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Published on: February 22, 2020
Functioning and disability after stroke in children: using the ICF-CY to classify health outcome and inform future
1Paediatric Neurosciences Department, Evelina London Children's Hospital, Guy's & St Thomas' Hospital NHS Foundation Trust, Kings Health Partners, London, UK; Clinical Sciences Theme, Murdoch Childrens Research Institute, Melbourne, Vic., Australia.
Insights
This study reviewed pediatric arterial ischemic stroke (AIS) outcomes using the ICF-CY framework. Most studies focused on body functions, with limited exploration of environmental factors and participation restrictions.
Area of Science:
- Rehabilitation Medicine
- Pediatric Neurology
- Health Services Research
Background:
- The International Classification of Functioning Disability and Health, Child-Youth version (ICF-CY) offers a comprehensive framework for health and disability assessment.
- The ICF-CY can be utilized to classify the focus of outcome studies and identify knowledge gaps in pediatric populations.
Purpose of the Study:
- To systematically review and classify the focus of outcome studies in pediatric arterial ischemic stroke (AIS) using the ICF-CY framework.
- To identify gaps in current knowledge regarding functioning and disability in children with AIS.
Main Methods:
- A systematic literature search was conducted across multiple databases targeting outcome studies in pediatric AIS.
- Findings from 28 identified studies were systematically rated and classified according to the ICF-CY framework.
- The focus of outcome measures, study designs, and participant demographics were analyzed.
Main Results:
- Twenty-eight studies were included, predominantly cross-sectional, with wide age ranges at assessment.
- Sixty-seven standardized measures were used, primarily assessing body functions.
- Commonly reported domains of activity and participation included learning, general tasks, and self-care; health-related quality of life was assessed in nine studies.
- Environmental factors were infrequently evaluated.
Conclusions:
- Recent AIS outcome studies increasingly address the link between body structures/functions and activities, participation, and quality of life.
- Heterogeneity in study design and outcome measures complicates cross-study comparisons.
- The relationship between activity limitations and participation restrictions remains underexplored in pediatric AIS research.
Aim:
The International Classification of Functioning Disability and Health, Child-Youth version (ICF-CY) provides a framework for describing and evaluating health, intervention outcomes, and needs assessment. It can, however, also serve as a system for classifying the focus of outcome studies and identification of gaps in current knowledge.
Method:
The paediatric arterial ischaemic stroke (AIS) population was targeted. Multiple databases were systematically searched for AIS outcome studies focussing on functioning or disability. Findings were rated using the ICF-CY framework.
Results:
Twenty-eight studies were identified. Most were cross-sectional and age range at assessment varied widely. Sixty-seven different standardized measures were used, predominantly evaluating body functions. The most common domains of activity and participation reported were learning and applying knowledge, general tasks and demands, and self-care skills. Health-related quality of life was measured in nine papers. Environmental factors were rarely evaluated.
Interpretation:
AIS outcome studies addressing the relationship between body structures and functions (e.g. brain lesion characteristics, neurological examination findings) and activities, participation, and quality of life have emerged in recent years. Comparison of findings across studies is complicated by design and tool selection. The relationship between components of activity limitation and participation restriction is rarely explored.
