to 31,251 participants. Great diversity was observed in the participants' health problems. The Cronbach's alpha was high – up to 0.96. The correlations between WHODAS 2.0 and other disability scales were high. Substantial floor without ceiling effect was reported by two studies. Exploratory factor analysis resulted in a multidimensional structure – up to five factors. The discriminative ability and test–retest reliability of the scale was good. It seems, that the 12-item self-administered WHODAS 2.0 is internally consistent and a reliable scale demonstrating overall good correlation with other measures of disability. However, it appears that it is a multidimensional scale and its total score may represent different combinations of several contributing factors. Thus, the 12-item WHODAS 2.0 can be more reliable when creating a person's functional profile formed by the 12 individual item scores instead of a single total sum. The 12-item self-administered WHODAS 2.0 is internally consistent and a reliable scale demonstrating overall good correlation with other measures of disability. It appears that it is a multidimensional scale and its total score may represent different combinations of several contributing factors. The 12-item WHODAS 2.0 can be more reliable when creating a person's functional profile formed by the 12 individual item scores instead of a single total sum. [ABSTRACT FROM AUTHOR]

The World Health Organization International Classification of Functioning, Disability and Health has the power to shape professional behaviour and positively influence all aspects of health and social care practice. The visual depiction of the ICF framework belies the complexity of this multifaceted classification and coding system which students and practitioners can find challenging to grasp. This guide offers twelve integrated practical tips to help health and social care educators embed the ICF throughout the curriculum with a view to supporting student learning and ultimately interprofessional and inclusive practice. [ABSTRACT FROM AUTHOR]

The World Health Organization International Classification of Functioning, Disability and Health Framework (ICF) states that a child's health conditions, functions, activities, participation in life and contextual factors shape disability. Research on the development of children with organic acidemias (OA) mostly focused on cognitive and medical outcomes. This study aimed to examine adaptive functioning of children with OAs based on ICF. In this cross-sectional study, children with propionic academia, methylmalonic acidemia and maple syrup urine disease receiving care at Ankara University School of Medicine, Department of Pediatrics, Pediatric Metabolism Division were recruited. Comprehensive developmental assessments included ICF-based methods. Adaptive functioning was measured with Vineland Adaptive Behavior Scales-Second Edition. The sample comprised 22 children with a median age of 47.5 months (IQR: 35–73.5). Most mothers (64%) had less than 5 years of education, half had depression. Two children (9%) were attending to school, 14 (64%) were not regularly playing with friends. Fourteen children (64%) had significant communication delays, 12 (55%) had significant problems in daily living skills, and 12 (55%) in social skills. Mean adaptive behavior composite score was 65.5 ± 16.8 (low), children with feeding disorders had significantly more low adaptive behavior composite scores than children with no feeding disorder diagnosis (p = 0.001). Our results imply that children with OAs from Turkey, a middle-income country had major difficulties in functioning, activities, participation and contextual factors. Feeding problems appeared as a risk factor for lower adaptive functioning. ICF-based assessments and interventions are urgently needed in the management of children with OAs. [ABSTRACT FROM AUTHOR]

BACKGROUND: The Muscle Energy Technique (MET) is one of the treatments of choice for the management of chronic mechanical low back pain (MLBP); however, there is a paucity of evidence to justify its effectiveness. OBJECTIVES: The objectives of this review are to explore, analyze and summarize the available evidence related to the effectiveness of MET in the management of chronic MLBP. METHOD: The scoping review methodology was adopted based on a recommendation from the work of Arksey and O'Malley, to systematically appraise literature and map the existing evidence on the effectiveness of MET in the management of chronic MLBP. A systematic search was performed comprising of an electronic search of online databases using key search terms and subsided by a hand search to identify the existing literature on the topic which was summarized and discussed. RESULT: Initially 25,195 hits were identified which were screened to examine their eligibility based on predetermined inclusion criteria after removing duplicate articles. Eleven articles met the inclusion criteria and were discussed. CONCLUSIONS: Generally there exists a scarcity of published articles on the effect of MET in chronic MLBP. However, the analysis of the retrieved articles showed that the MET procedure is a favourable intervention that is safe (i.e. no adverse effects) and can be effective as a standalone treatment or in combination with other treatment strategies for patients with chronic MLBP with the potential to provide numerous physical and psychosocial benefits. [ABSTRACT FROM AUTHOR]

