a Karl Landsteiner Institute, Institute for Outpatient Rehabilitation Research , Vienna , Austria.
b Department of Psychology , Karl Landsteiner University of Health Sciences , Krems , Austria.
Disabil Rehabil. 2019 May;41(10):1190-1199. doi: 10.1080/09638288.2018.1424950. Epub 2018 Jan 12.
To evaluate the impact of age and gender on the international classification of functioning, disability and health (ICF)-based assessment for chronic low back pain.
Two hundred forty-four chronic low back pain patients (52% female) with a mean age of 49 years (SD =17.64) were interviewed with the comprehensive ICF core set for activities and participation, and environmental factors. After conducting explorative factor analysis, the impact of age and gender on the different factors was analyzed using analyzes of variances.
Results revealed that older patients experienced more limitations within "self-care and mobility" and "walking" but less problems with "transportation" compared to younger patients. Older or middle-aged low back pain patients further perceived more facilitation through "architecture and products for communication", "health services", and "social services and products for mobility" than younger patients. Regarding gender differences, women reported more restriction in "housework" than men. An interaction effect between age and gender was found for "social activities and recreation" with young male patients reporting the highest impairment.
The study demonstrated that the comprehensive ICF core set classification for chronic low back pain is influenced by age and gender. This impact is relevant for ICF-based assessments in clinical practice, and should be considered in intervention planning for rehabilitative programs. Implications for rehabilitation It is important to consider age and gender differences when classifying with the ICF. The intervention planning based on the ICF should focus on improvement of bodily functioning and mobility in older patients, facilitation of household activities in women, consideration of work-life balance and recreation (e.g., through mindfulness based stress reduction), and reduction of dissatisfaction with rehabilitation in younger patients. It is important to offer patients the opportunity to participate in intervention planning based on the ICF. For intervention planning professionals should bear in mind the resource-oriented approach of the ICF (e.g., facilitation through environmental factors), and a collaboration with other professionals.
评估年龄和性别对慢性下背痛基于国际功能、残疾和健康分类（ICF）的评估的影响。
对 244 例慢性下背痛患者（52%为女性）进行了访谈，这些患者的平均年龄为 49 岁（标准差=17.64），使用活动和参与综合 ICF 核心集以及环境因素进行访谈。在进行探索性因素分析后，使用方差分析分析年龄和性别对不同因素的影响。
结果显示，与年轻患者相比，年龄较大的患者在“自我护理和移动”和“行走”方面的限制更多，但在“交通”方面的问题较少。年龄较大或中年的下背痛患者比年轻患者进一步感知到更多的“沟通的建筑和产品”、“卫生服务”和“移动的社会服务和产品”的促进作用。关于性别差异，女性比男性报告更多的“家务”受限。年龄和性别之间存在“社会活动和娱乐”的交互作用，年轻男性患者报告的损伤最高。
该研究表明，慢性下背痛的综合 ICF 核心集分类受到年龄和性别影响。这种影响与临床实践中的 ICF 评估相关，应在康复计划的干预规划中考虑。
在使用 ICF 进行分类时，考虑年龄和性别差异很重要。基于 ICF 的干预计划应侧重于改善老年患者的身体功能和移动能力，促进女性的家务活动，考虑工作-生活平衡和娱乐（例如，通过正念减压），并减少年轻患者对康复的不满。为患者提供基于 ICF 参与干预计划的机会很重要。对于干预计划专业人员，应牢记 ICF 的资源导向方法（例如，通过环境因素促进），并与其他专业人员合作。
