bims-ricfun 2025-08-10 papers

bims-ricfun

Biomed News

on rehabilitation ICF

Issue of 2025–08–10
nine papers selected by
Gerardo Amilivia, Médica Uruguaya Corporación de Asistencia Médica

Validation of extended international classification of functioning, disability and health (ICF) core set for stroke in post-acute stroke rehabilitation using FIM Scoring.
International Classification of Functioning-Based Analysis of Activity Limitations and Participation in Hospitalized Elderly Patients in Poland: A Cross-Sectional Study.
Validation and evaluation of the application of the ICF Rehabilitation Set: a Polish clinical perspective.
Social Participation When Aging With an Early-Onset Neurological Disability: Protocol for Descriptive Qualitative Research.
Structural barriers and facilitators to accessing postsurgical rehabilitation in adults who were treated with surgery for low back pain: protocol for a scoping review.
Occupational Therapy Practice Guidelines for Nonoperative Management of Osteoarthritis and Rheumatoid Arthritis.
Exploring the essential components in a mobile application for non-pharmacological management of fibromyalgia: a qualitative study from the perspective of patients and professionals.
Advances in nursing care for post-stroke limb dysfunction rehabilitation.
Exploring Barriers and Facilitators to Early Rehabilitation in Post-Stroke Hand Dysfunction: A Qualitative Study.

J Pak Med Assoc. 2025 Jul;75(7): 1095-1099

Validation of extended international classification of functioning, disability and health (ICF) core set for stroke in post-acute stroke rehabilitation using FIM Scoring.

Roohi Abbas, Arshad Nawaz Malik, Hina Gul.

   OBJECTIVE: To validate the extended International Classification of Functioning, Disability and Health core sets for stroke in the functional assessment of post-acute stroke patients.
METHODS: The validation, cross-sectional study was conducted from January to July 2020 in the Physiotherapy departments of selected private and public hospitals located in Lahore, Pakistan including Ghurki Trust and Teaching Hospital, Ittefaq Hospital, Shalamar Hospital and the National Hospital, Lahore. Stroke patients of either gender aged at least 18 years 3 days post-diagnosis were recruited, general information regarding patient demographics, category of stroke, and the involved side was documented, while data about function and disability was gathered using semi a structured questionnaire based on the International Classification of Functioning, Disability and Health core sets categories of "Activity and Participation" through interviews. The functional independence measure was administered during the interview. Data was analysed using SPSS 22.
RESULTS: Of the 82 patients with mean age 62.13±9.40 years, 60(73.2%) were males and 22(26.8%) were females. Internal consistency of International Classification of Functioning, Disability and Health core sets with total score had a Cronbach's alpha value of 0.847 for cognitive, 0.911 for motor, 0.817 for communication and 0.728 for social scores. The correlation value between International Classification of Functioning, Disability and Health core sets and functional independence measure total score was strongly negative (-0.735).
CONCLUSIONS: The International Classification of Functioning, Disability and Health core sets for stroke could be used as a valid assessment tool to asses the functional status of post-acute care stroke patients.

Keywords:  International Classification of Functioning, Disability and Health, Stroke, Stroke rehabilitation, Post-acute care.

DOI:  https://doi.org/10.47391/JPMA.20659
Med Sci Monit. 2025 Aug 05. 31 e948648

International Classification of Functioning-Based Analysis of Activity Limitations and Participation in Hospitalized Elderly Patients in Poland: A Cross-Sectional Study.

Agnieszka Wiśniowska-Szurlej, Justyna Brożonowicz, Anna Wilmowska-Pietruszyńska, Bernard Sozański, Héctor Hernández-Lázaro, Agnieszka Sozańska.

