ICF Core Set Research Articles

Conformities and gaps of clinical audiological data with the international classification of functioning disability and health core sets for hearing loss

Objective The International Classification of Functioning Disability and Health (ICF) is a classification of health and health-related domains created by the World Health Organization and can be used as a standard to evaluate the health and disability of individuals. The ICF Core Set for Hearing Loss (CSHL) refers to the ICF categories found to be relative to Hearing Loss (HL) and the consequences of it on daily life. This study aimed to adapt the content of a database gathered in Hörzentrum Oldenburg gGmbH that included HL medical assessments and audiological data to the ICF. Design ICF linking rules were applied to these assessment methods including medical interviews, ear examinations, pure-tone audiometry, Adaptive Categorical Loudness Scaling, and speech intelligibility test. Study sample 1316 subjects. Results In total, 44% of the brief and 18% of the comprehensive CSHL categories were addressed. The hearing functions were broadly evaluated. “Activities and Participation” and “Environmental Factors” were poorly examined (17% and 12% of the comprehensive CSHL categories, respectively). Conclusions The HL correlation with day-to-day activities limitation, performance restriction, and environmental conditions were poorly addressed. This study showed the essence of incorporating these methodologies with approaches that assess the daily-life challenges caused by HL in rehabilitation.

Content validity of patient-reported outcome measures for patients with chronic pain: considering the patient's perspective.

Understanding chronic pain and disability requires a consideration of the lived experience of the patient. There is limited evaluation of the content validity of patient-reported outcome measures (PROMs) in chronic pain using a comprehensive biopsychosocial view of the patient's experience. To address this gap, this study aimed to evaluate the content validity of PROMs for patients with chronic pain. A literature review was performed to identify PROMs for patients with chronic pain. Concepts from PROMs were linked to the International Classification of Functioning, Disability, and Health (ICF); the ICF Core Set for Chronic Widespread Pain; and the International Classification of Diseases-11 Functioning Properties of Chronic Pain (FP). Concepts were compared with published "attributes'' of chronic pain. 62 PROMs (1336 items total) were identified and linked to 560 unique second-level ICF categories. The greatest number of items across PROMs were represented in the activities and participation category (44% of all total items), followed by body functions (41%), environmental factors (9%), personal factors (5%), and body structures (0.3%). There was a 41% to 78% match with the Core Set for Chronic Widespread Pain and the International Classification of Diseases-11 FP, respectively. 20% of items reflected the pain-experience attributes with the most items reflecting the concept of "control over pain." Content validity analysis suggests chronic widespread pain patient-reported outcome measures poorly address attributes of living with chronic pain that matter most to patients. Future development or refinement should consider a more comprehensive view of the patients' lived experience.

Development of upper limb functions and self-assessment in students with cerebral palsy in inclusive education

Upper limb movements are essential from a very early age in children’s learning processes, and play an important role in school tasks such as handwriting. In cerebral palsy (CP), the functions of upper limbs are often impaired, a factor that affects children’s learning success. The aim of this paper is to briefly present the results of research that has been carried out in recent years at the Eötvös Loránd University’s Bárczi Gusztáv Faculty of Special Needs Education, investigating the upper limb movements of students with CP and their self-assessment of function. Standardized hand function tests (MACS, QUEST, JHFT, Abilhand-Kids specific to CP) were used to assess upper limb function, and the International Classification of Functioning, Disability, and Health core sets for CP (ICF core set for CP) was used to self-assess functioning of students. The results suggest that CP pupils in inclusive education have a high level of upper limb function in general; they do not generally report serious problems with their own function and their environment, but they rate themselves lower than their peers in special education. Changes during the school year were poorly detectable. The ICF-based self-assessment also highlighted problems that other outcome measure methods cannot detect but may affect school life.

