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Of the three broad outcome domains of body functions and structures, activities, and participation (eg, engaging in valued social roles) outlined in the World Health Organization's (WHO) International Classification of Functioning, Disability and Health (ICF), it has been argued that participation is the most important to individuals, particularly those with chronic health problems.
When functioning could be classified into ICF it was mainly provided on the component of the body.
With the ICF it is possible to systematically define the prototypical spectrum of functioning and health domains for specific health conditions, therapy targets, and age groups.
Based on the ICF it is possible to select sets of categories, the ICF Core Sets [ 12], out of the whole classification which can serve as minimal standards for the assessment of the consequences of contractures on functioning.
If this is an interactive forum whereby learning can occur from sharing experiences of attempts to adopt the ICF, it could provide a way to enhance the ownership of the change process for clinicians.
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Therefore, to facilitate the use of the ICF codes, it is necessary to tailor them to the target population.
Based on the ICF model, it is a 36-item, generic, multidimensional questionnaire which is used for measuring the levels of disability in terms of activities and participation.
Turning now to the ICF findings, it is revealing that even in this early phase of recovery following primary TKA, some patient concerns were linked to the ICF Participation component.
When the items were examined regarding their links with the ICF categories, it was seen that items in the first dimension were related to pain, sleep, cognitive and emotional aspects of health, therefore this dimension was named as "body functions".
We also used a conceptual framework synthesized from (a) the World Health Organization's (WHO) International Classification of Functioning, Disability, and Health, or ICF as it is widely known [ 22] and (b) the American Occupational Therapy Association's (AOTA) practice framework [ 23] (see Figure 1).
This may explain the fact that, in many European countries, the legislation on functional dependency is theoretically based on ICF while it uses the ADL approach for the assessment and for the development of eligibility criteria to different levels of care provision [ 4].
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