The International Classification of Functioning Disability and Health (ICF) was approved in 2001 and, since then, several studies reported the increased interest about its use in different sectors. A recent overview that summarizes its applications is lacking. This study aims to provide an updated overview about 20 years of ICF application through an international online questionnaire, developed by the byline authors, and sent to each World Health Organization Collaborating Centers of the Family of International Classifications (WHO-FIC CCs). Data was collected during October 2020 and December 2021 and descriptive content analyses were used to report main results. Results show how, in most of the respondent countries represented by WHO-FIC CCs, ICF was mainly used in clinical practice, policy development and social policy, and in education areas. Despite its applications in different sectors, ICF use is not mandatory in most countries but, where used, it provides a biopsychosocial framework for policy development in health, functioning and disability. The study provides information about the needs related to ICF applications, that can be useful to organize targeted intervention plans. Furthermore, this survey methodology can be re-proposed periodically to monitor the use of the ICF in the future.

Albrecht Federal Scientific Centre of Rehabilitation of the Disabled 195067 St Petersburg Russia

Canadian Institute for Health Information Ottawa ON K2A 4H6 Canada

CanChild Centre for Childhood Disability Research McMaster University Hamilton ON L8S 4L8 Canada

Census and Disability Analysis Office for National Statistics Swyddfa Ystadegau Gwladol Newport SA42 UK

Centre for Community Technologies Nelson Mandela University Gqeberha 6019 South Africa

Centre Head of NordClass Department of Classifications and Terminology in Healthcare The Norwegian Directorate of e Health 0277 Oslo Norway

Classification Area Azienda Sanitaria Universitaria Giuliano Isontina 34128 Trieste Italy

Classification Terminology and Standards Unit World Health Organization 1211 Geneva Switzerland

DEFACTUM Corporate Quality Central Denmark Region 8000 Aarhus Denmark

Department of Conegliano Pieve di Soligo IRCCS E Medea Scientific Institute 31015 Conegliano Italy

Department of Health and Rehabilitation Sciences Faculty of Health Sciences University of Cape Town Cape Town 7700 South Africa

Department of Physical Therapy College of Health and Welfare Silla University Busan 46958 Korea

Department of Physical Therapy Universidade Federal do Ceará UFC Fortaleza 60020 181 Brazil

Department of Public Health Aarhus University 8000 Aarhus Denmark

Department of Rehabilitation Medicine School of Medicine Fujita Health University Toyoake 470 1101 Aichi Japan

Department of Sociology Criminology and Social Work Bradley University Peoria IL 61625 USA

Directorate of Health 105 Reykjavik Iceland

Faculty of Health Sciences University of Sydney Sydney NSW 2006 Australia

Finnish Institute for Health and Welfare 00271 Helsinki Finland

General Directorate of Health Information and Research Ministry of Health Mexico City 03100 Mexico

Institute for Medical Information Processing Biometry and Epidemiology IBE Chair of Public Health and Health Services Research LMU Munich 80539 Munich Germany

Institute of Health Information and Statistics of the Czech Republic 128 01 Prague Czech Republic

International Society of Experts and Researchers on Functioning and the ICF University of São Paulo São Paulo 05508 220 Brazil

Jena University Hospital 07743 Jena Germany

National Board of Health and Welfare 10333 Stockholm Sweden

National Institute for Public Health and the Environment 3721 Bilthoven The Netherlands

Neurology Public Health Disability Unit Fondazione IRCCS Istituto Neurologico Carlo Besta 20133 Milan Italy

Pettenkofer School of Public Health 80539 Munich Germany

School of Health and Social Studies JAMK University of Applied Sciences 40200 Jyväskylä Finland

School of Public Health École des Hautes Études en Santé Publique 35043 Rennes France

The German Institute for Medical Documentation and Information 51149 Cologne Germany

WHO FIC Collaborating Centre South African Medical Research Council Cape Town 8000 South Africa

Zobrazit více v PubMed

World Health Organization . How to Use the ICF: A Practical Manual for Using the International Classification of Functioning, Disability and Health (ICF); Exposure Draft for Comment. WHO; Geneva, Switzerland: 2013.

