Multidisciplinary Management of Knee Osteoarthritis using the International Classification of Functioning, Disability and Health

Abstract

Purpose: To identify the role of environmental, cultural and accessibility factors in community reintegration and to assess how a healthcare team can provide complete rehabilitation to a client with knee osteoarthritis (OA). Method: A 57-year-old woman with bilateral knee OA was assessed using the ICF core set for OA. The components identified were linked to ICF categorical profile and assessment sheet. ICF allowed the team to identify the global, service programme and cycle goals. The client’s clinical status was followed over a 4 month period. Results: At 16 weeks, the client was able to walk faster and reported an increased ability to sit continuously, climb stairs and carry out her routine activities for a full day without increase in pain. Though she is satisfied with the outcome of the treatment, her engagement with public sphere continues to pose a problem in her attempts to reintegrate in to community. She is also concerned that her pace of doing activities has decreased within the household and outside world. Conclusion: The social construct of disability needs to be emphasized more seriously for complete rehabilitation, failing which there may not be any success at the level of functioning. Implications: This method of depicting the problems from both the client’s and health professionals’ perspective ensured that the process of goal setting is shared between the client and rehabilitation team. Some of the non-modifiable goals identified by the team revolved around environmental factors and social policy development. These factors have to be considered by policy makers to improve functioning of persons with OA at the community and society level.