Community integration following TBI: an examination of community integration measures within the ICF framework

The objectives of the present study are (1) to examine whether the content of existing community integration measures used following traumatic brain injury (TBI) is represented in the International Classification of Functioning, Disability and Health (ICF) and (2) to determine if the ICF provides a reasonable framework within which such measurement tools may be compared.

Five commonly-used assessment instruments were selected for inclusion. Independent raters mapped identified measurement concepts to the ICF using established linking rules.

One hundred and eighty-five concepts were identified from 85 items in five scales. Of these more than 75% could be linked to the ICF. The majority of linked concepts were assigned to 64 categories within the activities and participation component of the ICF; however, the focus of assessment within each instrument varied considerably.

Through a standardized process of item mapping to the ICF, one may examine operationalizations of community integration. This may help inform selection of a method of assessment appropriate to both the subject population and clinical or research purpose. However, this process allows comparison of only the objective content of measurement tools. Subjective evaluations may also be necessary to provide comprehensive assessment of community integration.