BACKGROUND The aim of this study was to assess disability (activities and participation) among older people hospitalized in an acute geriatric hospital in south-eastern Poland, using the International Classification of Functioning, Disability, and Health (ICF) as a framework, and to explore the relationship with contextual factors. MATERIAL AND METHODS A set of ICF entities and a disability index were used to assess activity limitations and/or participation restrictions in older people admitted to Przeworsk Hospital. Contextual factors included sociodemographic characteristics, medication use, history of falls, self-assessment of quality of life, and health satisfaction. The relationship between them was assessed using a linear regression model. RESULTS A total of 281 people aged 80 years and older participated in the study. Severe problems were found in activities such as walking (45.20% of respondents), undertaking a single task (28.83%), and carrying out daily routine (18.86%). Problems were found in doing housework (24.20%), preparing meals (8.90%), and washing oneself (8.19%). The disability index showed a statistically significative relationship with age, history of falls (P<0.001), and self-perception of health and quality of life. CONCLUSIONS Disability in activities and participation in older people admitted to a geriatric hospital for acute care is influenced by contextual factors, some of which are modifiable. Identifying these factors and the implementing therapeutic interventions to prevent them could improve the level of functioning and prevent long-term disability in these patients.

DOI: https://doi.org/10.12659/MSM.948648
BMC Health Serv Res. 2025 Aug 05. 25(1): 1027

Validation and evaluation of the application of the ICF Rehabilitation Set: a Polish clinical perspective.

Agnieszka Wiśniowska-Szurlej, Agnieszka Sozańska, Justyna Brożonowicz, Anna Wilmowska-Pietruszyńska, Bernard Sozański.

   BACKGROUND: Monitoring a patient's functional status in the rehabilitation process is essential for the ongoing improvement of the quality of the rehabilitation services offered. This possibility is provided by the use of the International Classification of Functioning, Disability and Health (ICF) and the ICF Core Sets developed on its basis. The purpose of this study was to validate and evaluate the use of the ICF Rehabilitation Set in rehabilitation patients in clinical practice in southeastern Poland.
METHODS: This study included patients who required comprehensive rehabilitation in a tertiary care rehabilitation centre. The study used the Polish version of a rating reference guide for the ICF Rehabilitation Set and the Barthel Index. The assessment was carried out by an interdisciplinary team, which established the ICF qualifier values by consensus. Interrater reliability was assessed using intraclass correlation coefficients (ICCs). Convergent validity was assessed using Spearman correlation coefficients between the Disability Index (DI) and the Barthel Index (BI). To assess the effectiveness of rehabilitation in the study group, a paired Wilcoxon test was used to compare the measurements of the two ICF codes.
RESULTS: This study demonstrated the consistency and reliability of the reference guide for the ICF Rehabilitation Set. The ICC values were very high (for B620; D450; D640, the ICC was 1.000) and high (for E155, the ICC was 0.793). The individual entries from the ICF Rehabilitation Set were found to have very high concordance for assessing individual qualifiers between researchers (the ICC for the DI was 0.995). The ICF Rehabilitation Set scores and the calculated DI were correlated with the BI scores. The ICF Rehabilitation Set is sensitive to changes in the functional status of patients undergoing rehabilitation and is consistent with the results obtained by the BI measure. There was also a statistically significant improvement in patients' functional status after rehabilitation.
CONCLUSIONS: The ICF Rehabilitation Set and the developed rating reference guide are reproducible, consistent and relevant and can be used in clinical settings to collect health information from people undergoing rehabilitation. Further research is needed to strengthen the evidence to validate the ICF in Poland.
TRIAL REGISTRATION: The study was registered in the clinical trial registry at ClinicalTrials.gov (NCT06718036, date of registration 2024-11-30, retrospectively registered).

Keywords:  Clinical tool; Disability and Health; ICF Rehabilitation Set; International Classification of Functioning; Interrater reliability; Rehabilitation

DOI:  https://doi.org/10.1186/s12913-025-13048-2
JMIR Res Protoc. 2025 Aug 06. 14 e66963

Social Participation When Aging With an Early-Onset Neurological Disability: Protocol for Descriptive Qualitative Research.

Mia Lapointe, Megan Veilleux, Pascale Simard, Hung Manh Nguyen, Angéline Labbé, Valérie Poulin, Samuel Turcotte.

