bims-ricfun Biomed News
on Rehabilitation ICF
Issue of 2025–08–24
seven papers selected by
Gerardo Amilivia, Médica Uruguaya Corporación de Asistencia Médica
  1. Development of an assessment protocol to operationalize the core set of the International Classification of Functioning for people with cerebral palsy.
  2. Clinical functioning information tool - coronavirus disease 2019 (ClinFIT COVID-19): psychometric evaluation and development of an interval-scaled functioning score across the care continuum.
  3. Consensus-Based Development and Validation of Iranian ICF Core Set for 6-12-Year-Old Children with Cerebral Palsy: Iranian Occupational Therapists' Perspectives.
  4. The Italian cross-cultural adaptation of the Social Vulnerability Index.
  5. Challenges in Nurses' Use of Behaviour Change Techniques in Chronic Pain Management.
  6. Challenges in Thirst Management for Intubated Patients in the ICU: A Qualitative Study of Healthcare Provider and Patient Perspectives.
  7. Patient Perspectives on the "Future Patient" Telerehabilitation Program for Atrial Fibrillation: Qualitative Study.
  1. Arch Argent Pediatr. 2025 Aug 21. e202410550
    Development of an assessment protocol to operationalize the core set of the International Classification of Functioning for people with cerebral palsy.
    L Johana Escobar Zuluaga, María de Las M Ruiz Brunner, Eduardo Cuestas, Elisabeth Cieri, Ana L Condinanzi, Carolina Ayllon, Verónica Schiariti.
      The core sets (CS) of the International Classification of Functioning, Disability and Health (ICF) for cerebral palsy (CP) have been applied in different contexts but have not been operationalized in the CP population in Argentina. To select instruments for implementation, a four-stage cross-sectional study was conducted: training in ICF, consensus on instruments, evaluation of intra- and interobserver agreement, and pilot testing. Sixtynine professionals participated in the training, and 13 in the consensus. In the first round, agreement was reached in 15 of 24 categories (92.8%), and new options were proposed for the remaining ones. The second round achieved 95.6% agreement. Intra-observer agreement was 0.84, and inter-observer agreement was 0.86. The pilot test (n = 7) allowed five categories to be adjusted. The first national protocol for assessing ICF CS in children with CP is thus proposed.
    Keywords:  International Classification of Functioning, Disability,and Health; cerebral palsy; child; rehabilitation
    DOI:  https://doi.org/10.5546/aap.2024-10550.eng
  2. J Rehabil Med. 2025 Aug 17. 57 jrm43227
    Clinical functioning information tool - coronavirus disease 2019 (ClinFIT COVID-19): psychometric evaluation and development of an interval-scaled functioning score across the care continuum.
    Masahiko Mukaino, Catarina Aguiar Branco, Alia Alghwiri, Sonia Amato, Antonios Kontaxakis, Mihai Berteanu, Hüma Bölük Şenlikci, Pinar Borman, Salmane Diouane, Maryam Fourtassi, Francesca Gimigliano, Abderrazak Hajjioui, Xiaolei Hu, Sinforian Kambou, Cho-I Lin, Mohamed I Mabrouk, Evanthia Mitsiokapa, Remus Iulian Nica, Christina-Anastasia Rapidi, Gabriella Serlenga, Arianna Silvestri, Sinikka Tarvonen-Schröder, Clara Ursescu, Arja Viinanen, Panagiotis Vorniotakis, Melissa Selb.
       OBJECTIVE: to report on the development and global testing of the COVID-19 version of the International Classification of Functioning, Disability and Health-based Clinical Functioning Information Tool called "ClinFIT COVID-19" to collect functioning data of rehabilitation patients across the care continuum to establish an interval-scaled functioning score.
    DESIGN: Multicentre, cross-sectional observational study.
    SUBJECTS/PATIENTS: Rehabilitation patients in acute, post-acute, and long-term settings.
    METHODS: Three context-specific versions (13-16 ICF categories) of ClinFIT-COVID-19 were administered to collect information on patient functioning. Rasch analysis examined psychometric properties and generated conversion tables from ordinal raw scores to a 0-100 interval metric.
    RESULTS: Twenty-six study centres in 17 countries across the globe collected data from 1,747 patients. Problems in exercise tolerance functions were most frequently reported in the acute and post-acute settings (74.2%; 87.6%), while long-term care patients most frequently reported pain as problematic (71.1%). With a testlets approach and item splitting, all 3 ClinFIT COVID-19 versions satisfied Rasch model expectations (item-trait χ² p > 0.05; PSI 0.742-0.812), making it feasible to develop respective transformation tables.
    CONCLUSION: This study found the psychometric properties of ClinFIT COVID-19 acceptable. Future studies are needed to validate the use of the transformation tables to monitor functioning and evaluate intervention impact.
