Application of the international classification of functioning to the assessment of pediatric non-cancer palliative patients during physical therapy

Abstract

The International Classification of Functioning is a tool that will provide a patient-centered, interdisciplinary approach to physical therapy for children requiring palliative care. Purpose: to analyze the dynamics of indicators for assessing impairments and limitations according to the components of the International Classification of Functioning in the process of rehabilitation of palliative pediatric patients of non-oncological profile. Material & Methods: empirical methods (comparison, description, measurement), theoretical methods (axiomatic), general logical methods (analysis, synthesis, generalization), multiple regression method. The basis of physical therapy for pediatric non-cancer palliative patients has been the biopsychosocial model presented in the International Classification of Functioning of Children and Youth (ICF-CY). Domains of ICF-CY components were selected that took into account the symptomatology of the criteria for palliative conditions. As a result, the list of domain codes in the study included 17 categories: structures and functions of the body – 6 categories (s710, b280, b710, b735, b760, b134), activity and participation – 7 categories (d310-340, d415, d465 d820, d920), environmental factors – 3 categories (e355, e320, e115). Initial patient surveys were interpreted into ICF classifiers and patient categories were generated. Results: the initial examination established the main limitations, revealed the severity of impairments in each domain, and recorded the vast majority of severe, absolute impairments in patients of both groups. A control rehabilitation assessment 24 months after the start of therapy showed positive dynamics of ICF indicators in both groups. Calculation of the dynamics of changes in classifiers showed that the components of the functioning of the body in the main group corresponded to 123,0%, in the comparison group – 52,9%, for components of activity and participation – 154,4% in the main group and comparison group – 49,9%; components Environmental factors – 81,6% in children of the main group and in patients of the comparison group, respectively – 22,9%. A reliable correlation has been established between all components of the ICF-CY version, mathematically confirmed, and the correlation coefficient is 0,787378. Conclusions: the use of the International Classification of Functioning contributed to a comprehensive examination of patients in need of non-oncological palliative care, helped to formulate a multi-vector rehabilitation program and ensured monitoring of the effectiveness of the rehabilitation program.