The aim of this study is to establish the perceptions of older adults in the South African context regarding falls and to link these perceptions to the International Classification of Functioning, Disability and Health (ICF). Data were analyzed by a summative, conventional, and deductive approach. The analysis indicated that the Body Function and Structure codes were most frequently used during the discussions, but the contextual analysis of the most frequently used categories indicated that Activities and Participation were the participants' main focus. The main focus of fall assessment in older adults should therefore be on Activities and Participation, as this can assist them in decreasing their fall risk, irrespective of whether they had a previous fall. Contrary to the majority of current literature on falls, this study included both participants who had fallen and those who hadn't, resulting in richer data and themes gathered from the focus groups. [ABSTRACT FROM AUTHOR]

No reviews to date have summarized the views of parents on the functional challenges and/or strengths of their children with autism spectrum disorder. We set out to perform a scoping review aiming (a) to identify and collate global results to provide a broad description of parental perspective of functioning research and (b) to summarize these using the International Classification of Functioning Disability and Health–Child and Youth version framework. The International Classification of Functioning Disability and Health provides a language to describe the functional skills of an individual with a health condition in terms of their body structures, body functions, activities and participation, their environmental and personal factors. Given the influence that context has on functioning, and the potential impact of economic status on availability of resources, we were specifically interested to compare perspectives from high-income countries and low-/middle-income countries. Two researchers conducted a comprehensive search of English peer-reviewed studies published between 1990 and June 2016. Articles were accessed and summarized using thematic analysis. Meaningful phrases were extracted from key findings and linked to second-level International Classification of Functioning Disability and Health–Child and Youth categories following international linking rules. Thirty-three studies were identified of which only six originated from low/middle-income countries (n = 6/33, 18%). Two studies compared perspectives from low-/middle-income countries and high-income countries (n = 2/33, 6%). Functional themes from high-income countries included a range across the International Classification of Functioning Disability and Health–Child and Youth bio-psychosocial framework while functional themes from low-/middle-income countries were predominantly focused on environmental factors. We propose further research should consider a systematic comparison of high-income and low/middle-income countries across functional categories to get a more accurate impression of the impact of context on functioning. No paper to date has summarized parents' views on the functional challenges and/or strengths of their children with autism spectrum disorder. In this review we set out to perform a scoping review aiming to (a) find and compare existing research from around the globe on parental perception of functioning and (b) summarize results from these papers using the International Classification of Functioning Disability and Health–Child and Youth version framework. Since we know that the place and circumstances we live in can have a significant influence on our functioning in daily life, we were specifically interested in comparing perceptions from high-income countries and low-/middle-income countries. Two researchers conducted a comprehensive search of English studies published between 1990 and June 2016. Papers were summarized and key findings were linked to International Classification of Functioning Disability and Health–Child and Youth categories. Thirty-three studies were identified, of which most were conducted in high-income countries (n = 25/33, 76%) with only six studies in low/middle-income countries (n = 6/33, 18%). Two studies compared views from low/middle-income and high-income countries (n = 2/33, 6%). Functional themes from high-income countries included a range across the International Classification of Functioning Disability and Health–Child and Youth framework while functional themes from low-/middle-income countries were mostly focused on environmental factors. It was difficult to directly compare studies from low/middle-income and high-income countries because they investigated and discussed such different parts of functioning. We suggest that future research should use an approach that will allow researchers to directly compare functional categories in order to get a more accurate impression of the impact of context on functioning. [ABSTRACT FROM AUTHOR]

