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Journal of Occupational Rehabilitation (2019) 29:241–273 https://doi.org/10.1007/s10926-018-9788-4

REVIEW

International Classification of Functioning, Disability and Health in Vocational Rehabilitation: A Scoping Review of the State of the Field

A. H. Momsen1,2,7 · C. M. Stapelfeldt1,2 · R. Rosbjerg1,2 · R. Escorpizo3,4 · M. Labriola1,2 · M. Bjerrum5,6

Published online: 5 June 2018 © The Author(s) 2018

AbstractPurpose The purposes of this study were to provide an outline of the existing literature on operationalization of the Inter-national Classification of Functioning, Disability and Health (ICF) within vocational rehabilitation (VR) and to explore the ICF utility within VR. Methods The process was undertaken in five stages according to a framework of scoping review. Screening and extraction of data were done by two independent reviewers, and data was summarized according to content analysis. Results Fifty papers (25 qualitative and 25 quantitative) were included. The operationalization of the ICF was described in four different ways: In total 18 (36%) papers described use of the ICF for structuring information, 8 (15%) for linking information to ICF, 12 (24%) for analysis of results, and 12 (24%) for development of a model. In total 15 (29%) papers described VR interventions involving stakeholders, whereas 32 (62%) were reviews. Forty of the papers described all the ICF components. Conclusions The review revealed use of the ICF within the field VR in 50 papers, and in various settings. The ICF framework was most often operationalized for structuring or linking information of functioning. A majority of papers were reviews and involved researchers only, whereas different stakeholders and VR professionals were involved in the interventions. In 40 papers all the ICF components were described, and the ICF was considered a useful tool to inform the VR professionals´ assessment of functioning. However, more research within VR is needed to standardize and ease the use of the ICF.

Keywords Occupational health services · Rehabilitation · Return to work · Outcome assessment

Background

Work disability is often associated with personal suffering and loss of income, diminished productivity and increased medical and societal costs and can be addressed through

vocational rehabilitation (VR) [1]. The essence of VR is promotion of workers’ health in order to enter or return to work (RTW), prevent work disability, and sustain work ability [1–4]. VR professionals have been challenged by different perceptions of health, and researchers argue for a definition of health as a dynamic process of adaptation and self-management [5]. The Organisation for Economic Co-operation and Development (OECD) states that several countries have made efforts to move away from assessing a

Electronic supplementary material The online version of this article (https ://doi.org/10.1007/s1092 6-018-9788-4) contains supplementary material, which is available to authorized users.

* A. H. Momsen [email protected]

1 Section of Clinical Social Medicine and Rehabilitation, Department of Public Health, Aarhus University, 8000 Aarhus, Denmark

2 DEFACTUM - Social & Health Services and Labour Market, Central Denmark Region, 8000 Aarhus, Denmark

3 Department of Rehabilitation and Movement Science, University of Vermont, Burlington, VT, USA

4 Swiss Paraplegic Research, Nottwil, Switzerland

5 Danish Centre of Systematic Reviews: A Joanna Briggs Institute Centre of Excellence, Department of Medicine and Technology, University of Aalborg, 9000 Aalborg, Denmark

6 Section of Nursing Science, Department of Public Health, Aarhus University, 8000 Aarhus, Denmark

7 DEFACTUM, Aarhus University Hospital, MarselisborgCentret, P.P. Oerums Gade 11, 8000 Aarhus, Denmark

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https://doi.org/10.1007/s10926-018-9788-4

242 Journal of Occupational Rehabilitation (2019) 29:241–273

1 3

person’s illness, but instead examining the person’s remain-ing work capacity [6]. The International Classification of Functioning, Disability and Health (ICF) (See Fig. 1) was approved by the World Health Assembly in 2001 [7], and the ICF framework covers a spectrum of body, personal, and societal aspects of human functioning. Thereby, the ICF captures a comprehensive view of disability relevant to VR, and the integration of “functioning” in VR rather than the traditional biomedical approach, which is in line with the efforts stated by OECD [2]. In VR a comprehensive under-standing of the aspects influencing patients’ functioning is important. Thus, the usefulness of the ICF may be demon-strated in VR [8]. The ICF framework has been proposed to offer opportunities to optimize VR for patients by providing a universal conceptual reference to improve communication between different users, such as health care professionals, researchers, and policy-makers.

There are several definitions of VR, e.g. medical, psycho-logical, social and occupational activities aiming to reestab-lish sick or injured peoples work capacity and prerequisites for returning or entering the labour market, i.e. to a job or availability for a job, 2009 [9]. In 2011, a broader ICF-based definition of VR was introduced: “A multi-professional evidence-based approach that is provided in different set-tings, services, and activities to working age individuals with health-related impairments, limitations, or restrictions with work functioning, and whose primary aim is to optimize work participation” [2].

A review showed diversity in the ICF contents of the measures used in the literature, and proposed that the ICF and VR interface should be further examined [10]. Know-ing more about how and to what extent the ICF framework is applied and has been utilized is suggested important in order to optimize VR interventions for patients [11] and the inter-professional approach in VR processes [8].

The purposes of this review were to provide an outline of the existing literature and to explore the ICF utility within VR. The primary aim was to examine and map the opera-tionalization of the ICF within VR. The second aim was to examine the different VR professionals´ use of the ICF.

Ideally a multi-professional, multimodal approach should be used in VR [12].

Within the WHO a number of ICF core sets have been developed in order to make the ICF more applicable for clinical practice. A third aim was to examine to what extent the components of the ICF framework, the VR core set, and other ICF core sets are used within VR. Core sets are lists of essential ICF-categories in specific health conditions and contexts to describe functioning, e.g. a comprehensive and a brief VR core set were developed and validated for interdis-ciplinary assessment, documentation, and communication in VR [13, 14].

A preliminary search in PROSPERO and PubMed showed no review on the topic, and to our knowledge there are no existing systematic reviews or scoping review on how the ICF is applied within VR.

Methods

The scoping review was conducted according the method-ology conduced in five steps: (1) identifying the research question, (2) identifying relevant studies, (3) study selection, (4) charting the data, and (5) collating, summarizing, and reporting results [15–17].

Identifying the Research Question

(1) How is the ICF operationalized in empirical papers within VR?

(2) Who are involved and how does the ICF inform the professionals´ assessment of functioning in VR?

(3) Which of the ICF components and core sets are consid-ered when functioning is evaluated in VR?

Identifying Relevant Studies

A three-step search strategy was conducted [16]. Firstly, initial keywords were identified and secondly all identified keywords and index terms were used to build a comprehen-sive and specific search strategy for each included database: PubMed, Embase, Scopus, CINAHL, PsycINFO, Swemed+, and PEDro. Thirdly, the search strategies were refined: VR and RTW (MeSH term) in PubMed and other terms, e.g. sick leave, work disability were used as keywords [10], and ICIDH was used as ICF was not a MeSH term until 2012 [18, 19]. The search was performed in collaboration with a research librarian at Aarhus University Library. The search was restricted to papers in English, German, Danish, Swed-ish, and Norwegian (Online Appendix A).

Fig. 1 The internation classification of functioning, disability and health (ICF) framework

243Journal of Occupational Rehabilitation (2019) 29:241–273

1 3

Study Selection

Inclusion criteria: ICF or International Classification of Functioning, Disability and Health mentioned in the title or abstract, ICF used in the field of VR research, peer reviewed original papers and reviews, date of publication from January 2001 to May 2016, abstract available, and study populations of working age adults. There were no limitations regarding including reviews and thereby poten-tial overlap of individual papers included in the reviews. There were no context limitations regarding geography or culture, and papers were eligible from any healthcare setting or research setting (e.g. rehabilitation clinic, in-patient or out-patient clinic, hospital, physicians, primary health care, occupational health services, insurance office, and research departments).

Exclusion criteria: papers only mentioning ICF in the abstract, background or discussion, or only mentioning ICIDH or ICIDH-2, overviews, editorials, comments, theo-retical papers, text and opinion papers, theses/dissertations, books, and papers on ICF-Children and Youth.

The process of study selection was reported using the PRISMA [20], and eligible studies were screened indepen-dently by two reviewers (AM and MB) followed by consen-sus discussions. The selection was performed in two groups for qualitative papers (AM and RR) and quantitative papers (AM and CMS), respectively.

Extraction of Data

Study characteristics were extracted from the included stud-ies using a pilot-tested non-software template. The papers were divided in qualitative and quantitative papers according to qualifications of the review team. Two authors extracted study characteristics independently for qualitative papers (AM and RR) and quantitative papers (AM and CMS), respectively. In case of disagreement, the final decision about characteristics was resolved through discussion. The papers were divided in qualitative and quantitative papers according to the data collection method described.

Study characteristics according to The Joanna Briggs Institute Reviewers’ Manual included: first author, publica-tion year, country, setting, study type (intervention yes/no), population, aims, methods, and outcomes [16]. Intervention was defined as “a treatment, whether for preventative or ther-apeutic reasons, an assessment or diagnostic tool or some other type of service or condition to which a patient might be exposed” [21]. Data from the included studies was coded by two authors (AM and RR; AM and CMS, respectively) using the three research questions.

Regarding the first research question; data was extracted according to the use of the ICF framework as described in the individual papers. Four different ways of operationalization

of the ICF were the most typical descriptions used in a sub-set of the papers included: (a) structuring, (b) linking, (c) analysing, or (d) developing instruments or models, respec-tively. All the included papers´ description were categorised in these. Structuring was considered present, when data or outcomes were categorized, or themes or information from interviews was coded according to the ICF framework. How-ever, in case structuring was followed by other use, data was extracted according to the latter. Linking was considered present, when health information (e.g. from questionnaires or interviews) was coded to specific ICF categories, based on linking rules, e.g. linking items in a questionnaire to catego-ries in a core set [9, 22]. Analysing was considered present if the paper explicitly described that data were analysed, most commonly after data or information had been structured fol-lowing the ICF framework. Developing instruments or mod-els based on the ICF framework was the last reported usage.

Regarding the second research question the description of VR professionals (e.g. health professionals) involved were extracted, and a descriptive summary of their use of the ICF in order to inform the assessment of functioning was presented. Regarding the third question; the use of the ICF components (body function, body structures, activity and participation, environmental factors) and the ICF core set(s) was extracted based on the information provided in individual papers.

Collating, Summarizing, and Reporting Results

A descriptive summary of the charted data was done inde-pendently by two authors on all the included papers. The coded data relevant to inform the three review questions were charted from each paper included and categorized according to content analysis [23–25]. Both deductive and inductive analyses were used, as the results were based on the description in the papers, e.g., of the pre-defined ICF components and core sets. The descriptive summary of the main results is presented in tables.

Results

In total 1343 papers were retrieved from seven databases, of which 702 duplicates were removed; thus, 641 papers were assessed for eligibility (Fig. 2). Sixty-four papers from these were read in full text of which 14 papers were excluded, mainly because the ICF was only mentioned in the introduc-tion or discussion and lack of information on VR. Thus, 50 papers (25 qualitative and 25 quantitative) were included. No additional papers were included.

A descriptive summary of the included study character-istics is shown in Table 1. The ICF referral in papers within VR was found among Western countries, except one paper


1 3

from Taiwan. Thus, nine papers were from Switzerland [10, 26–33] four were from the USA [34–37], three from Italy [38–40], two from Germany [41, 42], one from Canada [43], UK [44], Portugal [45], Turkey [46], Slovenia [47], Spain [48], Israel [49], and Taiwan [50]. Five papers were authored by an international [38, 51–54], three were from settings in Sweden [55–57], and three from Norway [58–60].

Although 32 of the papers were reviews, primarily from research settings (e.g. rehabilitation social medicine or phys-iotherapy departments) in Switzerland and the Netherlands; other VR settings in which the ICF was used were wide-spread, i.e. hospitals, rehabilitation centres, primary health care centres, and sickness certificate registration offices.

A minority of papers reported interventions within VR; only seven of the qualitative papers [34, 36, 38, 55, 61–63], and eight among the quantitative papers [37, 40–42, 46, 57, 60, 64]. Eleven papers were from health care and research settings in the Netherlands [61–71].

How is the ICF Operationalized in Empirical Papers within VR?

In total 18 papers (36%) used the ICF as a framework for structuring of information: twelve of the qualitative papers [26, 27, 30, 44, 61, 62, 66, 68–70, 72–74], and six of the quantitative papers [29, 37, 42, 57, 64, 74]; e.g. relating information in sickness certificates to the ICF framework [57] (Table 2). As an example, one paper reported that the ICF was used for verifying data on claimants´ disabilities

by comparing the information provided by the ICF and the bio-psycho model to see the extent of match [61].

In total eight papers (15%) used the ICF as a framework for linking between ICF categories and e.g. items in ques-tionnaires: three qualitative papers [31, 38, 52], and five quantitative papers [32, 33, 39, 71, 75]; e.g. of Italian leg-islative procedures to the ICF [39], of factors coded on the second- level ICF classifications [71], of items to the core set and following the linking rules [32, 33, 75]. As an example, one paper aimed at merging an ICF core set for a specific health-related condition (spinal cord injury) to the catego-ries of the VR core set [75]. Another paper identified the concepts within the functional problems which were coded, and linked to ICF categories, or to the categories of the VR core set [38].

The analysis was performed according to the ICF frame-work in 12 papers (24%): five qualitative papers [34, 36, 43, 55, 63], e.g. listing of the respondents´ answers followed by frequency analysis according to the relevant ICF domains [55] and seven quantitative papers [28, 40, 46, 49, 50, 56, 58]; e.g. rating and analysing problems regarding work [28], and extraction of phrases from a patients´ electronic record that could potentially be interpreted as an ICF category [46]. One of the quantitative papers analysed levels of function and how it correlated with vocational status [49].

The ICF was used as a framework for the development of an instrument or a new model for various aspects within VR in 12 papers (24%) : five qualitative papers [35, 48, 54, 65, 67]; e.g. a model relating the levels of activity to the ICF [48], and a model explaining work disability by health-related problems at work [53]. A paper concluded that the ICF may contribute by informing our thinking of RTW and work maintenance by conceptualizing phase-based RTW outcomes [54]. Seven quantitative papers reported use of the ICF for development [41, 45, 47, 53, 59, 60, 76]; e.g. relating with other questionnaires used in VR [41], and use of the ICF core sets for developing a questionnaire for description of workplace accommodation [60].

Who are Involved and How Does the ICF Inform the Professionals´ Assessment of Functioning in VR?

Four papers described involvement of patients and research-ers [34, 55] or patients and health professionals [38, 61]. Two papers described involvement of professionals, employ-ers, and employees as informants [68], medical profession-als as evaluators of work disability and researchers [26], respectively. A majority (32) of papers were reviews involv-ing solely the authors (researchers): twenty of the qualita-tive papers, and eleven of the quantitative papers, respec-tively. Two papers involved a research team, interviewers and project staff [37], researchers and an adjudicator [56], respectively. Seven papers involved researcher and numerous

Records iden�fied through database searching (n = 1343) PubMed 283 Embase 317 Scopus 283 CINAHL 243 PsychInfo 192 PEDdro 17 SweMed 8

Scre

enin

g In

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ed

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ibili

ty

Iden

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Addi�onal records iden�fied through other sources

(n = 0)

Records a�er duplicates removed (n = 641 )

Records screened (n = 641 )

Records excluded (n = 577) ICF not mentioned in title/abstract (n=573) Books, thesis (n=4)

Full-text ar�cles assessed for eligibility

(n = 64)

Full-text ar�cles excluded, with reasons

(n=14)

ICF only men�oned in discussion (n = 7)

Not Voca�onal rehabilita�on (n = 3) Not English, German,

Danish, Swedish or Norwegian (n = 4) Studies included in

qualita�ve synthesis (n = 50)

Fig. 2 Flow diagram


1 3

Tabl

e 1

Sum

mar

y of

bas

ic c

hara

cter

istic

s of t

he in

clud

ed p

aper

s, ai

ms,

met

hods

, and

out

com

es

Aut

hor

Year

Cou

ntry

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ngIn

terv

entio

n (y

es/

no) S

tudy

type

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latio

nA

ims

Met

hods

Out

com

es (p

rimar

y/se

cond

ary)

Qua

litat

ive

pape

rs A

bbot

t [55

]20

11Sw

eden

Orth

opae

dic

Clin

ic,

Kar

olin

ska

Uni

ver-

sity

Hos

pita

l

Yes.