Knowledge and use of the International Classification of Functioning, disability and health (ICF) and ICF Core Sets for musculoskeletal conditions among saudi physical therapists

BackgroundThe International Classification of Functioning, Disability, and Health (ICF) provides a coherent biopsychosocial view of health states. The ICF Core Sets were developed to facilitate and encourage the use of the ICF in clinical practice and research. ObjectiveTo examine the level of knowledge and use of the ICF and ICF Core Sets for musculoskeletal conditions among Saudi physical therapists. DesignCross-sectional study. MethodWe approached Saudi physical therapists (PTs) involved in managing patients with musculoskeletal conditions. Data were collected through an electronic survey consisting of multiple-choice questions related to the knowledge of the ICF, general ICF Core Sets and ICF Core Sets for musculoskeletal conditions. ResultsA total of 203 PTs participated in this study. Seventy percent of PTs knew about the meaning of ICF, but only 33% recognized aspects of the ICF. For the osteoarthritis (OA) ICF Core Set, 71.9% had poor knowledge, and for the low back pain (LBP) ICF Core Set, 61.8% had poor knowledge. ConclusionsThe Saudi PTs surveyed in this study had a good level of knowledge about the meaning of the ICF; however, this knowledge appeared to be limited when they were asked about aspects of the ICF. They had poor knowledge of musculoskeletal ICF Core Sets but seemed to be more familiar with the LBP ICF Core Set compared to the OA ICF Core Set.

Quality of life in pediatric-onset multiple sclerosis: Different disease course, different impact, different measurement approach needed

ObjectiveTo understand the impact of pediatric multiple sclerosis (MS), health-related quality of life (HRQL) measures have been used. However, specific areas of concern of youths with MS are not known. The objective of this study was to contribute content for inclusion in a new condition-specific measure of the life impact of MS for children and adolescents. MethodsA patient engagement framework was used, and an online survey was developed using the Patient Generated Index (PGI). Text threads generated by the PGI were mapped to the International Classification of Functioning, Disability, and Health (ICF) and the Comprehensive ICF Core Set for MS. ResultsA total of 20 people completed the PGI survey of which 11 were youths with MS aged 14 to 22 years. Over 75% of the areas nominated by youths with MS were related to activities and participation and approximately 20% were related to body function. In contrast, 60% of the areas nominated by parents were related to body function. This finding indicated that a measure of life impact would need to include both impairments associated with MS and important activities and roles. This new approach has a disability component covers MS-related impairments and is completed using the PGI system where the youth select disability areas affected by MS, rate, and prioritize each area for improvement. The "quality of life" component queries those areas that are going well. ConclusionThis new measurement approach could prove useful in overcoming challenges in developing condition-specific measures for rare conditions.

Simplified Post-stroke Functioning Assessment Based on ICF via Dichotomous Mokken Scale Analysis and Rasch Modeling.

PurposeThis study aims to accomplish two tasks for International Classification of Functioning, Disability and Health (ICF) application among persons with stroke: (1) to make an ICF tool for measuring personal abilities with simplified assessment operations; (2) to quantitatively evaluate ICF categories for being functioning rather than being disabled.MethodsA total of 130 inpatients with stroke via convenience sampling were evaluated by the extended comprehensive ICF core set for stroke, modified Rankin scale, and modified Barthel index (MBI). This study investigated the responses to 118 stroke-related ICF items (59 items in b and d domains individually) using Mokken scale analysis followed with Rasch modeling.ResultsA Mokken scale with 47 items was extracted from the binary data (1 as no-impairment or mild-impairment and 0 as moderate to complete impairment). A Rasch model with 45 items was derived from the Mokken scale. The conversion chart was available involving the original ordinal scores to Rasch-transformed scores from 0 to 100 (interval scale). Total scores exhibited a high correlation with the personal abilities estimated by the Rasch model. The personal ability also demonstrated a significantly strong correlation with the score of the MBI. Thus, the 45 ICF items were suggested to rate potential functional ability as a single measurement.ConclusionBased on simple “functioning or disabled” judgment tasks, ICF assessment can be simplified to a questionnaire with answering “yes-or-no” questions for each category. Functioning level for each person and difficulty of being functioning for each category can be estimated by the Rasch model of this questionnaire.