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To provide prevalence estimates for problems in functioning of community-dwelling persons with spinal cord injury (SCI) and to examine associations between various areas of functioning with the purpose of supporting countries in identifying targets for interventions. Cross-sectional survey. Community, 22 countries including all World Health Organization regions. Persons (N=12,591) with traumatic or nontraumatic SCI aged 18 years or older. Not applicable. We estimated the prevalence of problems in 53 areas of functioning from the Brief International Classification of Functioning, Disability and Health (ICF) core set for SCI, long-term context, or ICF rehabilitation set covering 4 domains: impairments in body functions, impairments in mental functions, independence in performing activities, and restrictions in participation. Associations between areas of functioning were identified and visualized using conditional independence graphs. Participants had a median age of 52 years, 73% were male, and 63% had paraplegia. Feeling tired, bowel dysfunction, sexual functions, spasticity, pain, carrying out daily routine, doing housework, getting up off the floor from lying on the back, pushing open a heavy door, and standing unsupported had the highest prevalence of problems (>70%). Clustering of associations within the 4 functioning domains was found, with the highest numbers of associations within impairments in mental functions. For the whole International Spinal Cord Injury sample, areas with the highest numbers of associations were circulatory problems, transferring bed-wheelchair, and toileting, while for the World Health Organization European and Western Pacific regions, these were dressing upper body, transferring bed-wheelchair, handling stress, feeling downhearted and depressed, and feeling happy. In each domain of functioning, high prevalence of problems and high connectivity of areas of functioning were identified. The understanding of problems and the identification of potential targets for intervention can inform decision makers at all levels of the health system aiming to improve the situation of people living with SCI. [ABSTRACT FROM AUTHOR]

Purpose: Patients with traumatic brain injury often experience cognition-related problems and difficulty in returning to work. This study analyzed the accuracy of a modified version of World Health Organization Disability Assessment Schedule 2.0 for predicting the return-to-work status of working-age patients diagnosed with traumatic brain injury more than 6 months ago. Materials and methods: We conducted a cross-sectional survey from a nationwide disability database. This study analyzed the data of 1312 patients diagnosed with traumatic brain injury (aged 20–60 years) more than 6 months ago from the Taiwan Data Bank of Persons with Disability for the period from July 2012 to January 2014. The demographic data and modified World Health Organization Disability Assessment Schedule 2.0 standardized scores of patients with traumatic brain injury who could and could not return to work (return-to-work and nonreturn-to-work groups, respectively) were analyzed. Receiver operating characteristic curve analysis was performed to investigate the prediction accuracy of the modified World Health Organization Disability Assessment Schedule 2.0 for predicting the return-to-work status, and the optimal cutoff point was determined using the Youden index. Binary logistic regression was used to determine the predictors of the return-to-work status of the participants. Results: The modified World Health Organization Disability Assessment Schedule 2.0 scores in all domains were lower in the return-to-work group than in the nonreturn-to-work group. Receiver operating characteristic analysis revealed the high accuracy of the summary scores of the modified World Health Organization Disability Assessment Schedule 2.0 (area under the curve >0.8). Binary logistic regression revealed that patients with standardized modified World Health Organization Disability Assessment Schedule 2.0 summary scores less than 39.50 were 11.20 (95% confidence interval, 4.80–26.14; p < 0.001) times more likely to return to work than patients with scores more than 39.50. Conclusions: The modified World Health Organization Disability Assessment Schedule 2.0 can be used as an objective and reliable assessment tool for predicting the return-to-work status of working-age patients with traumatic brain injury. This tool can facilitate goal setting and rehabilitation strategy design to enable patients with traumatic brain injury to return to work. Summary scores of six domains of a modified World Health Organization Disability Assessment Schedule 2.0 had better accuracy of predicting the opportunity to return to work among traumatic brain injury patients than each domain. Sex, education level and severity of impairment were related to the opportunity to return to work in traumatic brain injury patients. Higher disability scores from a modified version of the World Health Organization Disability Assessment Schedule 2.0 were associated with less opportunity to return to work and can be referenced for establishing effective rehabilitation strategies for facilitating return to work among persons with traumatic brain injury. [ABSTRACT FROM AUTHOR]

