PURPOSE: To describe functioning and disability in patients with multiple sclerosis (MS) according to the model endorsed by the International Classification of Functioning Disability and Health (ICF). METHODS: Adult patients with MS were consecutively enrolled. The Expanded Disability Status Scale (EDSS), the WHO Disability Assessment Schedule II (WHO-DAS II) and the ICF checklist were administered in individual sessions. Descriptive analyses were performed to report on EDSS and WHO-DAS II scores. ICF categories reported as a problem by more than 20% of patients were described in detail. RESULTS: One hundred patients (70 females, mean age 41.7), 73 with relapsing-remitting MS were enrolled. Mean WHO-DAS II score was 10.6 and 58 ICF categories were selected: 23 Body Functions and Structures, 21 Activities and Participation and 14 Environmental Factors. CONCLUSIONS: The ICF can be successfully implemented in clinical and rehabilitation of patients with MS, because it enables to describe its multiple facets. Little differences between capacity and performance in ICF categories connected with activities of daily living, and presence of technical aids and other environmental factors are reported. On the contrary, in categories related to relationships, performance was worse than capacity thus revealing attitudinal barriers.

Department of Rehabilitation Medicine Charles University Albertov 7 Prague 128 00 Czech Republic

Neurology Public Health and Disability Unit Scientific Directorate Neurological Institute C Besta IRCCS Foundation Milan Italy

Swiss Paraplegic Foundation Notwill Switzerland

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