Developing an International Classification of Functioning, Disability and Health Core Set for Pediatric Brain Tumor Survivors in Chinese Clinical Settings.

The International Classification of Functioning, Disability and Health (ICF) core set (CS) facilitates the standardization of functioning and impairment assessment for integration of holistic care. This study developed an ICF CS for interviewing pediatric brain tumor survivors in Taiwan to help healthcare professionals in implementing disability assessment and management measures. A group of 29 experts in 10 relevant fields with at least 5 years of experience working with children with brain tumors participated in this study. The first questionnaire contained 247 second-level ICF categories. The experts rated the significance of each category by using a 5-point Likert scale. Correlations between individual and group scores were calculated to determine consensus. Categories with an average rating of higher than 4 and for which greater than or equal to 80% (23) of the participants provided a rating of 4 or higher were included in the final CS. The final CS contained a total of 57 ICF categories: 20 from the Body Functions and Structures component, 36 from the Activities and Participation component, and 1 from the Environmental Factors component. The ICF CS for pediatric brain tumor survivors provides a framework for relevant healthcare professionals to deliver patient-centered care, ensuring that services focus on all areas of development. Patient ratings for this ICF CS may serve as a new practical and effective patient-reported information tool for acquiring patient input and for the systematic monitoring of pediatric brain tumor survivors in clinical practice. Further research should be conducted on this CS to verify our findings.

An international clinical perspective on functioning and disability in adults with cerebral palsy

BackgroundThis international, multi-center cross-sectional study is one of the preparatory studies in the development of the International Classification of Functioning, Disability and Health (ICF) Core Sets for adults with cerebral palsy (CP) to describe their functioning and health. ObjectiveTo identify the most common problems in functioning of adults with CP presenting in healthcare services, and facilitating and hindering environmental factors, using the ICF as a reference. MethodsParticipants were adults with CP who visited healthcare services in the Netherlands, Sweden, Thailand, and the United States. Structured interviews were performed using an adapted version of the generic ICF checklist 2.1a (106 categories) to rate the participant's functioning and the impact of environmental factors. Descriptive statistics were used for frequency analysis. ResultsIn total, 101 participants were included, of whom 69 without intellectual disability (mean age ± SD of 38.4 ± 14.7 y; 85.5% with spastic type of CP; Gross Motor Function Classification System (GMFCS) levels I–V) and 32 with intellectual disability (mean age ± SD of 25.0 ± 6.4 y; 71.9% with spastic type of CP; GMFCS levels I–V). A total of 104 ICF categories in the ICF checklist were frequently present in adults with CP: 27 body functions, 4 body structures, 53 activities and participation, and 20 environmental factors. ConclusionsThe most common problems of adults with CP presenting in healthcare services are diverse and highly prevalent. The study results add the clinical perspective on relevant categories of functioning to the basis for developing the ICF Core Sets for adults with CP.

Assessing the content based on ICF and quality based on COSMIN criteria of patient-reported outcome measures of functioning in breast cancer survivors: a systematic review.

