ICF Domains Research Articles

Longitudinal relationship between hip displacement and hip function in children and adolescents with cerebral palsy: A scoping review.

To identify, describe, and synthesize available evidence on the longitudinal relationship between hip displacement and hip function, using the International Classification of Functioning, Disability and Health (ICF) framework, in children and adolescents with cerebral palsy (CP) aged up to 18 years. Five databases were searched systematically from inception to May 2022. Study and sample characteristics, and hip displacement and hip function measures, mapped to the ICF domains, were extracted for narrative synthesis. Twenty-nine studies were included: four longitudinal registry-based studies; 12 prospective studies; 12 retrospective studies; and one randomized controlled trial. Sample size ranged from 11 to 267. Twenty-seven (93%) studies entailed an intervention: surgery (n = 16); rehabilitation (n = 2); nerve block or botulinum neurotoxin A injection (n = 4); and combined surgery and injection (n = 2). Twenty-six studies (90%) reported outcomes at the body structure and function and impairment domain of the ICF; 17 (59%) reported outcomes in the activity domain; and three (10%) included participation measures. The most common hip displacement measure was Reimers' migration percentage (79%). Because of the inclusion of interventions in most studies, and the preponderance of retrospective studies, the relationship between hip displacement and hip function in CP is unclear. More high-quality prospective evidence on the natural history of hip displacement, and its effect on function, is needed to improve population-wide screening of children with CP.

Development of a core predictor set of weaning in critically ill patients: a Delphi-based study protocol.

Prolonged mechanical ventilation in intensive care units (ICUs) leads to increased morbidity, higher mortality rates, and elevated healthcare costs. Predicting successful weaning from mechanical ventilation with accuracy is essential for optimizing resource use and improving patient outcomes. The International Classification of Functioning, Disability and Health (ICF) framework offers a holistic perspective on health conditions and can be adapted to identify key predictors of weaning readiness. This study aims to develop a Delphi-based core predictor set for weaning in critically ill patients, utilizing the ICF model. The core predictor set development comprises three steps: (1) Literature review and expert consultation to gather weaning predictors, (2) Predictor alignment with ICF categories per established rules, and (3) Three-round Delphi survey with a multidisciplinary team. A systematic review across major databases will be conducted to identify predictors related to weaning predictors in critically ill adults from cohort studies, trials, and reviews. Predictors will then be categorized within ICF domains. A multidisciplinary expert panel will evaluate the relevance of each predictor using a 9-point Likert scale to achieve consensus. This study will contribute to the development of a standardized, evidence-based predictor set for weaning readiness in critically ill patients. Using the ICF framework, this study aims to encompass the complex factors that influence weaning, thereby enabling personalized care plans and improving weaning outcomes. The Delphi methodology guarantees a thorough, iterative process for building consensus by integrating diverse clinical perspectives. The proposed Delphi-based study protocol aims to establish a core set of predictors for weaning in the ICU setting, guided by the ICF model. Successful implementation of this predictor set could enhance decision-making around weaning trials, reduce unnecessary ventilation days, and ultimately improve patient outcomes and healthcare efficiency. Future validation and implementation studies will be essential to confirm the utility and generalizability of this predictor set in clinical practice.

Do facilitators and barriers to community ambulation differ among stroke survivors in low resource settings? A cross-sectional study in Nigeria

ABSTRACT Purpose Stroke survivors (SSV) in many low- and middle-income countries experience frustrating participation restriction in community ambulation (CA), which impedes community life. This study assessed facilitators and barriers to CA among community-dwelling SSV in a southwest state of Nigeria. Methods This cross-sectional study involved 66 community-dwelling ambulating SSV, purposively recruited from physiotherapy out-patient clinics of selected hospitals in southwest Nigeria. Semi-structured questionnaire containing physical and social environment elements of the ICF domains was administered on respondents. Mobility status at home and community, socio-demographic and clinical data of SSV were also obtained. Responses from open-ended questions were triangulated with appropriate close ended options. Data were analyzed using descriptive statistics and logistic regression at p < 0.05 Alpha value. Results Majority of the SSV were independent in their homes (59.1%), used mobility aids (87.9%) and assisted in CA (66.7%). They identified limited physical accessibility by crowds 25 (37.9%), lack of inclined surfaces 40 (95.2%), uneven floors 36 (87.8%), public seating arrangements 33 (78.6%), rain (73.8%) and inability to use services, systems and policies (77.3%) as barriers to CA. Built physical environment was a significant predictor of home (OR = 0.754, p = 0.001) and community mobility (OR = 0.850; p = 0.018), while post-stroke depression was a significant predictor of community mobility (OR = 1.038; p = 0.014). Conclusion Mobility aids, social attitudes and general support were identified as facilitators, whereas barriers to CA included built physical environment, services and policies, products and technology. Facilitators and barriers to CA are similar to some HIC contexts, perceived difficulties and experiences differ for infrastructural and social reasons among others.

