Reflective of our time, the ICF Research Branch Newsletter - referred to from now on as the Branch Newsletter - will be published as an online newsletter rather than paper-based or as a PDF.
The Branch Newsletter can be read directly on the ICF Research Branch website www.icf-research-branch.org, and individual articles can be printed. An email notification that a new edition of the Branch Newsletter is available will be sent to those who have subscribed to the Branch Newsletter by completing the form here.
Melissa Selb, ICF Research Branch Coordinator
What’s New at the Branch
New Steering Committee Member
We are pleased to welcome Prof. Liane Simon as a new member of the ICF Research Branch Steering Committee. In Autumn 2017, Prof. Simon joined the renowned group of scientists and leaders in the ICF community – Prof. Jerome Bickenbach, Dr. Michaela Coenen, Prof. Judith Hollenweger and Prof. Gerold Stucki – who have been serving on the ICF Research Branch Steering Committee the last several years. ICF Research Branch will benefit tremendously from Liane Simon’s many years of clinical and academic experience in early childhood intervention. For more information about Liane Simon, go to the Team section of the ICF Research Branch website: https://www.icf-research-branch.org/about-us/team/639-liane-simon.
Updated ICF Case Studies Booklets and Website
To illustrate the use of the ICF in rehabilitation practice, Swiss Paraplegic Research together with Swiss Paraplegic Centre (SPZ), one of Europe's leading (acute and rehabilitation) centres for paraplegia, spinal cord injury (SCI) and spinal cord diseases (SCD), conducted a series of 20 ICF-based case studies from 2007-2009. In this project, persons of different age groups and gender and who are living with SCI of varying etiology and levels of severity, were accompanied during their rehabilitation at SPZ. The rehabilitation process was then described using the Rehab-Cycle® and the corresponding ICF-based documentation tools. Each case focused on a specific theme of SCI rehabilitation, such as goal-setting, community reintegration, SCI and chronic pain management. For each case, a booklet was produced that is available as hardcopy and also as a PDF in the download section of www.icf-research-branch.org. Additionally, there is a designated website for the case studies, www.icf-casestudies.org, on which the content of the booklet is also displayed electronically with figures and tables as pop-ups.
What’s Up at the WHO-FIC
New WHO-FIC Governance Structure
The WHO Family of International Classifications (WHO-FIC) Network was established in 1970 to promote the implementation, use, maintenance, and updating of the WHO reference classifications. It includes all designated WHO Collaborating Centres (as well as those under designation), such as the German Collaborating Centre. Since the ICF Research Branch is a partner within the German Collaborating Centre, it is considered a part of the WHO-FIC Network. The WHO-FIC Network is governed by an Advisory Council and supported by a small executive group. Since 1970, the WHO-FIC Network has established 4 committees and 3 reference groups.
New Developments in the "ICF World"
Since the last Branch Newsletter there have been new developments in the "ICF world"... More than 30 updates (or changes) to the ICF have been approved by WHO. The majority of these updates stem from proposals that tried to integrate elements from the children and youth version of the ICF (ICF-CY) into the reference version of the ICF. These updates include minor text changes, addition or modification of inclusion and exclusion criteria, as well as additions of new categories. For example, to d4700 Using human-powered vehicles additional text was included to reflect specific characteristics of children and youth and wheelchair users; the description now reads "Being transported as a passenger by a mode of transportation powered by one or more people, such as riding in a pram or stroller, wheelchair propelled by another, rickshaw or rowboat. An example of a new category is d451 Going up and down stairs Moving upwards and downwards so that at least one foot is always on the ground such as ascending and descending stairs or curbs. Exclusions: walking (d450); climbing (d4551). This new category is intended to differentiate from d4551 Climbing. Previously d4551 Climbing was the only category available to describe both the action of walking up and down stairs and, for example, rock-climbing. However, rock-climbing and walking up and down stairs are quite different activities of mobility. Now it is possible to differentiate these actions with different codes.
Functioning Section in ICD-11
Recognising the value of jointly using the ICF with the International Classification of Diseases (ICD), specifically to capture health more comprehensively and for practical uses such as for needs assessment and for reimbursement purposes [1,2], WHO has introduced a supplementary section for functioning assessment in the 11th revision of ICD (ICD-11). The use of this section by member states is optional.