Qua

litat

ive

inte

rvie

w a

nd

self

repo

rt sc

ales

Lum

bar f

usio

n pa

tient

s, N

= 20

To d

escr

ibe

with

in

the

cont

ext o

f IC

F, p

atie

nts’

ex

perie

nces

of

post-

lum

bar f

usio

n re

gard

ing

low

bac

k pr

oble

ms,

reco

very

an

d ex

pect

atio

ns o

f re

habi

litat

ion.

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cont

rast

with

the

cont

ent o

f out

com

e m

easu

res a

nd th

e IC

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w b

ack

pain

co

re se

ts

Mix

ed m

etho

d:

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litat

ive

cont

ent

anal

ysis

of s

emi-

struc

ture

d in

ter-

view

s 3–6

mon

ths

afte

r sur

gery

and

co

mpa

ring

ICF

with

que

stion

naire

s. IC

F lin

king

rule

s w

ere

used

to c

ode

mea

ning

uni

ts

Expe

rienc

es w

ith re

ha-

bilit

atio

n po

st-lu

m-

bar f

usio

n. E

xpec

ta-

tion

with

out

com

e of

re

habi

litat

ion

ICF

cate

gorie

s of a

ll co

mpo

nent

s

Aia

chin

i [38

]20

15Te

am (I

taly

, USA

, Sw

itzer

land

)Sp

inal

uni

t at R

eha-

bilit

atio

n ho

spita

l, Pa

via

Yes.

Focu

s gro

up

inte

rvie

ws

Patie

nts w

ith sp

inal

co

rd in

jury

(SC

I),

N =

24

To v

alid

ate

the

com

preh

ensi

ve IC

F C

ore

Set f

or V

R

from

the

pers

pec-

tive

of S

CI p

atie

nts

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xplo

re th

e as

pect

s of f

unct

ion-

ing

and

heal

th

impo

rtant

to

patie

nts w

ith S

CI

rega

rdin

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W,

and

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xam

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to w

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xten

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aspe

cts a

re

repr

esen

ted

by th

e cu

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sion

of

VR

cor

e se

t

Focu

s gro

up in

ter-

view

s7

focu

s gro

ups w

ere

digi

tally

reco

rded

an

d tra

nscr

ibed

ve

rbat

im. T

he

mea

ning

con

dens

a-tio

n pr

oced

ure

was

us

ed fo

r the

dat

a an

alys

isLi

nkin

g ru

les w

ere

used

to c

ode

mea

n-in

g un

itsA

ddin

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e sp

ecifi

c IC

F C

ore

Set f

or

SCI i

n lo

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rm

cont

ext f

or n

ot

cove

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conc

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Con

cept

s ide

ntifi

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th

e fo

cus g

roup

s and

th

eir l

inki

ng to

ICF

com

preh

ensi

ve c

ore

set f

or V

R o

r not


1 3

Tabl

e 1

(con

tinue

d)

Aut

hor

Year

Cou

ntry

Setti

ngIn

terv

entio

n (y

es/

no) S

tudy

type

Popu

latio

nA

ims

Met

hods

Out

com

es (p

rimar

y/se

cond

ary)

Ann

er [2

6]20

12Sw

itzer

land

Aca

dem

y of

Sw

iss

Insu

ranc

e M

edi-

cine

, Uni

vers

ity

Hos

pita

l Bas

el

No.

Qua

litat

ive

liter

atur

e stu

dySi

ck-li

sted

and

pers

ons u

nabl

e to

w

ork

(dis

abili

ty

eval

uatio

n in

med

i-ca

l rep

orts

)

To d

iscu

ss p

oten

tial

bene

fits o

f the

ICF

to st

ruct

ure

and

phra

se d

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ility

ev

alua

tion

in th

e fie

ld o

f soc

ial i

nsur

-an

ceTo

des

crib

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re

feat

ures

of d

is-

abili

ty e

valu

atio

n of

the

ICF

acro

ss

coun

tries

, and

to

addr

ess h

ow a

nd to

w

hat e

xten

t the

ICF

may

be

appl

ied

in

disa

bilit

y ev

alu-

atio

n

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litat

ive

met

hod:

a

Euro

pean

com

-pa

rison

. Dis

cuss

ion

of IC

F (in

4 st

udie

s an

d in

gen

eral

)Re

porti

ng a

bout

wor

k di

sabi

lity

in so

cial

in

sura

nce

Cor

e fe

atur

es fo

r as

sess

ing

wor

k di

s-ab

ility

for m

edic

al

expe

rts

Bak

ker [

65]

2006

Net

herla

nds

Dis

abili

ty in

sura

nce,

C

entre

of H

ealth

-ca

re R

esea

rch,

U

nive

rsity

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ical

C

entre

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ning

en

No.

Lite

ratu

re st

udy,

co

nsul

tatio

ns

amon

gst e

xper

ts

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able

d se

lf-em

ploy

ed p

erso

nsFo

ur e

xper

ts

To tr

ace

risk

fac-

tors

for d

isab

ility

am

ongs

t the

self-

empl

oyed

To c

ontri

bute

to m

ore

evid

ence

-bas

ed

unde

rwrit

ing

cri-

teria

for d

isab

ility

in

sura

nce

Lite

ratu

re st

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and

cons

ulta

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n am

ongs

t fou

r ex

perts

/rese

arch

ers

Ris

k fa

ctor

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med

i-ca

l cha

ract

erist

ics i

n lo

ng-te

rm d

isab

ility

in

the

empl

oyed

an

d se

lf-em

ploy

ed

popu

latio

ns

Cul

ler [

34]

2011

USA

Reha

bilit

atio

n In

sti-

tute

of C

hica

goYe

s. Q

ualit

ativ

e in

terv

iew

sSt

roke

surv

ivor

s, em

ploy

ers,

voca

-tio

nal s

peci

alist

s N

= 10

, 7, 2

1

To id

entif

y fa

ctor

s th

at fa

cilit

ate

or a

ct

as a

bar

rier t

o RT

W

for s

troke

surv

ivor

s

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litat

ive

met

hods

: In

terv

iew

s with

str

oke

surv

ivor

s ab

out t

heir

RTW

ex

perie

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post

strok

eSu

rvey

with

voc

a-tio

nal s

peci

alist

s ab

out b

arrie

rs a

nd

faci

litat

ors o

f RTW

ba

sed

on th

eir c

lini-

cal p

ract

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Inte

r-vi

ews w

ith e

mpl

oy-

ers e

xper

ienc

ed in

in

terv

iew

ing

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riers

and

faci

lita-

tors

to R

TW fo

r str

oke

surv

ivor

s fro

m

thre

e pe

rspe

ctiv

es

wer

e ill

ustra

ted

Iden

tified

com

pone

nts

wer

e m

appe

d ba

sed

on th

e IC

F


1 3

Tabl

e 1

(con

tinue

d)

Aut

hor

Year

Cou

ntry

Setti

ngIn

terv

entio

n (y

es/

no) S

tudy

type

Popu

latio

nA

ims

Met

hods

Out

com

es (p

rimar

y/se

cond

ary)

Dal

eman

s [66

]20

08N

ethe

rland

sH

ealth

car

e, Z

uyd

Uni

vers

ity, H

eerle

nN

o. S

yste

mat

ic

revi

ewSt

roke

surv

ivor

sTo

des

crib

e w

hat

is k

now

n in

the

liter

atur

e ab

out

parti

cipa

tion

in

wor

king

-age

per

-so

ns w

ith a

phas

ia

afte

r stro

ke

Syste

mat

ic li

tera

ture

se

arch

ing

for t

he

perio

d 19

60–2

005

on p

artic

ipat

ion:

th

e pe

rform

ance

of

peo

ple

in a

ctua

l ac

tiviti

es in

soci

al

life

dom

ains

th

roug

h in

tera

ctio

n w

ith o

ther

s in

the

cont

ext i

n w

hich

th

ey li

ve

Four

soci

al li

fe

dom

ains

(1) d

omes

tic li

fe(2

) int

erpe

rson

al li

fe(3

) edu

catio

n an

d em

ploy

men

t(4

) com

mun

ity, c

ivic

, an

d so

cial

life

, in

clud

ing

relig

ion,

po

litic

s, re

crea

tion,

an

d le

isur

e

Dan

iel [

44]

2009

UK

Stro

ke re

habi

litat

ion;

D

ivis

ion

of H

ealth

an

d So

cial

Car

e Re

sear

ch

No.

Sys

tem

atic

re

view

of q

uant

i-ta

tive

and

qual

i-ta

tive

studi

es

Stro

ke su

rviv

ors

To id

entif

y th

e so

cial

co

nseq

uenc

es o

f str

oke

in w

orki

ng-

aged

adu

lts, w

hich

m

ight

impl

y so

cial

nee

ds to

be

addr

esse

d by

hea

lth

and

soci

al c

are

serv

ices

. Inf

orm

th

e de

velo

pmen

t an

d ev

alua

tion

of

serv

ices

for t

his

grou

p

Revi

ew o

f qua

ntita

-tiv

e an

d qu

alita

tive

studi

es id

entif

ying

so

cial

con

sequ

ence

s fo

r wor

king

-age

d ad

ults

with

stro

ke

usin

g m

ultip

le

sear

ch st

rate

gies

Prev

alen

ce o

f wor

k af

ter s

troke

Soci

al c

onse

quen

ces o

f str

oke

for w

orki

ng-

aged

adu

lts

De

Boe

r [61

]20

09N

ethe

rland

sSo

cial

insu

ranc

e,

Dut

ch A

ssoc

iatio

n of

Insu

ranc

e M

edi-

cine

Yes.

Des

crip

tive

Surv

ey a

nd a

qu

estio

nnai

re

Soci

al In

sura

nce

Phys

icia

ns (S

IPs)

, N

= 98

To in

vesti

gate

to

wha

t ext

ent S

IPs

are

fam

iliar

with

th

e pr

otoc

ols,

and

to w

hat e

xten

t th

ey a

dher

e to

th

e pr

inci

ples

of

the

expe

rt- a

nd

prac

tice-

base

d pr

o-to

cols

dev

elop

ed to

co

nduc

t int

ervi

ews

with

cla

iman

ts fo

r lo

ng-te

rm in

capa

c-ity

for w

ork

Mix

ed m

etho

ds:

Surv

ey a

mon

g ex

perie

nced

SIP

sQ

ualit

ativ

e stu

dy:

com

paris

on o

f the

th

ree

prot

ocol

s w

ith e

ach

othe

r and

w

ith IC

F to

pics

. D

evel

opm

ent o

f a

ques

tionn

aire

to

elic

it th

e ad

her-

ence

SIP

s hav

e to

th

e pr

otoc

ols,

thei

r un

derly

ing

prin

ci-

ples

and

topi

cs

App

licat

ion

of

prot

ocol

(s)

Trai

ning

in a

nd a

ctua

l us

e. C

onstr

uctio

n of

ow

n pr

otoc

ol.

Ans

wer

s to

ques

tions

no

ted

in %

, in

tota

l an

d pe

r pro

toco

l


1 3

Tabl

e 1

(con

tinue

d)

Aut

hor

Year

Cou

ntry

Setti

ngIn

terv

entio

n (y

es/

no) S

tudy

type

Popu

latio

nA

ims

Met

hods

Out

com

es (p

rimar

y/se

cond

ary)

Des

iron

[67]

2013

Bel

gium

Dep

artm

ent o

f O

ccup

atio

nal,

Envi

ronm

enta

l and

In

sura

nce

Med

i-ci

ne, L

euve

n

No.

Qua

litat

ive

liter

atur

e stu

dyPe

rson

s with

bre

ast

canc

erTo

iden

tify

a th

eore

ti-ca

l fra

mew

ork

for

occu

patio

nal t

hera

-pi

st (O

T) in

terv

en-

tion

by q

uesti

onin

g ho

w O

T m

odel

s can

be

use

d in

OT

inte

r-ve

ntio

ns in

RTW

of

bre

ast c

ance

r pa

tient

s

Lite

ratu

re se

arch

ing:

Re

sear

ch sp

ecifi

c cr

iteria

der

ived

fro

m O

T lit

erat

ure

conc

eptu

al O

T-m

odel

, mul

tidis

ci-

plin

ary,

refe

rrin

g to

the

ICF.

Con

tent

an

alys

is. C

heck

ing

for b

reas

t can

cer

spec

ific

issu

es

OT

mod

els t

o fa

cilit

ate

RTW

in b

reas

t ca

ncer

, mat

ches

be

twee

n lit

erat

ure

and

care

-mod

els

rega

rdin

g RT

W in

br

east

canc

er

Esc

orpi

zo [7

5]20

13Te

am (U

SA, G

erm

any,

Sw

itzer

land

)D

epar

tmen

t of

Phys

ical

The

rapy

, Lo

uisi

ana

Stat

e U

ni-v

ersi

ty H

ealth

Sc

ienc

es C

ente

r

No.

Pre

sent

atio

n pa

per

Aim

ed a

t per

sons

to

eval

uate

dis

abili

tyTo

pre

sent

the

ICF

as a

stan

dard

in

disa

bilit

y ev

alua

-tio

n an

d to

dis

cuss

th

e us

eful

ness

and

ch

alle

nges

of t

he

ICF

whe

n ap

plie

d in

dis

abili

ty e

valu

-at

ion

incl

udin

g th

e IC

F co

re se

t for

V

R.

Illus

tratio

n of

ope

ra-

tiona

lizin

g th

e IC

F in

a h

ypot

hetic

al

case

of a

con

struc

-tio

n w

orke

r who

ha

s chr

onic

low

ba

ck p

ain.

Ass

ess-

men

t of s

ampl

e IC

F ca

tego

ries

and

thei

r int

egra

-tio

n in

dev

elop

ing

goal

s and

pla

nnin

g in

terv

entio

n

Sam

ple

of IC

F ca

t-eg

orie

s

Esc

orpi

zo [5

2]20

09Te

am (S

witz

erla

nd,

Ger

man

y, C

anad

a,

Net

herla

nds)

ICF

Rese

arch

Bra

nch

of th

e W

HO

C

olla

bora

ting

Cen

ter

No.