To identify currently used patient-reported outcome measures (PROMs) to evaluate disability in breast cancer survivors (BC) and critically evaluate their content and measurement properties. Four electronic databases (PubMed, EMBASE, CINAHL, Scopus and Google Scholar) were searched from 2001 to February 2021. PRISMA guidelines were followed. The content of the included PROM was evaluated by linking the items of the questionnaires to the International Classification of Functioning, Disability and Health (ICF) Core Set for BC using standard linking rules. Methodological quality and measurement properties were assessed using the COSMIN checklist. Qualitative synthesis was used to summarize the evidence on content validity and measurement properties. The overall quality of evidence on each measurement property was provided using GRADE principles. Ten eligible studies reported measurement properties of seven PROMs. The content of included PROMs mostly focused on disability (70% of items), and less on body function and structure (23%) or environmental factors (6%). There was high linkage to The Comprehensive Core Set for BC, Q-DASH (100%), UEFI (95%) and DASH (92%). The Core Set Unique Disability Representation for DASH, and WHODAS2 was 39% and BCSQ-BC, Lymph-ICF was 34%. BCSQ-BC, and Lymph-ICF represented 32, and 20% of the content of the Core Set for BC, respectively, however, the other questionnaires covered less than 20% of the content of the Core Set. High quality of evidence supports sufficient results for internal consistency, testretest, and measurement error for BCSQ-BC, Lymph-ICF, DASH and WHODAS2. Despite a lack of evidence on all-important clinical measurement, two generic (DASH and WHODAS2) and two disease-specific (BCSQ-BC, Lymph-ICF) PROM demonstrated emerging evidence of adequate measurement properties. The stronger alignment of the BCSQ-BC to the breast cancer ICF core set makes it preferable is a disease-specific measure. The Lymph-ICF is recommended where lymphedema is a specific focus. The DASH and WHODAS2 might be most useful where patients with a variety of upper extremity conditions, including breast cancer survivors, are being evaluated in the clinic or research study.

Validation of a Brief ICF Core Set for COPD from the Perspective of Multidisciplinary Experts: A Delphi Study

Validation of a Brief ICF Core Set for COPD from the Perspective of Multidisciplinary Experts: A Delphi Study

Content validity of the Work Rehabilitation Questionnaire (WORQ) for persons with spinal cord injury: A mixed methods study

Mixed methods. The aim of our study was to investigate the content validity of the Work Rehabilitation Questionnaire (WORQ) for use in persons with post-acute and chronic spinal cord injury (SCI). A university-based Rehabilitation Center in The Netherlands. Contents of the WORQ, brief ICF core sets for SCI for post-acute care and for chronic situation were compared with semi-guided interviews with persons with SCI and controlled for relevance by SCI rehabilitation professionals in two group meetings. Fourteen interviews with persons with SCI were performed. Two group meetings with 8 and 9 SCI rehabilitation professionals were held. Thirty seven of the 46 ICF categories (80%) of the WORQ were confirmed by both sources: mentioned in interviews with persons with SCI and considered important by the SCI professionals. The remaining 9 categories (20%) were confirmed by either the persons with SCI or the SCI professionals. Fourteen ICF categories that are part of the brief ICF core set for SCI for acute care and/or chronic situation, however are not part of the WORQ, have revealed importance by persons with SCI and SCI professionals. Our study confirms that most categories of the WORQ are important to consider for VR in persons with SCI, however, there are ICF categories that are absent in the WORQ and deemed relevant for use in VR in persons with SCI. Consequently, the content validity of the WORQ without additional items is insufficient for persons with SCI.

Do the WHO-ICF personal factors “age” and “sex” impact limited activity and restricted participation category profiles differently between younger and older women and men in multimodal chronic back pain rehabilitation?

Purpose To investigate if the International Classification of Functioning and Health (ICF) context factors “age” and “sex” would impact the disablement and respective improvement with rehabilitation defined with the ICF core set for chronic low back pain (cLBP). Furthermore, associations between limitations/restrictions and measures of body function or quality of life were of interest. Materials and methods One thousand five hundred and twelve employed cLBP patients who completed 6 months of outpatient rehabilitation and for whom complete assessments were available before and after rehabilitation. Rehabilitation comprised of progressive resistance training, psychological counseling, and educational sessions. Main outcome measures were the ICF-activity/participation core categories automatically predicted from random forests and utilizing information from the Roland Morris Disability Questionnaire and Pain Disability Index. Results Generalized linear-mixed models revealed that upon completion of rehabilitation the presence of a limitation within the ICF activity “walking” significantly decreased with significant between-group differences. The category “doing housework” demonstrated gender-specific differences, and both gender- and age-specific differences were observed for work-related participation categories. There were no meaningful associations between ICF limitation/restriction categories and body function measures (point-biserial/Spearman’s correlations). Conclusions The personal factors “age” and “sex” impact some ICF limitation/restriction categories in cLBP; appropriately addressing these personal features could further improve phase III rehabilitation outcome. Implications for rehabilitation Consistent with calls to explore the age and sex/gender influence on health and disease, little is known how these factors affect the disablement of individuals with chronic back pain. The factors “age” and “sex” drive differences in some categories within the ICF activity/restriction categories. If age- and gender-specific features in activities and participation are not appropriately addressed through interventions, rehabilitation outcome may remain suboptimal in cLBP.