   BACKGROUND: Due to improvements in health care and rehabilitation, as well as better social conditions, individuals living with traumatic brain injury (TBI), multiple sclerosis (MS), or spinal cord injury (SCI) are living longer. It is therefore necessary to ensure the presence of social and health services adapted to the realities and specific needs of these populations aging with disabilities. Social participation is a key determinant of active aging and health. However, there is limited evidence regarding the social participation of these aging populations. To support the development of more inclusive approaches promoting the health of older adults, it is essential to better understand the diversity of social participation experiences among individuals aging with neurological disabilities.
OBJECTIVE: This study aims to explore how social participation is experienced by individuals aging with TBI, MS, or SCI; document the barriers and facilitators to their social participation; and explore avenues for interventions supporting their social participation.
METHODS: This descriptive qualitative research is part of a larger action research project conducted in partnership with individuals aging with disabilities, researchers, and community organizations providing services to these populations. Individuals 50 years or older living with TBI (n=8), MS (n=8), or SCI (n=8) will participate in a semistructured interview. The interviews will be transcribed verbatim, and the accuracy of the transcripts will be ensured through peer validation. Qualitative data will be analyzed using a mixed approach in alignment with the Framework methods. The use of the Human Development Model-Disability Creation Process (HDM-DCP) conceptual model will be used for deductive analysis. The coding tree will combine significant themes arising from the interviews' inductive part and the themes from the HDM-DCP. Also, 12.5% of the analysis will be tested for stringency (ie, double-blind and interrater reliability exercise).
RESULTS: This study will provide insights into the diversity of social participation experiences of these populations as well as the influence of individual characteristics and environmental resources on their social participation.
CONCLUSIONS: This project will lay the groundwork for the codevelopment of health promotion programs aimed at supporting the social participation of individuals aging with neurological disabilities. This study will also help to identify the resources and strengths that support social participation for these populations, as well as the systemic barriers that need to be addressed.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/66963.

Keywords:  MS; SCI; TBI; active and healthy aging; aging; elder; elderly; geriatrics; gerontology; individuals aging with disabilities; multiple sclerosis; neuro; neurological conditions; neurological disability; neurological diseases; neurological illnesses; neurologists; neuroscience; older adults; older people; older person; social participation; spinal cord injury; traumatic brain injury

DOI:  https://doi.org/10.2196/66963
Syst Rev. 2025 Aug 06. 14(1): 161

Structural barriers and facilitators to accessing postsurgical rehabilitation in adults who were treated with surgery for low back pain: protocol for a scoping review.

Jessica J Wong, Jen Rinaldi, Paulo Pereira, Silvano Mior, Lauren Ead, Alanna Veitch, Kent Murnaghan, Pierre Côté.

   BACKGROUND: Low back pain (LBP) is a major contributor to disability and rehabilitation needs globally. A proportion of patients with LBP undergo surgery and require postsurgical rehabilitation to optimize functioning. However, many encounter barriers to accessing rehabilitation due to structurally generated inequities linked to socioeconomic position. Structural barriers to accessing rehabilitation intersect with diversity-related factors (e.g., gender, ethnicity) to perpetuate stigma and marginalization, leading to tremendous consequences. This literature needs to be reviewed to identify key themes and knowledge gaps focused on structural factors to accessing post-surgical rehabilitation. Our objectives are to conduct a scoping review of the literature to (1) systematically map the literature on the experiences with structural barriers and facilitators to accessing post-surgical rehabilitation of adults who were treated with surgery for LBP (including with or without radiculopathy, symptomatic spinal stenosis); (2) investigate whether these experiences differ when grouped by diversity-related factors (e.g., gender, ethnicity, geographic region).
METHODS: We will conduct a scoping review of the literature based on Joanna Briggs Institute (JBI) scoping review guidance and report it according to PRISMA-Scoping Reviews. We will search multiple databases from inception to 2025 for qualitative research exploring experiences with structural barriers or facilitators to rehabilitation access after surgery among adults with LBP. Drawing upon the World Health Organization (WHO) Action on Social Determinants of Health framework, structural factors to accessing rehabilitation will include socioeconomic and political contexts; governance; macroeconomic, social and public policies; and cultural and societal values/norms. Paired reviewers will independently screen articles and extract data. Results will be summarized and grouped by type of LBP and rehabilitation, and by intersections with diversity-related factors (e.g., gender, age, ethnicity, disabilities, geographic region). Our interdisciplinary team will engage with an Advisory Committee of knowledge users with lived experience throughout.
DISCUSSION: Aligned with WHO and EUROSPINE priorities, our scoping review will elucidate the structural barriers and facilitators influencing access to post-surgical rehabilitation for LBP more inclusively. Findings will advance knowledge of structural challenges experienced by adults needing post-surgical rehabilitation, informing rehabilitation and other healthcare strategies to remove barriers and improve functioning globally.
SYSTEMATIC REVIEW REGISTRATION: Open Science Framework (OSF) https://osf.io/26h9w.

