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ICF based assessment

Measurement of functioning based on the content of the Brief ICF Core Set for Hand Conditions

The Brief ICF Core Set for Hand Conditions includes the health domains and contextual factors from the whole ICF classification which should be taken into account in the care of patients with hand injuries or diseases. It comprises 20 aspects of functioning (body functions and -structures, activities and participation) as well as three contextual (environmental) factors that allow the patient’s current situation to be described in terms of biopsychosocial perspectives. Since the ICF generally concerns classification rather than providing instruments of measurement, it does not define how (i.e. with which clinical tests, measurement methods and/ or lines of questioning) the individual aspects should be measured or captured.

Here we share the range of clinical tests, measurement methods and/or lines of questioning applied in the Lighthouse Project Hand to capture body functions, activities and participation aspects of the Brief ICF Core Set for Hand Conditions in clinical routine.The ICF based assessment (ICF HandA) was developed as a two-stage procedure involving: (1) a screening and (2) a supplementary test of functioning.  If a supplementary examination is indicated according to the results of the screening, for example, to evaluate impairment for a certain aspect of functioning in more detail, the ICF HandA provides 11 outcome measures for an optional supplementary test.

Body structures (anatomical structures such as the bones of the hand) are realised with contemporary imaging techniques and are thus not mentioned.

Body functions

  • Swelling

  • Touch function

  • Mobility of joint functions

  • Sensory functions

  • Stability of joint functions

  • Pain

  • Muscle power functions

  • Emotional functions

  • Protective functions of the skin

  • Control of voluntary movement functions

Activities and Participation

  • Fine hand use

  • Hand and arm use

  • Lifting and carrying objects

  • Carrying out daily routine

  • Self-care

  • Domestic life

  • Interpersonal interactions and relationships

  • Work and employment

Contextual factors

The ICF’s bio-psycho-social perspective also contains contextual factors alongside body functions and structures, activities and participation. These contextual factors comprise two components: On the one hand, environmental factors which form the physical, social and attitudinal environment, and on the other, personal factors which describe the patient’s specific individual background, for instance gender, age or individual experience. Until now, personal factors have not been classified in the ICF.

The Brief ICF Core Set for Hand Conditions contains environmental factors from the areas of ‘Products and Technology‘ (e.g. medication and aids), ‘Support and Relationships’ (e.g. support through relationships with closest family or healthcare professionals) as well as ‘Services, Systems and Policies’ (e.g. the services, systems and policies of social security or health services).

  • Products and technology - Aids

  • Products and technology - Medication

  • Support and relationships

  • Services, systems and policies

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