International Classification of Functioning, Disability, and Health (ICF) is a model approved by WHO in 2001 to like health with functioning and disability.
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3. Healthy person with fractured arm- rehab process is simple-
improving ROM, strength, and impairments in body function will re-
establish the skills in performance of activities.
Person with stroke- tasks are more complex- because the problems
are much more extensive, complicated, and interwoven.
Both the cases are broadly similar.
Therapist begins by describing the problem in functional terms
obtained from the history, performing a systems review and detailed
examination using selected tests and measures, evaluating the data,
establishing a diagnosis and prognosis, implementing interventions
to reduce or eliminate the problems identified, and documenting the
progress toward the desired functional outcome.
4. The construct of function encompasses
all those tasks, activities, and roles that
identify a person as an independent adult
or as a child progressing toward adult
independence. These activities require
the integration of both cognitive and
affective abilities with motor skills.
Functional activity is a patient-reference
concept and is dependent on what the
individual self-identifies as essential to
support physical and psychological well-
being, as well as to create a personal sense
of meaningful living.
5. AIMS OF ICF are to:
Provide a scientific basis for understanding and studying health-
related states, outcomes, determinants, and change in health
status and functioning;
Establish a common language for describing health and health-
related states in order to improve communication between
different users, such as health-care workers, researchers, policy-
makers and the public, including people with disability;
Permit comparison of data across countries, health-care disciplines,
services and time; and
Provide a systematic coding schemes for health information
systems.
6. A CONCEPTUAL FRAMEWORK
• A broad conceptual framework is necessary to fully understand the
concept of health and its relationship to function and disability.
• Terms like well-being, health-related quality of life, and functional status
are used interchangeably.
• HEALTH: According to WHO, health is a state of complete physical, mental,
and social well-being, and not merely the absence of diseases and infirmity.
• To describe the components of health and provide a unified and standard
language and framework for the description of health and health-related
states, the INTERNATIONAL CLASSIFICATION OF FUNCTIONING,
DISABILITY, and HEALTH (ICF) was developed.
7. • FUNCTION in the ICF is an umbrella term
encompassing all body functions and
structures, activities, and participation;
• Whereas, DISABILITY is a term that
encompasses impairments in the body
functions and structures, activity limitations,
and participation restrictions.
• ICF framework consists of 2 parts:
1. Describes the components of function and
disability in the context of health
2. Describes the contextual factors which
may interact with components of first part.
8. THE ICF MODEL
• Bidirectional arrows-
represents complexity.
• For example: angina can
influence mobility- and
mobility can influence the
management of health
condition.
9.
10. • In the ICF, functioning and disability are multi-
dimensional concepts, relating to:
• The body functions and structures of people, and
impairments thereof (functioning at the level of the
body);
• The activities of people (functioning at the level of
the individual) and the activity limitations they
experience;
• The participation or involvement of people in all
areas of life, and the participation restrictions they
experience (functioning of a person as a member of
society); and
• The environmental factors which affect these
experiences (and whether these factors are
facilitators or barriers).
11. ICF COMPONENTS
I. Body function: The physiological functions of body systems (including psychological
functions)
II. Body structures: Anatomical parts of the body such as organs, limbs and their
components.
III. Impairments: Problems in function and structure such as significant deviation or
loss.
IV. Activity: The execution of a task or action by an individual.
V. Participation: Involvement in a life situation.
VI. Activity limitations: Difficulties an individual may have in executing activities.
VII. Participation restrictions: Problems an individual may experience in involvement in
life situations.
VIII. Environmental factors: The physical, social and attitudinal environment in which
people live and conduct their lives. These are either facilitators to or barriers to the
person’s functioning.
12. FUNCTIONING: is an umbrella
term for body function, body
structures, activities and
participation. It denotes the
positive or neutral aspects of the
interaction between a person’s
health condition(s) and that
individual’s contextual factors
(environmental and personal
factors).
DISABILITY: is an umbrella term
for impairments, activity
limitations and participation
restrictions. It denotes the
negative aspects of the
interaction between a person’s
health condition(s) and that
individual’s contextual factors
(environmental and personal
factors).
13. ICF COMPONENTS AND DOMAINS
BODY FUNCTION
1. Mental functions
2. Sensory functions and pain
3. Voice and speech functions
4. Functions of cardiovascular, haematological,
immunological and respiratory systems
5. Functions of the digestive, metabolic,
endocrine systems
6. Genitourinary and reproductive functions
7. Neuromusculoskeletal and movement-
related functions
8. Functions of the skin and related structures
BODY STRUCTURE
1. Structure of the nervous system
2. The eye, ear, and related structures
3. Structures involved in voice and speech
4. Structure of cardiovascular,
immunological and respiratory systems
5. Structures related to digestive, metabolic
and endocrine systems
6. Structure related to genitourinary and
reproductive systems
7. Structures related to movement
8. Skin and related structures
14. ACTIVITIES AND PARTICIPATION
1. Learning and applying knowledge
2. General tasks and demands
3. Communication
4. Mobility
5. Self care
6. Domestic life
7. Interpersonal interactions and
relationships
8. Major life areas
9. Community, social and civic life
ENVIRONMENTAL FACTORS
1. Products and technology
2. Natural environment and human-made
changes to environment
3. Support and relationships
4. Attitudes
5. Services, system and policies
