Purpose: This study was to conduct a Korean cultural adaptation of the WHO disability assessment schedule (WHODAS) 2.0: 36-item version. Methods: An internationally standardized process of translation and cultural adaptation of an instrument was used to develop a Korean version of WHODAS 2.0: 36-item version. Linking each item into the International Classification of Functioning, Disability and Health (ICF) was also conducted in order to ensure the concepts in the translated instrument were compatible with ICF. All translated versions of the instrument, linking results and feedback from participants were used for the final adaptation of the Korean version of the instrument. The Korean version of the instrument was assessed twice on different occasions to examine Inter- and intra-rater reliability, and the intra-class correlation coefficient (ICC) was calculated. Results: Twelve participants were involved in the translation and linking process. Ninety-five volunteers were invited to participate to examine the reliability of the instrument. Fifty participants completed the self-rated version of the instrument and 45 finished the interviewer version. The Korean WHODAS 2.0: 36-item version was found to have excellent reliability: self-rated version and interviewer version reliability coefficients were ICC=0.92 and ICC=0.94, respectively. Thirty-four items of the translated instrument were to be linked to ICF categories. Some adaptation was made; details and a familiar example were added to help respondents answer the questions. Conclusion: The study results show that the adaptation of the 36-item version of WHODAS 2.0 to Korean was successful and the instrument is ready for use in testing its psychometric properties.
The purposes of this study were: 1) to show the item difficulty hierarchy of walking/moving construct of the International Classification of Functioning, Disability and Health-Activity Measure (ICF-AM), 2) to evaluate the item-level psychometrics for model fit, 3) to describe the relevant physical activity defined by level of activity intensity expressed as Metabolic Equivalent of Tasks (MET), and 4) to explore what extent the empirical activity hierarchy of the ICF-AM is linked to the conceptual model based on the level of energy expenditure described as MET. One hundred and eight participants with lower extremity impairments were examined for the present study. A newly created activity measure, the ICF-AM using an item response theory (IRT) model and computer adaptive testing (CAT) method, has a construct on walking/moving construct. Based on the ICF category of walking and moving, the instrument comprised items corresponding to: walking short distances, walking long distances, walking on different surfaces, walking around objects, climbing, and running. The item difficulty hierarchy was created using Winstep software for 20 items. The Rasch analyses (1-parameter IRT model) were performed on participants with lower extremity injuries who completed the paper and pencil version of walking/moving construct of the ICF-AM. The classification of physical activity can also be performed by the use of METs that is often preferred to determine the level of physical activity. The empirical item hierarchy of walking, climbing, running activities of the ICF-AM instrument was similar to the conceptual activity hierarchy based on the METs. The empirically derived item difficulty hierarchy of the ICF-AM may be useful in developing MET-based activity measure questionnaires. In addition to convenience of applying items to questionnaires, implications of the finding could lead to the use of CAT method without sacrificing the objectivity of physiologic measures.
Journal of the Korean Society of Physical Medicine
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v.19
no.1
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pp.95-105
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2024
PURPOSE: This study aimed to utilize the International Classification of Functioning, Disability, and Health (ICF) tool to identify a problem list and explore intervention effects using proprioceptive neuromuscular facilitation (PNF) for improving the crosswalk performance of patients who have undergone a bilateral hip arthroplasty. METHODS: The subject of this study was a 43-year-old male who had undergone a bilateral hip arthroplasty. To address the subject's functional status, a clinical decision-making process was carried out in the order of examination, evaluation, diagnosis, prognosis, intervention, and outcome. Patient information during the examination was collected using the ICF core set. The evaluation involved listing the items of each problem using the ICF assessment sheet and identifying the interaction between activity limitations and the impairment level. The diagnosis explicitly described the causal relationships derived from the evaluation using ICF terminology. The prognosis presented activity goals, body function, and structured goals in terms of the activity and participation levels that needed to be achieved for an individual's functional status. The intervention approached problems through the four components of the PNF philosophy, namely basic principles and procedures, techniques, and patterns, in an indirect-direct-task sequence. Results were compared before and after the intervention using the ICF evaluation display. RESULTS: The results of the study showed that the primary activity limitation, which was the walking time across the crosswalk, showed improvement, and the trunk's counter rotation and the weight-bearing capacity of both the lower limbs, which were impairment level indicators, were enhanced. CONCLUSION: This study suggests that PNF intervention strategies will serve as a positive approach for improving crosswalk walking in patients with bilateral hip arthroplasty.
