Use of the International Classification of Functioning, Disability, and Health in Traumatic Brain Injury Rehabilitation Linking Issues and General Perspectives

Objective: The aims of this study were to summarize the possible benefits of using the International Classification of Functioning, Disability, and Health (ICF) in rehabilitation after traumatic brain injury and to explore the technical aspects of linking existing medical records to the ICF in such cases. Design: A literature review was conducted using PubMed, Cochrane Collaboration, and Trip. Medical records of 100 patients admitted to University Rehabilitation Institute of Slovenia in 2007-2009 were linked to the ICF. Results: Fourteen relevant articles were identified from 2002 to 2010, suggesting that in patients with traumatic brain injury, the ICF can contribute to evaluation of disabilities, identification of treatment goals and intervention targets, and categorizing important environmental factors. Linking existing medical records to the ICF proved successful although time-consuming. Identified challenges included need for frequent use of "unspecified" qualifier, different scope of reports from different specialists, and mapping of either one Functional Independence Measure to more ICF codes or vice versa. Conclusions: Despite some criticism, the literature suggests that the ICF is useful as a model of health and disability and the basis for the development of practical instruments for description and assessment of functioning of persons with traumatic brain injury. Although challenging, time-consuming, and subject to limitations, linking existing medical records to the ICF can provide a clear functional profile of a patient or group with the additional advantage of being able to describe contextual factors.