World Health Organization . The International Classification of Functioning, Disability and Health: ICF. WHO; Geneva, Switzerland: 2001.

World Health Organization . International Statistical Classification of Diseases and Related Health Problems. 10th ed. WHO; Geneva, Switzerland: 1992–1994.

Cerniauskaitė M., Quintas R., Boldt C., Raggi A., Cieza A., Bickenbach J., Leonardi M. Systematic literature review on ICF from 2001 to 2009: Its use, implementation and operationalisation. Disabil. Rehabil. 2001;33:281–309. doi: 10.3109/09638288.2010.529235. PubMed DOI

World Health Organization . The Global Burden of Disease: 2004 Update. WHO; Geneva, Switzerland: 2008.

Leonardi M. Libro Bianco sull’invalidità civile in Italia: Uno studio nelle Regioni del Nord e del Centro. Franco Angeli; Milan, Italy: 2008.

Leonardi M., Bickenbach J., Ustun T.B., Kostanjsek N., Chatterji S. The definition of disability: What is in a name? Lancet. 2006;368:1219–1221. doi: 10.1016/S0140-6736(06)69498-1. PubMed DOI

Rauch A., Cieza A., Stucki G. How to apply the International Classification of Functioning, Disability and Health (ICF) for rehabilitation management in clinical practice. Eur. J. Phys. Rehabil. Med. 2008;44:329–342. PubMed

World Health Organization. World Bank . World Report on Disability. WHO; Geneva, Switzerland: 2011. [(accessed on 20 May 2022)]. Available online: http://www.who.int/disabilities/world_report/2011/report.pdf.

United Nations . Treaty Series. Volume 2515 UN; New York, NY, USA: 2006. Convention on the Rights of Persons with Disabilities.

Bickenbach J.E., Chatterji S., Badley E., Üstün T. Models of disablement, universalism and the international classification of impairments, disabilities and handicaps. Soc. Sci. Med. 1999;48:1173–1187. doi: 10.1016/S0277-9536(98)00441-9. PubMed DOI

Üstün T., Chatterji S., Bickenbach J., Kostanjsek N., Schneider M. The International Classification of Functioning, Disability and Health: A new tool for understanding disability and health. Disabil. Rehabil. 2003;25:565–571. doi: 10.1080/0963828031000137063. PubMed DOI

Bruyère S.M., Van Looy S.A., Peterson D.B. The International Classification of Functioning, Disability and Health: Contemporary literature overview. Rehabil. Psychol. 2005;50:113–121. doi: 10.1037/0090-5550.50.2.113. DOI

Jelsma J. Use of the International Classification of Functioning, Disability and Health: A literature survey. J. Rehabil. Med. 2009;41:1–12. doi: 10.2340/16501977-0300. PubMed DOI

Kostanjsek N. Use of the International Classification of Functioning, Disability and Health (ICF) as a conceptual framework and common language for disability statistics and health information systems. BMC Public Health. 2011;11((Suppl. 4)):S3. doi: 10.1186/1471-2458-11-S4-S3. PubMed DOI PMC

Madden R.H., Bundy A. The ICF has made a difference to functioning and disability measurement and statistics. Disabil. Rehabil. 2019;41:1450–1462. doi: 10.1080/09638288.2018.1431812. PubMed DOI

Bornbaum C.C., Day A.M., Izaryk K., Morrison S.J., Ravenek M.J., Sleeth L.E., Skarakis-Doyle E. Exploring use of the ICF in health education. Disabil. Rehabil. 2015;37:179–186. doi: 10.3109/09638288.2014.910558. PubMed DOI

Linacre J.M., Heinemann J.W., Wright B.D., Granger C.V., Hamilton B.B. The structure and stability of the functional independence measure. Arch. Phys. Med. Rehabil. 1994;75:127–132. doi: 10.1016/0003-9993(94)90384-0. PubMed DOI

Mahoney F.I., Barthel D.W. Functional evaluation: The Barthel Index. Md. State Med. J. 1965;14:61–65. PubMed

International Classification of Functioning, Disability and Health: ICF Education Portal. [(accessed on 20 June 2022)]. Available online: www.ICFeducation.org.

