Purpose: This study evaluated the usefulness of International Classification of Functioning, disability and health core set for children and youths with cerebral palsy (ICF-core set for CP) by comparing the Gross Motor Function Measure-88 (GMFM-88), which is the most widely used outcome measure in children with cerebral palsy (ICF-core set for CP). Method: One subject (Female, 14) was evaluated by GMFM-88 and ICF-core set for CP. In addition, the concept of GMFM-88 was compared with the concept of the ICF-core set for CP in compliance with ICF linking rules. The numerical values both of the GMFM-88 categories and the ICF-core set for CP's items were compared. Results: The ICF b760 was linked to the GMFM-88 59~61. d415 was linked to 57~58 of GMFM-88. d450 was linked to GMFM-88's 65~72. d455 was linked to GMFM-88 at 77and 80~83. Conclusion: The association of the ICF-core set for CP and GMFM-88 was confirmed. In addition, the number of categories of ICF-core set for CP was smaller than the number of items of GMFM-88. In conclusion, the ICF-core set for CP is an evaluation tool that can identify the various features of children. In addition, GMFM-88 was linked to the ICF core set for CP according to the ICF linking rules.
Purpose: The purpose of this study was to investigate level of functioning in patients with stroke using Modified Bathel Index (MBI), World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0), and ICF core-set for stroke. Methods: Sixty-four patients with stroke were recruited for this study from nine medical institutes. The ICF core-set for stroke, WHODAS 2.0, and MBI were used to collect subjects' functional levels. ICF core-set was employed here as a standard frame to observe multi-dimension of functioning, that is physiological bodily function, activity and participation (AP) in daily life, and current environmental factors (EF) in patients with stroke. WHODAS 2.0 and MBI were also used in order to have a specific functioning level for subjects. The linkage of each item in WHODAS 2.0 and MBI into the ICF core-set for stroke was examined. Pearson correlation coefficient was used for analysis of their relationships. Results: Functioning level of participants showed moderate resulting from MBI and WHODAS 2.0 ($73.48{\pm}22.27$ and $35.55{\pm}12.53$, respectively). Strong relationship was observed between ICF core-set and WHODAS 2.0, and with MBI. Each item of disability scales was obtained its linkage into ICF in the domain of AP. However, lack of correlation between MBI and ICF in the domain of EF was found due to absence of related factors. Conclusion: MBI was found to be linked mainly into ICF in the domain of AP and to have limited linkage into EF. Therefore, it should be suggested that the ICF concept frame should be used as a multi-dimensional approach to patients with stroke.
Purpose: This study was conducted to extract international classification of functioning, disability, and health (ICF) core sets for measuring functional status in acute stroke patients, and to evaluate clinical applicability of the core sets. Methods: A set of 22 ICF items on functional status in acute stroke patients were extracted from the Korean general ICF core sets and ICF core sets for stroke patients. The extracted ICF functional items were assessed at the time of admission and discharge among 100 stroke patients who were admitted in a university hospital. Results: Comparing to functional status at admission of acute stroke patients, the overall functional status at discharge was improved. However, functions on defecation, skin protection, and relationship with immediate family at the time of discharge were not significantly changed. Conclusion: The set of ICF functional items identified in this study may be reliable and valid to assess acute stoke patients' body functions, activities and participation and environmental factors in the holistic and comprehensive nursing context. Nursing interventions on bowel elimination and skin protection for acute stroke patients need to be developed.
Background: The International Classification of Functioning, Disability, and Health-core set (ICF-core set) for children and youth (CY) with cerebral palsy (CP) provides a useful conceptual framework and a guide for health care planning and measuring the changes brought by interventions across a multitude of dimensions from body functions to personal activities, social participation, and environmental factors for them. Objects: This single case study was reported to illustrate the use of a goal directed approach in applying the ICF-core set for CY with CP from a physical therapist perspective. Methods: An eleven year old boy with spastic CP, Gross Motor Function Classification System (GMFCS) level V, and his mother participated in an evaluation of his functioning state. The intervention goal was set through an interview using the ICF-core set, Canadian Occupational Performance Measure (COPM) and Goal Attainment Scale (GAS). Physical therapy was carried out on an outpatient basis using a goal directed approach for 30 min, 1 time/week during 12 weeks and the boy's gross motor function was assessed using the Gross Motor Function Measure (GMFM)-66 version (item set 2) before and after the intervention. Results: As measured by the boy's mother, the COPM score showed a meaningful clinical change (performance=mean 3.5, satisfaction=mean 2.5) and the T-score of GAS changed 34.4 after the goal directed approach. The GMFM-66 (item set 2) score changed from 31.8 to 38.7 and evaluation using the ICF-core set displayed improvement in 6 items of activity level between before and after the intervention. Conclusion: The ICF-core set for CY with CP is useful for understanding the overall functioning of CY with this condition and provides an opportunity to share and integrate information and opinions from different disciplines. We consider it as a useful tool in the universal language for the therapy and education of CY with CP.
