ICF Activity and Participation Needs in Post-stroke Patients
Condition: Stroke
MeSH terms: Stroke
Study type: Interventional

Summary: 
      Stroke is regarded as one of the leading causes of adult mortality and disability.
      Conventional rehabilitation programs for post-stroke patients focus on the augmentation of
      body functions. Their service delivery models are mostly operationalized according to the
      individual discipline's knowledge domain and practices. The International Classification of
      Functioning, Disability and Health (ICF) model provides a comprehensive framework which
      places focus on patients' activity and participation. It also emphasizes cross-disciplinary
      integration of service provision, patient-centred approach and personalization of treatment
      aims. This study is aimed to investigate how the ICF model can be integrated into the
      planning and implementation of personalized post-stroke programs, and evaluate the program's
      effectiveness in fulfilling the activity and participation needs of patients.
    

Detailed description: 
      Stroke is a neurological disease and is regarded as one of the leading causes of adult
      mortality and disability. Post-stroke rehabilitation to promote functional recovery is
      important to restitute the brain tissue to relearn and compensate for the lost functions.
      Early rehabilitation to enhance neuroplasticity within three to six months of post-stroke is
      recommended to reduce neurological deficits caused by stroke. Promising stroke rehabilitation
      interventions to tackle mobility and cognitive impairments include fitness training, upper
      and lower extremity interventions, and reminiscence therapy.

      The ICF model is proposed by the World Health Organization to describe health and
      health-related domains. It was developed based on the biopsychosocial model. Within the
      model, disability and functioning are identified as difficulties in 1) body functions and
      structure; 2) activity; and 3) participation. They are affected by the interaction between
      health conditions and contextual factors. The former is different diseases, disorders and
      injuries, while the latter consists of environmental factors and personal factors. The ICF
      model has been widely applied in assessment, treatment and evaluation in various disciplines.
      On top of the ICF model, there is a related neurorehabilitation process framed by ICF which
      makes up four steps. The first step is the assessment to understand the diagnosis and
      consequences of the current health condition of an individual. Followed by the goal-setting
      part to formulate short-term or long-term rehabilitation plans for patients' perspective.
      These two steps will inform the therapists of an ICF rehabilitation plan with corresponding
      ICF codes to describe patients' health conditions. The third step is to launch appropriate
      interventions based on the ICF rehabilitation plan, and the final step is the outcome
      measurements to review the appropriateness of interventions. Yet, a similar process has
      seldom been applied in post-stroke rehabilitation to guide the treatment program.

      This project aims to investigate how the ICF model can be integrated into planning and
      implementation of an ICF-based post-stroke rehabilitation program (ICF-PSRP), and evaluate
      the program's effectiveness on fulfilling the activity and participation needs of patients.
    

Intervention name(s): ICF-based post-stroke rehabilitation program
Intervention type(s): Behavioral
Intervention description(s): Patients completed an intake interview with a case therapist for an initial assessment and setting of personal treatment goals. The therapist assisted the patient with setting goals that were related to their life roles and functional gaps in terms of body function and activity and participation. Patients' personalized treatment plans were composed in case conferences. The treatment program contents were organized as ICF-based body function and activity and participation intervention modules. Each of the occupational therapy, physiotherapy, and speech therapy disciplines set the aims and developed the training contents, intensities, durations, and upgrading and completion criteria.
Intervention model: Single Group Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: ICF; Stroke rehabilitation