ICF Research Branch. [(accessed on 20 May 2022)]. Available online: https://www.icf-research-branch.org/icf-training/icf-e-learning-tool.

Mitra S., Shakespeare T. Remodeling the ICF. Disabil. Health J. 2019;12:337–339. doi: 10.1016/j.dhjo.2019.01.008. PubMed DOI

Yen T.H., Liou T.H., Chang K.H., Wu N.N., Chou L.C., Chen H.C. Systematic review of ICF core set from 2001 to 2012. Disabil. Rehabil. 2014;36:177–184. doi: 10.3109/09638288.2013.782359. PubMed DOI

Uhlig T., Lillemo S., Moe R.H., Stamm T., Cieza A., Boonen A., Mowinckel P., Kvien T.K., Stucki G. Reliability of the ICF Core Set for rheumatoid arthritis. Ann. Rheum. Dis. 2007;66:1078–1084. doi: 10.1136/ard.2006.058693. PubMed DOI PMC

Geyh S., Cieza A., Schouten J., Dickson H., Frommelt P., Omar Z., Kostanjsek N., Ring H., Stucki G. ICF Core Sets for stroke. J. Rehabil. Med. 2004;36:135–141. doi: 10.1080/16501960410016776. PubMed DOI

Bos I., Stallinga H.A., Middel B., Kuks J.B., Wynia K. Validation of the ICF core set for neuromuscular diseases. Eur. J. Phys. Rehabil. Med. 2013;49:179–187. PubMed

Grill E., Hermes R., Swoboda W., Uzarewicz C., Kostanjsek N., Stucki G. ICF Core Set for geriatric patients in early post-acute rehabilitation facilities. Disabil. Rehabil. 2005;27:411–417. doi: 10.1080/09638280400013966. PubMed DOI

Kaech Moll V.M., Escorpizo R., Portmann Bergamaschi R., Finger M.E. Validation of the Comprehensive ICF Core Set for Vocational Rehabilitation From the Perspective of Physical Therapists: International Delphi Survey. Phys. Ther. 2016;96:1262–1275. doi: 10.2522/ptj.20150365. PubMed DOI

Ustün T.B., Chatterji S., Kostanjsek N., Rehm J., Kennedy C., Epping-Jordan J., Saxena S., von Korff M., Pull C. Developing the World Health Organization Disability Assessment Schedule 2.0. Bull. World Health Organ. 2010;88:815–823. doi: 10.2471/BLT.09.067231. PubMed DOI PMC

Garin O., Ayuso-Mateos J.L., Almansa J., Nieto M., Chatterji S., Vilagut G., Alonso J., Cieza A., Svetskova O., Burger H., et al. Validation of the “World Health Organization Disability Assessment Schedule, WHODAS-2” in patients with chronic diseases. Health Qual. Life Outcomes. 2010;8:51. doi: 10.1186/1477-7525-8-51. PubMed DOI PMC

Federici S., Bracalenti M., Meloni F., Luciano J.V. World Health Organization disability assessment schedule 2.0: An international systematic review. Disabil. Rehabil. 2017;39:2347–2380. doi: 10.1080/09638288.2016.1223177. PubMed DOI

Belio C., Prouteau A., Koleck M., Saada Y., Merceron K., Dayre E., Destaillats J.M., Barral C., Mazaux J.M. Participation restrictions in patients with psychiatric and/or cognitive disabilities: Preliminary results for an ICF-derived assessment tool. Ann. Phys. Rehabil. Med. 2014;57:114–137. doi: 10.1016/j.rehab.2013.11.005. PubMed DOI

