All talk, no action?: the global diffusion and clinical implementation of the international classification of functioning, disability, and health.

Department of Health Sciences and Health Policy at University of Lucerne, Nottwil, Switzerland.
American journal of physical medicine & rehabilitation / Association of Academic Physiatrists (Impact Factor: 1.56). 05/2012; 91(7):550-60. DOI:10.1097/PHM.0b013e31825597e5
Source: PubMed

ABSTRACT We aimed to review the global diffusion and clinical implementation of the International Classification of Functioning, Disability, and Health (ICF) endorsed by the World Health Assembly in 2001.
First, we analyzed the diffusion process of the ICF, with a special focus on clinical rehabilitation. This was done by researching the spread of ICF-related terms in Pubmed and Google from 2001 to 2010. Second, we examined the clinical implementation of the ICF in rehabilitation settings by a systematic review of the literature in the databases Pubmed and Embase. Eligible were studies evaluating the current application and impact of the ICF in the daily practice of clinical rehabilitation.
We found that the diffusion of the ICF as a mere term and concept in the area of rehabilitation is successful. However, the implementation in clinical rehabilitation practice is highly idiosyncratic and rarely evaluated appropriately. The question arises whether this idiosyncratic implementation can be regarded as a process toward standardization at all. Evidence of concrete benefits of a clinical ICF implementation for team members or even patients is at best weak.
We suggest more comprehensive and comparable multicenter studies to solve the urgent need for best practice recommendations on ICF implementation in clinical rehabilitation.

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    ABSTRACT: The extent of the implementation of the International Classification of Functioning, Disability and Health (ICF), developed by the WHO, in rehabilitation units and in physical therapy (PT) departments is unknown. The study aims to describe the extent to which the ICF has been implemented in PT services within rehabilitation units in Israel. To update data on ICF implementation since its inception. An online semi-structured survey was administered to 25 physiotherapists in charge of PT departments in all rehabilitation units throughout Israel. Rehabilitation units were grouped into three categories: general, geriatric and pediatric. The questionnaire included items regarding the ICF implementation, its strengths, and weaknesses. Twenty two physiotherapists (88%) completed the questionnaire. The majority was familiar with the ICF and nearly two thirds reported partial implementation in their units. Implementation focused mostly on adopting the biopsychosocial concepts and using ICF terms. The ICF was not used either for evaluating patients, or for reporting or encoding patient information. Physiotherapists, directors of most Israeli PT departments in rehabilitation units are familiar with the ICF; however, its clinical implementation is very limited. There is need for further research into the processes of knowledge transfer and implementation of the ICF, in order to better understand the factors that facilitate and those that impede ICF implementation.
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