Keywords:  Low back pain; Post-surgical rehabilitation; Scoping review; Structural barriers; Structural facilitators

DOI:  https://doi.org/10.1186/s13643-025-02919-8
Am J Occup Ther. 2025 Sep 01. pii: 7905397010. [Epub ahead of print]79(5):

Occupational Therapy Practice Guidelines for Nonoperative Management of Osteoarthritis and Rheumatoid Arthritis.

Brocha Z Stern, Patricia Siegel, Elizabeth G Hunter.

IMPORTANCE: Occupational therapy practitioners play an essential role in supporting the occupational performance needs of people with osteoarthritis (OA) and rheumatoid arthritis (RA).
OBJECTIVE: These Practice Guidelines aim to assist occupational therapy practitioners, educators, and researchers in applying evidence-based clinical recommendations within the scope of occupational therapy for people with OA and RA. These guidelines can also serve as a reference for people with arthritis as well as other health care professionals, health care managers, regulators, policymakers, third-party payers, and managed-care organizations.
METHOD: The ADAPTE methodology was the basis for the development of these Practice Guidelines. It supported efficiency by allowing us to systematically adapt existing clinical practice guidelines (CPGs) to occupational therapy practice. We selected existing CPGs for inclusion, extracted relevant evidence-based clinical recommendations, and developed associated action statements to align the recommendations with occupational therapy practice. We evaluated the quality of all the included CPGs using the Appraisal of Guidelines for Research and Evaluation (AGREE) II and AGREE-Recommendations Excellence instruments.
RESULTS: Seven existing CPGs were included, from which 53 evidence-based clinical recommendations were extracted.
CONCLUSIONS AND RELEVANCE: Six action statements were developed related to (1) client education and self-management interventions, (2) psychosocial interventions, (3) lifestyle management interventions, (4) physical activity and exercise interventions, (5) interventions to support occupation, and (6) interventions for work participation. These statements can guide the application of the evidence-based clinical recommendations to develop personalized care solutions to support people with OA and RA so they can live well with these chronic conditions. Plain-Language Summary: These Practice Guidelines provide strategies for occupational therapy practitioners to help people with osteoarthritis and rheumatoid arthritis live well with their chronic condition. The guidelines include specific recommendations that have been published by other professional groups. The guidelines also provide examples of how to apply these recommendations in ways that are relevant for occupational therapy practitioners. The strategies focus on educating clients with arthritis and supporting them in managing pain, fatigue, well-being, health, and participation in daily activities.

DOI: https://doi.org/10.5014/ajot.2025.790510
Mhealth. 2025 ;11 26

Exploring the essential components in a mobile application for non-pharmacological management of fibromyalgia: a qualitative study from the perspective of patients and professionals.

María Adelaida Arboleda-Trujillo, Sara Gabriela Pacichana-Quinayaz, María Paz Grisales Gafaro, Katalina Espinosa Soto, Olga Marina Hernández Orobio, María Ana Tovar-Sánchez.

   Background: Fibromyalgia is a syndrome characterized by widespread chronic pain, associated with fatigue, sleep disturbances, and cognitive impairment, among others. Effective management of fibromyalgia requires an integrated pharmacological and non-pharmacological approach that involves the patient in self-care. M-health devices are widely used as complementary resources for chronic pain management and patient empowerment. The objective of this study is to define the content of a mobile application, FibroApp, for the non-pharmacological management of fibromyalgia, based on the perspectives of patients and expert professionals.
Methods: FibroApp was developed through a qualitative design, with the unit of analysis being meaningful discourse fragments from interviews with key informants (rheumatologists, physiatrists, physical and occupational therapists, psychiatrists, and patients diagnosed with fibromyalgia). Atlas.ti software was used for the analysis and triangulation of literature and qualitative findings.
Results: The content of FibroApp, in consensus with the interviewees-both patients and experts-includes modules on physical activity or exercise, education, cognitive stimulation, reminders, and freely accessible supplementary material. The study highlighted the importance of social support, educational resources, and personalized exercise programs as essential components of the app.
Conclusions: The development of FibroApp underscores the potential of mHealth applications in enhancing the management of fibromyalgia by providing a multifaceted tool that addresses the physical, emotional, and educational needs of patients. The integration of social support, education, physical activity, and relaxation techniques within a mobile application offers a promising approach to improving the quality of life for individuals with fibromyalgia. Further research is needed to evaluate the app's effectiveness in larger, diverse populations.

