International Classification of Functioning, Disability, and Health-based rehabilitation program promotes activity and participation of post-stroke patients

Mabel Ngai-Kiu Wong; Mike Kwun-Ting Cheung; Yuk-Mun Ng; Huan-Ling Yuan; Bess Yin-Hung Lam; Siu Ngor Fu; Chetwyn Che Hin Chan

doi:10.3389/fneur.2023.1235500

International Classification of Functioning, Disability, and Health-based rehabilitation program promotes activity and participation of post-stroke patients

Front Neurol. 2023 Nov 3:14:1235500. doi: 10.3389/fneur.2023.1235500. eCollection 2023.

Authors

Mabel Ngai-Kiu Wong^{1

2}, Mike Kwun-Ting Cheung³, Yuk-Mun Ng⁴, Huan-Ling Yuan¹, Bess Yin-Hung Lam⁵, Siu Ngor Fu¹, Chetwyn Che Hin Chan²

Affiliations

¹ Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China.
² Department of Psychology, The Education University of Hong Kong, New Territories, Hong Kong SAR, China.
³ Centre on Research and Advocacy, The Hong Kong Society of Rehabilitation, Hong Kong, Hong Kong SAR, China.
⁴ Rehabilitation Division, The Hong Kong Society for Rehabilitation, Hong Kong, Hong Kong SAR, China.
⁵ Department of Counselling and Psychology, Hong Kong Shue Yan University, Hong Kong, Hong Kong SAR, China.

Abstract

Background: The International Classification of Functioning, Disability, and Health (ICF) model has been applied in post-stroke rehabilitation, yet limited studies explored its clinical application on enhancing patients' Activity and Participation (ICF-A&P) level.

Purpose: This study gathered evidence of the effects of an ICF-based post-stroke rehabilitation program (ICF-PSRP) in enhancing community reintegration in terms of ICF-A&P of post-stroke patients.

Methods: Fifty-two post-stroke patients completed an 8 to 12 weeks multidisciplinary ICF-PSRP after setting personal treatment goals in an outpatient community rehabilitation center. Intake and pre-discharge assessments were administered for primary outcomes of Body function (ICF-BF; e.g., muscle strength) and ICF-A&P (e.g., mobility), and secondary outcomes of perceived improvements in ability (e.g., goal attainment and quality of life).

Results: There were significantly higher levels in the ICF-BF and ICF-A&P domains, except cognitive function under the ICF-BF. Improvements in the primary outcomes predicted corresponding secondary outcomes. Firstly, expressive and receptive functions (ICP-BF) were mediated by the everyday language (ICF-A&P) which predicted patients' satisfaction with the language-related quality of life. Secondly, upper extremity function (ICP-BF) was mediated by the lower extremity mobility (ICF-A&P) predicting work and productivity-related quality of life. Content analyses showed that combined ICF-BF and ICF-A&P contents throughout the ICF-PSRP contributed to the positive treatment effects.

Conclusion: The ICF-PSRP was effective in promoting body function, and activity and participation levels of post-stroke patients. Positive treatment effects are characterized by goal-setting process, cross-domain content design, and community-setting delivery.Clinical trial registration: https://clinicaltrials.gov/study/NCT05941078?id=NCT05941078&rank=1, identifier NCT05941078.

Keywords: community reintegration; goal-setting process; multidisciplinary approach; resuming life roles; stroke rehabilitation.

Associated data

ClinicalTrials.gov/NCT05941078

Grants and funding

This study is supported by the Peter T C Lee Endowed Chair Professor fund (Grant no.: S2006) awarded to CC.