The purpose of this study was to investigate the effect of self-care training based on ICF(International Classification of functioning, Disability and Health) on functional independence in the young children with spastic cerebral palsy. Total of 43 young children(male=25, female=18; age range from 36month to 72month) with spastic cerebral palsy, classified at GMFCS(Gross Motor Function Classification System) levels III-IV. Total of 32sessions of a self-care training (eating, grooming, bathing, toileting) were given 4 times a week for 30minutes from August 1th to September 30th of 2008. Changes in the functional independence after the training obtained by Wee-FIM(Functional Independence Measure for Children). Results were as follows: Functional independence was significantly increased after the training. As a result, a self-care training should be applied as an effective intervention to improve the functional independence in the young children with spastic cerebral palsy.
Purpose: Physical therapists are required to properly choose the most appropriate treatment for each patient within the framework of the International Classification of Functioning, Disability, and Health (ICF model). The aims of this study were to determine whether neurological physical therapists in clinical settings in South Korea know about the ICF model and to investigate the current trends of outcome measures (OMs) used by them. Methods: Two hundred and one physical therapists who worked with patients with neurological disorders participated in this study. The survey was conducted via e-mail and asked about commonly used OMs and the considerations for selecting OMs. Results: All physical therapists involved in this study responded completely, and 45.8% of participants learned about the ICF model, while 37.3% understood the detailed information related to the ICF model. The rest of the participants did not know or just heard about the ICF model. The most frequently used tools at the body function/structure level were the Range of Motion (98%), Manual Muscle Test (97%), Berg Balance Scale (83.1%), and Modified Ashworth Scale (70.6%) when allowing repetition. At the activity level, the 10-meter walk test (71.1%), 6-minute walk test (54.2%), and Functional Ambulatory Category (43.3%) were used, while the Activity-Specific Balance Confidence Scale (23.9%) was used at the participation level. There was a positive relationship between the number of tools used and years of work, as well as the level of understanding of the ICF model. Conclusion: The results of this study suggest that it is necessary to learn the ICF model in a clinical setting. In addition, the medical system needs to be modified to encourage physical therapists in South Korea to use proper OMs within the ICF model.
Purpose: This study was examined to improve the standing posture of a scoliosis client using the ICF Tool. Methods: For examination, the study subject was a 16-year-old female student diagnosed with 3curve-pelvic (3CP) type scoliosis. Information about her were collected through a client interview and based on international Classification of Functioning, Disability and Health (ICF). The ICF core set was for post-acute musculoskeletal conditions, and the ICF level 2 items suggested by National Rehabilitation Information Center (NARIC) were added to the recommendations for scoliosis. For evaluation, the ICF assessment sheet was used to identify the interaction among the problems. For the diagnosis, the client's functional problems were described in ICF terms. For the prognosis, the global goals for reaching the client's functional activity and participation level were presented as the long-and short-term goals. For the intervention, a coordinative locomotor training program composed of warm-up, main exercise, and cool-down was applied 3 times a week, 50 minutes a day, for 5 weeks. For the outcome, the differences between before and after the intervention were compared with the ICF qualifier and are shown with the ICF evaluation display. Results: Clinical advantages were observed in body function and structure (7° decrease of thoracic angle, 7 score increase of trunk muscle power, 6.47s improve of one leg standing, 4 score decrease of neck pain). The activity for maintaining the standing posture, in which the client had a primary limitation, was improved. Conclusion: Applying the coordinative locomotor training program is expected to improve scoliosis client's standing posture.
