Helgeson Kevin, Smith A Russell
Physical and Occupational Therapy Department, Idaho State University, Campus Stop 8045, Pocatello, ID 83209-8045, USA.
Phys Ther. 2008 Aug;88(8):956-64. doi: 10.2522/ptj.20070233. Epub 2008 Jun 12.
The International Classification of Functioning, Disability and Health (ICF) has been proposed as a possible framework for organizing physical therapist practice. The purpose of this case report is to describe an evaluative and diagnostic process that is based on the ICF framework for a patient with a patellar dislocation.
The patient was a 23-year-old woman who sustained a right knee and patellofemoral joint injury, resulting in a sprain of the medial collateral ligament and a suspected sprain of the medial patellofemoral ligament. Evaluation at 4 weeks demonstrated a primary impairment of patellar instability associated with the primary activity limitation of limited walking distances. A plan of care to address impairments, activity limitations, and participation restrictions was developed, with modifications made on the basis of the patient's health condition and personal and environmental factors.
The patient attained all of her goals for therapy and was able to return to her normal activities and recreational pursuits without a recurrence of a patellar dislocation. Lower-Extremity Function Scale scores increased from 30 out of 80 to 76 out of 80 during the course of treatment.
The ICF model has been proposed as a framework for developing diagnostic classifications for rehabilitation professionals. The ICF model also should be assessed with regard to whether it provides a useful process for clinical decision making. The ICF model directs practitioners to address patients' problems at the level of the whole person, with modifications made on the basis of health conditions and personal and environmental factors.
国际功能、残疾和健康分类(ICF)已被提议作为组织物理治疗师实践的一个可能框架。本病例报告的目的是描述一个基于ICF框架对一名髌骨脱位患者的评估和诊断过程。
患者为一名23岁女性,右膝和髌股关节受伤,导致内侧副韧带扭伤和内侧髌股韧带疑似扭伤。4周时的评估显示,主要损伤为髌骨不稳定,主要活动受限为步行距离有限。制定了一项针对损伤、活动受限和参与限制的护理计划,并根据患者的健康状况以及个人和环境因素进行了调整。
患者实现了所有治疗目标,能够恢复正常活动和娱乐活动,髌骨脱位未复发。在治疗过程中,下肢功能量表评分从80分中的30分提高到了80分中的76分。
ICF模型已被提议作为康复专业人员制定诊断分类的框架。还应评估ICF模型是否为临床决策提供了有用的过程。ICF模型指导从业者从整个人的层面解决患者的问题,并根据健康状况以及个人和环境因素进行调整。