Background: Chronic obstructive pulmonary disease (COPD) develops as a multifaceted and complex disorder, with clinical and functional repercussions. Objective: To investigate the association among contextual factors (personal and environmental) and clinical features and the disability of COPD patients, with emphasis on activity and social participation. Methods: A cross-sectional study with stable COPD participants (n = 47) was conducted to assess personal and clinical characteristics, activity of daily living using the London Chest Activity of Daily Living scale (LCADL), disability by the World Health Organization Disability Assessment Schedule 2.0 (WHODAS), and environmental factors by the Craig Hospital Inventory of Environmental Factors (CHIEF). Statistical analysis was performed by the multivariate method. Results: In the LCADL predictive analysis, the variables forced expiratory volume in 1 second (FEV1), dyspnea levels 3–4 by the modified Medical Research Council scale (mMRC), and active level of regular physical activity were included in the final model (adjusted R2 = 0.523). In addition, WHODAS was influenced by CHIEF physical structure score and mMRC 1–2 and mMRC 3–4 grades (adjusted R2 = 0.500). Conclusions: Disability is a complex in COPD patients and encompasses a prominent role of dyspnea levels in the prediction of activity and participation. Multivariate models presented clinical and contextual factors as functional predictors that included the physical structure of the environment in the determination of social participation. [ABSTRACT FROM AUTHOR]

To explore the psychometric properties of the Greek version of the World Health Organization Disability Assessment Schedule (WHODAS 2.0–12 item) in adult patients suffering from motor disabilities. The questionnaire of WHODAS 2.0–12 item was officially translated and cross-culturally adapted into Greek (WHODAS 2.0–12Gr).136 adult patients with motor disabilities included in the present observational study. A reliability study was carried out to explore WHODAS 2.0–12Gr's internal consistency (Cronbach's a), repeatability (Pearson's r) and test retest test-retest reliability between the WHODAS 2.0–12Gr outcomes of day-1 and day-8 [intra-class correlation coefficients with 95% confidence intervals (ICC 95%CI)], and the convergent validity (item-total correlation) of the questionnaire. Exploratory factor analysis (EFA) was used to explore the construct validity of the WHODAS 2.0–12Gr, while the concurrent validity of the questionnaire was testing against the Greek Medical Outcomes Study 36-item Short Form Health Survey version 1.0 (SF-36v1.0-Gr). Reliability properties: WHODAS 2.0–12Gr Cronbach's a was 0.814 (p < 0.001), Pearson's r value was 0.980 (p < 0.001) and ICC (95%CI) was 0.990 (0.985–0.993) (p < 0.001). Validity properties: Pearson's r values of item-total correlation were ranged from 0.376 to 0.736. EFA extracted a 3-factor model. Regarding concurrent validity, the significant correlations between the WHODAS 2.0–12Gr and the SF36v1.0-Gr ranged from −0.169 to −0.720. WHODAS 2.0–12Gr showed significant high to excellent reliability and significant weak to strong validity properties. Overall, it can be suggested that WHODAS 2.0–12Gr could be a reliable and valid tool for assessing patients with motor disabilities. [ABSTRACT FROM AUTHOR]

The World Health Organization's (WHO) International Classification of Functioning, Disability and Health (ICF) provides an appropriate framework for conceptualizing cases within vocational rehabilitation (VR) programs. VR counselors can improve service delivery by using the framework and tools of the ICF, including the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0), the ICF Checklist 2.1, and the ICF Core Sets. VR counselors can more readily begin the initial step of evidence-based practice (i.e., formulating well-defined, answerable questions) by using the ICF framework and its tools to identify and categorize common barriers and facilitators among VR consumers. The ICF framework and its tools are described in relation to their potential utilization in VR practice. In addition, specific case examples are given, describing how VR counselors can incorporate ICF perspectives and tools into their practice. The authors briefly describe training resources, future directions, and other considerations for the use of the ICF in VR settings. [ABSTRACT FROM AUTHOR]

Background: Participation outcomes and family‐centred services are now widely agreed standards of care in paediatric rehabilitation. Evidence suggests that adoption of these practices into usual care has been slow internationally, and no studies of participation‐focused or family‐centred practices in New Zealand have been undertaken to date. The aims of this study were to identify the extent that goal setting in paediatric rehabilitation services is participation focused and family centred and to profile clinicians' beliefs about these foci. Methods: Observational study including a retrospective case note audit and questionnaire. Case notes ('charts') were audited for participation‐focused goal‐related practice. Subgroup analysis of audit data by service, profession and child ethnicity were completed using weighted mean differences. Clinicians whose case notes were audited completed a 42‐item questionnaire on factors related to practice behaviour including text responses with each item. Numerical and text data were analysed descriptively. Results: Five services were recruited (N = 46 clinicians) with case notes for 220 children audited. Auditors extracted 368 potentially participation‐related goals (Mdn = 2 goals per child) with no goals extracted for 43 (20%) of case notes. Subsequent coding of extracted goals identified 61% reflected participation (225/368). Subgroup analysis revealed significant differences between services (p = 0.006) and professions (p < 0.001). Clinicians' reported valuing participation outcomes and family involvement and largely felt they did target participation. Skill gaps, absence of self‐monitoring strategies and unsupportive professional and work cultures were cited as key challenges. Conclusions: Although valued by clinicians, participation‐focused practice is unusual care in paediatric rehabilitation in New Zealand. Substantial gains in the quality of care for children with disabilities could be afforded through training in collaborative goal setting to target participation outcomes. [ABSTRACT FROM AUTHOR]

