Article

Interrater Reliability of the Extended ICF Core Set for Stroke Applied by Physical Therapists

Clinics Schmieder, Allensbach, Germany.
Physical Therapy (Impact Factor: 2.53). 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.

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Available from: Mario Prosiegel, Jan 25, 2014
    • "The use of ICF qualifiers for rating a client's functioning as seen in the ICF Categorical Profile and ICF Evaluation Display generally provides comprehensive information about the severity of problems reflected in the ICF categories. However , since a standard guide on how to use ICF qualifiers to rate an ICF category is yet to be established, less-than-desired reliability and precision[53,54]may result. Another confounding factor is that ICF Core Sets define only " what to measure and not how to measure "[19]. "
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    ABSTRACT: An important goal of rehabilitation with regard to community integration is return-to-work, and vocational rehabilitation plays a key role in return-to-work efforts as well as encouraging employment retention. For vocational rehabilitation to be successful, a comprehensive, client-oriented, and inter-professional rehabilitation management approach is essential. The International Classification of Functioning, Disability, and Health (ICF), specifically ICF-based documentation tools that correspond to the “Rehab-Cycle” model, can guide the inter-professional rehabilitation management process by providing the rehabilitation team tools for structuring and coordinating their tasks from the identification of the problem to the planning of rehabilitation services, thereby promoting inter-professional communication and facilitating comprehensive client-oriented documentation. This chapter outlines the ICF-based documentation tools – ICF Assessment Sheet, ICF Categorical Profile, ICF Intervention Table, and the ICF Evaluation Display – and illustrates the use of these tools in a case example of Martin, a 26-year-old male with paraplegia, who participated in vocational rehabilitation program.
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    • "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. "
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    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.
    Full-text · Article · Apr 2014 · Physiotherapy Research International
    • "Third, the use of the ICF qualifier scale generally provides comprehensible information about the severity of problems reflected in the ICF categories. However , it may lack reliability and precision [43] [44]. The literature documents that Core Sets define only " what to measure and not how to measure " [18]. "
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    ABSTRACT: Vocational rehabilitation (VR) plays a key role in bringing persons with acquired disabilities back to work, while encouraging employment participation. The purpose of this case study is to illustrate the systematic application of International Classification of Functioning, Disability, and Health (ICF)-based documentation tools by using ICF Core Sets in VR shown with a case example of a client with traumatic spinal cord injury (SCI). The client was a 26-year-old male with paraplegia (7th thoracic level), working in the past as a mover. This case study describes the integration of the ICF Core Sets for VR into an interdisciplinary rehabilitation program by using ICF-based documentation tools. Improvements in the client's impairments, activity limitations, and participation restrictions were observed following rehabilitation. Goals in different areas of functioning were achieved. The use of the ICF Core Sets in VR allows a comprehensive assessment of the client's level of functioning and intervention planning. Specifically, the Brief ICF Core Set in VR can provide domains for intervention relevant to each member of an interdisciplinary team and hence, can facilitate the VR management process in a SCI center in Switzerland.
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