The Adolescent Patient Perspective on Activity Limitations After Sport-Related Concussion.

Assessment of sport-related concussion (SRC) has begun to include patient-reported outcome measures. However, understanding of which health limitations are most meaningful to adolescents after SRC is limited. To explore patient-perceived activity limitations after SRC and throughout recovery to return to play and mapped according to the International Classification of Functioning, Disability, and Health (ICF) model. Longitudinal study. Secondary school athletic training facilities. Fifty patients (41 males, 5 females, 4 sex not reported, age = 14.9 ± 3.5 years, grade = 10.2 ± 0.93 level) with a medically diagnosed SRC. The Patient Specific-Functional Scale (PSFS) was used to assess changes in the patient's condition and the effect the injury posed on their ability to perform activities. The PSFS is a self-reported assessment of health used to identify activity limitations and rate the difficulty of performing those tasks. The PSFS was administered to patients on days 3 (D3) and 10 (D10) after SRC and at return to play. Activities affected by injury were coded into common categories and themes by a 3-person research team for subsequent analysis. The coded themes were also mapped to the ICF domains, chapters, and categories. The dependent variables were the PSFS themes, number of activities endorsed, PSFS scores, ICF domains, chapters, and categories. Descriptive analyses and frequencies were reported for the dependent variables. A total of 157 different activities were identified at D3 and coded into 28 categories that fit into 6 themes: activities of daily living, cognitive and school (COG), sports and physical activity (SPA), screen time, sleep, and social. On D3, all patients (50/50) identified at least 1 activity limitation. Most related to SPA (37.6%) and COG (31.2%). Sixty percent of patients endorsed activity limitations at D10, primarily in COG (38.6%) and SPA (36.6%). All (100%) response categories were mapped to the ICF, with most (75%) fitting the activities and participation domain. Our primary findings suggest that SRC influences many facets of the lives of adolescent athletes. Specifically, adolescent athletes identified activity restrictions primarily related to physical activity and sports participation.

Narrative Review of the Theoretical-Methodological Foundations of the TREINI Program.

Scientific knowledge has advanced in the implementation of safe and beneficial interventions for children and adolescents with cerebral palsy (CP). Although the importance of interdisciplinary interventions that integrate all components of the International Classification of Functioning, Disability and Health (ICF) into family-centered practices is widely recognized, this approach is not yet widely adopted. Instead, many programs remain focused on isolated domains. This study presents the theoretical and methodological foundation of TREINI, an interdisciplinary and family-centered program developed for children and youth with CP and other neurodevelopmental disorders. TREINI incorporates intervention strategies that address all ICF domains. It is grounded in the biopsychosocial model of health and utilizes principles based on the best evidence in pediatric rehabilitation, including intensive training, task-oriented training, and a naturalistic learning environment. Unlike traditional rehabilitation approaches, the care provided by the TREINI program is delivered through an intensive and interdisciplinary approach, by a team working collaboratively in a single location. In addition to including evidence-based interventions, the TREINI program features two innovative components: the "City of Tomorrow", a naturalistic learning environment, and the "TREINI Exoflex" therapeutic suit, specifically designed to address deficiencies in the body functions and structures of children with CP and other neurodevelopmental disorders. This program has been carefully designed to support the process of neurological re-education and rehabilitation for children and adolescents with neuropsychomotor developmental delays.