Lite

ratu

re re

view

Aim

ed a

t res

earc

hers

to

sele

ct a

n ap

pro-

pria

te q

uesti

onna

ire

for a

spec

ific

study

qu

estio

n

To d

escr

ibe

the

con-

tent

of s

elf-

repo

rt qu

estio

nnai

res

that

ass

ess w

orke

r pr

oduc

tivity

and

th

at a

re b

eing

use

d or

cou

ld p

oten

tially

be

use

d in

arth

ritis

an

d ot

her m

uscu

lo-

skel

etal

con

ditio

ns

usin

g th

e IC

F as

re

fere

nce

Lite

ratu

re se

arch

, co

nten

t exa

min

a-tio

n an

d us

e of

IC

F ca

tego

ries

as a

refe

renc

e fo

r co

mpa

rison

of

ques

tionn

aire

s

Mea

ning

ful c

once

pts

wer

e id

entifi

ed

and

linke

d to

the

corr

espo

ndin

g IC

F ca

tego

ry


1 3

Tabl

e 1

(con

tinue

d)

Aut

hor

Year

Cou

ntry

Setti

ngIn

terv

entio

n (y

es/

no) S

tudy

type

Popu

latio

nA

ims

Met

hods

Out

com

es (p

rimar

y/se

cond

ary)

Fin

ger [

29]

2014

Switz

erla

ndSw

iss P

arap

legi

c Re

sear

ch, N

ottw

ilN

o.C

ase

study

(tea

ch-

ing

case

)

42-y

ear-o

ld te

ache

r, w

ho w

as o

n si

ck

leav

e fo

r 10

wee

ks

due

to n

on-s

peci

fic

low

bac

k pa

in N

= 1

To il

lustr

ate

an

appl

icat

ion

of

ICF-

base

d to

ols i

n a

mul

tidis

cipl

inar

y RT

W p

rogr

am

for p

atie

nts w

ith

non-

spec

ific

low

ba

ck p

ain

from

the

pers

pect

ive

of th

e ph

ysio

ther

apist

To g

uide

the

reha

-bi

litat

ion

proc

ess

and

faci

litat

e te

am-b

ased

and

ph

ysio

ther

apist

go

al se

tting

and

do

cum

enta

tion

Ass

essm

ent

of e

mpl

oyed

di

scip

line-

spec

ific

clin

ical

tests

and

m

easu

res t

ak-

ing

into

acc

ount

th

e as

sign

ed IC

F ca

tego

ries f

rom

the

chec

klist

. The

team

al

loca

ted

the

ICF

cate

gorie

s inc

lude

d in

the

Reha

bilit

a-tio

n M

anag

emen

t-Sh

eet t

o th

e m

ost

appr

opria

te lo

ng-

term

or s

hort-

term

go

als

The

team

and

pat

ient

ag

reed

on

the

inte

r-ve

ntio

ns th

at w

ould

ta

rget

the

spec

ific

goal

s and

resp

onsi

-bi

litie

s

Cat

egor

ies i

nclu

ded

in th

e IC

F-ba

sed

tool

(Reh

abili

tatio

n M

anag

emen

t-She

et)

and

clin

ical

tests

and

m

easu

res

Gla

ssel

[31]

2012

Switz

erla

ndSw

iss P

arap

legi

c Re

sear

ch N

ottw

ilN

o.C

ase

study

Patie

nts w

ith sp

inal

co

rd in

jury

. Aim

ed

at V

R p

rofe

ssio

nals

To il

lustr

ate

the

sys-

tem

atic

app

licat

ion

of IC

F-ba

sed

docu

-m

enta

tion

tool

s by

usin

g IC

F B

rief

Cor

e Se

ts in

VR

sh

own

with

a c

ase

exam

ple

of a

clie

nt

with

trau

mat

ic

spin

al c

ord

inju

ry

(SC

I)

Dev

elop

men

t of I

CF-

base

d do

cum

enta

-tio

n to

ols t

akin

g in

to a

ccou

nt th

e IC

F SC

I Cor

e Se

ts

to fa

cilit

ate

the

docu

men

tatio

n an

d pl

anni

ng o

f reh

a-bi

litat

ion

serv

ices

The

tool

s inc

lude

th

e IC

F A

sses

s-m

ent S

heet

, IC

F C

ateg

oric

al P

rofil

e,

ICF

Inte

rven

tion

Tabl

e an

d th

e IC

F Ev

alua

tion

Dis

play

Pres

enta

tion

of IC

F-ba

sed

docu

men

tatio

n to

ols:

ICF

Inte

rven

-tio

n Ta

ble

and

the

ICF

Eval

uatio

n D

ispl

ay o

f a c

lient

w

ith S

CI i

n a

VR

pr

ogra

m


1 3

Tabl

e 1

(con

tinue

d)

Aut

hor

Year

Cou

ntry

Setti

ngIn

terv

entio

n (y

es/

no) S

tudy

type

Popu

latio

nA

ims

Met

hods

Out

com

es (p

rimar

y/se

cond

ary)

Gla

ssel

[30]

2011

Switz

erla

ndSw

iss P

arap

legi

c Re

sear

ch N

ottw

ilN

o.M

ixed

-met

hods

m

ultic

ente

r stu

dy, f

ocus

gr

oup

desi

gn

Prof

essi

onal

s in

VR

, N

= 26

To e

xplo

re th

e liv

ed

expe

rienc

es o

f pe

rson

s in

VR

with

re

gard

to fu

nctio

n-in

g an

d co

ntex

tual

fa

ctor

s

Focu

s gro

up in

ter-

view

s7

focu

s gro

ups

yiel

ding

rele

vant

co

ncep

ts b

y6

open

-end

ed q

ues-

tions

Link

ing

to th

e IC

F ca

tego

ries b

ased

on

est

ablis

hed

linki

ng ru

les:

Tr

ansc

riptio

n—C

once

pt—

ICF

cat-

egor

y—Q

ualit

ativ

e an

alys

is—

Link

ing

Iden

tified

con

cept

sre

late

d to

the

ICF

com

pone

nts

Cla

ssifi

catio

n of

con

-ce

pts w

ith IC

F as

a

refe

renc

e

Hoe

fsm

it [6

8]20

14N

ethe

rland

sD

epar

tmen

t of S

ocia

l M

edic

ine,

Maa

s-tri

cht U

nive

rsity

No.

Qua

litat

ive

study

Empl

oyee

s, em

ploy

-er

s, oc

cupa

tiona

l ph

ysic

ians

, N =

14,

15, 4

To id

entif

y w

hich

an

d ho

w e

nviro

n-m

enta

l and

per

sona

l fa

ctor

s sup

port

early

RTW

, and

ex

amin

e w

heth

er

the

ICF

can

be u

sed

to d

escr

ibe

thes

e fa

ctor

s

Inte

rvie

ws w

ith

empl

oyee

s, em

ploy

-er

s and

OPs

from

m

ultip

le o

rgan

isa-

tions

with

var

ying

or

gani

satio

nal

size

s and

type

s of

indu

stry

such

as

hea

lthca

re a

nd

educ

atio

n. Q

ualit

a-tiv

e da

ta a

naly

sis

parti

ally

bas

ed o

n th

e Q

ualit

ativ

e A

naly

sis G

uide

of

Leuv

en

Fact

ors t

hat s

uppo

rt em

ploy

ees’

ear

ly

RTW

and

fact

ors

that

can

or c

anno

t be

des

crib

ed a

nd

clas

sifie

d us

ing

ICF

codi

ng

Hom

a [3

5]20

07U

SAD

epar

tmen

t of R

eha-

bilit

atio

n an

d C

oun-

selin

g, U

nive

rsity

of

Wis

cons

in-S

tout

No.

Ove

rvie

w,

desc

riptiv

eA

imed

at p

rofe

s-si

onal

s in

VR

and

re

sear

cher

s

To p

rovi

de a

n ov

ervi

ew o

f the

IC

F, h

ighl

ight

its

appl

icab

ility

in jo

b pl

acem

ent,

and

desc

ribe

futu

re

poss

ibili

ties f

or

rese

arch

and

out

-co

me

mea

sure

men

t in

VR

Use

of t

he IC

F fr

amew

ork

in jo

b pl

acem

ent a

s a te

m-

plat

e to

org

aniz

e cl

ient

info

rmat

ion,

hi

ghlig

ht st

reng

ths

and

limita

tions

, and

pr

ovid

e gu

idan

ce

for i

nter

vent

ions

in

the

plac

emen

t pr

oces

s

Des

crip

tion

of IC

F us

ed in

job

plac

e-m

ent


1 3

Tabl

e 1

(con

tinue

d)

Aut

hor

Year

Cou

ntry

Setti

ngIn

terv

entio

n (y

es/

no) S

tudy

type

Popu

latio

nA

ims

Met

hods

Out

com

es (p

rimar

y/se

cond

ary)

Koo

lhaa

s [62

]20

13N

ethe

rland

sD

epar

tmen

t of H

ealth

Sc

ienc

es, C

omm

u-ni

ty a

nd O

ccup

a-tio

nal M

edic

ine,

Uni

vers

ity M

edic

al

Cen

ter G

roni

ngen

Yes.

Surv

ey o

f per

spec

-tiv

es

Wor

kers

, > 45

yea

rs,

N =

3008

To u

nder

stan

d th

e nu

mbe

r and

type

of

exp

erie

nced

ag

eing

pro

blem

s an

d ob

stac

les t

o pe

rform

wor

k ta

sks,

rete

ntio

n fa

ctor

s to

mai

ntai

n w

ork

and

supp

ort

need

s to

cont

inue

w

orki

ng li

fe in

the

next

yea

rs a

mon

g w

orke

rs w

ith a

nd

with

out a

chr

onic

he

alth

con

ditio

n

Surv

ey a

mon

g w

ork-

ers i

n 9

com

pani

es.

Cla

ssifi

catio

n us

ing

ICF

Occ

upat

ion

was

di

vide

d in

to fo

ur

grou

ps: e

xecu

tive,

se

cret

aria

l, po

licy

and

man

agem

ent

Chr

onic

hea

lth c

ondi

-tio

n w

as d

efine

d as

the

subj

ectiv

e ex

perie

nce

of lo

ng-

term

irre

vers

ible

di

seas

e > 3

mon

ths

Prob

lem

s and

obs

tacl

es

rega

rdin

g w

ork;

age

, ge

nder

, edu

catio

n,

occu

patio

n, se

ctor

an

d w

heth

er th

e w

orke

r exp

erie

nced

a

chro

nic

heal

th

cond

ition

Min

is [6

9]20

09N

ethe

rland

sD

epar

tmen

t of

Occ

upat

ion

and

Hea

lth, p

reve

ntio

n an

d re

inte

grat

ion

HA

N U

nive

rsity

of

App

lied

Scie

nces

No.

Sys

tem

atic

re

view

Patie

nts w

ith n

euro

-m

uscu

lar d

isea

ses

(NM

D)

To id

entif

y he

alth

an

d co

ntex

tual

fa

ctor

s ass

ocia

ted

with

em

ploy

men

t in

patie

nts w

ith N

MD

an

d to

per

form

a

best

evid

ence

sy

nthe

sis

Lite

ratu

re se

arch

, ex

tract

ion

offa

ctor

s rel

ated

to

empl

oym

ent s

tatu

sRe

sults

of t

he fa

ctor

ex

tract

ion

rela

ted

to e

mpl

oym

ent

wer

e in

clud

ed

in th

e sc

hem

e of

H

eerk

ens´

ext

ende

d IC

F m

odel

Dis

ease

rela

ted

fact

ors,

func

tions

(phy

si-

cal,

mus

cle

pow

er),

pers

onal

fact

ors (

age,

ge

nder

and

edu

ca-

tion)

, wor

k re

late

d pe

rson

al fa

ctor

s (ty

pe o

f occ

upat

ion,

ex

pres

sed

inte

rest

in

empl

oym

ent)

Sev

illa

[48]

2013

Spai

nEl

ectri

cal a

nd E

lec-

troni

c En

gine

erin

g D

epar

tmen

t, U

ni-

vers

idad

Pub

lica

de

Nav

arra

No.

Lite

ratu

re re

view

Pers

ons w

ith d

isab

ili-

ties a

nd in

tend

ed

user

s (em

ploy

ees,

empl

oyer

s, or

VR

st

aff)

To p

ropo

se a

hie

r-ar

chic

al m

odel

of

acco

mm

odat

ion

asse

ssm

ent b

ased

on

leve

l of s

peci

fic-

ity o

f job

act

ivity

Lite

ratu

re re

view

: A

ppro

ach

to th

e hi

erar

chic

al m

odel

w

as te

sted

agai

nst

seve

ral c

ase

study

sc

enar

ios t

o ch

eck

its fe

asib

ility

and

co

mpl

eten

ess

App

licat

ions

of t

he

mod

el to

eac

h of

the

case

s´ c

ore

activ

i-tie

s of o

ccup

atio

ns,

such

as:

coo

k, o

ffice

as

sist

ant,

gard

ener

, se

win

g m

achi

ne

oper

ator

, or r

eal

esta

te b

roke

r


1 3

Tabl

e 1

(con

tinue

d)

Aut

hor

Year

Cou

ntry

Setti

ngIn

terv

entio

n (y

es/

no) S

tudy

type

Popu

latio

nA

ims

Met

hods

Out

com

es (p

rimar

y/se

cond

ary)

Ste

rgio

u-K

ita [4

3]20

13C

anad

aTo

ront

o Re

ha-

bilit

atio

n In

stitu

te,

Uni

vers

ity H

ealth

N

etw

ork

No.

Sys

tem

atic

re

view

to o

utlin

e gu

idel

ines

Indi

vidu

als w

ith b

urn

inju

ries (

BI)

To g

athe

r evi

denc

e to

de

velo

p a

guid

e-lin

e fo

r voc

atio

nal

eval

uatio

n fo

llow

-in

g bu

rn in

jurie

s (B

I)To

iden

tify

the

key

proc

esse

s ev

alua

tors

shou

ld

follo

w a

nd th

e ke

y fa

ctor

s the

y sh

ould

co

nsid

er w

hen

com

plet

ing

such

ev

alua

tions

Lite

ratu

re re

view

; Se

arch

ing

in d

ata-

base

s and

web

site

sQ

ualit

y as

sess

men

t: U

sing

the

ICF

mod

el a

nd V

R c

ore

sets

and

dire

cted

co

nten

t ana

lysi

s, ke

y pr

oces

ses a

nd

fact

ors w

ere

ana-

lyse

d an

d sy

nthe

-si

zed

Key

fact

ors a

nd

proc

esse

s rel

evan

t to

a vo

catio

nal e

valu

-at

ion

in re

latio

n to

in

divi

dual

’s b

ody

func

tions

, act

ivity

lim

itatio

ns a

nd p

ar-

ticip

atio

n re

stric

tions

an

d pe

rson

al a

nd

envi

ronm

enta

l sup

-po

rts to

succ

essf

ul

RTW

Tre

nam

an [7

3]20

15C

anad

a/Sw

itzer

land

Dep

artm

ent o

f Occ

u-pa

tiona

l Sci

ence

an

d O

ccup

atio

nal

Ther

apy,

Uni

vers

ity

of B

ritis

h C

olum

bia

No.

Sys

tem

atic

re

view

Indi

vidu

als w

ith

spin

al c

ord

inju

ryTo

revi

ew fa

ctor

s tha

t ar

e co

nsist

ently

and

in

depe

nden

tly a

sso-

ciat

ed w

ith e

mpl

oy-

men

t out

com

es in

in

divi

dual

s with

sp

inal

cor

d in

jury

To u

nder

stan

d th

e m

agni

tude

of t

heir

influ

ence

Lite

ratu

re se

arch

id

entifi

ed st

ud-

ies p

ublis

hed

1952

–201

4. D

ata

wer

e ca

tego

rized

ba

sed

on th

e IC

F w

ith e

ach

dom

ain

sub-

cate

goriz

ed b

y m

odifi

abili

ty

Mod

ifiab

le a

nd n

on-

mod

ifiab

le fa

ctor

s in

the

cont

ext o

f em

ploy

men

t fol

low

-in

g SC

I

van

Vel

zen

[63]

2011

Net

herla

nds

Aca

dem

ic M

edic

al

Cen

ter,

Uni

vers

ity

of A

mste

rdam

Yes.

Sem

i-stru

c-tu

red

inte

rvie

ws

Pers

ons w

ith

acqu

ired

brai

n in

jury

, N =

12

To d

escr

ibe

the

fact

ors e

xper

i-en

ced

by a

dults

w

ith m

oder

ate-

to-

seve

re a

cqui

red

brai

n in

jury

as

eith

er li

miti

ng o

r fa

cilit

atin

g du

ring

the

RTW

pro

cess

in

ord

er to

giv

e an

ad

vice

abo

ut th

e V

R p

roce

ss

Sem

i-stru

ctur

ed

inte

rvie

ws w

ith 1

2 ad

ults

who

wer

e w

orki

ng b

efor

e ac

quiri

ng tr

aum

atic

or

non

-trau

mat

ic

brai

n in

jury

(2

–3 y

ears

ear

lier)

Asp

ects

that

wer

e ex

perie

nced

as b

eing

im

porta

nt d

urin

g th

e pr

oces

s of R

TW a

fter

AB

I


1 3

Tabl

e 1

(con

tinue

d)

Aut

hor

Year

Cou

ntry

Setti

ngIn

terv

entio

n (y

es/

no) S

tudy

type

Popu

latio

nA

ims

Met

hods

Out

com

es (p

rimar

y/se

cond

ary)

Voo

ijs [7

0]20

15N

ethe

rland

sA

mste

rdam

No.