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aim of this study is to analyze the relationship between intestinal constipation and functioning in adult women living in a municipality in the interior of northeast Brazil. Materials and Methods: This is a cross-sectional study conducted with 195 adult women in the city of Santa Cruz-RN. Constipation was diagnosed using the Rome III criteria. Functioning was measured through WHODAS 2.0. Social conditions, habits and lifestyle were also investigated. Inferential analysis was performed using the chi-squared test and the Mann–Whitney U-test, and the effect size was determined by eta squared (η2). Multivariate analysis was performed using multiple linear regression to analyze the relationship between the WHODAS total score and constipation, being adjusted by covariates with p≤ 0.20 in the bivariate. A statistical significance level of p< 0.05 was considered. Results: Most of the participants in this study were aged 19 to 39 years (69.7%) and had an income of up to 1 minimum monthly salary (79.5%). WHODAS scores showed that women with constipation had more disability in the cognitive (p < 0.001), mobility (p < 0.002), self-care (p < 0.001), and participation (p < 0.001) domains, as well as the total score (p < 0.001). After multiple linear regression analysis, the total WHODAS score remained associated with constipation (p < 0.001), in which this condition increases the score by nine points. Conclusion: The results of this study show that there is a reduction in functioning associated with the presence of constipation in adult women, mainly affecting the cognition, mobility, self-care and participation domains, in addition to the total score. [ABSTRACT FROM AUTHOR]

The World Health Organization's International Classification of Functioning, Disability and Health (WHO-ICF) is a comprehensive and highly adaptable framework that provides a universal language and shared health concepts to articulate human functioning across the lifespan and from individual to population health settings. It provides a global, biopsychosocial, and holistic structure for conceptualising the human experience of health and health service provision. Consequently, the ICF framework offers hope for a universal map for health service providers that bridges professional, cultural, economic, and geographical variations. While the use of the ICF is typically mandated by health professions accreditation bodies, integration of the ICF in medical and health professional education programmes has been slow. In addition, its potential for scaffolding interprofessional education for collaborative practice has not been maximised. In this Perspective paper, we draw on our extensive experience in developing curricula and teaching within a range of health professions programmes (medicine, occupational therapy, physiotherapy, and speech-language pathology) to provide advice on conceptual, theoretical, and practical dimensions of embedding the ICF framework within curricula to support interprofessional education and collaborative practice. [ABSTRACT FROM AUTHOR]

Healthcare practitioners (HCPs) from all backgrounds will encounter children who require and variably use orthoses to improve or maintain function. A basic understanding of why and when these are required is helpful, as it can allow a deeper discussion between HCPs, the family, child and carers. Orthotic interventions involve complex science and complex goal setting from birth to adulthood. This article presents a systematic 'Inside-Out Approach', incorporating all components of the International Classification of Functioning, Disability and Health and the International Standards Organisation objectives for orthotic interventions. This identifies the potential goals for bones and joints, muscles, motor control, motor learning, development of standing and walking, functioning, activities and participation, and prevention of pain, an indicator of quality of life. Achieving short and long term goals requires early intervention. The design and dosage, the duration and frequency the child needs to wear the orthosis, required to achieve goals will be determined by an understanding of natural history and prognosis, the goals set and the child's schedule of activities. Recent improved understanding of the contribution of the footwear, joint and segment alignments and segment proportion is discussed. [ABSTRACT FROM AUTHOR]

