Toward a framework for developing an ICF-based documentation system in spinal cord injury-specific rehabilitation based on routine clinical practice: a case study approach

The study presents a framework for creating a documentation system based on the International Classification of Functioning, Disability and Health (ICF) for spinal cord injury (SCI) rehabilitation. Data were collected from interviews and health records of four SCI cases across the continuum of care (acute, post-acute, early and late long term) and were linked to ICF categories. The study highlights the need for standardized assessment of functioning among health professionals in the field of SCI, particularly in developing countries.

• 1
  Clinical assessment tools (CATs) covered less than half of the ICF categories in defined ICF sets, particularly in acute and late long-term phases.
• 2
  Categories of activities and participations, and environmental factors were the least well covered by CATs.
• 3
  The coverage of ICF categories increased when considering additional ICF categories identified from patient interviews.