International classification of functioning, disability and health.

1. INTERNATIONAL CLASSIFICATION
OF FUNCTIONING, DISABILITY
AND HEALTH
Sakshi Sadhu P.T
Assistant Professor
M.P.T Sports, PG Dip. Yoga

2. Introduction
• The International Classification of
Functioning, Disability and Health (ICF) is
a classification of the health components of
functioning and disability.
• It is a framework for describing and organizing
information on functioning and disability.

3. Origin of ICF
• The ICF received approval from all 191 World Health
Organization (WHO) member states on May 22, 2001, during the
54th World Health Assembly.
• Its approval followed nine years of international revision efforts
coordinated by WHO.
• WHO's initial classification for the effects of diseases, the International
Classification of Impairments, Disabilities, and Handicaps (ICIDH),
was created in 1980.
• The ICF classification complements WHO's International Classification
of Diseases-10th Revision (ICD), which contains information on
diagnosis and health condition, but not on functional status.
• The ICD and ICF constitute the core classifications in the WHO Family of
International Classifications (WHO-FIC).

4. Aims
• The ICF is a multipurpose classification system
designed to serve various disciplines and sectors
— for example in education and transportation
as well as in health and community services —
and across different countries and cultures.

5. • Provide a scientific basis for understanding and
studying health and health-related states, outcomes,
determinants, and changes in health status and
functioning.
• Establish a common language for describing health
and health-related states in order to improve
communication between different users, such as
health care workers, researchers, policy-makers and
the public, including people with disabilities.
• Permit comparison of data across countries, health
care disciplines, services and time.
• Provide a systematic coding scheme for health
information systems

6. Underlying principles
Four general principles guided the development of the
ICF and are essential to its application:
• Universality. A classification of functioning and
disability should be applicable to all people
irrespective of health condition and in all physical,
social and cultural contexts. The ICF achieves this
and acknowledges that anyone can experience some
disability. It concerns everyone’s functioning and
disability, and was not designed, nor should be used,
to label persons with disabilities as a separate social
group.

7. • Parity and aetiological neutrality: In classifying
functioning and disability, there is not an
explicit or implicit distinction between different
health conditions, whether ‘mental’ or 'physical'.
In other words, disability is not differentiated by
aetiology. By shifting the focus from health
condition to functioning, it places all health
conditions on an equal footing, allowing them to
be compared using a common metric. Further, it
clarifies that we cannot infer participation in
everyday life from diagnosis alone

8. • Neutrality. Domain definitions are worded in
neutral language, wherever possible, so that the
classification can be used to record both the
positive and negative aspects of functioning and
disability.
• Environmental Influence. The ICF includes
environmental factors in recognition of the
important role of environment in people’s
functioning. These factors range from physical
factors (such as climate, terrain or building design)
to social factors (such as attitudes, institutions, and
laws). Interaction with environmental factors is an
essential aspect of the scientific understanding of
'functioning and disability'.

9. Application of ICF
Application
of ICF
Statistical
tool
Social policy
tool
Clinical tool
Research
tool
Educational
tool

10. Properties of ICF
A classification should be clear about what it classifies:
• Its universe
• Its scope
• Its units of classification
• Its organization
• How these elements are structured in terms of their
relation to each other.

11. Universe of ICF
• ICF encompasses all aspects of human health and some
health-relevant components of well-being and describes
them in terms of health domains and health-related
domains. The classification remains in the broad
context of health and does not cover circumstances that
are not health-related, such as those brought about by
socioeconomic factors. For example, because of their
race, gender, religion or other socioeconomic
characteristics people may be restricted in their
execution of a task in their current environment, but
these are not health related restrictions of participation
as classified in ICF.
• There is a widely held misunderstanding that ICF is only
about people with disabilities; in fact, it is about all
people. The health and health-related states associated
with all health conditions can be described using ICF. In
other words, ICF has universal application

12. Scope of ICF
• ICF has two parts, each with two components:
Part 1. Functioning and Disability
• (a) Body Functions and Structures
• (b) Activities and Participation
Part 2. Contextual Factors
• (c) Environmental Factors
• (d) Personal Factors

13. Unit of classification
• ICF classifies health and health-related states.
The unit of classification is, therefore, categories
within health and health-related domains. It is
important to note, therefore, that in ICF persons
are not the units of classification; that is, ICF
does not classify people, but describes the
situation of each person within an array of
health or health-related domains. Moreover, the
description is always made within the context of
environmental and personal factors.

14. Presentation of ICF
• ICF is presented in two versions in order to meet
the needs of different users for varying levels of
detail.
• The full version of ICF, provides classification
at four levels of detail. The two level system is
also available as a short version of ICF

15. Interactions between the
components of ICF

16. DEFINITIONS
• Body functions are the physiological functions of body systems
(including psychological functions).
• Body structures are anatomical parts of the body such as organs, limbs
and their components.
• Impairments are problems in body function or structure such as a
significant deviation or loss.
• Activity is the execution of a task or action by an individual.
• Participation is involvement in a life situation.
• Activity limitations are difficulties an individual may have in executing
activities.
• Participation restrictions are problems an individual may experience in
involvement in life situations.
• Environmental factors make up the physical, social and attitudinal
environment in which people live and conduct their lives.

18. Overview
• ICF has two parts, each with two components:
Part 1. Functioning and Disability
• (a) Body Functions and Structures
• (b) Activities and Participation
Part 2. Contextual Factors
• (c) Environmental Factors
• (d) Personal Factors
• Each component can be expressed in both positive and negative terms.
• Each component consists of various domains and, within each domain,
categories, which are the units of classification.
• Health and health-related states of an individual may be recorded by
selecting the appropriate category code or codes and then adding
qualifiers, which are numeric codes that specify the extent or the
magnitude of the functioning or disability in that category, or the extent
to which an environmental factor is a facilitator or barrier.

19. ICF components an domains/chapters
Body Function:
• Mental functions
• Sensory functions and pain
• Voice and speech functions
• Functions of the cardiovascular, haematological,
immunological and respiratory systems
• Functions of the digestive, metabolic, endocrine
systems
• Genitourinary and reproductive functions
• Neuromusculoskeletal and movement-related
functions
• Functions of the skin and related structures

20. Body Structure:
• Structure of the nervous system
• The eye, ear and related structures
• Structures involved in voice and speech
• Structure of the cardiovascular, immunological
and respiratory Systems
• Structures related to the digestive, metabolic
and endocrine systems
• Structure related to genitourinary and
reproductive systems
• Structures related to movement
• Skin and related structures

21. Activities and Participation:
• Learning and applying knowledge
• General tasks and demands
• Communication
• Mobility
• Self care
• Domestic life
• Interpersonal interactions and relationships
• Major life areas
• Community, social and civic life

22. Environmental Factors:
• Products and technology
• Natural environment and human-made changes
to environment
• Support and relationships
• Attitudes
• Services, systems and policies

23. ICF Qualifier scales
Generic qualifier:
0 No problem
1 Mild problem
2 Moderate problem
3 Severe problem
4 Complete problem
8 Not specified
9 Not applicable

24. • Qualifier for Environmental factors:
.0 No barrier +0 No facilitator
.1 Mild barrier +1 Mild facilitator
.2 Moderate barrier +2 Moderate facilitator
.3 Severe barrier +3 Substantial facilitator
.4 Complete barrier +4 Complete facilitator
.8 Barrier, not specified +8 Facilitator, not specified
.9 Not applicable +9 Not applicable

25. Examples

28. Reference
• THE ICF: AN OVERVIEW
• International Classification of Functioning,
Disability and Health by WHO.
• Internet

29. Thank you