Investigate the Principles and Applications of Task-Specific Training in Neuro-Physiotherapy Rehabilitation

In India, the third leading cause of mortality is a neurological damage known as a stroke, which happens when blood flow to the brain is interrupted. Disabilities in the hands and legs are among the most prevalent effects of stroke on humans. Exercise and rehabilitation are crucial in the healing process after a stroke. While there are a variety of exercises that may help with stroke management, job specific training is a typical recommendation. Proprioceptive Neuromuscular facilitation (PNF) is another prominent approach utilised in Proprioceptive Neuromuscular facilitation (PNF). Evidence for the efficacy of task-specific training in neurological rehabilitation is growing. Stroke patients' quality of life was the primary outcome of this research, which sought to identify the impact of an ICF model-based exercise programme that was both task- and context-based. Mann Whitney U test, intention to treat analysis, and repeated measures ANOVA with generalised estimating equations using the log link function was used to analyse the data. Patients were surveyed in a more casual setting to assess feasibility. Patients' reports of pleasure, their level of adherence to the exercise programme, and the absence of adverse events all pointed to the program's viability. Stroke patients living in the community may have benefited more from an exercise programme that focused on the structure/function, activity, and involvement domains of the ICF than from traditional physiotherapy, according to one research. So, it's clear that while creating an intervention, it's important to concentrate on all of the ICF domains. Stroke patients were able to benefit from a fitness programme that was both task and context driven.

Subjective Well-Being, Positive Affect, Life Satisfaction, and Happiness With Multiple Sclerosis: A Scoping Review of the Literature.

People with multiple sclerosis (MS) may face challenges maintaining their subjective well-being, life satisfaction, happiness, and positive emotions. This scoping review's purpose was to summarize studies on these positive psychological constructs among people with MS. Observational and interventional studies that included measures of subjective well-being, life satisfaction, happiness, or positive affect were identified. Variables associated with these constructs were classified using the International Classification of Functioning, Disability and Health (ICF). The review included 22 observational and 10 interventional studies. Variables were categorized into each of the ICF domains. Cognitive behavior therapy was the most common intervention, with content and dosing varying widely. Subjective well-being, life satisfaction, happiness, and positive affect are crucial components of community and individual health. The findings of this scoping review highlight the complex interplay between function, personal factors, and environmental conditions in influencing positive psychological constructs. Given the limited evidence, rehabilitation nurses should leverage their skills in delivering holistic care and adopt data-driven approaches to integrate positive psychological strategies into care plans. Further research is needed to measure and compare interventions aimed at improving these constructs and to examine the influence of personal and environmental factors among diverse MS populations.

Caregiver and child perspectives of wellbeing in school-age children with childhood apraxia of speech

Purpose Childhood apraxia of speech (CAS) is a communication deficit that impacts a child’s overall quality of life, including their academic and social interactions, yet few studies have investigated the impact from the child’s perspective. Using The World Health Organization’s International Classification of Functioning, Disability, and Health (ICF) framework, we examined the children’s and caregivers’ perspectives on the impact of CAS on their overall wellbeing. Method Survey data were collected from 32 child-caregiver dyads for children ages 9–17 years with CAS. Items elicited responses along a 5-point scale to examine the perceived impact of children’s speech impairments using the framework, including impact on communication, interpersonal interactions/relationships, and major life events. Result Results from non-parametric statistical analyses revealed: (a) caregivers reported a significantly greater impact than children across individual ICF domains; (b) child responses were not significantly correlated with their caregiver’s responses or with the child’s age, gender, or severity indicators; and (c) both caregivers and children indicated the domain of communication was impacted more than other domains. Conclusion Results suggest a potential disconnect in the perceived impact of CAS between the caregiver and child. Recommendations include facilitating a dialogue between the child-caregiver dyad and considering treatment goals that address wellbeing.

Social rhythm and implications on functionality of patients after stroke

ABSTRACT The study aimed to assess the regularity, intensity, frequency, and period of activities comprising social rhythm and associate them with the functionality of stroke patients. The sample consisted of 73 patients (41 men and 32 women) with a mean age of 60 years (±10). Social rhythm was assessed by Social Rhythm Metric (SRM) and Activity Level Index (ALI). The functionality was evaluated using the International Classification of Functioning, Disability, and Health (ICF). Data were analyzed using Student’s t-test, ANOVA, and Chi-square test. The mean SRM was 5.1 ± 0.9, and ALI was 58.3 ± 14.9. Notably, 40% of the patients exhibited both low regularity and low intensity of activities. Six SRM activities, performed with low frequency (going outside, starting work, exercising, snacking, watching other TV programs, and going home), exhibited a tendency to have periods that deviated from the expected 24-hour daily cycle. ICF domains most associated with SRM were: d2-General tasks and demands, d3-Communication, d4-Mobility, d5-Self care, d8-Major life areas, and d9-Community, social and civic life. The results indicated changes in social rhythm with implications for patient functionality. Screening for disruptions in social rhythm could be part of the functional assessment during the rehabilitation process for post-stroke patients.