Keywords:  Fibromyalgia; mobile health; pain management; qualitative research

DOI:  https://doi.org/10.21037/mhealth-24-56
Front Neurol. 2025 ;16 1615500

Advances in nursing care for post-stroke limb dysfunction rehabilitation.

Jie Bai, Kecheng Chen.

  Stroke-induced limb dysfunction has a significant impact on patients' functional independence and quality of life. While rehabilitation efficacy depends largely on patient motivation, psychological factors often impede treatment adherence and functional recovery. This narrative review synthesizes current evidence on psychological factors affecting rehabilitation motivation, assessment tools, and evidence-based interventions for stroke patients with limb dysfunction. Psychological barriers, including kinesiophobia, diminished self-efficacy, perceived burden, and inadequate social support, significantly predict rehabilitation outcomes. Clinically validated assessment tools demonstrate variable utility across recovery phases, with the Pittsburgh Rehabilitation Participation Scale offering efficiency in acute settings and the Motivation in Stroke Patients for Rehabilitation Scale providing comprehensive evaluation during subacute and chronic phases. Evidence supports multimodal intervention strategies that combine psychological approaches (such as motivational interviewing) with technological innovations (virtual reality, game-based therapy, wearable devices). Clinical implementation should prioritize early psychological screening within 72 h of admission, followed by integrated assessment protocols combining clinician-rated and self-report measures. Furthermore, personalized motivation enhancement protocols tailored to patients' cognitive status and recovery phase, along with robust interdisciplinary collaboration between rehabilitation nurses, physical therapists, and psychologists, are essential. Ultimately, this integrated approach optimizes rehabilitation outcomes by comprehensively addressing both physical and psychological dimensions of stroke recovery. In the future, studies should emphasize multidimensional analyses that incorporate individual patient characteristics to develop precise rehabilitation interventions, thereby proposing new strategies for optimizing functional recovery in stroke survivors.

Keywords:  limb dysfunction; nursing care; psychology; rehabilitation motivation; stroke

DOI:  https://doi.org/10.3389/fneur.2025.1615500
J Multidiscip Healthc. 2025 ;18 4469-4480

Exploring Barriers and Facilitators to Early Rehabilitation in Post-Stroke Hand Dysfunction: A Qualitative Study.

Xiaohuan Qin, Qinhan Zou, Yanan He, Lang Liu, Chunyan Zhao.

   Background: Early rehabilitation can improve limb function and enhance quality of life for patients with hand dysfunction following a stroke. Currently, there is a lack of research exploring the factors that facilitate or hinder the participation of patients with hand dysfunction in early rehabilitation. Exploring these factors is crucial for the formulation of strategies aimed at boosting patients' motivation towards early rehabilitation and cultivating their proactive engagement.
Aim: This study aimed to explore the barriers and facilitators to early rehabilitation in post-stroke hand dysfunction.
Methods: This is a descriptive qualitative study. 15 patients with post-stroke hand dysfunction were selected using the purposive sampling method. Data were collected through semi-structured, face-to-face, in-depth interviews conducted at a tertiary hospital in Shanghai, China, between March and April 2024. The data were coded using NVivo software and analyzed via Braun and Clarke's reflective thematic approach.
Results: Four themes were identified, encompassing eight sub-themes: (1) gaining benefits from early treatments, (2) active participation of individuals and their families, (3) a low level of perceived self-efficacy, and (4) unmet medical needs.
Conclusion: The likelihood of patients with hand dysfunction following a stroke participating in early rehabilitation treatments is influenced by numerous factors. Intervention strategies can be tailored around these factors and may include educating patients and their families about stroke and early rehabilitation, training healthcare professionals (HCPs) to enhance their skills, providing professional support to patients after discharge and optimizing health insurance policies.

Keywords:  barriers; early rehabilitation treatments; facilitators; hand dysfunction; qualitative study; stroke

DOI:  https://doi.org/10.2147/JMDH.S533560