International Classification of Functioning, Disability, and Health-based rehabilitation program promotes activity and participation of post-stroke patients

Ngai Kiu Mabel WONG, Mike Kwun-Ting CHEUNG, Yuk-Mun NG, Huan-Ling YUAN, Bess Yin-Hung LAM, Siu Ngor FU, Che Hin Chetwyn CHAN

Research output: Contribution to journalArticlespeer-review

Abstract

Background: The International Classification of Functioning, Disability, and Health (ICF) model has been applied in post-stroke rehabilitation, yet limited studies explored its clinical application on enhancing patients’ Activity and Participation (ICF-A&P) level. 

Purpose: This study gathered evidence of the effects of an ICF-based post-stroke rehabilitation program (ICF-PSRP) in enhancing community reintegration in terms of ICF-A&P of post-stroke patients. 

Methods: Fifty-two post-stroke patients completed an 8 to 12 weeks multidisciplinary ICF-PSRP after setting personal treatment goals in an outpatient community rehabilitation center. Intake and pre-discharge assessments were administered for primary outcomes of Body function (ICF-BF; e.g., muscle strength) and ICF-A&P (e.g., mobility), and secondary outcomes of perceived improvements in ability (e.g., goal attainment and quality of life). 

Results: There were significantly higher levels in the ICF-BF and ICF-A&P domains, except cognitive function under the ICF-BF. Improvements in the primary outcomes predicted corresponding secondary outcomes. Firstly, expressive and receptive functions (ICP-BF) were mediated by the everyday language (ICF-A&P) which predicted patients’ satisfaction with the language-related quality of life. Secondly, upper extremity function (ICP-BF) was mediated by the lower extremity mobility (ICF-A&P) predicting work and productivity-related quality of life. Content analyses showed that combined ICF-BF and ICF-A&P contents throughout the ICF-PSRP contributed to the positive treatment effects. 

Conclusion: The ICF-PSRP was effective in promoting body function, and activity and participation levels of post-stroke patients. Positive treatment effects are characterized by goal-setting process, cross-domain content design, and community-setting delivery. 

Clinical trial registration: https://clinicaltrials.gov/study/NCT05941078?id=NCT05941078&rank=1, identifier NCT05941078. Copyright © 2023 Wong, Cheung, Ng, Yuan, Lam, Fu and Chan.

Original languageEnglish
Article number1235500
JournalFrontiers in Neurology
Volume14
DOIs
Publication statusPublished - Nov 2023

Citation

Wong, M. N.-K., Cheung, M. K.-T., Ng, Y.-M., Yuan, H.-L., Lam, B. Y.-H., Fu, S. N., & Chan, C. C. H. (2023). International Classification of Functioning, Disability, and Health-based rehabilitation program promotes activity and participation of post-stroke patients. Frontiers in Neurology, 14, Article 1235500. https://doi.org/10.3389/fneur.2023.1235500

Keywords

  • Goal-setting process
  • Multidisciplinary approach
  • Community reintegration
  • Resuming life roles
  • Stroke rehabilitation

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