Sys

tem

atic

re

view

Peop

le o

f wor

king

ag

e w

ith a

chr

onic

di

seas

e

To se

arch

syste

m-

atic

ally

for d

isea

se-

gene

ric fa

ctor

s as

soci

ated

with

ei

ther

wor

k re

ten-

tion

or R

TW in

pe

ople

of w

orki

ng

age

with

a c

hron

ic

dise

ase

Lite

ratu

re se

arch

in

data

base

s, on

syno

-ny

ms o

f the

term

s:

chro

nic

dise

ase,

w

ork

rete

ntio

n an

d RT

W

Fact

ors a

ssoc

iate

d w

ith

wor

k pa

rtici

patio

n fo

r par

ticip

ants

with

a

chro

nic

dise

ase

(15–

67 y

ears

)

Was

iak

[54]

2007

USA

, NZ,

Net

herla

nds

Libe

rty M

utua

l Re

sear

ch In

stitu

te

for S

afet

y, C

ente

r fo

r Dis

abili

ty

Rese

arch

, Hop

kin-

ton,

MA

No.

Dev

elop

men

t stu

dyW

orke

rsTo

ope

ratio

naliz

e th

e co

ncep

tual

-iz

atio

n of

RTW

, w

hich

arg

ues f

or a

n ex

pand

ed aw

are-

ness

that

enc

om-

pass

es 4

pha

ses:

off

wor

k, w

ork

rein

tegr

atio

n, w

ork

mai

nten

ance

and

ad

vanc

emen

t

Revi

ew o

f exi

sting

in

strum

ents

for

thei

r use

as m

eas-

ures

of R

TW

Whe

re g

aps i

n in

strum

enta

tion

wer

e fo

und,

a w

ider

se

arch

was

don

e fo

r ins

trum

ents

that

co

uld

be a

dapt

ed

for u

se in

RTW

re

sear

ch

Use

of m

easu

rem

ent

tool

s tha

t do

not

capt

ure

a co

mpl

ete

pict

ure

of w

orke

rs’

RTW

exp

erie

nces

You

ng [3

6]20

10U

SALi

berty

Mut

ual

Rese

arch

Insti

tute

fo

r Saf

ety,

Cen

ter

for D

isab

ility

Re

sear

ch, H

opki

n-to

n, M

A, U

SA

Yes.

Qua

ntita

tive

and

qual

itativ

e co

mpo

nent

s

Occ

upat

iona

lly

inju

red

wor

kers

af

ter V

R, N

= 15

0

To d

eter

min

e po

st-RT

W d

isab

ility

an

d fu

nctio

ning

am

ongs

t occ

upa-

tiona

lly in

jure

d w

orke

rsTo

test

the

exte

nt to

w

hich

dem

ogra

phic

an

d ot

her v

aria

bles

re

late

to e

mpl

oy-

men

t mai

nten

ance

, an

d to

doc

umen

t w

hat w

orke

rs

belie

ve d

eter

min

ed

thei

r wor

k co

ntin

u-at

ion

Sem

i-stru

ctur

ed

in-d

epth

inte

rvie

ws

abou

t par

tici-

pant

s´ p

ost-V

R

RTW

exp

erie

nces

re

gard

ing

impo

rtant

fa

ctor

s det

erm

inin

g th

eir c

ontin

uatio

n of

wor

k

Fact

ors e

xper

ienc

ed

rega

rdin

g RT

W.

Func

tiona

l res

tric-

tions

, act

ivity

-bas

ed-,

or c

onte

xtua

l-Fa

ctor

s diff

eren

tiatin

g th

ose

empl

oyed

from

th

ose

not


1 3

Tabl

e 1

(con

tinue

d)

Aut

hor

Year

Cou

ntry

Setti

ngIn

terv

entio

n (y

es/

no) S

tudy

type

Popu

latio

nA

ims

Met

hods

Out

com

es (p

rimar

y/se

cond

ary)

Qua

ntita

tive

pape

rs A

ndel

ic [5

8]20

12N

orw

ayH

ospi

tal o

utpa

tient

cl

inic

, Osl

oN

o.C

ross

-sec

tiona

l stu

dy

Patie

nts w

ith n

eck

pain

refe

rred

to th

e ne

ck a

nd b

ack

N =

249

To d

escr

ibe

com

-m

only

repo

rted

self-

dete

rmin

ed

func

tiona

l pro

blem

s in

pat

ient

s with

ne

ck p

ain

E.g.

pro

blem

s with

w

ork

parti

cipa

tion

To e

valu

ate

thei

r fit

to th

e co

mpo

nent

s of

the

ICF

Self-

repo

rted

func

-tio

nal p

robl

ems o

n th

e Pa

tient

-Spe

cific

Fu

nctio

nal S

cale

. Th

e IC

F w

as u

sed

as a

tool

for a

naly

-si

s. M

eani

ngfu

l co

ncep

ts w

ithin

the

func

tiona

l pro

blem

s w

ere

iden

tified

, co

ded,

and

link

ed

to se

cond

-leve

l ca

tego

ries w

ithin

th

e co

mpo

nent

s of

bod

y fu

nctio

ns,

activ

ities

and

pa

rtici

patio

n. T

he

ICF

cate

gorie

s w

ere

pres

ente

d by

pe

rcen

tage

of t

he

tota

l num

ber o

f fu

nctio

nal p

robl

ems

linke

d to

the

ICF

Func

tiona

l pro

blem

s fit

with

the

ICF

mod

el;

13 m

eani

ngfu

l IC

F do

mai

ns w

ere

iden

ti-fie

d: 4

dom

ains

in

body

func

tion

(= 12

un

derly

ing

cate

go-

ries)

. 13

dom

ains

in

activ

ity a

nd p

artic

i-pa

tion

(= 31

und

erly

-in

g ca

tego

ries)

Cho

w [3

7]20

14U

SAEi

ght s

tate

sYe

s. Lo

ngitu

dina

l, 4

year

8-s

tate

m

ultis

ite d

emon

-str

atio

n pr

ojec

t, qu

asi-e

xper

i-m

enta

l des

ign

Psyc

hiat

ric d

isab

ility

ou

t-pat

ient

s: S

ever

e an

d pe

rsist

ent m

en-

tal i

llnes

s, N

= 16

54Re

ferr

ed b

y pr

ovid

er,

self,

fam

ily, w

ord

of m

outh

, new

spa-

per a

ds

To e

valu

ate

the

impa

ct o

f an

evid

ence

-bas

ed

appr

oach

to

deliv

erin

g em

ploy

-m

ent s

ervi

ces t

o in

divi

dual

s with

ps

ychi

atric

dis

abili

-tie

s bet

wee

n 19

96

and

2000

To c

ompa

re th

ose

with

/with

out

repo

rted

wor

k ac

com

mod

atio

ns

Inte

rvie

w p

roto

cols

, str

uctu

red

asse

ss-

men

ts, w

eekl

y re

cord

ing,

and

de

taile

d de

scrip

tion

of a

ccom

mod

a-tio

ns-s

umm

ariz

edEff

ects

ass

esse

d w

ith

mod

els i

nfor

med

by

ICF

and

othe

r. G

ener

aliz

ed li

near

m

odel

(num

ber o

f ho

urs o

f ove

rtim

e w

ork

afte

r job

ac

com

mod

atio

n)

and

surv

ival

ana

ly-

sis (

time

until

job

shift

/acc

omm

oda-

tion)

How

job

acco

mm

oda-

tions

that

are

mod

er-

ated

by

clin

ical

and

co

ntex

tual

fact

ors a

re

rela

ted

to(1

) ave

rage

-mon

thly

ho

urs w

orke

d in

co

mpe

titiv

e em

ploy

-m

ent a

cros

s mul

tiple

sp

ells

of e

mpl

oy-

men

t?(2

) the

dur

atio

n of

jo

b te

nure

acr

oss

mul

tiple

spel

ls o

f em

ploy

men

t


1 3

Tabl

e 1

(con

tinue

d)

Aut

hor

Year

Cou

ntry

Setti

ngIn

terv

entio

n (y

es/

no) S

tudy

type

Popu

latio

nA

ims

Met

hods

Out

com

es (p

rimar

y/se

cond

ary)

Con

clav

e [3

9]20

09Ita

lyN

atio

nwid

e, o

rder

ed

by It

alia

n M

inis

-try

of L

abou

r and

So

cial

Pol

icie

s

No.

Expe

rimen

tal

appl

icat

ion

of

the

ICF

base

d m

etho

d an

d de

velo

pmen

t

Aim

ed fo

r eva

luat

ion

of P

erso

ns w

ith d

is-

abili

ty (P

wD

)

To d

evel

op a

nat

ion-

wid

e IC

F-ba

sed

wor

ker c

heck

list

To p

rese

nt th

e pr

o-ce

ss a

nd th

e re

sults

of

ICF

and

Labo

ur

Polic

ies P

roje

ct

with

a sp

ecia

l foc

us

on th

e de

velo

pmen

t of

the

chec

klist

Dev

elop

men

t of

the

dedi

cate

d IC

F-ba

sed

wor

ker

chec

klist

on

the

basi

s of t

he m

inist

e-ria

l sch

edul

e fo

r the

ev

alua

tion

of P

wD

an

d th

e W

HO

’s IC

F ch

eckl

ist, (

a lis

t of

128

ICF

cate

gorie

s em

ploy

ed d

urin

g IC

F’s fi

eld

trial

)St

anda

rdis

ed li

nkin

g ru

les w

ere

follo

wed

to

iden

tify

conc

epts

co

ntai

ned

in th

e m

inist

eria

l sch

edul

e

Tool

sTw

o m

ain

tool

s hav

e be

en p

rodu

ced

by

the

ICF

and

labo

ur

polic

ies p

roje

ct: t

he

wor

ker c

heck

list a

nd

the

prot

ocol

de

Bee

r [71

]20

14N

ethe

rland

sD

epar

tmen

t Occ

upa-

tion

& H

ealth

, H

AN

Uni

vers

ity o

f A

pplie

d Sc

ienc

esN

ijmeg

en, T

he N

eth-

erla

nds

No.

Syste

mat

ic re

view

Pers

ons w

ith d

ys-

lexi

a or

(spe

cific

) le

arni

ng/re

adin

g di

sord

er

To d

eter

min

e hi

nder

-in

g an

d fa

cilit

atin

g fa

ctor

s ass

ocia

ted

with

par

ticip

atio

n in

wor

k of

indi

vidu

-al

s with

dev

elop

-m

enta

l dys

lexi

a (D

D),

clas

sifie

d ac

cord

ing

to th

e di

men

sion

s of t

he

ICF

To e

xplo

re a

nd fu

lly

unde

rsta

nd fa

ctor

s as

soci

ated

with

w

ork

parti

cipa

tion

of a

dults

with

DD

Syste

mat

ic li

tera

ture

se

arch

of q

uant

ita-

tive

or q

ualit

ativ

e m

etho

dolo

gy, p

ub-

lishe

d af

ter 1

995.

IC

F-ex

pand

ed w

ith

two

subd

ivis

ions

: on

e th

at m

ade

the

envi

ronm

enta

l fa

ctor

s mor

e w

ork-

rela

ted

and

one

of

pers

onal

fact

ors.

For d

ata

extra

ctio

n:

qual

itativ

e m

eta

sum

mar

y w

as u

sed

and

the

man

ifest

freq

uenc

y eff

ect

size

(MFE

S) fo

r ea

ch c

ateg

ory

Effec

t siz

e of

fact

ors

betw

een

dysl

exia

or

lear

ning

/read

ing

diso

rder

/dis

abili

ty

and

wor

kTh

e m

anife

st fr

e-qu

ency

effe

ct si

ze is

pr

esen

ted:

cal

cula

ted

by d

ivid

ing

the

num

ber o

f all

studi

es

(that

met

the

qual

ity

crite

rion)

and

in

whi

ch a

fact

or w

as

foun

d by

the

tota

l nu

mbe

r of s

tudi

es


1 3

Tabl

e 1

(con

tinue

d)

Aut

hor

Year

Cou

ntry

Setti

ngIn

terv

entio

n (y

es/

no) S

tudy

type

Popu

latio

nA

ims

Met

hods

Out

com

es (p

rimar

y/se

cond

ary)

Esc

orpi

zo [7

5]20

11Sw

itzer

land

Swis

s Par

aple

gic

Rese

arch

, Not

will

No.

Dev

elop

men

t stu

dy

Pers

ons w

ith sp

inal

co

rd in

jury

(SC

I)To

dev

elop

a se

t of

ICF-

base

d SC

I Pa

rtici

patio

n an

d SC

I Env

ironm

ent

Dom

ain

Set a

nd

mea

sure

men

t in

strum

ents

that

in

tend

to m

easu

re

thos

e do

mai

ns,

base

d on

the

ICF

Cor

e Se

ts fo

r SC

I

Mer

ging

of t

he IC

F C

ore

Set f

or S

CI

and

cate

gorie

s fro

m

the

ICF

Cor

e Se

t fo

r VR

ICF

cate

gorie

s bas

ed

on th

e ex

istin

g IC

F co

re se

ts fo

r SC

I and

V

R

Esc

orpi

zo [3

3]20

11Sw

itzer

land

Dep

artm

ent o

f H

ealth

Sci

ence

s an

d H

ealth

Pol

icy,

N

otw

ill

No.

Dev

elop

men

t stu

d-ie

s, in

tern

atio

nal

cons

ensu

s co

nfer

ence

VR

pro

fess

iona

ls a

nd

rese

arch

ers

Pres

enta

tion

of fi

ve

artic

les i

n an

effo

rt to

adv

ance

our

un

ders

tand

ing

and

mea

sure

men

t of V

R

and

RTW

pro

cess

Diff

eren

t per

spec

tives

on

ICF/

VR

Dist

ribut

ion

of IC

F ca

tego

ries a

cros

s IC

F co

mpo

nent

s an

d ac

ross

stud

ies.

3 co

re se

ts (2

SC

I + 1

VR

) and

6 in

stru-

men

ts th

at m

easu

re

envi

ronm

ent a

nd

parti

cipa

tion

Esc

orpi

zo [3

2]20

11Sw

itzer

land

Inte

rnat

iona

l sur

vey

No.

Inte

rnet

-bas

ed su

r-ve

y w

ith e

xper

tpa

rtici

pant

s fro

m si

x W

HO

Re

gion

s

VR

pro

fess

iona

ls,

(exp

erts

from

6 W

HO

Reg

ions

), N

= 15

1

Surv

ey th

e ex

perts

in

the

VR

fiel

d w

ith re

gard

to w

hat

fact

ors a

re c

onsi

d-er

ed im

porta

nt to

pa

tient

s par

ticip

at-

ing

in V

R u

sing

the

ICF

as th

e la

ngua

ge

to su

mm

ariz

e th

e re

sults

Surv

ey w

ith V

R

expe

rts. Q

uesti

on

was

rela

ted

to a

co

mpo

nent

of t

he

ICF,

resp

onse

s lin

ked

to IC

F

List

of IC

F ca

tego

ries

that

wer

e co

nsid

ered

to

be

impo

rtant

in th

e V

R p

roce

ss


1 3

Tabl

e 1

(con

tinue

d)

Aut

hor

Year

Cou

ntry

Setti

ngIn

terv

entio

n (y

es/

no) S

tudy

type

Popu

latio

nA

ims

Met

hods

Out

com

es (p

rimar

y/se

cond

ary)

Fer

rario

[40]

2014

Italy

Occ

upat

iona

l Med

i-ci

ne D

epar

tmen

t, Tu

rin U

nive

rsity

Yes.

Cro

ss- s

ectio

nal

study

Out

patie

nts u

nder

-go

ne h

eart

trans

-pl

anta

tion,

live

r -,

and

kidn

ey- a

nd

surv

ived

at l

east

12 m

onth

s, N

= 15

0

To p

rovi

de e

valu

-at

ion

of p

ossi

ble

RTW

and

of fi

tnes

s fo

r spe

cific

and

ad

equa

te ta

sks o

f su

rviv

ing

trans

plan

t re

cipi

ents

and

to

com

pare

the

resu

lts

with

the

asse

ss-

men

t of t

heir

actu

al

empl

oym

ent s

tatu

s

ICF

ques

tionn

aire

; 10

que

stion

s wer

e fu

rther

app

lied

to

thos

e w

ho w

ere

empl

oyed

at t

he

time

of th

e stu

dy.

