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European Journal of Physical and Rehabilitation Medicine 2021 Sep 20

DOI: 10.23736/S1973-9087.21.06706-X


lingua: Inglese

Functional profiles derived from the ICF Generic set and the responsiveness and validity of the Generic-6 set’s Functioning score among persons after stroke

Johanna JONSDOTTIR , Thomas BOWMAN, Anna CASIRAGHI, Marina RAMELLA, Angelo MONTESANO, on behalf of the IRCCS FDG-ICF group 

IRCCS Don Gnocchi Foundation Onlus, Milan, Italy


BACKGROUND: The International Classification of Functioning, Disability and Health (ICF) parsimonious Generic set can provide identification of functional profiles and recovery after rehabilitation in persons post stroke.
AIM: To explore concurrent validity of the ICF Generic-6_Functioning score with the Barthel Index (BI) and responsiveness after rehabilitation in persons post stroke. Further, the feasibility of applying the ICF Brief Stroke Core set in routine rehabilitation recovery was evaluated.
DESIGN: Prospective study.
SETTING: Inpatient rehabilitation setting.
POPULATION: Persons post stroke.
METHODS: The study included 71 persons post stroke (mean age 66,8 (standard deviation 14.5), mean onset 199.3 (565.3) days, BI score improvement: 17/100), N=44 acute stroke (< 3 months, Stroke subacute (SA)_group) and N=27 chronic stroke (>3 months, Stroke chronic (SC)_group). The Brief Stroke core set, including the Generic set, was used for classification at admission and at discharge using the five grade qualifiers. The median value of the groups' qualifiers on the Generic set (excluding item 850) was used to form a Functioning score (Generic-6 FS). Responsiveness was assessed with Effect Sizes (ES) and confidence intervals (CI). The concurrent validity of the Generic-6 FS was explored with the BI as a gold standard using Spearman's correlation coefficient. P was set at 0.05.
RESULTS: The Generic-6 FS proved responsive with ES being moderate for the Generic-6 FS and the BI for the whole group (0.48, CI 0.14-0.82 and 0.67, CI -1.02--0.32 respectively). ES of the Generic-6 FS was significant only for the SA_group (0.62, CI 0.27-0.96. Correlation between the Generic-6 FS and the BI at baseline and discharge were respectively r=-0.59 and r=0.60, while correlation between change values was lower (r=0.44). The Generic-6 FS did not distinguish between the SA_group and the SC_group. Classification with the ICF brief stroke core set was feasible with 89% of the persons being classified both at admission and discharge.
CONCLUSIONS: ICF classification of persons post stroke during rehabilitation recovery was feasible. The Generic-6 FS detected changes in functioning and health in persons recovered for rehabilitation after stroke and distinguished between different recovery rates of persons in the acute and chronic phase after stroke.

KEY WORDS: Stroke; International classification of Function; Health and Disability (ICF); ICF Generic set; Barthel index; Responsiveness; Validity

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