The International Classification of Functioning, Disability and Health (ICF) can be used to describe multidisciplinary clinical assessments of people with chronic musculoskeletal conditions

Abstract

The objective of this study was to determine whether the International Classification of Functioning, Disability and Health (ICF) and an associated core set are adequate to describe multidisciplinary clinical assessments of patients with chronic musculoskeletal conditions. The multidisciplinary assessment (medical, psychiatry, nursing, physiotherapy, occupational therapy and psychology) of a patient with chronic low back pain (LBP) was audio-recorded, transcribed and qualitatively examined. Concepts were extracted by two raters using a meaning condensation procedure and linked to the ICF. Descriptive analyses were used to examine the adequacy of the ICF and selection of categories contained in the comprehensive LBP core set. Overall, 1,228 concepts were extracted from the 5 h of assessment data. This included 1,056 (86.0 %) concepts that could be linked to the ICF, 366 (34.7 %) of which were designated as personal factors. Eighty different second-level ICF categories were represented in the multidisciplinary assessment. This included 48 of the 78 (61.5 %) comprehensive LBP core set categories and 32 non-core set categories. In addition, 32 of the 80 assessed categories were considered by three or more disciplines during their assessment. The ICF was found to adequately cover the concepts extracted from this patient's assessment. This study demonstrates that clinical assessments of chronic musculoskeletal conditions can be mapped to the overall ICF framework by applying the ICF linking rules. However, it also questions the content validity and clinical utility of the current comprehensive LBP core set and highlights the need for further research prior to widespread application of the tool in clinical practice.