Que

stion

s reg

ard-

ing

the

follo

win

g:

time

to R

TW a

fter

surg

ery,

jobs

per

-fo

rmed

afte

r RTW

, pa

rt-tim

e or

fixe

d-sh

ift jo

b as

sign

a-tio

n, d

ifficu

lties

in

per

form

ing

the

prev

ious

or t

he n

ew

job,

pos

sibl

e pe

ri-od

s of u

nem

ploy

-m

ent,

satis

fact

ion

with

the

job

gain

ed

afte

r tra

nspl

anta

-tio

n, th

e re

latio

ns

with

the

empl

oyer

an

d th

e oc

cupa

-tio

nal p

hysi

cian

, the

su

ppor

t rec

eive

d

Com

paris

on o

f wor

k-in

g ab

ility

eva

luat

ion

and

empl

oym

ent s

ta-

tus.

Inte

rnal

com

pari-

son

amon

g di

ffere

nt

orga

n re

cipi

ents

61%

of p

atie

nts w

ere

in p

aid

empl

oym

ent,

4% o

f stu

dent

s and

ho

usew

ives

. 24%

un

empl

oyed

rela

ted

or n

ot to

hea

lth

cond

ition

s, 11

% w

ere

retir

ed

Fin

ger [

28]

2011

Switz

erla

ndV

R c

entre

s; 4

in

Switz

erla

nd 1

in

Ger

man

y

No.

Cro

ss-s

ectio

nal

mul

ticen

ter s

tudy

Pers

ons w

ith v

ario

us

heal

th p

rob-

lem

s > 18

yea

rsN

= 15

2

To d

escr

ibe

pers

ons

unde

rgoi

ng V

RTo

iden

tify

the

mos

t co

mm

on p

robl

ems

arou

nd w

ork

and

in

VR

usi

ng th

e IC

F

Cas

e Re

cord

For

m

base

d on

an

exte

nded

ver

sion

of

the

ICF

Che

cklis

t co

ntai

ning

292

and

SE

S

Cat

egor

ies f

rom

all

four

ICF

com

pone

nts


1 3

Tabl

e 1

(con

tinue

d)

Aut

hor

Year

Cou

ntry

Setti

ngIn

terv

entio

n (y

es/

no) S

tudy

type

Popu

latio

nA

ims

Met

hods

Out

com

es (p

rimar

y/se

cond

ary)

Fin

ger [

27]

2014

Switz

erla

ndV

R c

entre

sN

o.D

evel

opm

ent a

nd

valid

atio

n stu

dy

Psyc

holo

gist.

Tes

t-sa

mpl

e of

pat

ient

s 18

–65

year

s, pa

r-tic

ipat

ing

in V

RN

= 74

To d

evel

op a

n in

ter-

view

er a

dmin

is-

tere

d IC

F-ba

sed

ques

tionn

aire

(W

OR

Q) t

o as

sess

fu

nctio

ning

in V

RTo

repo

rt pr

elim

i-na

ry p

sych

omet

ric

evid

ence

Mix

ed m

etho

ds

incl

udin

g so

phis

-tic

ated

stat

istic

al

appr

oach

and

qu

alita

tive

cont

ent

asse

ssm

ent.

cat.

from

ICF

VR-

Cor

e Se

ts, e

xplo

rativ

e R

asch

-ana

lysi

s an

d V

R li

tera

ture

re

view

.Q

uesti

ons w

ere

wor

ded

to a

sses

s id

entifi

ed IC

F ca

tego

ries.

WO

RQ

w

as tr

ansl

ated

from

En

glis

h to

Ger

man

. Ex

amin

atio

n of

ps

ycho

met

rics f

or

the

Ger

man

ver

sion

of

WO

RQ

Item

s of W

OR

Q,

the

ICF

cate

gory

m

easu

red

Kui

jer [

64]

2006

Net

herla

nds

Cen

tre fo

r Reh

abili

-ta

tion,

Uni

vers

ity

Med

ical

Cen

tre

Gro

ning

en

Yes.

Cro

ss. s

ectio

nal

study

Patie

nts w

ith

chro

nic

low

bac

k pa

in re

ferr

ed fo

r m

ultid

isci

plin

ary

treat

men

tN

= 92

To e

xplo

re w

hich

va

riabl

es a

re re

late

d to

wor

k st

atus

ac

cord

ing

to IC

F

Que

stion

naire

s (h

ealth

, lim

itatio

n),

test

of p

hysi

cal

perfo

rman

ceLo

gisti

c re

gres

sion

an

alys

is w

as p

er-

form

ed to

exp

lain

wor

k st

atus

(out

-co

me)

from

the

incl

uded

var

iabl

es

offu

nctio

ning

Wor

k st

atus

, var

iabl

es

of fu

nctio

ning


1 3

Tabl

e 1

(con

tinue

d)

Aut

hor

Year

Cou

ntry

Setti

ngIn

terv

entio

n (y

es/

no) S

tudy

type

Popu

latio

nA

ims

Met

hods

Out

com

es (p

rimar

y/se

cond

ary)

Ley

shon

[76]

2008

Can

ada

Uni

vers

ity o

f Wes

t-er

n O

ntar

ioN

o.Li

tera

ture

revi

ewIn

jure

d w

orke

rs

(mus

culo

skel

-et

al d

isor

ders

mos

t co

mm

on)

To in

trodu

ce a

n IC

F-ba

sed

new

pra

ctic

e m

odel

of o

ccup

a-tio

nal r

ehab

ilita

tion

ergo

nom

ics

Trad

ition

al m

odel

: M

icro

/mac

ro-e

rgon

omic

s ha

ve b

een

defin

ed

as “

the

study

and

pr

oces

s of d

esig

n-in

g an

d/or

mod

ify-

ing

tool

s, m

ater

ials

, eq

uipm

ent,

wor

k sp

aces

, tas

ks, j

obs,

prod

ucts

, sys

tem

s, an

den

viro

nmen

ts to

m

atch

the

abili

ties,

limita

tions

, and

so

cial

nee

ds o

f hu

man

bei

ngs i

n th

e w

orkp

lace

”

Mod

el, i

n or

der t

o be

tter d

escr

ibe

inte

rven

tions

, as

inte

rven

tions

car

ried

out i

n th

e w

orkp

lace

ap

pear

to b

e “v

ery

hete

roge

neou

s and

ill

-defi

ned”

Lin

den

[41]

2010

Ger

man

yIn

patie

nts,

depa

rt-m

ent o

f beh

avio

ural

and

psyc

hoso

mat

ic

med

icin

e, T

elto

v

Yes.

Cro

ss-s

ectio

nal,

exam

inat

ion

and

inte

rvie

w

Patie

nts a

dmitt

ed to

th

e D

epar

tmen

t of

Beh

avio

ral M

edi-

cine

, N =

213

To e

xam

ine

the

rela

-tio

nshi

p be

twee

n m

easu

res o

f cap

ac-

ity*,

mot

ivat

ion

and

perfo

rman

ce*i

nabi

lity

to p

erfo

rm

activ

ities

(i.e

. dys

-fu

nctio

ns)

Spec

ial c

linic

al

inte

rvie

w a

nd

ques

tionn

aire

s ob

serv

er ra

ting

for

Men

tal D

isor

ders

(M

ini-I

CF-

APP

), w

ork

perfo

rman

ce

Endi

cott

Wor

k Pr

oduc

tivity

Sca

le

(EW

PS),

and

volit

iona

l and

mot

i-va

tiona

l pro

blem

s

Ass

essm

ent o

f cap

aci-

ties (

wor

k-re

late

d at

titud

es, v

oliti

on a

nd

mot

ivat

ion)


1 3

Tabl

e 1

(con

tinue

d)

Aut

hor

Year

Cou

ntry

Setti

ngIn

terv

entio

n (y

es/

no) S

tudy

type

Popu

latio

nA

ims

Met

hods

Out

com

es (p

rimar

y/se

cond

ary)

Mar

tins [

45]

2015

Portu

gal

Coi

mbr

a H

ealth

Sc

hool

, Phy

siot

her-

apy

Dep

artm

ent

No.

Expl

orat

ive,

cro

ss-

sect

iona

l stu

dy

Wor

king

-age

per

sons

w

ith d

isab

ilitie

s liv

-in

g in

com

mun

ity

dwel

ling

setti

ngs.

Seve

re li

mita

tions

in

mob

ility

due

to

a ch

roni

c di

seas

e or

inju

ry, u

sing

a

whe

elch

air f

or >

1 ye

ar, N

= 14

9

To e

xplo

re k

ey

indi

cato

rs o

f soc

ial

parti

cipa

tion

(life

ha

bits

) of p

erso

ns

with

dis

abili

ties,

parti

cula

rly re

late

d to

wor

k

Que

stion

naire

s:

Atti

tude

s Tow

ards

D

isab

led

Pers

ons

Que

stion

naire

, se

lf-effi

cacy

and

the

LIFE

-H(7

7 ite

ms a

cros

s 12

prim

ary

dom

ains

, in

clud

ing

nutri

tion,

fit

ness

, per

sona

l ca

re, c

omm

uni-

catio

n, h

ousi

ng,

mob

ility

, res

pons

i-bi

lity,

inte

rper

sona

l re

latio

ns, c

om-

mun

ity, e

duca

tion,

em

ploy

men

t, an

d re

crea

tion)

Det

erm

inan

ts fo

r so

cial

par

ticip

atio

n,

empl

oym

ent (

self-

effica

cy, Q

oL)

Nils

ing

[56]

2012

Swed

enH

ospi

tal p

hysi

cian

s an

d G

Ps, O

sterg

ot-

land

Cou

nty

No.

Com

para

tive

study

All

new

sick

leav

e ce

rtific

ates

dur

ing

2-w

eek

perio

d in

20

07 a

nd 4

-wee

k pe

riod

in 2

009,

N

= 47

5501

To c

ompa

re q

ualit

y of

sick

ness

cer

tifi-

cate

s bet

wee

n 20

07

and

2009

. (D

if-fe

renc

es b

etw

een

ICF-

code

s in

2007

an

d 20

09)

Pear

son’

s chi

2 an

d t-t

est w

as p

er-

form

ed to

test

diffe

renc

es b

etw

een

varia

bles

Qua

lity

in si

ckne

ss

certi

ficat

es, d

escr

ip-

tion

of fu

nctio

ning

an

d pr

escr

iptio

ns o

f ea

rly re

habi

litat

ion

Pty

ushk

in [4

7]20

11Sl

oven

iaO

rgan

isat

ions

gr

ante

d to

ass

ess

pers

ons w

ith d

isab

ili-

ties a

nd to

ope

rate

th

eir V

R

No.

Revi

ew, s

urve

yPs

ycho

logi

sts, s

ocia

l w

orke

rs a

nd o

ccu-

patio

nal t

hera

pists

To re

view

use

of t

he

ICF

in V

R a

nd d

is-

abili

ty a

sses

smen

t

Revi

ew o

f the

Sl

oven

ian

law

, su

rvey

, gro

up a

nd

indi

vidu

al in

ter-

view

s. N

ine

of 1

3 or

gani

satio

ns w

ere

surv

eyed

tota

lly o

r pa

rtial

ly

Mai

n ad

vant

ages

/di

s-ad

vant

ages

and

qu

aliti

es/d

efici

en-

cies

; whe

ther

the

ICF

help

s to

esta

blis

h a

com

mon

lang

uage

Rei

chel

[42]

2010

Ger

man

yIn

patie

nt re

habi

lita-

tion

cent

re, B

adB

rück

enau

Yes.

Cha

rt re

view

Patie

nts w

ith g

astro

-in

testi

nal d

isea

ses,

N =

355

To li

nk IC

F to

oth

er

spec

ific

instr

umen

ts

and

com

pare

with

ot

her p

redi

ctor

s of

reha

bilit

atio

n ou

tcom

es

Scre

enin

g fil

es;

Cro

hn’s

Dis

ease

A

ctiv

ity In

dex

vari-

able

s wer

e lin

ked

with

ICF

cate

gorie

s us

ing

linki

ng ru

les

Varia

bles

link

ed w

ith

clin

ical

impr

ove-

men

t (de

crea

se in

H

arve

y-B

rads

haw

In

dex

of ≥

2 U

) and

V

R su

cces

s


1 3

Tabl

e 1

(con

tinue

d)

Aut

hor

Year

Cou

ntry

Setti

ngIn

terv

entio

n (y

es/

no) S

tudy

type

Popu

latio

nA

ims

Met

hods

Out

com

es (p

rimar

y/se

cond

ary)

Sal

tych

ev [4

6]20

13Tu

rkey

Turk

ish

Uni

vers

ity

Hos

pita

lYe

s. Re

trosp

ectiv

e co

hort

study

Patie

nts w

ith c

hron

ic

mus

culo

skel

etal

di

sord

ers,

unde

rgo-

ing

VR-

eval

uatio

n,

N =

32

To id

entif

y th

e m

ost

freq

uent

func

tiona

l lim

itatio

ns a

ccor

d-in

g to

ICF

Each

phr

ase

from

the

patie

nts’

ele

ctro

nic

reco

rd th

at c

ould

po

tent

ially

be

inte

r-pr

eted

as a

n IC

F co

de w

as e

xtra

cted

ICF

code

s cat

egor

ized

141

diffe

rent

wer

e id

entifi

ed w

ith a

pr

ecis

enes

s of t

hree

or

mor

e di

gits

Stu

ress

on [5

7]20

15Sw

eden

Swed

ish

Soci

al In

sur-

ance

Age

ncy

146

diffe

rent

GPs

, at

29 c

entre

s

Yes.

Qua

lity

asse

ss-

men

t, ba

sed

on

an in

terv

entio

n

Patie

nts a

tpr

imar

y he

alth

car

e ce

ntre

s, si

ck-

ness

cer

tifica

tes,

N =

323

To e

valu

ate

the

qual

ity o

f sic

knes

s ce

rtific

ates

issu

ed

in p

rimar

y he

alth

ca

re a

nd e

xam

ine

if th

e pa

tient

s’ o

r ph

ysic

ians

’ gen

der

influ

ence

s

Eval

uatio

n w

as

perfo

rmed

in

acco

rdan

ce w

ith th

e sa

me

crite

ria a

s in

the

natio

nal ‘

Sick

Le

ave

Bill

ion’

Suffi

cien

t inf

orm

atio

n co

ncer

ning

the

diag

-no

sis,

leve

l of s

ick

leav

e an

d tim

e pe

riod

for t

he si

ck le

ave

Var

ekam

p [5

3]20

13N

ethe

rland

s/G

erm

any

Cur

rent

Hea

lth in

G

erm

any

No.

Des

crip

tive

study

, re

giste

rs

Popu

latio

n 18

–65

year

, N =

35,5

74To

exp

lore

pro

blem

s or

solu

tions

for

wor

kers

with

a

chro

nic

dise

ase;

fro

m q

uant

itativ

e an

d qu

alita

tive

rese

arch

Tele

phon

e su

rvey

s co

nduc

ted

from

Ju

ly 2

008

to Ju

ly

2010

am

ong

adul

ts

Chr

onic

dis

ease

, pa

rtici

patio

n (w

ork

disa

bilit

y)

Wan

g [5

0]20

13Ta

iwan

Uni

vers

ity C

olle

ge o

f So

cial

Sci

ence

No.

Surv

ey, s

econ

dary

an

alys

es

Labo

ur fo

rce

with

di

sabi

lity

livin

g at

ho

me,

N =

2,90

9

To e

xplo

re IC

F fa

ctor

s ass

ocia

tion

with

em

ploy

men

t in

disa

bled

Surv

ey: L

ife si

tua-

tion

for d

isab

led;

se

cond

ary

data

an

alys

is, r

egre

ssio

n m

odel

Empl

oym

ent,

type

of

disa

bilit

y an

d IC

F ca

tego

ry

Zei

lig [4

9]20

12Is

rael

Post-

polio

out

patie

nt

clin

ic. T

el-

Has

hom

er

No.