Brief ICF Core Set for Schizophrenia: Development of Criteria for Assessing the Degree of Disability

Introduction: A paradigm shift in the assessment and rehabilitation of people with schizophrenia is needed, with an integrative perspective rather than a simple focus on the underlying symptomatology. To this end, it is essential to adopt integrated and continuous care focused on the person in his/her context. As a contribution, the Brief International Classification of Functioning, Disability and Health (ICF) Core Set for schizophrenia has been developed by international experts. The present study aims to develop a scale to classify the degree of disability for each of the categories of the Brief ICF Core Set for schizophrenia. Methods: The classification criteria were first developed by the researchers and then submitted for assessment by national experts in the area of schizophrenia, using the modified e-Delphi method. Results: Two rounds of questions were asked, and a consensus was reached on the development of the Schizophrenia Functioning Core Set, consisting of all categories of the Brief ICF Core Set for schizophrenia and the criteria for classifying the degree of disability. The degree of agreement of the experts was greater than 90% in all categories. Conclusion: The construction of the disability grading criteria was based on the characteristics of schizophrenia as defined in DSM-V, as well as on some functional assessment scales specifically for this disorder. The development of the Schizophrenia Functioning Core Set allows for reducing the subjectivity in the assessment of the functioning of people with schizophrenia, standardizing the application of criteria to assign the degree of disability in each of the categories.

An ICF-based assessment schedule to facilitate the assessment and reporting of functioning in manual medicine – low back pain as a case in point

Purpose This paper outlines the first steps toward developing the ICF-based assessment schedule for manual medicine with a focus on low back pain (LBP). It reports on the results of a consensus process to develop the default and optional versions of the set of ICF categories (ManMed Set) the assessment schedule should cover, and gives insight in expert input toward building a toolbox of instruments for assessing the ManMed Set categories. Methods A scoping review and qualitative study were conducted, each resulting in a list of ICF categories. These categories, along with the categories of the ICF Generic-30 Set, Comprehensive ICF Core Set for LBP, and from an existing Delphi study, served as the starting point for an established consensus process to decide on the ManMed Set. Results After alternating plenary and working group sessions, an iterative ranking process and cut-off calculation, the multi-professional and international group of 20 experts in manual medicine included 23 categories in the default ManMed version (16 + the ICF Generic-7 Set categories) and 25 in the optional version. Conclusions Their development is a major step toward developing an assessment schedule that can be employed in standardizing the assessment and reporting of functioning in manual medicine, initially of LBP patients. Implications for rehabilitation The ICF assessment schedule for manual medicine has potential use in supporting rehabilitation practice, such as for planning interventions, defining rehabilitation goals, and measuring and documenting functioning outcomes. It can be used to promote interdisciplinary coordination of care and facilitate communication between members of a multidisciplinary rehabilitation team within manual medicine and beyond. The ICF assessment schedule for manual medicine can facilitate rehabilitation and manual medicine research by providing evidence for optimizing rehabilitation practice.

