Validation and evaluation of the application of the ICF Rehabilitation Set: a Polish clinical perspective

Monitoring a patient's functional status in the rehabilitation process is essential for the ongoing improvement of the quality of the rehabilitation services offered. This possibility is provided by the use of the International Classification of Functioning, Disability and Health (ICF) and the ICF Core Sets developed on its basis. The purpose of this study was to validate and evaluate the use of the ICF Rehabilitation Set in rehabilitation patients in clinical practice in southeastern Poland.

This study included patients who required comprehensive rehabilitation in a tertiary care rehabilitation centre. The study used the Polish version of a rating reference guide for the ICF Rehabilitation Set and the Barthel Index. The assessment was carried out by an interdisciplinary team, which established the ICF qualifier values by consensus. Interrater reliability was assessed using intraclass correlation coefficients (ICCs). Convergent validity was assessed using Spearman correlation coefficients between the Disability Index (DI) and the Barthel Index (BI). To assess the effectiveness of rehabilitation in the study group, a paired Wilcoxon test was used to compare the measurements of the two ICF codes.

This study demonstrated the consistency and reliability of the reference guide for the ICF Rehabilitation Set. The ICC values were very high (for B620; D450; D640, the ICC was 1.000) and high (for E155, the ICC was 0.793). The individual entries from the ICF Rehabilitation Set were found to have very high concordance for assessing individual qualifiers between researchers (the ICC for the DI was 0.995). The ICF Rehabilitation Set scores and the calculated DI were correlated with the BI scores. The ICF Rehabilitation Set is sensitive to changes in the functional status of patients undergoing rehabilitation and is consistent with the results obtained by the BI measure. There was also a statistically significant improvement in patients' functional status after rehabilitation.

The ICF Rehabilitation Set and the developed rating reference guide are reproducible, consistent and relevant and can be used in clinical settings to collect health information from people undergoing rehabilitation. Further research is needed to strengthen the evidence to validate the ICF in Poland.

The study was registered in the clinical trial registry at ClinicalTrials.gov (NCT06718036, date of registration 2024-11-30, retrospectively registered).