Dat

a ex

tract

ion

from

reco

rds

Patie

nts w

ith lo

ng-

stan

ding

pol

iom

ye-

litis

(LSP

), N

= 12

3

To d

eter

min

e th

e eff

ects

of a

num

ber

of so

cial

and

fu

nctio

nal v

ari-

able

s as b

arrie

rs o

r fa

cilit

ator

s to

wor

k pa

rtici

patio

n in

pe

rson

s with

LSP

Revi

ew o

f the

m

edic

al re

cord

s. Em

ploy

men

t de

fined

as >

= 20

h

of re

gula

r rem

u-ne

rativ

e ac

tivity

Empl

oym

ent;

assi

stan

t de

vice

s for

mob

ility

, de

pend

ent f

or b

asic

A

DL

asso

ciat

ed w

ith

low

er e

mpl

oym

ent.

Driv

ing

posi

tive

asso

ciat

ions

Øste

rås [

60]

2007

Nor

way

Ulle

nsak

er m

unic

i-pa

lity

Yes.

Surv

eySe

ven

birth

coh

orts

, N

= 16

20To

pro

vide

mea

sure

-m

ent o

f pop

ulat

ion

func

tiona

l lev

els,

asse

ssm

ent o

f re

liabi

lity

of a

Nor

-w

egia

n sc

ale

base

d on

ICF

Post

al q

uesti

onna

ire

in 2

004

Instr

umen

t bas

ed o

n IC

F-fu

nctio

nal a

bil-

ity; d

eriv

ed fr

om th

e ac

tiviti

es/p

artic

ipa-

tion

com

pone

nt


1 3

VR professionals [32, 39, 40, 42, 46, 47, 59], e.g. psycholo-gists, social workers, technologists, occupational therapists, occupational physicians, education counsellor, rehabilitation counsellor. Two papers involved health professionals and patients [28], and solely health professionals [27], respec-tively. A paper described all professionals involved in reha-bilitation research (experienced physiotherapists, certified physiotherapist/movement scientist, research assistant) [64], another paper involved independent insurance specialists, who were trained to assess the quality of information in sick-ness certificates [57].

How the ICF Inform Assessment of Functioning

Regarding to what extent the ICF informed professionals´ assessment of functioning; several papers reported discus-sions on the ICF´s applicability for VR, service delivery, and RTW support. As examples were papers reporting on potential benefits of the ICF: to structure and phrase dis-ability evaluation in the field of social insurance [26], on tracking risk factors for disability amongst the self-employed [65], highlight its applicability in job placement [35], and to identify the most common problems around work and in VR.

One paper concluded that a questionnaire based on the ICF proved to be a “useful framework that can be used for research but also by occupational physicians in their usual practice after specific training” [29]. A paper reported on an expert survey on use of the ICF as the language to sum-marize the results in VR [32]. Another paper concluded, that although the procedure using the ICF was “complex, time-consuming, and requires specific training of the staff involved in its use”; the occupational physicians were pro-vided with a standardized procedure to evaluate working ability and suggest re-employment for transplant recipients [40].

A paper described how VR professionals used the ICF to guide assessment in the job placement process and used the appropriate ICF domains and categories as a template to determine what specific information needed to be obtained, and how to organize it in a systematic way. Thus, an inter-view format informed by the ICF structure enabled the pro-fessionals to highlight the needs for assessment information [35].

Criticism of the ICF

One paper involving several health and non-health profes-sionals concluded, that disadvantages of the ICF are the “complicated terminology, perceived subjectivity of the assessor in coding” and that ‘it is too bulky’ [47]. Another paper described factors that support employees’ early RTW and reported that some factors cannot be described and clas-sified using the existing coding system of the ICF [68].Ta

ble

1 (c

ontin

ued)

Aut

hor

Year

Cou

ntry

Setti

ngIn

terv

entio

n (y

es/

no) S

tudy

type

Popu

latio

nA

ims

Met

hods

Out

com

es (p

rimar

y/se

cond

ary)

Aas

[59]

2007

Nor

way

Com

mun

ity-b

ased

O

T se

rvic

esN

o. C

ross

-se

ctio

nal p

osta

l su

rvey

Clie

nts i

n co

mm

u-ni

ty h

ealth

car

e,

N =

168

To d

escr

ibe

soci

o-de

mog

raph

ic fa

ctor

s an

d th

e oc

curr

ence

of

dise

ases

and

di

sabi

litie

s am

ong

a re

pres

enta

tive

sam

ple

of c

lient

s w

ho w

ere

usin

g co

mm

unity

OT

serv

ices

Com

mun

ity o

ccup

a-tio

nal t

hera

pyC

oded

dia

gnos

es

-acc

ordi

ng to

the

Inte

rnat

iona

l Cla

s-si

ficat

ion

of P

rimar

y C

are

(IC

PC-2

)

Aas

[74]

2011

Nor

way

Coc

hran

e B

ack

Gro

upN

o. S

yste

mat

ic

revi

ewA

dult

wor

kers

with

ne

ck p

ain

To d

eter

min

e th

e eff

ectiv

enes

s of

wor

kpla

ce in

terv

en-

tions

com

pare

d to

no

trea

tmen

t, us

ual

care

or o

ther

wor

k-pl

ace

inte

rven

tions

fo

r adu

lt w

orke

rs

with

nec

k pa

in

Lite

ratu

re se

arch

, w

orke

rs a

t wor

k or

abs

ent f

rom

w

ork.

Wor

kers

with

ac

ute,

sub-

acut

e or

ch

roni

c ne

ck p

ain

Two

mai

n ou

tcom

esPa

in re

lief a

nd re

duce

d si

ckne

ss a

bsen

ce/

RTW

. Pai

n se

verit

y or

pai

n pr

eval

ence


1 3

Tabl

e 2

Sum

mar

y of

the

incl

uded

pap

ers´

ope

ratio

naliz

atio

n of

ICF,

per

sons

invo

lved

in V

R, a

nd IC

F co

mpo

nent

s use

d

Aut

hor

Ope

ratio

naliz

atio

n of

ICF

(i.e.

as a

fram

ewor

k fo

r: str

uctu

ring,

link

ing,

ana

lysi

s or d

evel

opm

ent)

Who

are

invo

lved

(sta

keho

lder

s, pa

tient

s)IC

F co

mpo

nent

s use

d

Qua

litat

ive

struc

turin

g A

nner

[26]

Fram

ewor

k to

stru

ctur

e an

d ph

rase

dis

abili

ty e

valu

atio

n by

use

of I

CF.

Med

ical

Eva

luat

ion

of w

ork

disa

bilit

y.

The

ICF

fram

ewor

k di

sting

uish

es th

e do

mai

ns a

nd

thei

r int

erac

tion

but d

oes n

ot fo

rese

e a

restr

icte

d ca

usal

rela

tion

Rese

arch

ers,

med

ical

eva

luat

ors o

f wor

k di

sabi

lity

All

com

pone

nts e

xcep

t per

sona

l fac

tors

Dal

eman

s [66

]Fr

amew

ork

for c

ateg

oriz

ing.

Sea

rch

term

s wer

e de

rived

fro

m IC

F. A

spec

ts o

f dom

estic

life

, int

erpe

rson

al

inte

ract

ions

and

rela

tions

hips

, edu

catio

n an

d em

ploy

-m

ent,

and

com

mun

ity, c

ivic

, and

soci

al li

fe w

ere

incl

uded

Rese

arch

ers

Parti

cipa

tion

only

In d

omes

tic li

fe, i

nter

-per

sona

l life

, edu

catio

n, c

omm

u-ni

ty, c

ivic

, and

soci

al li

fe

Dan

iel [

44]

Fram

ewor

k fo

r cat

egor

izin

g. D

efini

ng so

cial

con

se-

quen

ces a

ccor

ding

as t

hose

per

tain

ing

to th

e IC

F do

mai

n of

“pa

rtici

patio

n”. S

ocia

l con

sequ

ence

s gr

oupe

d in

to 5

dom

ains

refle

ctin

g th

e to

pics

inve

sti-

gate

d: R

TW, f

amily

rela

tions

hips

, sex

ual,

finan

ces,

and

soci

al a

ctiv

ities

. Dev

elop

ing

a st

anda

rdiz

ed

instr

umen

t, w

hich

take

s int

o ac

coun

t spe

cific

nee

ds

of w

orki

ng-a

ged

peop

le. T

his s

cale

shou

ld b

e in

line

w

ith th

e IC

F

Rese

arch

ers

Parti

cipa

tion

only

In w

ork

only

De

Boe

r [61

]Fr

amew

ork

and

verifi

catio

n ac

cord

ing

to IC

F ca

tego

-rie

s. Th

e to

pics

that

add

ress

a c

laim

ant’s

dis

abili

ty

wer

e co

mpa

red

to IC

F an

d a

bio-

psyc

ho-s

ocia

l ap

proa

ch to

see

the

exte

nt o

f mat

ch

Rese

arch

er a

nd so

cial

insu

ranc

e ph

ysic

ians

All

com

pone

nts

Esc

orpi

zo [7

5]Fr

amew

ork.

Des

crip

tion

and

use

of IC

F ca

tego

ries.

Use

of I

CF

as a

lang

uage

of d

isab

ility

, a c

omm

on

refe

renc

e fr

amew

ork

to p

rovi

de d

isab

ility

crit

eria

in

dete

rmin

ing

func

tiona

l and

wor

k ca

paci

ty, a

nd to

hel

p fa

cilit

ate

a co

mm

on g

roun

d of

und

erst

andi

ng

Rese

arch

ers

All

com

pone

nts

ICF

gene

ric se

t, co

re se

ts fo

r VR

and

Dis

abili

ty E

valu

a-tio

n in

Soc

ial S

ecur

ity

Fin

ger [

29]

Fram

ewor

k of

stru

ctur

ing.

App

licat

ion

and

com

pari-

son

of IC

F-ba

sed

tool

s the

Reh

abili

tatio

n M

anag

e-m

ent S

heet

, the

Wor

k Re

habi

litat

ion

Que

stion

naire

(W

OR

Q, t

he g

ener

ic a

nd b

rief c

ore

set o

f low

bac

k pa

in).

ICF

struc

ture

s use

d to

faci

litat

e co

mm

unic

atio

n be

twee

n st

akeh

olde

rs, t

o he

lp st

ruct

ure

reha

bilit

atio

n pl

ans a

nd fo

r set

ting

goal

s, an

d cl

arify

ing

team

role

s

Rese

arch

er a

nd st

akeh

olde

rs: r

ehab

ilita

tion

phys

icia

n,

a ph

ysio

ther

apist

, a p

sych

olog

ist a

nd a

voc

atio

nal

coun

sello

r

All

com

pone

nts

Exce

pt p

erso

nal f

acto

rsC

ore

set o

f low

bac

k pa

in (L

BP)

Gla

ssel

[31]

Fram

ewor

k fo

r a sy

stem

atic

app

licat

ion

of IC

F-ba

sed

docu

men

tatio

n to

ols b

y us

ing

ICF

Cor

e Se

ts in

VR

. U

se o

f the

ICF

Cor

e Se

ts in

VR

allo

ws a

com

preh

en-

sive

ass

essm

ent

Rese

arch

er a

nd V

R te

am O

T, p

hysi

cal t

hera

pist,

nu

rses

, voc

atio

nal

Cou

nsel

lor,

soci

al w

orke

r, ph

ysic

ian,

and

psy

chol

ogist

All

com

pone

nts

Cor

e se

t for

VR

Hoe

fsm

it [6

8]Fr

amew

ork

for d

escr

iptio

n of

env

ironm

enta

l and

per

-so

nal f

acto

rs re

gard

ing

supp

ort o

f em

ploy

ees´

RTW

. Pr

ofes

sion

als´

use

of t

he IC

F

Rese

arch

er a

nd p

erso

ns in

terv

iew

ed: 1

4 em

ploy

ees,

15 e

mpl

oyer

s and

4 O

Ps fr

om m

ultip

le o

rgan

isat

ions

(h

ealth

care

and

edu

catio

n)

All

com

pone

nts.

Exce

pt p

erso

nal f

acto

rs


1 3

Tabl

e 2

(con

tinue

d)

Aut

hor

Ope

ratio

naliz

atio

n of

ICF

(i.e.

as a

fram

ewor

k fo

r: str

uctu

ring,

link

ing,

ana

lysi

s or d

evel

opm

ent)

Who

are

invo

lved

(sta

keho

lder

s, pa

tient

s)IC

F co

mpo

nent

s use

d

Koo

lhaa

s [62

]Fr

amew

ork

for c

ateg

oriz

atio

n. IC

F us

ed fo

r cla

ssifi

ca-

tion

and

com

parin

g th

e w

orke

rs’ p

ersp

ectiv

esRe

sear

cher

All

com

pone

nts

Min

is [6

9]Fr

amew

ork,

ICF

used

as a

stru

ctur

e fo

r fac

tor e

xtra

c-tio

n in

dica

tive

for a

ssoc

iatio

n w

ith e

mpl

oym

ent s

tatu

s fro

m st

udie

s. Fa

ctor

s rel

ated

to h

ealth

stat

e, w

ork

and

othe

r env

ironm

enta

l and

per

sona

l fac

tors

is n

eede

d to

im

prov

e ca

re a

nd se

rvic

es b

y al

lied

heal

th p

rofe

ssio

n-al

s and

org

anis

atio

ns in

volv

ed in

the

(re-

) int

egra

tion

proc

ess

Rese

arch

erA

ll co

mpo

nent

s

Tre

nam

an [7

3]Fr

amew

ork

for c

ateg

oriz

atio

n. F

acto

rs c

ateg

oriz

ed

base

d on

the

ICF

with

eac

h do

mai

n su

b-ca

tego

rized

by

mod

ifiab

ility

Rese

arch

ers

All

com

pone

nts

Voo

ijs [7

0]Fr

amew

ork

for c

ateg

oriz

atio

n. F

acto

rs a

ssoc

iate

d w

ith w

ork

parti

cipa

tion

wer

e ca

tego

rized

acc

ordi

ng

to IC

F. V

ario

us d

isea

se-g

ener

ic fa

ctor

s are

ass

oci-

ated

with

wor

k pa

rtici

patio

n, o

f whi

ch m

ost o

f the

re

porte

d fa

ctor

s are

inde

pend

ent o

f dia

gnos

is

Rese

arch

ers

All

com

pone

nts

Qua

litat

ive

linki

ng A

iach

ini [

38]

Fram

ewor

k fo

r lin

king

. Val

idat

ion

of c

ore

set f

or V

R.

Con

cept

s wer

e lin

ked

to IC

F ca

tego

ries a

ccor

ding

to

esta

blis

hed

linki

ng ru

les.

70%

of 9

0 ca

tego

ries i

n V

R

core

set w

ere

foun

d

Spin

al c

ord

inju

ry p

atie

nts,

two

heal

th p

rofe

ssio

nals

lin

ked

the

conc

epts

to IC

FA

ll co

mpo

nent

s. C

ompr

ehen

sive

cor

e se

t for

VR

Esc

orpi

zo [5

2]Fr

amew

ork

for l

inki

ng, I

CF

used

as a

refe

renc

e to

de

scrib

e an

d co

mpa

re th

e co

nten

tsof

thes

e qu

estio

nnai

res:

Hea

lth a

nd W

ork

Q.,

Wor

k Ro

le F

unct

ioni

ng Q

.R

heum

atoi

d A

rthrit

is-W

ork

Inst

abili

ty S

cale

, Hea

lth

and

Labo

ur Q

Rese

arch

ers

All

com

pone

nts

Hea

lth a

nd W

ork

Q. t

he o

nly

incl

udin

g en

viro

nmen

tal

and

pers

onal

fact

ors

Gla

ssel

[30]

Fram

ewor

k fo

r lin

king

. Ref

eren

ce to

ICF

cate

gorie

s ac

cord

ing

to e

stab

lishe

d lin

king

rule

sRe

sear

cher

All

com

pone

nts

Qua

litat

ive

anal

ysin

g A

bbot

t [55

]Fr

amew

ork

for a

naly

sing

inte

rvie

ws.