Daste C., Abdoul H., Foissac F., Papelard A., Alami S., Kwakkenbos L., Carrier M., Lefèvre-Colau M., Thombs B., Poiraudeau S., et al. Development of a new patient-reported outcome measure to assess activities and participation in people with systemic sclerosis: The Cochin 17-item Scleroderma Functional scale. Br. J. Dermatol. 2020;183:710–718. doi: 10.1111/bjd.18922. PubMed DOI

Raggi A., Leonardi M., Schiavolin S., Antozzi C., Brenna G., Maggi L., Mantegazza R. Validation of the MG-DIS: A disability assessment for myasthenia gravis. J. Neurol. 2016;263:871–882. doi: 10.1007/s00415-016-8072-9. PubMed DOI

Martinuzzi A., Carraro E., Petacchi E., Pasqualotti S., Costalunga M., Betto S. Implementation of an ICF-based project/program in a pediatric neuro-rehabiltation hospital: Follow-up evaluation by stakeholders. Disabil. Rehabil. 2013;35:1059–1064. doi: 10.3109/09638288.2012.720347. PubMed DOI

Rentsch H.P., Bucher P., Dommen Nyffeler I., Wolf C., Hefti H., Fluri E., Wenger U., Wälti C., Boyer I. The implementation of the “International Classification of Functioning, Disability and Health” (ICF) in daily practice of neurorehabilitation: An interdisciplinary project at the Kantonsspital of Lucerne, Switzerland. Disabil. Rehabil. 2003;25:411–421. doi: 10.1080/0963828031000069717. PubMed DOI

Guide for the Use of the Functional Independence Measure (WeeFIM) of the Uniform Data Set for Medical Rehabilitation. Research Foundation of the State University of New York; Albany, NY, USA: Uniform Data Set for Medical Rehabilitation; Buffalo, NY, USA: 1996.

Msall M.E., DiGaudio K., Rogers B.T., LaForest S., Catanzaro N.L., Campbell J., Wilczenski F., Duffy L.C. The functional independence measure for children (WeeFIM®): Conceptual basis and pilot use in children with developmental disabilities. Clin. Pediatrics. 1994;33:421–430. doi: 10.1177/000992289403300708. PubMed DOI

Msall M.E., DiGaudio K., Duffy L.C., LaForest S., Braun S., Granger C.V. WeeFIM®: Normative sample of an instrument for tracking functional independence in children. Clin. Pediatrics. 1994;33:431–438. doi: 10.1177/000992289403300709. PubMed DOI

McCarthy M.L., Silberstein C.E., Atkins E.A., Harryman S.E., Sponseller P.D., Hadley-Miller N.A. Comparing reliability and validity of pediatric instruments for measuring health and well-being of children with spastic cerebral palsy. Dev. Med. Child Neurol. 2002;44:468–476. doi: 10.1111/j.1469-8749.2002.tb00308.x. PubMed DOI

Francescutti C., Fusaro G., Leonardi M., Martinuzzi A., Sala M., Russo E., Frare M., Pradal M., Zampogna D., Cosentino A., et al. Italian ICF training programs: Describing and promoting human functioning and research. Disabil. Rehabil. 2009;31((Suppl. 1)):S46–S49. doi: 10.3109/09638280903317757. PubMed DOI

Iezzoni L.I., Greenberg M.S. Capturing and classifying functional status information in administrative databases. Health Care Financ. Rev. 2003;24:61–76. PubMed PMC

Francescutti C., Frattura L., Troiano R., Gongolo F., Martinuzzi A., Sala M., Meucci P., Raggi A., Russo E., Buffoni M., et al. Towards a common disability assessment framework: Theoretical and methodological issues for providing public services and benefits using ICF. Disabil. Rehabil. 2009;31((Suppl. 1)):S8–S15. doi: 10.3109/09638280903317815. PubMed DOI