International Classification of Functioning, Disability and Health core set for vision loss: A discussion paper and invitation

The World Health Organization created the International Classification of Functioning, Disability and Health (ICF) to provide a common framework to understand and describe functioning and disability. To make the ICF more applicable for everyday use, an ICF core set can be developed. We are going to reduce the entire ICF of 1400 categories to essential categories that can be used in a specific health context. These ICF core sets are created through a scientific process based on preparatory studies and the involvement of a multidisciplinary group of experts. The aim of this project is the development of an internationally accepted, evidence-based and valid ICF core set for irreversible vision loss. This article describes the process that is followed in detail and invites stakeholders to participate in the development.

ICF Core Sets for the assessment of functioning of adults with cerebral palsy.

AimTo report on the results of the online international consensus process to develop the comprehensive and brief International Classification of Functioning, Disability and Health (ICF) Core Sets for adults with cerebral palsy (CP).MethodAn online iterative decision‐making and consensus process involved 25 experts, including clinicians and researchers working with adults with CP, an adult with CP, and the parents of adults with CP from all six regions of the World Health Organization. The most relevant categories were selected from a list of 154 unique second‐level candidate categories to develop the ICF Core Sets for adults with CP. This list resulted from evidence gathered during four preparatory studies, that is, a systematic literature review, a qualitative study, an expert survey, and an empirical study.ResultsThe consensus process resulted in the comprehensive ICF Core Set containing 120 second‐level ICF categories: 33 body functions; eight body structures; 50 activities and participation; and 29 environmental factors, from which the most essential categories, 33 in total, were selected for the brief ICF Core Set. For body functions, most of the categories were mental functions and neuromusculoskeletal and movement‐related functions. Body structures were mostly related to movement. All the chapters of the activities and participation component were represented, with mobility and self‐care as the most frequently covered chapters. For environmental factors, most of the categories addressed products and technology and services, systems, and policies.InterpretationThe comprehensive and brief ICF Core Sets for adults with CP were created using a new online version of an established ICF Core Set consensus process. These Core Sets complement the age‐specific ICF Core Sets for children and young people with CP and will promote standardized data collection worldwide.

Relevance and applicability of ICF Core Sets for adults with cerebral palsy in low‐ and middle‐income countries

This commentary is on the original article by Noten et al. on pages 569–577 of this issue.

ICF Linking and Cognitive Interviewing Are Complementary Methods for Optimizing Content Validity of Outcome Measures: An Integrated Methods Review.

Content validity is a fundamental requirement of outcome measures. After reviewing operational needs and existing definitions, content validity we as defined as: the extent to which a measure provides a comprehensive and true assessment of the key relevant elements of a specified construct or attribute across a defined range, clearly and equitably for a stated target audience and context. ICF linkage rules from 2002, 2005, and 2019 have provide increasingly clear processes for describing and evaluating content of outcome measures. ICF Core Sets provide international reference standards of the core constructs of importance for different health conditions. Both are important as reference standards during content validation. To summarize their use as reference standards, the following summary indicators were proposed: (1) Measure to ICF linkage, (2) Measure to (Brief or Comprehensive) Core Set Absolute Linkage, (3) Measure to (Brief or Comprehensive) Core Set Unique Linkage, (4) Core Set Representation, and (5) Core Set Unique Disability Representation. Methods to assess how respondents engage with content are needed to complement ICF-linking. Cognitive interviewing is an ideal method since it used to explore how respondents interpret and calibrate response to individual items on an outcome measure. We proposed a framework for classifying these responses: Clarity/Comprehension, Relevance, Inadequate response definition, Reference Point, Perspective modification, and Calibration Across Items. Our analysis of 24 manuscripts that used ICF linking for content validation since updated linking rules were published found that authors typically used linking to validate existing measures, involved multiple raters, used 2005 linking rules, summarized content at a concept level (e.g., impairment, activity, participation) and/or use core sets as a reference standard. Infrequently, ICF linking was used to create item pools/conceptual frameworks for new measures, applied the full scope of the 2019 linking rules, used summary indicators, or integrated ICF-linking with qualitative methods like cognitive interviews. We conclude that ICF linkage is a powerful tool for content validity during development or validation of PROM. Best practices include use of updated ICF linking rules, triangulation of ICF linking with participant assessments of clarity and relevance preferably obtained using cognitive interview methods, and application of defined summary indicators.