Bas

ed o

n IC

F a

qual

itativ

e co

nten

t ana

lysi

s of s

emi-s

truct

ured

in

terv

iew

s pos

t-sur

gery

was

per

form

ed. I

CF

was

ap

plie

d to

iden

tify

and

code

mea

ning

ful u

nits

, whi

ch

wer

e co

mpa

red

with

the

ICF

rela

ted

cont

ent o

f the

O

swes

try D

isab

ility

Inde

x, S

F-36

, EQ

5D a

nd th

e IC

F LB

P co

re se

ts

Patie

nts,

rese

arch

ers

All

com

pone

nts

Cor

e se

t for

low

bac

k pa

in


1 3

Tabl

e 2

(con

tinue

d)

Aut

hor

Ope

ratio

naliz

atio

n of

ICF

(i.e.

as a

fram

ewor

k fo

r: str

uctu

ring,

link

ing,

ana

lysi

s or d

evel

opm

ent)

Who

are

invo

lved

(sta

keho

lder

s, pa

tient

s)IC

F co

mpo

nent

s use

d

Cul

ler [

34]

Fram

ewor

k fo

r ana

lysi

ng in

terv

iew

s. C

ompo

nent

s ide

n-tifi

ed in

3 p

ersp

ectiv

es (p

atie

nts,

voca

tiona

l exp

erts

an

d em

ploy

ers)

wer

e ill

ustra

ted

and

map

ped

onto

the

ICF

codi

ng

10 st

roke

surv

ivor

s, 21

voc

atio

nal s

peci

alist

s, 7

empl

oyer

s (ex

perie

nced

in in

terv

iew

ing

pers

ons

with

dis

abili

ties a

nd w

ith a

utho

rity

to m

ake

hirin

g de

cisi

ons)

All

com

pone

nts.

Impa

irmen

ts o

f bod

y, a

ctiv

ity li

mita

-tio

ns to

par

ticip

atio

n. R

estri

ctio

ns b

y en

viro

nmen

tal

and

pers

onal

fact

ors

Ste

rgio

u-K

ita [4

3]Fr

amew

ork

for d

ata

anal

ysis

. Util

ized

as g

uidi

ng

fram

ewor

ks d

urin

g da

ta a

naly

sis.

ICF

focu

sed

mor

e sp

ecifi

cally

on

iden

tifyi

ng k

ey d

omai

ns o

r fac

tors

and

fa

iled

to c

aptu

re th

e pr

oces

ses r

elev

ant t

o a

rigor

ous

eval

uatio

n

Rese

arch

erA

ll co

mpo

nent

s

Van

Vel

zen

[63]

Fram

ewor

k fo

r the

inte

rvie

w a

nd th

e an

alys

isRe

sear

cher

sA

ll co

mpo

nent

s Y

oung

[36]

Fram

ewor

k fo

r ana

lysi

ng in

terv

iew

s. Re

sults

wer

e in

terp

rete

d us

ing

the

heal

th a

nd h

ealth

-rel

ated

do

mai

ns fr

om th

e IC

F. In

terv

iew

s wer

e co

nduc

ted

to

inqu

ire a

bout

par

ticip

ant’s

pos

t-VR

RTW

exp

eri-

ence

s. C

odin

g of

the

qual

itativ

e da

ta a

nd a

naly

sis w

as

cond

ucte

d in

tand

em

Rese

arch

ers a

nd p

ost V

R p

artic

ipan

tsA

ll co

mpo

nent

s

Qua

litat

ive

deve

lopm

ent

Bak

ker [

65]

Fram

ewor

k fo

r dev

elop

ing

a ris

k as

sess

men

t mod

el,

with

a st

rong

focu

s on

pers

onal

and

env

ironm

enta

l fa

ctor

s, as

it w

ill a

ffect

cla

im b

ehav

iour

. The

mod

el

will

brin

g th

e cu

rren

t med

ical

mod

el a

t the

und

er-

writ

ing

stag

e m

ore

in li

ne w

ith th

e so

cial

mod

el a

t cl

aim

stag

e

Rese

arch

ers

All

com

pone

nts

Focu

s on

envi

ronm

enta

l and

per

sona

l fac

tors

in a

dditi

on

to m

edic

al d

ata

Des

iron

[67]

Fram

ewor

k us

ed to

iden

tify

elem

ents

in O

T m

odel

s. Re

sear

ch sp

ecifi

c cr

iteria

der

ived

from

OT

liter

atur

e (c

once

ptua

l OT

mul

tidis

cipl

inar

y m

odel

refe

rrin

g to

th

e IC

F)

Rese

arch

erA

ll co

mpo

nent

s. Id

entifi

ed e

lem

ents

: fun

ctio

nal,

med

i-ca

l, RT

W

Hom

a [3

5]Fr

amew

ork

for d

evel

opm

ent o

f int

ervi

ew fo

rmat

in

form

ed b

y th

e IC

F str

uctu

re. U

sed

in jo

b pl

acem

ent

as a

tem

plat

e to

org

aniz

e cl

ient

info

rmat

ion,

hig

hlig

ht

stren

gths

and

lim

itatio

ns, a

nd p

rovi

de g

uida

nce

for

inte

rven

tions

Rese

arch

erA

ll co

mpo

nent

sEx

cept

per

sona

l fac

tors

Sev

illa

[48]

Fram

ewor

k fo

r dev

elop

men

t of a

mod

el o

f whi

ch th

e le

vels

of a

ctiv

ity c

an b

e cr

oss-

wal

ked

to th

e IC

FRe

sear

cher

All

com

pone

nts

The

new

mod

el in

clud

e m

ore

than

ICF

Was

iak

[54]

Fram

ewor

k fo

r dev

elop

men

tal c

once

ptua

lizat

ion

of

RTW

. Usi

ng th

e IC

F to

info

rm o

ur th

inki

ng a

nd

codi

ng st

ruct

ure,

con

cept

ualiz

ing

phas

e-ba

sed

RTW

ou

tcom

es a

nd c

ateg

oriz

atio

n in

‘tas

ks a

nd a

ctio

ns’,

‘con

text

ual’

or ‘p

roce

ss d

riven

’. A

war

enes

s of R

TW

enco

mpa

ssin

g fo

ur p

hase

s: o

ff w

ork,

wor

k re

inte

gra-

tion,

wor

k m

aint

enan

ce a

nd a

dvan

cem

ent

Rese

arch

ers

All

com

pone

nts


1 3

Tabl

e 2

(con

tinue

d)

Aut

hor

Ope

ratio

naliz

atio

n of

ICF

(i.e.

as a

fram

ewor

k fo

r: str

uctu

ring,

link

ing,

ana

lysi

s or d

evel

opm

ent)

Who

are

invo

lved

(sta

keho

lder

s, pa

tient

s)IC

F co

mpo

nent

s use

d

Qua

ntita

tive

struc

turin

g C

how

[37]

Fram

ewor

k fo

r cat

egor

izat

ion

and

desc

riptio

n on

how

lim

itatio

ns in

func

tioni

ng a

nd th

e en

viro

nmen

t are

re

late

d to

em

ploy

men

t out

com

es

Rese

arch

team

; tra

ined

inte

rvie

wer

s; p

roje

ct st

aff

mem

bers

All

com

pone

nts

Pers

onal

cha

ract

erist

ics

Fin

ger [

27]

Fram

ewor

k fo

r stru

ctur

ing.

ICF

core

set b

asis

for

deve

lopi

ng a

n in

strum

ent.

Parti

cipa

nts c

omm

ente

d on

th

e us

abili

ty

Prof

essi

onal

s, 25

pat

ient

s, vo

catio

nal c

ouns

ello

rs, a

nd

a w

ork

rein

tegr

atio

n sp

ecia

list

All

com

pone

nts

Exce

pt p

erso

nal f

acto

rsC

ore

set

Kui

jer [

64]

Fram

ewor

k fo

r cla

ssifi

catio

n. V

aria

bles

cla

ssifi

ed

acco

rdin

g to

the

ICF

Rese

arch

ass

istan

t; 2

phys

ioth

erap

ists (

PT);

PT/m

ove-

men

t sci

entis

t, tra

ined

, cer

tified

and

exp

erie

nced

All

com

pone

nts

Part

1, fu

nctio

ning

and

dis

abili

tyPa

rt 2,

con

text

ual f

acto

rs R

eich

el [4

2]Fr

amew

ork

for c

ateg

oriz

atio

n. L

inki

ng e

ach

mea

ning

-fu

l con

cept

and

obj

ectiv

e w

ith th

e m

ost p

reci

se IC

F ca

tego

ry

Phys

icia

ns sp

ecia

lized

in g

astro

ente

rolo

gica

l reh

abili

-ta

tion

Bod

y fu

nctio

ns/b

ody

struc

ture

s onl

y

Stu

ress

on [5

7]Fr

amew

ork

for c

ateg

oriz

atio

n an

d ve

rifyi

ng th

e in

form

atio

n of

sick

ness

cer

tifica

tes.

The

asse

ssm

ent

of S

wed

ish

Soci

al In

sura

nce

Age

ncy

(SSI

A) h

as to

ve

rify

that

the

info

rmat

ion

clar

ifies

a lo

gica

l lin

k be

twee

n di

agno

ses,

impa

irmen

t of b

ody

func

tion

and

activ

ity li

mita

tion

(the

‘DFA

cha

in’)

. The

voc

abul

ary

and

defin

ition

s in

the

DFA

cha

in a

re in

acc

orda

nce

with

the

ICF

Inde

pend

ent i

nsur

ance

spec

ialis

t fro

m th

e SS

IA, e

du-

cate

d an

d tra

ined

to a

sses

s the

qua

lity

Impa

irmen

t of b

ody

func

tion,

lim

itatio

n of

act

ivity

onl

y

Aas

[74]

Fram

ewor

k fo

r cat

egor

izat

ion.

ICF

term

inol

ogy

was

us

ed to

cla

ssify

the

inte

rven

tion

com

pone

nts.

ICF

coul

d ha

ve c

ontri

bute

d to

a c

once

ptua

l fra

me

of re

fer-

ence

bas

ed o

n co

mm

on te

rmin

olog

y

Rese

arch

ers

All

com

pone

nts

Qua

ntita

tive

linki

ng C

oncl

ave

[39]

Fram

ewor

k fo

r stru

ctur

ing

follo

wed

by

linki

ng It

alia

n le

gisl

ativ

e pr

oced

ures

to th

e IC

F do

mai

ns a

nd c

ateg

o-rie

s, an

d ad

ding

stan

dard

ICF

chec

klist

cat

egor

ies.

The

ICF-

base

d w

orke

r che

cklis

t is c

ompo

sed

of 1

83

ICF

cate

gorie

s

Prof

essi

onal

s in

job

plac

emen

t of p

erso

ns w

ith d

is-

abili

ties.

Parti

cipa

nts:

895

in B

asic

ICF

train

ing,

552

in

Adv

ance

d

All

com

pone

nts

de

Bee

r [71

]Fr

amew

ork

for l

inki

ng, c

odin

g. T

he fa

ctor

s fro

m a

ll stu

dies

cod

ed o

n th

e tw

o-le

vel c

lass

ifica

tions

of I

CF.

Fr

eque

ncy

and

cons

isten

cy in

hin

derin

g or

faci

litat

ing

mad

e vi

sibl

e by

use

of I

CF

cate

gorie

s

Rese

arch

team

All

com

pone

nts

Wor

k-re

late

d ac

tiviti

es, p

artic

ipat

ion,

env

ironm

enta

l and

pe

rson

al fa

ctor

s

Esc

orpi

zo [7

5]Fr

amew

ork

for s

truct

urin

g fo

llow

ed b

y lin

king

. Ite

ms

of m

easu

rem

ent i

nstru

men

ts w

ere

linke

d to

the

ICF

core

sets

, app

lyin

g th

e lin

king

rule

s

Rese

arch

er, t

wo

code

rsA

ll co

mpo

nent

s exc

ept b

ody

fact

ors

Act

iviti

es, p

artic

ipat

ion

and

envi

ronm

ent c

ompo

nent

s. C

ompr

ehen

sive

ICF

Cor

e Se

t for

SC

I, V

R


1 3

Tabl

e 2

(con

tinue

d)

Aut

hor

Ope

ratio

naliz

atio

n of

ICF

(i.e.

as a

fram

ewor

k fo

r: str

uctu

ring,

link

ing,

ana

lysi

s or d

evel

opm

ent)

Who

are

invo

lved

(sta

keho

lder

s, pa

tient

s)IC

F co

mpo

nent

s use

d

Esc

orpi

zo [3

3]Fr

amew

ork

for s

truct

urin

g fo

llow

ed b

y lin

king

. Lin

king

be

twee

n 3

core

sets

of 6

que

stion

naire

s ass

essi

ng

envi

ronm

ent a

nd p

artic

ipat

ion

by tw

o in

depe

nden

t re

sear

cher

s. M

ergi

ng IC

F ca

tego

ries

Inte

rnat

iona

l tea

m o

f res

earc

hers

All

com

pone

nts

Exce

pt p

erso

nal f

acto

rs

Esc

orpi

zo [3

2]Fr

amew

ork

for l

inki

ng. I

CF

appl

ying

pub

lishe

d lin

king

ru

les;

resp

onse

s wer

e lis

ted

and

freq

uenc

y an

alys

is

was

per

form

ed

Resp

onde

rs (1

51),

expe

rts fr

om 4

7 co

untri

es, r

ando

m

sam

ple

of p

rofe

ssio

ns, W

HO

regi

ons,

coun

tries

All

com

pone

nts

Qua

ntita

tive

anal

ysin

g A

ndel

ic [5

8]Fr

amew

ork,

tool

for a

naly

sis.

Link

ing

of se

lf-re

porte

d pr

oble

ms r

elat

ed to

nec

k pa

in to

dom

ains

of t

he IC

FRe

sear

ch te

amA

ll co

mpo

nent

s exc

ept e

nviro

nmen

tal f

acto

rs. D

omai

ns

load

ing

on th

e ac

tiviti

es a

nd p

artic

ipat

ion

Nils

ing

[56]

Fram

ewor

k fo

r ana

lysi

s. Fr

ee te

xt o

n fu

nctio

ning

was

an

alys

ed d

educ

tivel

y us

ing

the

ICF

fram

ewor

k an

d pl

aced

into

cat

egor

ies

Rese

arch

ers a

nd a

n ad

judi

cato

r. C

onse

nsus

mee

ting

betw

een

the

rese

arch

ers a

nd a

djud

icat

orB

ody

and

activ

ity o

nly

(Sen

satio

ns o

f pai

n or

em

otio

nal f

unct

ions

. Wal

king

or

hand

ling

stres

s) W

ang

[50]

Fram

ewor

k fo

r ana

lysi

s. D

epen

dent

and

inde

pend

ent

varia

bles

bas

ed o

n IC

F, a

nd th

eir o

pera

tiona

l defi

ni-

tion

wer

e us

ed fo

r cod

ing;

e.g

. 0 =

not e

mpl

oyed

/no,

1 =

empl

oyed

/yes

Rese

arch

erA

ll co

mpo

nent

s

Fer

rario

[40]

Fram

ewor

k fo

r ana

lysi

s. IC

F qu

estio

nnai

re; u

sed

the

ICF

to e

valu

ate

wor

king

abi

lity

of tr

ansp

lant

reci

pi-

ents

to p

rovi

de th

e oc

cupa

tiona

l phy

sici

ans a

stan

d-ar

dize

d pr

oced

ure

to su

gges

t the

bes

t pos

sibi

lity

of

re-e

mpl

oym

ent i

n cl

ose

co-o

pera

tion

with

the

patie

nt

Occ

upat

iona

l phy

sici

an o

f the

Occ

upat

iona

l Med

icin

e D

epar

tmen

t, re

sear

cher

All

com

pone

nts

Fin

ger [

28]

Fram

ewor

k fo

r ana

lysi

s. Id

entifi

catio

n of

the

mos

t com

-m

on p

robl

ems a

roun

d w

ork

and

in V

R. E

xam

ine

the

freq

uenc

y an

d ra

te p

robl

ems b

ased

on

the

exte

nded

IC

F ch

eckl

ist (t

he IC

F C

heck

list v

ersi

on 2

.1a)

Hea

lth p

rofe

ssio

nals

All

com

pone

nts

Exce

pt p

erso

nal f

acto

rs

Sal

tych

ev [4

6]Fr

amew

ork

for c

odin

g fo

llow

ed b

y an

alys

is o

f com

-pa

rison

. Des

crip

tions

of f

unct

iona

l lim

itatio

ns w

ere

conv

erte

d to

ICF

code

s, an

d th

e m

ost f

requ

ent w

ere

com

pare

d w

ith th

e IC

F C

heck

list a

nd V

R c

ore

sets

Mul

ti-pr

ofes

sion

al te

am. (

Spec

ialis

t in

phys

ical

and

re

hab.

med

icin

e, re

hab.

pla

nner

, psy

chol

ogist

and

the

patie

nts)

All

com

pone

nts

Exce

pt p

erso

nal f

acto

rsC

ore

set f

or V

R

Zei

lig [4

9]Fr

amew

ork

for a

naly

sis.