Technologies for ageing in place may help older adults in their homes to overcome multiple impairments and to promote their autonomy and independence. When conceptualizing technologies for ageing in place, the International Classification of Functioning, Disability and Health (ICF) is a key element due to its functioning and disability framework with consolidated concepts and terminologies. Based on the ICF conceptual framework, the article presents the ICF based Usability Scale (ICF-US) to evaluate the usability of technologies for ageing in place and reports a study aiming: (1) to validate the ICF-US to evaluate usability according to the evaluators' perspective about the users' performance and (2) to evaluate the utility and applicability of the ICF-US. Two observational studies evolving 184 participants were conducted to: (1) assess the validity and reliability of the ICF-US to evaluate usability according to the evaluators' perspective about the users' performance and (2) to verify the utility and applicability of the ICF-US. The results suggest that the ICF-US is valid and reliable and can be used in different stages of technological developments without losing its discriminatory capacity. [ABSTRACT FROM AUTHOR]

Objective: To demonstrate the influence and added value of a Standardized Assessment and Reporting System (StARS) upon the reporting of functioning outcomes for national rehabilitation quality reports. A StARS builds upon an ICF-based (International Classification of Functioning, Disability and Health) and interval-scaled common metric.Design: Comparison of current ordinal-scaled Swiss national rehabilitation outcome reports including an expert-consensus-based transformation scale with StARS-based reports through descriptive statistical methods and content exploration of further development areas of the reports with relevant ICF Core Sets.Setting: Swiss national public rehabilitation outcome quality reports on the clinic level.Participants: A total of 29 Swiss rehabilitation clinics provided their quality report datasets including 18 047 patients.Interventions: Neurological or musculoskeletal rehabilitation.Main Outcome Measures: Functional Independence Measure™ or Extended Barthel Index.Results: Outcomes reported with a StARS tended to be smaller but more precise than in the current ordinal-scaled reports, indicating an overestimation of achieved outcomes in the latter. The comparison of the common metric's content with ICF Core Sets suggests to include 'energy and drive functions' or 'maintaining a basic body position' to enhance the content of functioning as an indicator.Conclusions: A StARS supports the comparison of outcomes assessed with different measures on the same interval-scaled ICF-based common metric. Careful consideration is needed whether an ordinal-scaled or interval-scaled reporting system is applied as the magnitude and precision of reported outcomes is influenced. The StARS' ICF basis brings an added value by informing further development of functioning as a relevant indicator for national outcome quality reports in rehabilitation. [ABSTRACT FROM AUTHOR]

Purpose: The prevalence of mobility disability reaches up to 20.5% among older adults. Mobility is a key factor of participation, thus rehabilitation interventions often aim to improve mobility and participation. Peer-based approaches to intervention delivery have become increasingly common. This study aims to identify peer-based rehabilitation interventions and summarize their influence on mobility and participation among individuals with mobility disabilities. Method: A systematic review was conducted using CINALH, EMBASE, MEDLINE, and PsycINFO. Articles that evaluated peer-based rehabilitation interventions for individuals with a mobility disability and assessed mobility or participation, as defined in the International Classification of Functioning, Disability and Health framework, were included. Study quality was assessed using the Physical Therapy Evidence Database and the Quality Assessment Tool for Before-After Studies With No Control Group. Results: Thirteen peer-based studies were identified. Six peer-led studies evaluated participation and two evaluated mobility. Seven professional-led studies evaluated participation and six evaluated mobility. Randomized controlled trials had fair to high quality. The quality of pre–post studies ranged from poor to good. Conclusion: Peer-based interventions should not be overlooked as a potential intervention strategy, but further research is needed to establish their influence on mobility and participation. Peers offer a unique model of intervention that could support clinicians in their effort to improve mobility and participation outcomes for individuals with disabilities. There are currently two main models of peer-based interventions in rehabilitation: professional-led (peers assist professionals to facilitate the intervention) and peer-led interventions (peers facilitate the intervention). Both professional-led and peer-led models of intervention could be helpful in facilitating participation and in increasing mobility. [ABSTRACT FROM AUTHOR]

