Abstract
Study design:
Cross-sectional, multicenter study.
Objectives:
To identify the most common problems of individuals with spinal cord injury (SCI) in the early post-acute and the long-term context, respectively, using the International Classification of Functioning, Disability and Health (ICF) as a frame of reference.
Setting:
International.
Methods:
The functional problems of individuals with SCI were recorded using the 264 ICF categories on the second level of the classification. Prevalence of impairment was reported along with their 95% confidence intervals. Data were stratified by context.
Results:
Sixteen study centers in 14 countries collected data of 489 individuals with SCI in the early post-acute context and 559 in the long-term context, respectively. Impairments in thirteen ICF categories assigned to Body functions and Body structures were more frequently reported in the long-term context, whereas limitations/restrictions in 34 ICF categories assigned to Activities and Participation were more frequently found in the early post-acute context. Eleven ICF categories from the component Environmental Factors were more frequently regarded as barriers, facilitators or both by individuals with SCI in the early post-acute context as compared with individuals with SCI in the long-term context. Only two environmental factors were more relevant for people with SCI in the long-term context than in the early post-acute context.
Conclusion:
The study identified a large variety of functional problems reflecting the complexity of SCI and indicated differences between the two contexts. The ICF has potential to provide a comprehensive framework for the description of functional health in individuals with SCI worldwide.
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Acknowledgements
This project was funded by the Swiss Paraplegic Research, Nottwil, Switzerland. We thank Sandra Landa, Sara Wadle and Cornelia Oberhauser from the ICF Research Branch in Munich for their most helpful contribution regarding data management and analysis, and Alarcos Cieza for her invaluable general support of the project. We also expand a special thanks to the health professionals worldwide who were involved in the local study organization or data collection (in alphabetical order): Caroline Abramson, Anita W Castro, HS Chabra, Angela Chu, Charlotte Dragon, Jennifer Dunn, Julia Maria D’Andréa Greve, Katja Hagemann Nielsen, Nazirah Hasnan, Denise Hislop, Amitabh Jha, Jonathan Kwan, Carina Løvholt Nielsen, Joanne Nunnerley, Janni Sleimann Steen, Catherine Tadey, Julian Toscano, Andrea Townsend, Daniel Rubios de Souza and Eric Weerts.
Professor Haim Ring (Julio Ring), our friend and colleague and author of this paper, died on 15 September 2008. Haim always supported and motivated the process of developing ICF Core Sets. He built bridges among disciplines and health professions. He also brought world regions and countries to work together. We will always be endlessly thankful of having the opportunity of being close to this inspiring spirit.
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Kirchberger, I., Biering-Sørensen, F., Charlifue, S. et al. Identification of the most common problems in functioning of individuals with spinal cord injury using the International Classification of Functioning, Disability and Health. Spinal Cord 48, 221–229 (2010). https://doi.org/10.1038/sc.2009.116
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DOI: https://doi.org/10.1038/sc.2009.116
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