    DOI:  https://doi.org/10.2340/jrm.v57.43227
  3. Phys Occup Ther Pediatr. 2025 Aug 18. 1-20
    Consensus-Based Development and Validation of Iranian ICF Core Set for 6-12-Year-Old Children with Cerebral Palsy: Iranian Occupational Therapists' Perspectives.
    Alireza Amiri, Seyed Ali Hosseini, Nazila Akbarfahimi.
       AIMS: To develop and validate the Iranian ICF-CS for 6-12-year-old children with CP from the perspective of Iranian Occupational Therapists (OTs).
    METHOD: In the first phase, using the Delphi technique, a three-round electronic-mail-survey was conducted from January to May 2022 among 22 experienced Iranian OTs working with children with CP. The experts were asked to identify and reach consensus on the most relevant ICF categories concerning the patients' problems, resources, and environmental aspects in children with CP. In the second phase, a new sample of 12 Iranian OTs rated the essentiality and relevancy of categories identified in the Delphi phase, with Content Validity Ratio (CVR), Item-Content Validity Index (I-CVI), Modified Kappa, and Scale-Content Validity Index/Average (S-CVI/Ave) calculated to ensure robust validation.
    RESULTS: Among 154 proposed categories of the Delphi process, 119 categories were confirmed in the validation phase including 6 Body-structures, 37 Body-functions, 52 Activity-and-participation, and 24 Environmental-factors with the CVR and I-CVI ranges of 0.67- 1.00 and 0.83-1.00 respectively. The S-CVI/Ave of 0.93 was obtained as the scale-level CVI.
    CONCLUSION: The Iranian ICF-CS for 6-12-year-old children with CP, consisting of 119 categories, demonstrated strong content validity from the perspective of Iranian OTs.
    Keywords:  Cerebral palsy; ICF core set; international classification of functioning disability and health
    DOI:  https://doi.org/10.1080/01942638.2025.2547371
  4. Front Public Health. 2025 ;13 1576223
    The Italian cross-cultural adaptation of the Social Vulnerability Index.
    Delphi Consensus Panel
       Background: Social vulnerability is a key health domain that is associated with frailty and disability in older adults, informing clinical trajectories and outcomes both on an individual and at a population level. The underlying concept is that frailty develops with the accumulation of physical, psychological, and social deficits, and the identification of losses in the social domain may allow for designing tailored interventions in a timely fashion. The aim of the present study was to adapt the Social Vulnerability Index (SVI) to the Italian language and culture for these purposes.
    Methods: The Italian version of the SVI (SVI-I) has been developed through a comprehensive cross-cultural adaptation of the original Canadian SVI. This process involved four steps: initial translation, synthesis of translations, back translation, and a Delphi procedure.
    Results: The result of the study is the face-valid 38-item SVI-I. Based on the Delphi procedure, the SVI-I can be administered to Italian-speaking, over-65, community-dwelling individuals not affected by cognitive decline.
    Conclusion: This study develops the first index to measure social vulnerability in the Italian-speaking population, aiming at a multidimensional approach to address social and healthcare needs. If proven effective in subsequent validation studies, it may enhance geriatric assessments, improve early social vulnerability detection, and support tailored care plans.
    Keywords:  Delphi consensus; Italian adaptation; Social Vulnerability Index; cross-cultural adaptation; frailty; social vulnerability
    DOI:  https://doi.org/10.3389/fpubh.2025.1576223
  5. Pain Res Manag. 2025 ;2025 4405696
    Challenges in Nurses' Use of Behaviour Change Techniques in Chronic Pain Management.
    Jasmine Heath Hearn, Areeba Rafiq, John Greenwood, Jordan Wilkey, Faith Johnson, Christopher McCarthy.
      Objective: Patient adherence to treatment recommendations is less than optimal within chronic pain management. Behaviour change techniques (BCTs) and frameworks can be used to maximise engagement with desired behaviours but are also underused. This study sought the perceptions of nurses to explore the perceived barriers and facilitators to utilising BCTs in clinical practice in chronic pain settings. Methods: Eight qualified nurses participated in semi-structured interviews. Reflexive thematic analysis was conducted to understand barriers and facilitators to the use of BCTs in practice. Results: Three themes were identified (1) behaviour change embedded in current practice, (2) complexities in chronic pain as barriers in implementing behaviour change and (3) from experience to expertise: training and supervision needs. Findings suggest that nurses engage in some BCTs (17 were discussed across all interviews), without explicit knowledge of specific BCTs and how to use them. The use of BCTs is restricted by patients' medical complexities, including mental health comorbidities, unhelpful biomedical beliefs about pain and opioid reliance. Furthermore, the opportunity to effectively utilise BCTs is impeded by a lack of training and clinical supervision. Conclusions: Improving nurses' capabilities by enhancing BCT training and clinical supervision is required. Furthermore, organisational change is recommended to create the opportunity for nurses to effectively utilise BCTs. Specifically, organisations should devote necessary resources, backed by effective implementation strategies, to enhance such engagement.