Copyright of Fisioterapia e Pesquisa is the property of Universidade de Sao Paulo, Faculdade de Medicina and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective The aim was to categorize the patient experience of PsA-related foot involvement by linking it to the International Classification of Functioning, Disability and Health (ICF) framework. Methods Concepts, obtained from a previous qualitative investigation of people with PsA and health professionals into their perspective of PsA-related foot involvement, were linked to the full version of the ICF classification. Concepts were linked to the most appropriate ICF category using established linking rules, which enable a systematic and standardized linking process. All concepts were linked independently to the ICF by two investigators, followed by a third investigator for adjudication. The professional backgrounds of the investigators included occupational therapy and podiatry. Results More than 100 distinct ICF categories were linked to the interview concepts. The most represented ICF category was body functions (35%), followed by environmental factors (31%), activities and participation (19%) and body structure (15%). Concepts that could not be linked to the ICF were related to coping, aspects of time and knowledge. Health professionals identified a greater proportion of body functions and fewer activity and participation categories compared with patients, indicating a possible mismatch of key concerns. Interdisciplinary group analysis demonstrated merit. Conclusion A list of ICF categories was generated, defining aspects of functioning important and relevant to the impact of PsA-related foot involvement. Despite the localized anatomical focus of this study, the effect of foot problems in PsA was linked to all components of the ICF, confirming the profound impact on functioning and daily life. [ABSTRACT FROM AUTHOR]

Background: Clinical questionnaires are mainly applied as screening tools for identification of the Obstructive sleep apnea (OSA) patients. Little attention has been paid to assess the body functions and health status of the patients. International Classification of Functioning, Disability and Health (ICF) was designed for better understanding and describing functioning and disability of patients. This study adopted the Brief ICF-Sleep Disorders and Obesity Core Set to evaluate the impairment of functioning and health status of OSA patients.Methods: Five hundred ninety-two participants were enrolled in this cross-sectional study. Data were collected using Brief ICF-Sleep Disorders and Obesity Core Set Polysomnography was performed and basic characteristics of the patients were recorded.Results: The scores for the component Body Functions and Code b130, b134, b140, b440, b530, s330, d160, d240, d450 of the two core sets were significantly different among the patients divided by apnea-hypopnea index (AHI) or oxygen saturation (SaO2) nadir, but the frequency of code s330, d160, d240, d450 was low. The Body Functions component of the both sets were closely related to neck circumference (NC), body mass index (BMI), apnea-hypopnea index (AHI) of the OSA patients. Body Functions of the Brief ICF-Sleep Disorders performed better with a threshold of 4 with sensitivity, specificity and area under the receiver operating characteristic curve (AUC) as 0.62, 0.74, 0.68(AHI ≥ 5), 0.69, 0.63, 0.66 (AHI ≥ 15), 0.75, 0.56, 0.66 (AHI ≥ 30), 0.56, 0.70, 0.63 (SaO2 nadir≤90%), 0.67, 0.66, 0.66 (SaO2 nadir<85%), 0.71, 0.59, 0.65 (SaO2 nadir<80%), separately.Conclusion: The Body Functions component of both two sets could be an evaluation tool of impairment of body functions for OSA patients. The Brief ICF-Sleep Disorders Body Functions component performed better with a threshold of 4 and might provide a new insight for physicians to assess OSA patients. [ABSTRACT FROM AUTHOR]

Objective: To identify the categories of the International Classification of Functioning, Disability and Health most suitable as outcome indicators in the transitional care for people with spinal cord injury in China. Methods: A three-round Delphi survey was conducted surveying 37 experts selected through purposive sampling. In the first round, each expert was required to suggest the most useful indicators in the transitional care for spinal cord injury patients. Categories of the International Classification of Functioning, Disability and Health were linked with the concepts extracted from the responses. In the second round, the experts were asked to make a yes/no judgment about the utility of those categories as outcome indicators and to rate their importance from 1 to 10. In the third round, the experts were asked to re-judge and re-rate the importance considering the second-round results. Results: Forty-one categories, seven personal factors, and three concepts not covered in the International Classification of Functioning, Disability and Health were identified. They generated agreement percentages over 80% in the third round. The means of the importance ratings ranged from 5.15 to 9.52. Conclusions: A set of categories and concepts was identified in the Delphi survey based on the International Classification of Functioning, Disability and Health. They provided a reference and a basis for establishing a system of outcome indicators in the transitional care for patients with spinal cord injury in China. In China, the people with spinal cord injury who live at home after discharge urgently need professional transitional care which can be extended from medical institutions to families. The categories and concepts identified by the Delphi survey based on the International Classification of Functioning, Disability and Health reflect the focuses in the transitional care of people with spinal cord injury in China. Those categories and concepts provide a reference and a basis for establishing a system of outcome indicators in the transitional care for patients with spinal cord injury in China. [ABSTRACT FROM AUTHOR]

