Review

Spinal Cord (2010) 48, 522–528; doi:10.1038/sc.2009.177; published online 5 January 2010

Outcome parameters in spinal cord injury research: a systematic review using the International Classification of Functioning, Disability and Health (ICF) as a reference

M W M Post1, I Kirchberger2, M Scheuringer3,5, M M Wollaars1 and S Geyh4

  1. 1Rehabilitation Centre ‘De Hoogstraat’ and Rudolf Magnus Institute for Neuroscience, Utrecht, The Netherlands
  2. 2ICF Research Branch of the WHO FIC CC (DIMDI), IHRS, Department of Physical Medicine and Rehabilitation, Ludwig-Maximilian University, Munich, Germany
  3. 3ICF Research Branch of the WHO FIC CC (DIMDI), IHRS, Department of Physical Medicine and Rehabilitation, Ludwig-Maximilian University, Munich, Germany
  4. 4Swiss Paraplegic Research, Nottwil, Switzerland

Correspondence: Dr MWM Post, De Hoogstraat, Rembrandtkade 10, Utrecht, 3583 TM, The Netherlands. E-mail: m.post@dehoogstraat.nl

5Current address: Outcomes Research, MSD Sharp & Dohme GmbH, Haar, Germany.

Received 2 June 2009; Revised 30 October 2009; Accepted 1 November 2009; Published online 5 January 2010.

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Abstract

Objectives:

 

This study is part of the development of an International Classification of Functioning, Disability and Health (ICF) Core Set for spinal cord injury (SCI). Its specific objectives were to identify outcome parameters reported in published studies on individuals with SCI in the early post-acute and chronic situation, and to identify and quantify the concepts of the reported parameters using the ICF as a reference.

Methods:

 

Electronic searches of Medline, EMBASE, PsycINFO and CINAHL from 2001 to 2005 were carried out. All outcome parameters and their underlying concepts were retrieved from the included studies. These concepts were linked to categories of the ICF using standardized rules.

Results:

 

From the 6681 abstracts retrieved, 2205 were randomly selected (33.0%) and 281 studies met the inclusion criteria (12.7%). A total number of 5217 concepts were retrieved from standardized and non-standardized measures, of which 4049 (77.6%) could be linked to 175 different ICF categories: 56 out of 114 Body Functions, 19 out of 56 Body Structures, 62 out of 118 Activities and Participation and 38 out of 74 Environmental Factors categories. Second-level categories reported in >20% of all studies were pain, remunerative employment, health services, systems and policies, school education and higher education.

Conclusion:

 

The ICF provides a valuable reference to identify and quantify the concepts of measures focusing on SCI in the early post-acute and chronic situation. The findings show a great diversity in the consequences of SCI and underscore the importance of social participation and environment for people with SCI.

Keywords:

mesh:spinal cord; systematic literature review; rehabilitation, outcome assessment nonmesh: ICF; ICF Core Set