Exploring the goals and outcomes of adults with severe acquired brain injury participating in an extended inpatient brain injury rehabilitation unit in Australia

Purpose To explore the rehabilitation goals and evaluate goal attainment outcomes of people with severe acquired brain injury (ABI), and investigate the relationship between goal engagement and goal attainment. Materials and methods Mixed-methods cohort study with twenty-nine adults with severe ABI in Australia. Demographic data, goal statements and pre-post program Goal Attainment Scale scores as well as Goal Engagement Scale scores were collected. Goals were coded using inductive content analysis and categorised by ICF component and domain. Goal attainment within ICF categories was described and compared using descriptive statistics. Pre-post program change in goal attainment was evaluated using Wilcoxon signed rank tests and correlations between goal engagement and attainment was explored using Spearman’s (rho). Results 94% of 320 goals were categorised as ICF Activity and Participation. There was significant improvement in goal attainment between admission and discharge (z=-0.47, p < 0.01). There was no significant relationship between goal engagement and goal attainment however there was a positive association between engagement in goal setting at admission and discharge. Conclusions: This interdisciplinary, inpatient rehabilitation program underpinned by key-worker facilitated person-centred, role-based goal setting resulted in goal attainment in chosen goals, which were primarily activity and participation-focused.

Investigating cognitive impairment, biopsychosocial barriers, and predictors of return to daily life among older stroke survivors.

The aim was to investigate the associations between cognitive impairment and biopsychosocial factors among older stroke survivors and predictors of poststroke return to daily life. This cross-sectional study involved 117 stroke survivors (61% men) with an average age of 77 years (range 65-91). The participants completed two questionnaires (Riksstroke and Short Form 36 questionnaires). The Montreal Cognitive Assessment (MoCA) was used to assess cognitive abilities. The International Classification of Functioning, Disability, and Health (ICF) framework guided the selection of biopsychosocial variables. We used Spearman's correlation coefficient and multiple logistic regression in the analyses. The average MoCA score was 21.7 points (range: 4-30, SD 5.6). The need for assistance from relatives and professionals, need for help with dressing and household chores, reliance on others for mobility, and reading and balance problems were correlated with more severe cognitive impairment (r = 0.20-0.33). Cognitive impairment, fatigue, and balance issues predicted an unfavorable return to daily life (odds ratio: 6.2-6.8). The study indicated that cognitive impairment is associated with difficulties in all ICF domains. Cognitive impairment, fatigue, and balance issues are associated with an unsuccessful return to daily life. Prioritizing these factors and screening for cognitive impairment with objective assessment tools may improve rehabilitation outcomes and enhance overall quality of life poststroke.

Efficiency of interval hypoxia-hyperoxytherapy in the rehabilitation of patients with nonspecific musculosceletal low back pain: results of а randomized placebo-controlled study

