Session Information
Session Title: Research Spotlight: General Rehabilitation
Session Time: None. Available on demand.
Disclosures: Thomas Kienbacher, MD: No financial relationships or conflicts of interest
Objective: The World Health Organization (WHO) recommended the International Classification of Functioning, Disability and Health (ICF) but its use in clinical practice is sparse. This study investigated the limitations and restrictions in the most relevant brief ICF core set activity and participation categories for chronic low back pain (cLBP) as automatically predicted from routinely measured outcomes using a novel, well validated computer-generated mapping algorithm.
Design: Prospective cohort studySetting : Outpatient rehabilitation centerParticipants : 2718 chronic low back pain patients (51,7 years of age, 65 % females)
Interventions: Six months comprehensive outpatient back pain rehabilitation
Main Outcome Measures: Roland Morris Disability (RMDQ) and Pain Disability Index (PDI) questionnaires, the percentage of patients with limitations and restrictions in important activity and participation ICF categories as predicted from bodily functional measurements, pain intensity, and anxiety/depression (EQ-5D questionnaire before and after rehabilitation
Results: At baseline, both the RMDQ and the PDI measures were within the third of the lowest disability scores whilst 80% of the patients had limitations with ‘maintaining a body position` and 30 % with `walking` ICF categories. Rehabilitation associated gains in the maximum isometric lumbar extension and flexion strength and the lumbar range of motion were overall significant, but improvements in patients’ limitations/restrictions were varied. Anxiety/depression, lumbar range of motion, and extension strength all had a significant impact on the majority of the ICF categories, whereas flexion strength had none.Conclusions: The rate of patients with limitations/restrictions in activity/participation ICF core categories for cLBP only partly mirrored disability levels and the impact of the body function scores on these limitations/restrictions was varied. Thus, assessing problems in the activity/participation core categories is of relevance to clinical practice for both treatment goal setting and intervention planning. This may be achieved by computer-generated mapping without additional time burden.
Level of Evidence: Level II
To cite this abstract in AMA style:
Kienbacher T, Ebenbichler GR. Back Pain Rehabilitation Associated Changes in Activity Limitations and Participation Restrictions of the International Classification of Functioning, Disability and Health [abstract]. PM R. 2021; 13(S1)(suppl 1). https://pmrjabstracts.org/abstract/back-pain-rehabilitation-associated-changes-in-activity-limitations-and-participation-restrictions-of-the-international-classification-of-functioning-disability-and-health/. Accessed May 21, 2025.« Back to AAPM&R Annual Assembly 2021
PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/back-pain-rehabilitation-associated-changes-in-activity-limitations-and-participation-restrictions-of-the-international-classification-of-functioning-disability-and-health/