Advances Toward a Classification of Health Interventions
In development since 2007, the International Classification of Health Interventions (ICHI) has progressed tremendously. ICHI is now its beta version, and includes interventions across various health sectors, such as primary care, rehabilitation, and public health, and a section addressing assistance with functioning as well as prevention. There is also an online browser for ICHI with a hyperlink on the WHO website: https://mitel.dimi.uniud.it/ichi/. Field testing of the ICHI beta version commenced in February 2018, and a final version is expected to be released in 2019.
ICF Education & Training
The New ICF e-learning Tool – An Interactive Learning Approach
The ICF e-Learning tool (Introductory Module) that has been online since 2009 has now been updated and re-designed using a new eLearning software. The introductory module is ideal for anyone interested in learning the framework and conceptualisation as well as possible application areas of the ICF in an interactive way. The ICF Research Branch has taken the lead in revising the ICF e-learning tool under the auspices of the Education and Implementation Committee of the WHO Family of International Classifications (WHO-FIC) and in collaboration with the WHO-FIC Functioning and Disability Reference Group.
German-language ICF Workshops
In the past, the ICF training team at Ludwig-Maximilians-Universität (LMU) Munich had carried out German-language ICF workshops only upon request. Since March 2017, the ICF Research Branch has been conducting German-language ICF workshops through the ICF training team at LMU. The workshop is run consistently with the English-language workshops, but with the addition of German-specific examples of ICF application. Due to the German Participation Law (Bundesteilhabegesetz) the need for ICF trainings have been rapidly increasing. The German Participation Law has adapted the definition of disability according to the biopsychosocial model, and requires that needs assessment (for rehabilitation) be done using ICF-based instruments. To meet this growing need, the ICF training team at LMU has been offering more ICF trainings. Further information about the German-language ICF workshops as well as the registration form can be found here: http://ihrs.ibe.med.uni-muenchen.de/veranstaltungen/icf_schulung1/index.html.
Individualised ICF Workshops
Beyond the regular ICF trainings offered at Swiss Paraplegic Research (in English) and at Ludwig-Maximilians-Universität (LMU) Munich (in German), the ICF Research Branch training team is often invited to hold individualised ICF workshops for specific stakeholders. For example, Michaela Kirschneck, a member of the training team at LMU conducts German-language ICF workshops every year for the Academy of Social and Occupational Medicine (Sozial- und Arbeitsmedizinische Akademie) Baden-Württemberg. The most recent one took place on 19 February 2018 at the regional centre of the German Statutory Pension Insurance (Deutschen Rentenversicherung) of the Germany state of Baden-Würtemberg. For more information about this, see the report on the homepage of the ICF Research Branch website www.icf-research-branch.org.
Training Trainers to Train Others on the ICF – An Approach That Doesn’t Have to Be a Tongue Twister
Preparing others to become potential trainers of ICF is a challenge, but it does not have to be complicated. In December 2017, the ICF Research Branch developed a train-the-trainer approach that expands the standard ICF workshop that it conducts regularly, partly to meet the growing need for ICF trainings. Given the limited human resources for conducting ICF workshops, the ICF Research Branch supports the multiplier effect – instead of holding all the ICF workshops needed, it provides workshop participants the knowledge, skills and material to become ICF trainers themselves.
ICF Core Set Updates
ICF Core Sets for Schizophrenia
As reported in the last Branch Newsletter, the University of Barcelona, with the support of the ICF Research Branch, spearheaded the project to develop the ICF Core Sets for schizophrenia. The Comprehensive ICF Core Set containing 97 categories and the Brief ICF Core Set with 25 categories complements the existing mental health-related ICF Core Sets (for depression and bipolar disorders). Based on the results of 4 preparatory studies (scientific literature review, international web-based expert survey , multicentre empirical study, focus groups of various stakeholders), 20 experts from all 6 WHO world regions and from diverse disciplines (psychiatry, (neuro)psychology, social work, occupational therapy, vocational rehabilitation, nursing) finalised the first version of the ICF Core Sets for schizophrenia. Two of the preparatory studies and the consensus conference were described in published papers [1-3].
