Disability and functional profiles of patients with migraine measured with ICF classification

To describe the functional profiles of patients with migraine, and the relationships between symptoms, activities and environmental factors, using WHO's International Classification of Functioning (ICF). Patients were consecutively enrolled at the Besta Institute of Milan. The ICF checklist was administered and two count-based indexes developed: 'extension', containing ICF categories rated with qualifiers 1-4, and 'severity', containing ICF categories rated with qualifiers 3-4. Categories rated with qualifiers 1-4 in at least 50% of patients are described separately. Spearman's correlation was performed to identify the relationships between symptoms, activities and environmental factors; linear regressions were performed to identify the best predictors of performance indexes in activities and participation domain. One hundred and two patients joined this study. Twenty-eight categories rated with qualifiers 1-4 in at least 50% of patients are reported: they include difficulties in daily activities, in mobility and in labor activities. Capacity and performance indexes are significantly different. Low correlations are reported between body functions impairments and limitations in activities and participation, slightly higher with capacity indexes. Environmental factors are mildly correlated with capacity indexes. Environmental factors play a relevant role in improving functioning of patients with migraine. Nevertheless, difficulties in activities and participation are explained more by functional impairments than by the effect of environmental factors: in particular, no facilitators target difficulties in work activities or mobility. To plan appropriate interventions that meet patients' needs, especially in the labor sector, methodologies and tools are needed to couple information on symptoms, on the difficulties in executing activities and on environment's features.