    Keywords:  behaviour change; chronic pain; implementation science; pain management; qualitative
    DOI:  https://doi.org/10.1155/prm/4405696
  6. J Multidiscip Healthc. 2025 ;18 4919-4932
    Challenges in Thirst Management for Intubated Patients in the ICU: A Qualitative Study of Healthcare Provider and Patient Perspectives.
    You Yuan, Li-Feng He, Qian Luo, Xia Zhang, Fang Chen, Ru-Jun Hu.
       Objective: This study aims to examine the challenges associated with thirst management among patients undergoing tracheal intubation in intensive care units (ICUs), and to inform the development of more effective clinical strategies.
    Methods: A qualitative research design was employed using semi-structured interviews with 32 participants, including healthcare professionals and patients who had experienced tracheal intubation and associated thirst in the ICU. Interview content addressed themes such as the expression, recognition, and management of thirst. Thematic analysis was used to identify key patterns within the data.
    Results: Four major themes emerged from the analysis: (1) communication barriers in the expression and recognition of thirst; (2) difficulty distinguishing between physiological and psychological thirst; (3) limitations and deficiencies in current thirst management practices; and (4) cognitive disparities between healthcare providers and patients regarding thirst perception. These findings underscore the multifaceted nature of thirst management in tracheal intubation.
    Conclusion: Thirst management for patients undergoing tracheal intubation in the ICU involves complex, multidimensional challenges. The findings offer clinically relevant insights that may enhance the ability of healthcare providers to recognize and assess thirst, support the development of targeted communication strategies and interventions, and facilitate greater patient involvement in care decisions, thereby contributing to improved treatment adherence and nursing quality.
    Keywords:  clinical challenges; cognitive differences; communication barriers; intubated patients; thirst management
    DOI:  https://doi.org/10.2147/JMDH.S519753
  7. JMIR Cardio. 2025 Aug 19. 9 e68663
    Patient Perspectives on the "Future Patient" Telerehabilitation Program for Atrial Fibrillation: Qualitative Study.
    Elisabet Dortea Ragnvaldsdóttir Joensen, Andi Eie Albertsen, Helle Spindler, Katja Møller Jensen, Lars Frost, Lars Dittmann, Mathushan Gunasegaram, Søren Paaske Johnsen, Mads Rovsing Jochumsen, Dorthe Svenstrup, Birthe Dinesen.
       Background: Atrial fibrillation (AF) is a prevalent chronic condition with increasing incidence worldwide. AF increases the risks of stroke, heart failure, and myocardial infarction and imposes a substantial burden on the health care system. Cardiac rehabilitation programs, while effective, often have low patient adherence. Recent evidence suggests that cardiac telerehabilitation, where patients are given home monitoring devices, could enhance adherence and outcomes. The program "Future Patient-Telerehabilitation of Patients with AF" (FP-AF) was created to assess the effects and potential benefits of cardiac telerehabilitation on patients with AF.
    Objective: The objective of this study is to explore the experiences of patients participating in the FP-AF program.
    Methods: This qualitative sub-study is part of the multicenter, randomized controlled FP-AF trial, which included 208 patients. Semi-structured interviews were conducted on 14 patients, randomly selected from participants in the intervention arm of the FP-AF program. The patient interviews, guided by self-determination theory, focused on patients' experiences with the FP-AF program, including the use of telerehabilitation technologies and a web-based portal called the "HeartPortal." Interview responses were analyzed using NVivo software (version 14.0; QSR International), with thematic coding based on interview guides and methodological guidance elaborated by Brinkmann & Kvale. The study adhered to ethical guidelines, with informed consent obtained from all participants.
    Results: Based on the interviews, the following themes were identified: the home monitoring devices are viewed positively by the patients; the HeartPortal is a useful digital toolbox; patients develop new coping strategies for living with AF; the measured values are useful for the patients; the community of practice is beneficial; and the FP-AF program creates a sense of security.
    Conclusions: Participation in the FP-AF program enhanced patients' sense of security, empowerment, and knowledge about AF. This improvement was due largely to a combination of patients' use of the HeartPortal and the educational sessions at health care centers. Telerehabilitation for patients with AF may be a useful way of researching this group of patients with a focus on rehabilitation and may be an effective means of offering rehabilitation to this group in the future.
    Keywords:  atrial fibrillation; home monitoring; patient education; qualitative interviews; telerehabilitation
    DOI:  https://doi.org/10.2196/68663
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