The Nottwil Standard-Development and Implementation of an International Classification of Functioning, Disability and Health-Based Clinical Standard Assessment for Post-acute Rehabilitation After Newly Acquired Spinal Cord Injury.

Introduction: Assessments during rehabilitation of spinal cord injury (SCI) align with the World Health Organization's classifications and national quality requirements. This paper aims to report on the development and first implementation experiences of an institutional standard of assessments performed after newly acquired SCI.Setting: Specialized SCI acute care and post-acute rehabilitation clinic in Switzerland.Methods: A situation analysis of an interdisciplinary post-acute SCI rehabilitation program was performed. The results informed a subsequent consensus-based selection of assessments, and an information and implementation strategy. Linking to the ICF Core Set for SCI in post-acute settings and ICF Generic-30 Set was performed. The Nottwil Standard was piloted for 18 months.Results: Situation analysis: A battery of 41 assessments were irregularly performed during initial rehabilitation after newly aquired SCI. Selection of assessments: A multidisciplinary group of clinicians agreed on 10 examinations, 23 assessments and two questionnaires that make up the Nottwil Standard. In total, 55 ICF categories are covered, including most of the ICF Generic-30 Set categories. The implementation strategy included Executive Board commitment, a structured improvement project, guidelines for documentation and assessments, a manual controlling system, and staff training on the Nottwil Standard. Pilot phase: 54 persons with paraplegia and 42 with tetraplegia (75 male; 21 female) were included. Twenty-seven assessments out of 33 assessments were performed in more than 80% of all observed patients' rehabilitation.Conclusion: Implementation of a standard assessment schedule was feasible but required a well-structured process with good communication strategy and controlling mechanism, and full engagement of involved professions.

Changes in the International Classification of Functioning, Disability, and Health Components "Activity/Participation" as Predicted Through Patient-Reported Outcomes Along With Comprehensive Back Pain Rehabilitation.

Objectives:The World Health Organization (WHO) recommended the International Classification of Functioning, Disability and Health (ICF) but its use in clinical practice is sparse. This study investigated the limitations and restrictions in the most relevant brief ICF core set categories for chronic low back pain (cLBP) as automatically predicted from routinely measured outcomes using a novel, validated mapping algorithm.Materials and Methods:Of 2718 cLBP patients recruited, data from 1541 (64% females) were available from before and at the end of 6 months comprehensive outpatient rehabilitation. Assessments included the Roland Morris Disability Questionnaire (RMDQ) and Pain Disability Index (PDI) questionnaires, the percentage of patients with predicted limitations and restrictions in important activity and participation ICF categories, bodily functional measurements, pain intensity, and anxiety/depression (EQ-5D).Results:At baseline, both the RMDQ and the PDI measures were within the third of the lowest disability scores whilst 80% of the patients had limitations with “maintaining a body position” and 30% with “walking” ICF categories. Intervention-associated gains in the maximum isometric lumbar extension and flexion strength and the lumbar range of motion were significant overall, but improvements in patients’ ICF limitations/restrictions varied. Anxiety/depression, lumbar range of motion, and extension strength all had a significant impact on the majority of the ICF categories, whereas flexion strength had none.Discussion:The rate of patients with predicted limitations/restrictions in activity/participation ICF core categories for cLBP partly mirrored disability levels and the impact of the body function scores on these limitations/restrictions in ICF categories was varied. Thus, assessing problems in the ICF activity/participation core categories is of relevance to clinical practice for both treatment goal setting and intervention planning. This may be achieved by computer-generated mapping without additional time burden.