Construct dimensionality and properties of the categories in the ICF Core Set for low back pain

Objective: The aim of this study was to explore by Rasch analysis whether the Comprehensive International Classification of Functioning, Disability and Health (ICF) Core Set might represent a future clinical tool for measuring functioning of patients with low back pain. Material and methods: The Comprehensive ICF Core Set for low back pain was scored by health professionals for 118 patients with low back pain. Qualifier levels, invariance, construct validity and ordering of the categories in the components of Body function, Body structure, Activities and participation and Environmental factors were explored by Rasch analysis. Results: The number of qualifier levels had to be reduced. Categories within Body functions and within Environmental factors reflected a single underlying construct. The categories within the component of Activities and Participation did not meet the requirements of a single underlying construct in the present population. Few categories covered the problems reported by patients with a relatively high level of function.Conclusion: Rasch analysis indicated that the Comprehensive ICF Core Set for low back pain may be used with some modification of categories as a common tool for assessing problems within the components Body functions, and Activity and Participation. However, detecting ICF categories that reflect the higher functional levels in patients with low back pain, and revision of the qualifier levels may be necessary

Validation of the Brief ICF core set for low back pain from the Norwegian perspective

Aim: The aim of this study was to identify candidate categories from the International Classification of Functioning, Disability and Health (ICF) to be included in the Brief ICF Core Set for low back pain (LBP) by examining their relation to general health and functionality.Methods: This was part of an international multicentre study with 118 participating Norwegian patients with LBP. The Comprehensive ICF Core Set for LBP was filled in by health professionals. The patients reported their health-related quality of life in the Medical Outcome Study Short Form 36 (SF-36) and function in the Oswestry Disability Index. Two questions regarding the patient's general health and functioning were completed by the health professionals and the patients themselves. Regression models were developed in order to identify ICF categories explaining most of the variance of the criterion measures.Results: Twelve ICF categories remained as significant explanatory factors according to the eight regression models, four of which were not included in a previously proposed Brief ICF Core Set for LBP.Conclusions: The present study complements the development of the Brief ICF Core Set for LBP, and indicates a minimum number of categories needed to explain LBP patients' functioning and health. Further elaboration of the Brief ICF Core Set for LBP with multinational data is needed

Does the International Classification of Functioning, Disability and Health (ICF) core set for low back pain cover the patients' problems? A cross-sectional content-validity study with a Norwegian population

Aim. The aim of this work was to evaluate the Norwegian form of the International Classification of Functioning, Disability and Health (ICF) Core Set for low back pain patients and investigate the feasibility of the Core Set in clinical practice.Methods. This was part of an international multicenter study with 118 participating Norwegian patients referred to Departments of Physical Medicine and rehabilitation with low back pain (LBP). The ICF Core Set for LBP was filled in by the health professionals. The patients reported their problems using the Medical Outcome Study Short Form 36 (SF-36) and the Oswestry Low Back Pain Disability Questionnaire (ODI).Results. The ICF Core Set categories capture the problems of the LBP patients, and few categories were reported to be missing. Many problems were reported within body function, and problems within work and employment were captured by the activity and participation component. The environmental factors in ICF were most frequently scored as facilitators, but the same factor could also represent a barrier in other individuals. Health professionals, family and friends were important factors within this domain. Few problems were scored as severe or complete indicating the need of collapsing the qualifier levels. Scoring of the ICF Core Set was feasibly, but rather time-consuming.Conclusion. The ICF Core Set for LBP captures the problems of LBP, and adds important aspects to clinical practice in the field of LBP. However, the ICF Core Set for LBP needs further elaboration in order to improve the clinical feasibility

Linking self-determined functional problems of patients with neck pain to the International Classification of Functioning, Disability, and Health (ICF)

Nada Andelic,1 Jan Borre Johansen,1 Erik Bautz-Holter,1,2 Anne Marit Mengshoel,3 Eva Bakke,3 Cecilie Roe1,21Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway; 2Faculty of Medicine, University of Oslo, Oslo, Norway; 3Department of Health Sciences, Institute of Health and Society, University of Oslo, Oslo, NorwayObjective: To describe commonly reported self-determined functional problems in patients with neck pain and to evaluate their fit to the components of the International Classification of Functioning, Disability, and Health (ICF).Methods: Overall, 249 patients were included in this cross-sectional study that comprised patients with neck pain referred to the outpatient clinic at Oslo University Hospital (2007–2009). Patients were asked to report their three most significant functional problems on the Patient-Specific Functional Scale, a self-determined measure of function. The ICF was used as a tool for analysis. Meaningful concepts within the functional problems were identified, coded, and linked to second-level categories within the components of “body functions,” and “activities and participation.” Two researchers performed coding and linking independently. The ICF categories were presented by percentage of the total number of functional problems linked to the ICF.Results: Of 628 reported functional problems, 13 meaningful ICF domains were identified: four domains belonging to the body functions component (b) and nine domains belonging to activities and participation components (d). Within the 88 second-level ICF classification categories of body functions, the most frequently reported items were sleep function (b134; 27%) and mobility of joint functions (b710; 26%). Within the 538 second-level categories of activities and participation, remunerative employment was reported as the most frequent item (d850; 15%), closely followed by doing housework (d640; 14%), and recreation and leisure activities (d920; 13%). Only two meaningful concepts, described as “be active” and “to function after activities,” were not assigned to a specific ICF category.Conclusion: The majority of the specific functional problems presented by patients in this study showed a good fit with the ICF model. The substantial number of links to the activities and participation categories, such as mobility, domestic life, employment, and social and civic life, suggests that a comprehensive approach, as well as the involvement of a multidisciplinary team, should be present in the rehabilitation of neck pain-related disability.Keywords: neck pain disability, self-determined functional problems, PSFS, IC