ICF Core Sets for Autism Spectrum Disorder and for Attention Deficit Hyperactivity Disorder
In 2013, the ICF Research Branch and the Center of Neurodevelopmental Disorders at Karolinska Institutet (KIND) initiated a research collaboration to develop the ICF Core Sets for autism spectrum disorders (ASD) and also for attention deficit hyperactivity disorder (ADHD) that culminated in the first version of these ICF Core Sets. These separate but related ICF Core Set projects were actively supported by international, multiprofessional steering committees. Since some of the steering committee members had expertise in both ASD and ADHD, several of them served on both committees.
Predicting rehabilitation outcome after trauma - the icfPROreha Project
In April 2017, the project Predicting the Rehabilitation Outcome after trauma based on the ICF (icfPROreha) started. icfPROreha is a joint effort of the BG Hospital Murnau (Department for Workman’s Compensation Rehabilitation; leading physician: Dr. Stefan Simmel) and the Chair for Public Health and Health Services Research (IBE) at the Ludwig-Maximilians-Universität (LMU) Munich.
Development of ICF Core Set-based Instruments – the Vestibular Activities and Participation-extended Questionnaire (VAP-e)
Vertigo and dizziness count among the most frequent complaints in clinical practice. Although the disabling effects of vestibular disorders on participation and quality of life are obvious, the full extent of the burden is still hardly known; in part this is due to a lack of consensus about which assessment instrument to use. Recognising this research gap, an international multidisciplinary working group began a set of projects designed to develop standards for the assessment of functioning for vestibular disease. These projects were carried out under the auspices of the German Center of Vertigo and Balance Disorders at the Ludwig-Maximilians Universität (LMU) München and funded by the German Federal Ministry of Education and Research.
Other ICF Core Set-based Instruments
In addition to the VAP-e Questionnaire that is based on the ICF Core Set for vestibular disease (see separate Branch Newsletter article), there have been other ICF Core Set-based instruments developed. These include the ASAS Health Index and the ICF Educational e-Tool.
Using the ICF Core Sets for hand conditions: Lighthouse Project Hand
From 2011-2016, the Research Unit for Biopsychosocial Health at the Ludwig-Maximilians Universität München (LMU Munich) and the Department of Hand Surgery, Plastic- and Microsurgery at the BG Hospital Hamburg (Germany) conducted the Lighthouse Project Hand to operationalise, implement and use the Brief ICF Core Set for Hand Conditions as a monitoring tool in the treatment and rehabilitation of persons with hand conditions in the institutions of the statutory accident insurance (Deutsche Gesetzliche Unfallversicherung - DGUV) in Germany. The project team of Lighthouse Project Hand developed data collection, scoring and reporting tools to assess and report on functioning information in a standardized way. Specifically, the ICF HandA was developed, an ICF-based assessment set that can be used to systematically assess functioning of patients with hand injuries and disorders in clinical practice, from acute patient care to return to work. The ICF HandA contains outcome measures and clinical tests. The ICF HandA was integrated into an electronic data collection tool (e-tool) that allows generating structured reports in a standardized way, specifying patients’ current functioning status and considering environmental factors besides additional information, such as ICD-10 diagnoses, treatments performed and patients’ future needs. Also developed were ICF-based treatment guidelines that define assessment time points using the ICF HandA for specific injuries and diseases, as well as case studies that illustrate the use of ICF HandA, and the treatment guidelines. Implementing the e-tool Hand in hospitals is a currently ongoing work-in-progress [2-6].
ICF in Black & White
Handbook of Vocational Rehabilitation and Disability Evaluation
Since the last Branch Newsletter, the ICF Research Branch has published the book entitled Handbook of Vocational Rehabilitation and Disability Evaluation: Application and Implementation of the ICF. This book outlines current science-based methods in assessing impairment and capabilities and emerging approaches to management specifically relating to work participation. It is part of the series "Handbooks in Health, Work, and Disability" of the Springer Publishing Company and was launched at the European Union of Medicine in Assurance and Social Security (EUMASS) Congress in Stockholm, Sweden on 12 September 2014.
Diverse Scientific Publications
In addition to the Handbook of Vocational Rehabilitation and Disability Evaluation: Application and Implementation of the ICF, the ICF Research Branch has published numerous papers in diverse scientific peer-review journals. They can be found under the section entitled "Publications" on the ICF Research Branch website: https://icf-research-branch.org/publications/2018.