BACKGROUND: Considering the high prevalence and social significance of nonspecific musculoskeletal lower back pain, the use of innovative non-drug rehabilitation methods, particularly interval hypoxia-hyperoxytherapy, is relevant. AIM: To evaluate the efficiency of the interval hypoxia-hyperoxytherapy in the complex medical rehabilitation of patients with nonspecific musculoskeletal lower back pain. MATERIALS AND METHODS: This randomized placebo-controlled study enrolled 62 patients (male, n=35; female n=27, aged 34–63 years) with nonspecific musculoskeletal lower back pain. All patients were randomized into two groups. The study group (n=34) received 10 procedures of hypoxia–hyperoxytherapy, and the comparison group (n=28) received 10 placebo procedures of breathing therapy. All groups underwent a 2-week standard rehabilitation program: 10 procedures of low-intensity laser therapy and low-frequency electrostatic therapy and 10 group sessions of physical exercises. The study group was breathing hypoxic (FiO2 13%–15%) and hyperoxic (FiO2 up to 40%) gas mixture through a mask in the interval mode using “ReOxy.” The duration of 1–4 procedures was 30 min and 5–10 procedures took 40 min. The placebo procedures were performed using masks with atmospheric air hole. Rehabilitation diagnosis by domains b28013, b7303, b7600, and d4500 of the International Classification of Functioning, Disability and Health (ICF), back pain and general health on a 100-mm visual analog scale, Lequesne index, 10-m walking test, Spielberger–Khanin reactive anxiety test, and Beck depression inventory were evaluated at baseline and week 2. RESULTS: After 2 weeks the values of the qualifiers of ICF domains significantly improved in the study group, back pain decreased by 65.2% (р 0.01), the Lequesne index by 76.1% (р 0.01), the 10-m walking test by 42.4% (р 0.05), the reactive anxiety level by 50.5% (р 0.01), and depression symptoms by 69.7% (р 0.01), whereas the general health improved by 71.2% (р 0.01), with statistically significant differences from the comparison group in all parameters (р 0.05). CONCLUSION: 2-week rehabilitation program, including interval hypoxia-hyperoxytherapy, reduces back pain and improves rehabilitation diagnosis based on the ICF, general health, functional status and psychoemotional state in patients with nonspecific musculoskeletal lower back pain.

A semi-structured interview to capture manual wheelchair use for mobility activities among individuals with spinal cord injury in real-life situations: development and content validity of the Wheelchair Mobility Activity Log (WC-MAL).

Mixed-method approach. To develop and assess the content validity of a semi-structured interview that captures the lived experience of using a manual wheelchair among individuals with SCI in the real world, the Wheelchair Mobility Activity Log (WC-MAL). SCIR-Group (UDESC)/Brazil. Developing the WC-MAL comprised five steps: (1) defining the construct-based on the International Classification of Functioning, Disability and Health (ICF); (2) identifying relevant activities from other assessment instruments and interviews with the end-users (14 Individuals with SCI and 13 rehabilitation professionals); (3) Selecting the items - activities were linked to ICF codes and grouped into sets; (4) developing the scoring scales based on interviews with the end-users; and, (5) evaluating content validity in accordance with the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN). The content validity ratio (CVR) for each item and scale and the overall instrument content validity index (CVI) were calculated. From an initial draft of 295 activities identified, a set of 222 activities was linked to the ICF domain of "Mobility (d4)" and further refined to generate the 23 items in the WC-MAL. Three scales were developed to assess Frequency (how often), Performance (how well), and Assistance (assistance needed) levels. The items and scales showed a CVR superior to the critical value established (≥0.64). The general CVI value was 0.96. The WC-MAL is a promising clinical instrument with adequate content validity to assess the spontaneous use of the manual wheelchair in the real world among individuals with SCI.

Scoping review: Mobility aids for people with sight loss across the ICF domains of functions, activities, and participation.

There is little literature linking mobility aids for people with sight loss to the functions, activities, and participation domains of the International Classification of Functioning, Disability and Health (ICF). Future studies on this relationship should be funded and pursued to better understand ways to maximize the benefit of mobility aids. The ICF domains of functions, activities, and participation are potentially health-supporting aspects of daily living that may be impeded for people with sight loss. Although mobility aids facilitate safely navigating obstacles to optimize independence, it is not clear if they have any effect on functions, activities, or participation. This review explores the current literature to establish the associations between mobility aids and ICF domains. An established scoping review methodological framework was used to systematically search, select, and synthesize the existing literature. Of 116 unique retrieved articles, three observational studies were eligible for inclusion with a total of 124 participants. A small experimental study found that blind adults had slower Timed Up and Go times than sighted and better performance with a long cane than without. One observational study found that physical activity was strongly related to level of visual acuity but with no independent impact of mobility aids. A single mixed-methods study explored travel frequency for blind people with assistance dogs and considered constraints to participation. Despite the included studies involving some aspect of mobility aid use by people with sight loss, to date, no study has focused exclusively on mobility aid intervention for people with sight loss within the physical function, physical activity, and participation domains of the ICF. There is no reliable evidence on the associations between mobility aids and physical function, physical activity, and participation. This is an important knowledge gap for determining the most suitable aids, as well as their use, to best facilitate health-supporting activities.

