physical medicine and rehabilitation

1. ICF
SKNAYAK
DNB PMR 2ND YR

2. HISTORICAL PERSPECTIVES
• THE INTERNATIONAL CLASSIFICATION OF
DISEASE (ICD) WAS FIRST PUBLISHED AS A
CLASSIFICATION OF CAUSES OF DEATH IN 1898.
• THE FIRST CLASSIFICATION OF DISABILITY, THE
INTERNATIONAL CLASSIFICATION OF
IMPAIRMENT, DISABILITY AND HANDICAPS
(ICIDH) WAS PUBLISHED AND RELEASED IN 1980
FOR TRIAL PURPOSE ONLY.

3. • THE INTERNATIONAL CLASSIFICATION OF FUNCTIONING,
DISABILITY AND HEALTH (ICF) WAS OFFICIALLY ENDORSED
BY ALL 191 WHO MEMBER STATES IN THE 54TH WORLD
HEALTH ASSEMBLY ON 22ND MAY 2001.
• IT IS A FRAMEWORK FOR DESCRIBING AND ORGANIZING
INFORMATION ON FUNCTIONING AND DISABILITY.

4. • WHILE ICD-10(INTERNATIONAL CLASSIFICATION OF
DISEASES, TENTH REVISION), PROVIDES AN ETIOLOGICAL
FRAMEWORK, FUNCTIONING AND DISABILITY ASSOCIATED
WITH HEALTH CONDITIONS ARE CLASSIFIED IN ICF.
• ICD-10 AND ICF ARE THEREFORE COMPLEMENTARY, AND
USERS ARE ENCOURAGED TO UTILIZE THESE TWO MEMBERS
OF THE WHO FAMILY OF INTERNATIONAL CLASSIFICATIONS
TOGETHER.

5. • A COMPANION CLASSIFICATION FOR CHILDREN
AND YOUTH (ICF-CY) WAS PUBLISHED IN 2007.

6. THE STRUCTURE OF THE ICF
ICF ORGANISES INFORMATION IN TWO PARTS.
PART 1:-FUNCTIONING AND DISABILITY
PART 2:-CONTEXTUAL FACTORS

7. FUNCTIONING AND DISABILITY
• BODY COMPONENT:-
– FUNCTIONS OF BODY
– BODY STRUCTURES
• ACTIVITIES AND PARTICIPATION:-
– INDIVIDUAL AND A SOCIETAL PERSPECTIVE

8. CONTEXTUAL FACTORS
• ENVIRONMENTAL FACTORS
• PERSONAL FACTORS(NOT CLASSIFIED IN ICF
BECAUSE OF THE LARGE SOCIAL AND
CULTURAL VARIANCE)

10. DEFINITIONS OF SOME OF THE KEY WORDS USED IN ICF :-
• HEALTH- STATE OF COMPLETE PHYSICAL, MENTAL AND
SOCIAL WELLBEING AND NOT MERELY AN ABSENCE OF
ANY DISEASE OR DEFORMITY.
• HEALTH CONDITION- AN UMBRELLA TERM FOR
DISEASE (ACUTE OR CHRONIC), DISORDER, INJURY OR
TRAUMA.HEALTH CONDITIONS ARE CODED USING ICD-
10.

11. • FUNCTIONING-AN UMBRELLA TERM FOR BODY FUNCTIONS,
BODY STRUCTURES, ACTIVITIES AND PARTICIPATION. IT
DENOTES THE POSITIVE ASPECTS OF THE INTERACTION
BETWEEN AN INDIVIDUAL (WITH A HEALTH CONDITION) AND
THAT INDIVIDUAL'S CONTEXTUAL FACTORS (ENVIRONMENTAL
AND PERSONAL FACTORS).

12. CODING GUIDELINES FOR ICF
ICF IS INTENDED FOR THE CODING OF DIFFERENT HEALTH AND HEALTH-
RELATED STATES.
THE COMPONENTS ARE DENOTED BY PREFIXES IN EACH CODE.
• B FOR BODY FUNCTIONS
• S FOR BODY STRUCTURES
• D FOR ACTIVITIES AND PARTICIPATION
• E FOR ENVIRONMENTAL FACTORS
THE LETTERS B, S, D AND E ARE FOLLOWED BY A NUMERIC CODE THAT
STARTS WITH THE CHAPTER NUMBER (ONE DIGIT), FOLLOWED BY THE
SECOND LEVEL (TWO DIGITS), AND THE THIRD AND FOURTH LEVEL(ONE
DIGIT EACH).

13. • FOR EXAMPLE, IN THE BODY FUNCTIONS
CLASSIFICATION THERE ARE THESE CODES:
• B2 SENSORY FUNCTIONS AND PAIN (FIRST-LEVEL
ITEM)
• B210 SEEING FUNCTIONS (SECOND-LEVEL ITEM)
• B2102 QUALITY OF VISION (THIRD-LEVEL ITEM)
• B21022 CONTRAST SENSITIVITY (FOURTH-LEVEL
ITEM)

14. ICF CONTAINS A TOTAL OF 1495 MEANINGFUL AND
DISCRETE OR MUTUALLY EXCLUSIVE CATEGORIES
AND TAKEN TOGETHER AND COVER THE WHOLE
SPECTRUM OF HUMAN FUNCTIONING.
IN REAL LIFE APPLICATION, A SET OF 3 TO 18 CODES
MAY BE ADEQUATE TO DESCRIBE A CASE.

15. • THEREFORE ICF CATEGORIES ARE THE BUILDING
BLOCKS FOR THE CONSTRUCTION OF THE ICF
BASED TOOLS SUCH AS ICF CHECKLIST, THE ICF
CORE SETS AS WELL AS CLINICAL MEASUREMENT
INSTRUMENTS
• SUCH AS THE ICF CORE SET INDEX AND GENERIC
HEALTH STATUS MEASUREMENT SUCH AS WHO
DISABILITY ASSESSMENT SCHEDULE(WHODAS 2.0).

16. THANK YOU