MULTICENTRE CROSS-SECTIONAL STUDY ASSESSING CONTENT VALIDITY OF THE INTERNATIONAL CLASSIFICATION OF FUNCTIONING, DISABILITY AND HEALTH CORE SET FOR POST-ACUTE MUSCULOSKELETAL CONDITIONS IN PRIMARY CARE PHYSIOTHERAPY SERVICES

Abstract

Objective

To assess content validity of the comprehensive International Classification of Functioning, Disability and Health (ICF) Core Set for post-acute musculoskeletal conditions in primary care physiotherapy services.

Design

Multicentre cross-sectional study.

Subjects

Patients with musculoskeletal disorders referred to primary care physiotherapy services.

Methods

Structured interviews were conducted using categories from the ICF Core Set, and their relevance was assessed using a visual analogue scale. An ICF category had to represent a problem for at least 5% of the sample in order to be validated.

Results

The study sample comprised 274 patients. All categories in the ICF Core Set were confirmed. Body functions related to pain and movement were the most commonly impaired, with ICF categories “b280 Sensation of pain” and “b710 Mobility of joint functions” having the highest prevalence (87.2% and 84.7%, respectively). Activity limitations and participation restrictions were concentrated in chapters “d4 Mobility” (63.5% for “d430 Lifting and carrying objects”) and “d2 General tasks and demands” (59.5% for “d240 Handling stress and other psychological demands”). The most relevant environmental factors were “e225 Climate” (55.8%) and “e580 Health services, systems and policies” (39.4%).

Conclusion

The ICF Core Set for post-acute musculoskeletal conditions shows appropriate content validity for primary care physiotherapy services.

LAY ABSTRACT

The International Classification of Functioning, Disability and Health (ICF) is an internationally recognized tool for systematically describing functioning using a wide range of categories. The comprehensive ICF Core Set for post-acute musculoskeletal conditions includes key ICF categories for assessing musculoskeletal disorders in a multidisciplinary rehabilitation setting. A validation study was needed to confirm its usefulness in primary care physiotherapy services. In this study, patients with musculoskeletal disorders referred for physiotherapy by general practitioners were asked to rate the relevance of the above ICF categories. The results confirm the importance of the functional aspects assessed by the ICF Core Set analysed from the patient’s perspective in a real-life clinical context. This finding highlights the clinical utility of this ICF-based tool for the assessment of patients with musculoskeletal problems in primary care physiotherapy services.