The assessment of people with disabilities by the INSS (National Institute of Social Security) through the ICF (International Classification of Functionality, Disability and Health) to obtain the Benefit of Continued Benefit (BPC) is little known the result of its use. The results of the evaluations and epidemiological profiles of the applicants were analyzed. Single women with low schooling and mean age of 49 years were found. Only 22% had their benefit approved. A difference was observed in the evaluation of the social worker and in relation to that of the physician-expert, making it a barrier of access to the disabled person, and therefore, it is necessary to improve the ICF. [ABSTRACT FROM AUTHOR]

Rationale: The long-term effects of delivering approximately 100% of recommended calorie intake via the enteral route during critical illness compared with a lesser amount of calories are unknown.Objectives: Our hypotheses were that achieving approximately 100% of recommended calorie intake during critical illness would increase quality-of-life scores, return to work, and key life activities and reduce death and disability 6 months later.Methods: We conducted a multicenter, blinded, parallel group, randomized clinical trial, with 3,957 mechanically ventilated critically ill adults allocated to energy-dense (1.5 kcal/ml) or routine (1.0 kcal/ml) enteral nutrition.Measurements and Main Results: Participants assigned energy-dense nutrition received more calories (percent recommended energy intake, mean [SD]; energy-dense: 103% [28] vs. usual: 69% [18]). Mortality at Day 180 was similar (560/1,895 [29.6%] vs. 539/1,920 [28.1%]; relative risk 1.05 [95% confidence interval, 0.95-1.16]). At a median (interquartile range) of 185 (182-193) days after randomization, 2,492 survivors were surveyed and reported similar quality of life (EuroQol five dimensions five-level quality-of-life questionnaire visual analog scale, median [interquartile range]: 75 [60-85]; group difference: 0 [95% confidence interval, 0-0]). Similar numbers of participants returned to work with no difference in hours worked or effectiveness at work (n = 818). There was no observed difference in disability (n = 1,208) or participation in key life activities (n = 705).Conclusions: The delivery of approximately 100% compared with 70% of recommended calorie intake during critical illness does not improve quality of life or functional outcomes or increase the number of survivors 6 months later. [ABSTRACT FROM AUTHOR]

Abstract Disability as a health outcome deserves more attention than it has so far received. With people living longer and the epidemiological transition from infectious to noncommunicable diseases as the major cause of health burden, we need to focus attention on disability – the non-fatal impact of heath conditions – over and above our concern for causes of mortality. With the first Global Burden of Disease study, WHO provided a metric that enabled the comparison of the impact of diseases, drawing on a model of disability that focused on decrements of health. This model has since been elaborated in the International Classification of Functioning, Disability and Health as being either a feature of the individual or arising out of the interaction between the individual’s health condition and contextual factors. The basis of WHO’s ongoing work is a set of principles: that disability is a universal human experience; that disability is not determined solely by the underlying health condition or predicated merely on the presence of specific health conditions; and finally, that disability lies on a continuum from no to complete disability. To determine whether interventions at individual or population levels are effective, an approach to disability measurement that allows for an appropriate and fair comparison across health conditions is needed. WHO has designed the Model Disability Survey (MDS) to collect information relevant to understand the lived experience of disability, including the person’s capacity to perform tasks actions in daily life, their actual performance, the barriers and facilitators in the environment they experience, and their health conditions. As disability gains prominence within the development agenda in the United Nations Sustainable Development Goals, and the implementation of the United Nations Convention on the Rights of Persons with Disabilities, the MDS will provide the data to monitor the progress of countries on meeting their obligations. The lesson learned from WHO’s activities is that disability is a universal human experience, in the sense that everyone can be placed on a continuum of functioning and either currently experiences or is vulnerable to experiencing disability over the course of their lives. This understanding of disability is the key to mainstreaming disability within the public discourse.