A survey on the short to medium-term satisfaction of neurological patients treated by functional surgery for the correction of limb deformities

Objectives Functional surgery (FS) is often used to correct congenital or acquired deformities in neurological patients. Along with functional results, short- and medium-term patient satisfaction should always be considered a key goal of surgery and rehabilitation. The aim of this study is to assess the short to medium-term satisfaction of patients who underwent FS and its correlation with perceived improvements. Methods Invitation to an anonymous online survey was sent via e-mail to all neurological adult patients or caregivers of children who underwent lower or upper limb FS over the 2018–2020 period. The survey investigated patients’ satisfaction with the surgery and the variation in pain, ADLs, level of independence, body image, self-esteem, social interaction skills, participation in social events, leisure activities and sports, and use of orthoses or walking aids. Descriptive data analysis was performed. Correlations were assessed using Kendall’s tau. Results 122 out of 324 adults and 53 out of 163 children’s caregivers filled out the questionnaire, with a response rate approaching 40%. Eighty-three percent of adult respondents and 87% of the children’s caregivers were satisfied or very satisfied in the short and medium terms and reported their expectations had been met. Satisfaction was significantly correlated (p < 0.01) with improvements in functional abilities, social participation, self-esteem, and pain reduction. Half of the adults and 40% of children stopped using their orthoses or replaced them with lighter ones. Dissatisfaction and worsened conditions were reported by <10% of the respondents. Conclusion According to patients and caregivers, FS was satisfactory in the short and medium terms, following improvements in all the ICF domains for most patients.

Mapping of Neck Disability Index domains linked to the international classification of functioning and disability

Objective: This study aims to link NDI items to CIF using specific and up-to-date linking rules. Methods: It is a measurement properties analysis study in which two evaluators performed the link between NDI and CIF, both with experience in CIF taxonomy and NDI application. Thus, ten binding rules developed and updated specifically for binding the ICF to other instruments were applied. Results: The Kappa coefficient determined the level of agreement between the evaluators with a confidence interval of 95%. All NDI items were linked to ICF codes; there was no need to use the term “non-definable.” The degree of agreement between the evaluators about the domains and the categories of the ICF's first, second, and third levels was almost perfect. Conclusion: Therefore, the NDI is well linked to the codes related to the ICF domains' Activity, Participation, Functions, and Structure. However, no concepts related to contextual factors were identified.

Expectations and experiences of a dance programme for autistic children: A qualitative study of parents, teachers and therapists

AbstractThis study explores the expectations of dance therapists/practitioners and parents and teachers of autistic children engaging in a developmental dance programme. Information gathered will support development of an evaluation tool aligned with the International Classification of Functioning Disability and Health (ICF) Core Sets for autism spectrum disorders (ASD). A qualitative study included a convenience cohort of teachers (n = 6), parents (n = 2) of children with ASD and therapists (n = 3). Three role specific focus groups were undertaken considering potential benefits and challenges of the programme. Content and thematic analysis was undertaken using NVivo12. Findings reflected four positive themes relating to behaviour, skills, social interaction and environmental supports. Therapists, teachers and parents focused differently on stereotypical and restricted behaviours, environmental supports and habits and routines respectively. These themes also emerged as challenges (to implement/achieve); with parents identifying more emotional and behavioural restrictions. A fourth challenge theme of transferability of skills emerged from teachers and therapists. Items mapped against 28 ICF Core Sets (across the lifespan) and six to ICF categories, with creativity and imagination mismatched. Findings highlight need for a specific outcome measure for dance and/or movement programmes for autistic individuals that captures meaningful functions across ICF domains for differing stakeholders.

May Spasticity-Related Unpleasant Sensations Interfere with Daily Activities in People with Stroke and Traumatic Brain Injury? Secondary Analysis from the CORTOX Study.

