Application of the International Classification of Functioning, Disability and Health (ICF) Model in Osteoporosis
Introduction[edit | edit source]
The International Classification of Functioning, Disability and Health (ICF) is a framework that describes in a more systematic way typical affected areas in health conditions in terms of body functioning and structure, activities and participation, personal and environmental circumstances. It uses a unified, globally agreed-upon language for the reporting of health and health-related states. The ICF has two components: a classification system for the coding of functioning and disability, and a conceptual framework that serves to define, describe, and organise information on health and disability aspects.
With regards to patients with osteoporosis (OP), in 2003, the World Health Organisation (WHO) produced a Technical Report on the burden of musculoskeletal conditions. Based on an iterative process that relied on the health domains covered by available evidence, expert and patient input, the most important health domains were proposed for patients with osteoporosis with the aim to develop internationally-accepted and evidence-based ICF Comprehensive and Brief Core Sets for osteoporosis.
ICF Core Set Categories for Osteoporosis[edit | edit source]
69 ICF categories have been included in the Comprehensive ICF Core Set; Fifteen relate to body functions, seven refer to body structures, twenty-one to activities and participation, and twenty-six to environmental factors. These categories can be considered when conducting a comprehensive, multidisciplinary assessment and are especially helpful for clinicians in multidisciplinary healthcare settings because they provide a thorough communication with the patient and a common language across healthcare disciplines. [1]
Out of the 69 categories, 22 ICF categories are included in the Brief ICF Core Set for osteoporosis. Two categories are related to body structures, four categories to body function, three categories related to activity and participation, and three categories refer to environmental factors.The Brief ICF Core Set can be used in assessing patients participating in a clinical study on osteoporosis. [2]
Applications[edit | edit source]
The ICF core-sets for OP have been used in applications within the literature related to: defining, universally and systematically, typical domains of the functioning of patients with OP; [3] comparing the OP- ICF codes to commonly used OP-specific patient-reported HRQL instruments in order to evaluate the quality of the disease-specific questionnaires; [4] assessing common areas between OP and osteoarthritis; [5][1] and using the OP-ICF codes in clinical practice and clinical vignettes to demonstrate how the ICF can apply across diverse clinical presentations of osteoporosis. [6]
There are also suggestions that the ICF framework can be used to map research questions and guide clinical practice specific to OP by providing insight into relevant treatment and rehabilitation; as a guide for clinicians working with OP patients; as a tool to ensure thorough patient intake, and to track progress during an intervention.[6]
Strengths[edit | edit source]
The OP ICF Core Sets main strength is that it can conceptualise a person’s level of functioning as a dynamic interaction between health condition, environmental factors, and personal factors. [6] The bi-directional feature of the conceptual framework allows for demonstrating how the components of disability interact in a multidimensional way to shape the experience and consequences of disability. Another key strength of the conceptual framework is that it is universal, i.e. it can be applied across different health disciplines. And most importantly, it focuses on the importance of personal factors, which can mediate how a disability or a health condition is really experienced.
Limitations[edit | edit source]
The use of ICF core sets is not a simple task; it requires training and expertise. Although a thorough understanding of the disease or its dimensions may not be entirely possible,[6] the ICF core sets still reflect a more comprehensive framework for the understanding of the dimensions of health that affect people with OP when compared OP-specific questionnaires.
Resources[edit | edit source]
ICF Core Set for Osteoporosis including the Comprehansive and Brief ICF Core Sets for Osteoporosis
World Health Organisation (WHO) International Classification of Functioning, Disability and Health (ICF)
References[edit | edit source]
- ↑ 1.0 1.1 Lorbergs AL, MacIntyre NJ. The International Classification of Functioning, Disability and Health (ICF) Core Sets: application to a postmenopausal woman with rheumatoid arthritis and osteoporosis of the spine. Physiother Theory Pract. 2013 Oct;29(7):547-61.
- ↑ ICF Research Branch. ICF Core Set for Osteoporosis. Available from: https://www.icf-research-branch.org/icf-core-sets-projects2/musculoskeletal-conditions/icf-core-set-for-osteoporosis [accessed 11/11/2023]
- ↑ Cieza A, Schwarzkopf S, Sigl T, Stucki G, Melvin J, Stoll T, Woolf A, Kostanjsek N, Walsh N. ICF Core Sets for osteoporosis. J Rehabil Med. 2004 Jul;(44 Suppl):81-6.
- ↑ Borchers M, Cieza A, Sigl T, Kollerits B, Kostanjsek N, Stucki G. Content comparison of osteoporosis-targeted health status measures in relation to the International Classification of Functioning, Disability and Health (ICF). Clin Rheumatol. 2005 Apr;24(2):139-44.
- ↑ Schwarzkopf SR, Ewert T, Dreinhöfer KE, Cieza A, Stucki G. Towards an ICF Core Set for chronic musculoskeletal conditions: commonalities across ICF Core Sets for osteoarthritis, rheumatoid arthritis, osteoporosis, low back pain and chronic widespread pain. Clin Rheumatol. 2008 Nov;27(11):1355-61.
- ↑ 6.0 6.1 6.2 6.3 Ziebart C, Page AD, MacDermid JC. Application of ICF conceptual framework in Osteoporosis. Physiother Theory Pract. 2020 Oct;36(10):1077-1087.