Purpose: The International Classification of Functioning, Disability and Health (ICF) model was proposed by the World Health Organization for enhancing interdisciplinary communication. The purpose of this study was to examine the functional status of acute stroke patients using ICF core sets-short form. Methods: A set of 15 ICF items on functional status was used by nurses for their daily nursing assessment on functional status in 44 acute stroke patients in a university hospital. Results: The highest level of function was "consciousness", while the lowest was "defecation". Compared with functional status on the first day, consciousness, ingestion, language (mental), and defecation functions were significantly improved on the 14th day. However, there was no significant changes in items on activity and participation or environmental functions. Conclusion: These findings suggest that the function-specific nursing interventions for acute stroke patients need to be developed. Future research needs to test the usefulness of ICF items as an measurement tool.
The process of physical therapy uses a problem-solving approach to enhance a patients's functioning status. The International Classification of Functioning, Disability and Health(ICF) is the common concept for the functioning in the world. Physical therapists require the ability to identify problems, formulate hypothesis, and plan intervention strategies through clinical reasoning. In the clinical process, physical therapists need to use standard and common languages in speech and in documentation. The purpose of this study was to suggest the process of making strategy for efficient intervention, examining and evaluating the functional problem of the person with stroke using ICF tools. For the first step in this process model, therapists could list the information relating to functional problems used by the ICF Core set and then could identify the interaction among the problems using the ICF assessment sheet. For the next step, 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. Finally, after setting the identified problems as the purpose of intervention through the hypothesis testing, therapist could do some intervention after making a plan to solve these problems, and find out the outcomes using the ICF evaluation display. This report illustrates how to apply the process based on ICF concept into physical therapy practice. Making a decision for the most efficient intervention requires that therapists use the clinical reasoning process based on ICF concept.
The Journal of Korean Academy of Orthopedic Manual Physical Therapy
/
v.17
no.1
/
pp.35-44
/
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.
Background and Purpose : Many Physical therapist are inclined to communicate less effectively each other because they hardly use the standard terminology. The purposes of this case report are (1) to apply ICF-based documentation in evaluation (2) to submit the strategy of intervention process to improve the ability of walking short distance of the client who has post-stroke. Description : The client was 44-years-old man with hemiplegia who was in 1 month post-stroke problems were diagnosed while applying the ICF core set. The goals agreed with client were independently walking short distance, stairs and obstacles. To come up with the intervention strategy, hypothesis was set and 4 weeks of intervention was carried out after proposing the short goal and detailed purpose. Outcome : The client's performance in walking short distance and confidence were increased after impairment focused intervention, that are improved in walking velocity, endurance, supporting ability in lower limbs, rhythmical movement in upper limbs and the coordination of both limbs. Activities focused intervention also enhanced the ability in climbing steps and walking around obstacles. Conclusion : The decided hypothesis and goal that are to solve the problems the client faced were remarkably meaningful.
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.
Journal of the Korean Society of Physical Medicine
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v.13
no.3
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pp.49-60
/
2018
PURPOSE: This study was conducted to investigate the intervention effect obtained by applying an ICF tool to improve the dressing in a patient with rotator cuff syndrome to schematize the problems and approaching with PNF to solve the problems. METHODS: The subject of this study was a 44-year-old patient who underwent surgery after complete right rotator cuff tear. To treat his symptoms, the processes of clinical practice were implemented in the order of examination, assessment, diagnosis, prognosis, intervention, and outcome. During examination, patient information was collected using the ICF core set. In the assessment, the problems were schematized, and an ICF assessment sheet was used to identify the interaction of the problems. The diagnosis was made by clearly describing the causal relationship derived from the assessment in ICF terms. To solve the problems, the intervention was given in the order of indirect, direct, and task based on the philosophy of PNF. To evaluate the outcome, the differences before and after the intervention were compared. Additionally, the comparison for the ICF qualifier is presented with the ICF evaluation display. RESULTS: The results of the study showed clinical advantages in shoulder strength, eccentric control, range of motion, scapular stability, and shoulder pain. Overall, our patient with rotator cuff syndrome showed improvement in dressing and undressing activity in response to the PNF strategy. CONCLUSION: Application of the PNF intervention strategy after complete rotator cuff tear would have a positive effect on patient upper extremity function.
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