Purpose: This study analyzes the predictive power of upper extremity activity and the activities of daily living in patients with stroke using an easy-to-use evaluation tool. Methods: The Fugl-Meyer assessment (FMA) of the upper extremity and action research arm test (ARAT) are performed, and the Korean modified Barthel index (K-MBI) is measured. The predictive power of the upper extremity activity level and the daily activity level are analyzed using regression analysis. The statistical significance level is 0.05. Results: The coefficient of determination, R2, for predicting the ARAT using FMA was high at 0.88, but the regression equation for predicting the K-MBI using the FMA and ARAT did not show a statistically significant difference. Conclusion: The assessment of the upper extremity should be performed at the activity level, as well as the impairment level. The assessment for predicting the activities of daily living should be carried out for each level of the international classification of functioning (ICF), disability, and health, which can be linked to daily life, in addition to the assessment of the upper arm. Future research should conduct more diverse analyses using the ICF assessment tools at various levels.
The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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v.17
no.1
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pp.35-44
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2011
Background: This study was to suggest the process of making strategy for effective intervention and evaluation on functional problems of the frozen shoulder patient applied International Classification of Functioning Disability and Health (ICF) Tools. Methods: The patient was 48years old woman with right shoulder adhesive capsulitis and calcific tendinitis. In first phase, therapists could list the information relating to functional problems used by the ICF Core set and then could confirm the interaction among the problems using the ICF assessment sheet. In second phase, therapist is needed to make the hypothesis and hypothesis testing and then set a primary functional goals and therapeutic goals in detail after prioritizing the problems to be managed based on the problem list. Lastly, after setting the confirmed problems as the purpose of intervention through the hypothesis testing, therapist could do some intervention after making a plan to solve these problems. Results: This report illustrates how to apply the process based on ICF concept into physical therapy practice. The decided hypothesis and goal that are to solve the problems the client faced were remarkably meaningful. Conclusions: Clinical decision making for the most effective intervention requires that therapists use the clinical reasoning process based on ICF concept.
The aim of the present study was to compare measurement precisions of the Oswestry Back Pain Disability Questionnaire (ODQ) and a computer adaptive testing (CAT) method. The ODQ has been regarded as one of the most reliable condition-specific measure for back pain for decades. Cross-sectional study was carried out with two independent convenient samples from two out-patient rehabilitation clinics for back pain ($n_1=42$) and non-back pain group ($n_2=42$). Participants were asked to fill out the ODQ and CAT of International Classification of Functioning, Disability and Health-Activity Measure (ICF-AM). A series of Rasch analyses were performed to calculate person ability measures. The CAT measures had greater relative precision in discriminating the groups than did the ODQ measure in comparisons of the relative precision. The CAT measure appears to be more effective than did the ODQ measure in terms of measurement precision. By administering test items calibrated in a way, CAT measures using item response theory may promise a means with measurement precision as well as efficiency.
The Journal of Korean Academy of Sensory Integration
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v.18
no.2
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pp.55-68
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2020
Objective : The purpose of this study is to summarize the best-available intervention evidence for children's sensory integration therapy, drawn from studies published domestically in Korea over the last 10 years. Methods : The articles evaluated in this study were collected from the RISS and DBpia databases using the search terms "sensory integration," "sensory processing," and "Ayres Sensory Integration (ASI)". A total of 19 papers were analyzed. The selected studies were then assessed using the Population, Intervention, Outcomes, and Comparison method, the International Classification of Functioning, Disability and Health (ICF) method, and the modified Evidence Alert Traffic Light Grading System. Results : Development delay was the most commonly applied diagnosis for children's sensory integration therapy and individual sensory integration therapy was the most frequently used intervention method. The intervention effect was 91 percent in the body structure and function of ICF. The areas concentrated on were sensory modulation, sensory processing, fine and gross motor, body scheme, body-self concept, balance, basic movement, postural control and hand function, attention, and self-esteem. Conclusion : This simple overview of the efficacy of children's sensory integration therapy provides a basis for easy understanding and use by therapists, researchers and families with children.
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