Interrater reliability of the extended ICF core set for stroke applied by physical therapists.

Clinics Schmieder, Allensbach, Germany.
Physical Therapy (Impact Factor: 3.25). 08/2008; 88(7):841-51. DOI: 10.2522/ptj.20070211
Source: PubMed

ABSTRACT The World Health Organization's International Classification of Functioning, Disability and Health (ICF) is gaining recognition in physical therapy. The Extended ICF Core Set for Stroke is a practical tool that represents a selection of categories from the whole classification and can be used along with the ICF qualifier scale to describe patients' functioning and disability following stroke. The application of the ICF qualifier scale poses the question of interrater reliability. The primary objective of this investigation was to study the agreement between physical therapists' ratings of subjects' functioning and disability with the Extended ICF Core Set for Stroke and with the ICF qualifier scale. Further objectives were to explore the relationships between agreement and rater confidence and between agreement and physical therapists' areas of core competence.
A monocentric, cross-sectional reliability study was conducted. A consecutive sample of 30 subjects after stroke participated. Two physical therapists rated the subjects' functioning in 166 ICF categories.
The interrater agreement of the 2 physical therapists was moderate across all judgments (observed agreement=51%, kappa=.41). Interrater reliability was not related to rater confidence or to the physical therapists' areas of core competence.
The present study suggests potential improvements to enhance the implementation of the ICF and the Extended ICF Core Set for Stroke in practice. The results hint at the importance of the operationalization of the ICF categories and the standardization of the rating process, which might be useful in controlling for rater effects and increasing reliability.

Download full-text


Available from: Mario Prosiegel, Jan 25, 2014
  • Source
    • "The functioning profile displays an overall expert rating of the patient's functioning using ICF qualifiers based on clinical data, i.e. findings of the discipline-specific clinical tests, clinical examinations and questionnaires. However, to some extent, the rating is sometimes wrought with reliability and precision concerns (Grill et al., 2007; Uhlig et al., 2007; Starrost et al., 2008; Jette et al., 2009). At a practical level for goal setting, the present case illustrates that ICF qualifiers are sufficiently precise to document a mutually shared, comprehensive overview of the patient's abilities and problems. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Objectives Multidisciplinary teamwork is increasingly recognized as a critical factor of success in vocational rehabilitation. Although its clinical implementation is still challenging, the International Classification of Functioning, Disability and Health (ICF) has shown to be a useful framework to facilitate communication between stakeholders, to help structure rehabilitation plans and for setting goals and clarifying team roles. With this in mind, the objective of this teaching case study is to illustrate an application of ICF-based tools in a multidisciplinary return to work (RTW) program for patients with non-specific low back pain (NLBP) from the perspective of the physiotherapist.ParticipantThe participant is a 42-year-old kindergarten teacher, who was on sick leave for 10 weeks due to NLBP.Methods This case study describes the use of ICF-based tools such as the Rehabilitation Management Sheet (RehabManagement-Sheet) to guide the rehabilitation process and facilitate team-based and physiotherapist goal setting and documentation in a multidisciplinary RTW program for NLBP.ResultsUtilizing ICF tools, we defined long-term and short-term goals, documented improvements in the patient's impairments, activity limitations, and participation restrictions and formulated action steps.Conclusion The use of ICF-based tools in multidisciplinary rehabilitation allows for a comprehensive assessment, common goal setting and coordinated intervention planning. ICF-based tools like the RehabManagement-Sheet support the physiotherapist's role within the rehabilitation team by enhancing transparency in goal setting and intervention planning across disciplines. Copyright © 2014 John Wiley & Sons, Ltd.
    Physiotherapy Research International 04/2014; DOI:10.1002/pri.1587
  • [Show abstract] [Hide abstract]
    ABSTRACT: Although the incidence of cancer in the United States is high, improvements in early diagnosis and treatment have significantly increased survival rates in recent years. Many survivors of cancer experience lasting, adverse effects caused by either their disease or its treatment. Physical therapy interventions, both established and new, often can reverse or ameliorate the impairments (body function and structure) found in these patients, improving their ability to carry out daily tasks and actions (activity) and to participate in life situations (participation). Measuring the efficacy of physical therapy interventions in each of these dimensions is challenging but essential for developing and delivering optimal care for these patients. This article describes the acute and long-term effects of cancer and its treatment and the use of the World Health Organization's International Classification of Functioning, Disability and Health (ICF) as a basis for selection of assessment or outcome tools and diagnostic or screening tools in this population.
    Physical Therapy 02/2009; 89(3):286-306. DOI:10.2522/ptj.20070309 · 3.25 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: The purpose of this study was to describe and analyse self-rated perceived functioning, disability and environmental facilitators/barriers with regard to disease severity, using the International Classification of Functioning, Disability and Health (ICF) checklist, in adults with myotonic dystrophy type 1. Cross-sectional design. Forty-one women and 29 men with myotonic dystrophy type 1. A modified ICF checklist was used for self-rating of perceived problems in 29 body-function categories, difficulties in 52 activity and participation categories, and facilitators/barriers in 23 environmental-factor categories according to the verbal anchors of the ICF qualifiers. Disease severity classification was based on the muscular impairment rating scale. Of the persons with myotonic dystrophy type 1, 80% perceived problems of excessive daytime sleepiness, 76% of muscle power, and 66% of energy and drive functions, while over 59% perceived difficulties in physically demanding mobility activities. Disabilities in mobility, self-care and domestic life were more frequently reported by persons with severe disease. Support from the immediate family, medicines and social security services were perceived as facilitators for 50-60% of the participants. Disabilities and important environmental facilitators in adults with myotonic dystrophy type 1 were identified, and this clinically-relevant information can be used for developing health services for people with this condition.
    Journal of rehabilitation medicine: official journal of the UEMS European Board of Physical and Rehabilitation Medicine 07/2009; 41(7):512-20. DOI:10.2340/16501977-0376 · 1.90 Impact Factor
Show more