The use of the International Classification of Functioning, Disability and Health in the physical therapy assessment of individuals with musculoskeletal disorders of the lower limbs and lumbar region

Abstract

The structure and contents of the International Classification of Functioning, Disability and Health (ICF) can contribute to the physical therapists’ clinical practice management and systematization. Although promising, its use is still limited, especially due to the complexity of its application. The aim of this study was to analyze the difficulties related to the use of the ICF to codify activities/ participation of patients with musculoskeletal disorders in the lower limbs and lumbar region, evaluated by a physical therapist. Methods: Reports of patients related to the activities/participation that were altered due to musculoskeletal disorders were used. Data were obtained from the charts and grouped into categories for subsequent coding. Results: Five ICF domains were used to describe the altered activities/participation (mobility, self-care, domestic life, major life areas and community, social and civic life) and four difficulties related to the coding process were identified: (1) multiple codes related to some activities/participation; (2) inaccurate code to detail one activity/participation (run distance); (3) “unspecified” code used for the classification of “getting into the car”; (4) generic codes attributed to activities/participation that refer to sports. Discussion: The possibility of choosing several codes to describe the same condition due to the overlap and interrelation of activities/participation can make the classification process inconsistent in some situations. The absence of detailing concerning some activities/participation can restrict the precision of categorization and data documentation. Conclusion: The ICF allowed the characterization of the health status of individuals, but presented some issues that must be considered in order to obtain its improvement.