Background/Objectives: This study examined the impact of spasticity-related unpleasant sensations (pain, heaviness, stiffness) on various domains of the International Classification of Functioning, Disability, and Health (ICF) and psychosocial well-being in individuals affected by stroke or traumatic brain injury (TBI). The primary aim is to explore how these sensations affect daily activities, participation, and overall quality of life, guided by the comprehensive framework of the ICF. Methods: Utilizing a secondary analysis of data from a cohort undergoing Botulinum toxin type-A treatment for spasticity post-stroke or TBI, we developed and administered an ad-hoc questionnaire focusing on ICF domains such as body function, activities and participation, and psychosocial aspects such as mood, relationship, social life, motivation, and sleep quality. Spearman rho correlation was applied to assess the relationship between unpleasant sensations and functional as well as psychosocial outcomes among 151 participants. Results: This study identified significant correlations between the severity of unpleasant sensations and limitations in daily functioning, particularly in activities of daily living and mobility. Furthermore, an impactful association was identified between increased unpleasant sensations and deterioration in psychosocial well-being, notably in mood and sleep quality. Conclusions: These findings advocate for a person-centered approach in spasticity management, emphasizing the integration of sensory impairment strategies into rehabilitation to enhance functional outcomes and quality of life. Such an approach aims to improve functional outcomes and enhance the quality of life for individuals experiencing spasticity post-stroke or TBI. Future directions include targeted interventions to alleviate these sensations, support better rehabilitation results and improve patient experiences.

Ab. No. 140 Non-Surgical Interventions for the Prevention and Treatment of Radiation-Induced Fibrosis and Its Associated Disability in Patients With Head and Neck Cancer: An ICF Framework-Based Systematic Review

Introduction: To outline non-surgical interventions effective in preventing or treating the effects of Radiation-induced fibrosis (RIF) in Head and Neck Cancer (HNC) Survivors across domains of International Classification of Functioning, Disability and Health (ICF). RIF is a debilitating, long term sequalae of radiotherapy in HNC survivors. ICF provides an opportunity to map limitation in body functions, activity and participation with interventions but has not been used in understanding the impact of RIF in HNC survivors. Methods: Studies reporting non-surgical interventions for prevention/treatment of RIF. The review was registered in PROSPERO. Using a systematic review framework, a comprehensive search was run in six databases, independently screened, and verified by authors. Risk-of-Bias was determined using NIH quality assessment tool. Qualitative descriptive analysis was performed for the included studies. Intervention targets and outcomes were mapped to ICF domains. Results: Fifteen of 7966 retrieved studies representing data of 603 participants were included for the review. Fourteen studies were of fair and one of good quality. Seven studies representing 294 participants aimed at prevention while eight representing 309 participants aimed at treatment of RIF. Interventions studied included- exercise, electrotherapy, orthotics, swallow therapy and pharmacotherapy. Studies weren’t mutually exclusive for ICF domains. Among prevention studies, four focused on body structure, six on body function, and one on activity and participation. Among treatment studies, five addressed body structure, seven on body function, and five on activity and participation. Conclusion: Non-surgical interventions for prevention or treatment of RIF are available across ICF domains. However, the studies are limited in numbers and are of fair quality. Implications: This review provides a summary of the current state of research evidence and could be useful in providing direction to future research for prevention/treatment of RIF in HNC survivors.

Linking the content of the Comprehensive Geriatric Assessment of a reference center for the health of the elderly with the International Classification of Functioning, Disability and Health

Objective: Linking the content of the Comprehensive Geriatric Assessment (CGA) of a reference center for the health of the elderly with the International Classification of Functioning, Disability and Health (ICF) and present its Basic Set of ICF codes. Method: The AGA were linked to the ICF by two specialists, trained according to the established linking rules. Agreement between the health professionals was determined based on Cohen's kappa index. Results: The agreement between the two health professionals was considered perfect for each ICF domain (k= 0.91; p&lt;0.00; agreement= 93.32%). The AGA contained 419 items, 106 of which could not be linked to the ICF, as they were associated with health conditions or did not fit into any category. It was found that 313 were linked to the ICF domains and that 181 (60.13%) were related to body functions, 18 (5.98%) to body structures, 73 (24.258%) to activity and participation, 30 (9.97%) to environmental factors and 11 (3.51%) to personal factors. Conclusions: The ICF can be inserted in specific contexts of health services, making it feasible to link the ICF with forms prepared by the health services themselves. The correspondence between a geriatric assessment instrument and the ICF enhances case discussions, therapeutic plans and continued care. The dynamics of the care process standardized by the ICF can facilitate the expansion of care and the establishment of therapeutic goals that go beyond the context of the service and reach the family and social sphere.