Bar

riers

and

faci

litat

ors o

f w

orki

ng p

artic

ipat

ion

defin

ed a

ccor

ding

to th

e IC

F ca

tego

ries.

Leve

ls o

f fun

ctio

n w

ere

then

ana

lyse

d fo

r co

rrel

atio

n to

the

voca

tiona

l sta

tus

Rese

arch

erB

ody

func

tions

and

act

iviti

es o

nly.

Foc

us o

n m

obili

ty in

re

gard

to e

mpl

oym

ent s

tatu

s

Qua

ntita

tive

deve

lopm

ent

Ley

shon

[76]

Fram

ewor

k, b

asis

for a

new

mod

el. D

iscu

ssio

n of

op

portu

nitie

s to

use

this

mod

el in

rese

arch

ing

out-

com

es o

f erg

onom

ic in

terv

entio

ns. I

llustr

ate

how

the

ICF

fram

ewor

k co

uld

be a

pplie

d to

a w

orke

r with

a

low

bac

k di

sord

er

Rese

arch

erA

ll co

mpo

nent

s


1 3

Tabl

e 2

(con

tinue

d)

Aut

hor

Ope

ratio

naliz

atio

n of

ICF

(i.e.

as a

fram

ewor

k fo

r: str

uctu

ring,

link

ing,

ana

lysi

s or d

evel

opm

ent)

Who

are

invo

lved

(sta

keho

lder

s, pa

tient

s)IC

F co

mpo

nent

s use

d

Lin

den

[41]

Fram

ewor

k fo

r eva

luat

ion.

Use

of m

ini I

CF

to a

sses

s its

clin

ical

rele

vanc

e. C

orre

latio

ns m

ade

with

oth

er

instr

umen

ts. F

unct

ions

, cap

aciti

es a

nd p

artic

ipat

ion

are

not l

inea

r but

inte

ract

ive,

as k

now

n fro

m o

ccup

a-tio

nal p

sych

olog

y

Rese

arch

erA

ll co

mpo

nent

s

Mar

tins [

45]

Fram

ewor

k fo

r eva

luat

ion.

To

expl

ore

corr

elat

ions

be

twee

n so

cial

par

ticip

atio

n, e

mpl

oym

ent a

nd

pers

onal

fact

ors s

uch

as se

lf-effi

cacy

and

atti

tude

s to

war

ds d

isab

ility

Rese

arch

erA

ll co

mpo

nent

s exc

ept b

ody

func

tions

and

act

ivity

Pty

ushk

in [4

7]Fr

amew

ork

for d

evel

opm

ent o

f que

stion

naire

. Sub

ject

fo

r que

stion

naire

: VR

pro

fess

iona

ls´ o

pini

ons a

bout

IC

F. (H

ow w

ould

you

defi

ne th

e IC

F? W

hat i

s the

IC

F fo

r you

? an

d ‘I

n yo

ur o

pini

on, w

hat i

s the

pur

-po

se o

f the

ICF’

)In

tegr

atio

n of

the

ICF

into

the

Slov

enia

n V

R a

nd

Empl

oym

ent o

f Per

sons

with

Dis

abili

ties A

ct m

ade

the

use

of IC

F ob

ligat

ory

45 p

rofe

ssio

nals

invo

lved

in V

R (P

sych

olog

ists,

soci

al

wor

kers

, tec

hnol

ogist

s, O

Ts, p

hysi

cian

s, ed

ucat

ion

coun

sello

r, re

habi

litat

ion

coun

sello

r)

Bod

y fu

nctio

ns c

ompo

nent

onl

y

Var

ekam

p [5

3]Fr

amew

ork

for e

valu

atio

n. U

nder

stan

ding

and

con

sid-

erin

g he

alth

-rel

ated

pro

blem

s at w

ork

and

findi

ng

solu

tions

; IC

F us

ed a

s a m

odel

to e

xpla

in w

ork

disa

bilit

y. P

reva

lenc

e of

chr

onic

med

ical

con

ditio

ns

(non

-com

mun

icab

le d

isea

ses)

is st

rong

ly re

late

d to

ag

e

Rese

arch

erA

ll co

mpo

nent

sFo

cus o

n en

viro

nmen

tal a

nd o

rgan

isat

iona

l fac

tors

Øste

rås [

60]

Fram

ewor

k fo

r dev

elop

men

t. IC

F us

ed a

s bas

is fo

r de

velo

pmen

t of n

atio

nal q

uesti

onna

ire (N

orw

egia

n Fu

nctio

n A

sses

smen

t Sca

le)

Rese

arch

erA

ctiv

ities

/par

ticip

atio

n co

mpo

nent

s

Aas

[59]

Fram

ewor

k fo

r dev

elop

men

t. IC

F us

ed a

s bas

is fo

r qu

estio

nnai

re in

surv

ey o

f im

pairm

ent,

activ

ity li

mi-

tatio

ns, a

nd p

artic

ipat

ion

restr

ictio

ns (e

.g. p

artic

ipa-

tion

in o

rdin

ary

wor

king

life

)9

OTs

from

4 m

unic

ipal

are

as te

sted

the

ques

tionn

aire

on

18

clie

nts

Occ

upat

iona

l the

rapi

sts (O

T) a

nd c

lient

sB

ody,

act

ivity

and

par

ticip

atio

n co

mpo

nent

s


1 3

Which of the ICF Components and Core Sets are Considered When Functioning is Evaluated in VR?

Except in 10 papers all the ICF components were described. Two papers commented on personal factors, despite the fact they are part of the ICF there are no categorizations [29, 35]. Only two papers described the component participation [44, 66]. One paper described all components but environmental factors [58]. Six papers evaluated the body functions compo-nent only [42, 47, 49, 56, 57, 59], and three papers reported on all components except body functions or participation components [45, 60, 75].

Seven papers used the ICF core set [27, 29, 30, 38, 46, 51, 55], among which four studies reported on the core set for VR [30, 38, 46, 72]. The VR core set was used for valida-tion of another ICF core set [38], development of ICF-based documentation tools [30], comparison of the most frequent ICF coding of functional limitations with the ICF Checklist and VR core sets [46].

Discussion

The ICF was primarily used in Western VR contexts. The ICF used as a framework was the most prevalent operation-alizing of ICF (18 papers), whereas linking, analysing and developing appeared in 8, 12 and 12 papers respectively. As 32 of the 50 included papers were reviews the predominant profession involved in ICF were researchers. Among the original papers no single profession stood out as particularly ICF users. In general the ICF enabled the various profes-sions involved in VR in a structured way to obtain relevant need assessments and communicate this across professions. The majority (40) of papers described all factors, which support the bio-psycho-social approach. However, it was not clear if the ICF was suitable as an instrument for goal setting and evaluation as merely single papers mentioned these properties. Moreover, the ICF was criticised for being time consuming. Unexpectedly four papers described the ICF components body and acidity only, despite participation and environmental factors seem inseparable from VR. The VR core set was not the primary tool when functioning was evaluated within VR.

Compared to the findings in another review where quali-tative papers only constituted a tenth [10], and despite some papers with a mixed study designs were defined as qualita-tive in this review, the number of qualitative and quantitative papers was more balanced in this review.

The ICF defines functioning as the interaction between an individual and that individual’s environmental and per-sonal factors; accordingly a paper illustrated the problems of functioning in a person with low back pain by use of the framework [75].

The ICF is seen as a useful tool for describing, compar-ing and contrasting information from outcome measures and clinical patient reports across diagnoses, settings, languages and countries [77]. A review showed that linking health and health-related information to the ICF is a useful way to apply the ICF in research [77].

Evaluation of functioning is relevant early in VR [8], and this review found several presentations of the applicability for VR and use of the ICF to examine and measure VR pro-cesses and outcomes. The findings show that the ICF was useful in providing a clear description of the consequences of diseases, and of the factors that can be described using the ICF coding, which may potentially support the VR pro-fessionals, e.g. factors that support employees’ early RTW [68]. The ICF can help VR professionals gain a more pre-cise understanding of the impact of disability on individu-als’ ability to perform life tasks or activities. Thus, the ICF might contribute to a more informative description in multi-professional assessments, because healthcare professionals have different perspectives on the health-care process [57]. However, a paper concluded that in primary care there seem to be a lack of knowledge about the ICF, and that increased cooperation between GPs and other health-care professions may require learning as well as a change of attitudes [57].

Furthermore, an ICF-based questionnaire regarding time to RTW, work difficulties, job satisfaction, and work rela-tions was reportedly useful for occupational physicians assessing patients after transplant procedures [40]. Thus, the ICF framework provided an effective evaluation of possible RTW and capabilities of these patients, who had undergone transplants and survived at least 12 months. However, the procedure of for assessment of self-reported work ability was reported as complex and required specific training of the staff involved [40].

The present review illustrates how the ICF may support development of questionnaires [59, 60], like e.g. the Work Rehabilitation Questionnaire (WORQ). The WORQ has proven to be a valuable instrument within VR [27], e.g. as to support the physiotherapist´s role within the rehabilitation team by enhancing transparency in goal setting and interven-tion planning across disciplines [29].

Although the ICF is a reasonable starting point in efforts to harmonize terminologies [33], the framework is also criti-cised for limitations. This scoping review reported on the ICF components only. However, each of the components (except for personal factors) is further divided into domains and underlying categories providing more detail of a com-ponent. The ICF coding system is intended to describe a per-son’s functioning at a specific time, in that person’s normal circumstances and environment. Qualifiers are built into the coding system to indicate the magnitude of the impairment, limitation or restriction for each category.


1 3

A review on the use of ICF in outcome measures used within VR identified that a third of categories were related to body functions [10]. This review also identified some papers solely reporting on body functions, which is not rep-resenting a bio-psycho-social approach. It should be recog-nized that the ICF is limited with respect to comprehensive descriptions of work disability, e.g. the cause why a person is not able to work is an important part of disability evalu-ation. The ICF however, cannot describe causal relation-ship [26], and a solution may be to use the ICF combined with other instruments, which can reveal causal relations. It was pointed out that although the framework includes personal factors, they cannot be classified in the ICF [68]. This is a limitation of the framework, as e.g. motivation is important to consider when making prognosis of work abil-ity and RTW. Personal factors also include an individual’s lifestyle, habits, social background, education, life events, race/ethnicity, sexual orientation, and coping mechanisms [43]. Work participation relies on both personal and environ-mental factors, which in addition to the medical data, affect functioning and participation, e.g. a paper concluded these factors affect claim behaviour [65]. Factors that are likely to be emphasized in a VR setting are within the components: activities, participation and environmental factors [35]. A Cochrane review found a lack of interventions targeting the ICF-domains: attitudinal and social environment [74]. However, this review found only a few papers lacking the environmental factors.

Unexpectedly, the review revealed a limited use of the ICF VR core sets. These include environmental factors that may prove to be useful when disability evaluation and work capacity is being assessed. However, a validation study of the comprehensive VR core set concluded, that it was insuf-ficient from a sole physiotherapist perspective, there was a need for additional ICF categories. Although the VR core set was considered useful to clarify responsibilities and for communication in a multidisciplinary setting, it was too comprehensive for mono-disciplinary use of physiothera-pist [78]. The core sets in general were not recognized to provide an exhaustive list but rather the minimum number of categories to be assessed [8]. Therefore practice may sup-ply the VR core set with other instruments in order to fully assess functioning.

Strengths and Limitations

One strength was the inclusion of both qualitative and quan-titative papers from multiple settings and countries. Further-more, the scoping review format offers an overview of study findings in a field where the knowledge is still limited.

The reviewers experienced difficulties in study selection, despite the method by two reviewers and how to ensure eligibility criteria is a limitation. In a scoping review the extracted data is based on information provided in individ-ual papers without critical assessment, which is a limitation despite no scope of synthesizing evidence. Furthermore, the categories of operationalization may not be mutual exclusive.

The sixth and optional stage of involving relevant stake-holders was not included but may have contributed with other VR professionals´ views [15].

Implications for Practice within VR

This review confirm challenges with the use of the ICF: e.g. it cannot infer causality in disability [8] and not categorize personal factors. The content of VR varies widely among countries because of differing insurance policies and dis-ability attitudes; e.g. in Slovenia the ICF for work assess-ment was made obligatory but the lack of interface between the ICF and policies on VR was a challenge [47]. The ICF may be used to ensure comprehensiveness of evaluation in study populations with chronic diseases [46]. Furthermore, the framework may cover all relevant aspects of disability and may encourage the VR professionals to draw a holistic picture [26]. The ICF “corresponds closely to this ecological systems approach and could help rehabilitation practitioners more specifically and precisely identify those subsystems or environmental factors that have an impact on successful job placement” [35]. The ICF may be combined with existing measures and incorporated in daily practice [31].

Implications for Future Research in Work Disability and VR

Our findings revealed that the ICF has been applied in differ-ent settings and for different purposes, which has important implications for future research. In order to ensure compara-bility across studies and robust testing of hypotheses the use of the ICF needs to be clarified. Furthermore, how data are collected, assessed and classified based is lacking in the field of VR. Hence, research on the practical utility of the ICF across different assessment instruments is crucially needed to inform a feasible framework development in VR.

Although the ICF provides a framework to evaluate contextual factors, this review finds there is a gap between the knowledge of the impact of personal factors and actual assessment within VR and more research is needed.


1 3

Conclusions

The scoping review revealed use of the ICF within the field VR in 50 papers, and in various settings; e.g. hospitals, rehabilitation centres, primary health care centres, sickness certificate registration offices, and research departments. The operationalization of the ICF was described in four ways: for structuring information, linking of categories or content, analysis according to the ICF framework, or development of instruments or models based on the ICF.

A majority of papers were reviews and involved research-ers only, whereas different stakeholders and VR profession-als were involved in the interventions. The components of the ICF that depict functioning and disability were largely incorporated in the VR research. This observation points to the benefit of using a common set of ICF components to inform the selection of set of measurement instruments. Such a process would lead to a single set of standardized measures looking at similar outcomes and make compa-rability across studies possible However, more research is needed to develop and validate instruments measuring rel-evant domains including personal factors and to standardize and ease the VR professionals´ use of the ICF.

Acknowledgements We thank the research librarian Helene Sognstrup Aarhus University Library, for providing support in the search strate-gies for this review.

Compliance with Ethical Standards

Conflict of interest A.H. Momsen, C.M. Stapelfeldt, R. Rosbjerg, M. Labriola, R. Escorpizo, and M. Bjerrum declare that they have no con-flict of interest.

Research Involving Human and Animal Participants This article does not contain any studies with human participants performed by any of the authors.

Open Access This article is distributed under the terms of the Crea-tive Commons Attribution 4.0 International License (http://creat iveco mmons .org/licen ses/by/4.0/), which permits unrestricted use, distribu-tion, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

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