School of Allied Health, Human Services and Sport (Occupational Therapy), La Trobe University, Melbourne, Australia.
Wagga Wagga Ambulatory Rehabilitation Service, Murrumbidgee Local Health District, Wagga Wagga, Australia.
Disabil Rehabil. 2022 Jul;44(15):3925-3937. doi: 10.1080/09638288.2021.1894490. Epub 2021 Mar 16.
To identify the impact of upper limb spasticity on stroke survivors by linking their shared experience to the International Classification of Functioning, Disability, and Health (ICF).
Ten community dwelling adults with a chronic stroke and spasticity, who had completed an upper limb rehabilitation trial participated in semi-structured interviews. Data were analysed using content analysis and linked to the ICF Comprehensive Core Set for stroke using standard linking rules.
Four hundred and thirty-nine meaningful concepts eligible for linking were identified. The majority ( = 178) linked to Body Function, = 137 to Activities and Participation, = 115 to Environmental Factors, and = 9 to Body Structures. Sixty-two of the 130 Comprehensive Core Set categories were used; an additional eight were required to fully represent experience. Stroke survivors with upper limb spasticity use words and discuss topics concentrated around mental functions, functions of the joints and bones, muscles and movements, carrying, moving and handling objects, support and relationships with immediate family and health professionals, products and technology, and health services.
Half of the Comprehensive Core Set categories for stroke were relevant, but to adequately capture experience an additional eight were needed. The ICF category profile may be unique to our participants or may suggest further research is needed to determine if additions to core set categories are required.Implications for rehabilitationOur ICF mapping demonstrated that the Brief Core Set for stroke was not sufficient to capture the range of experience for stroke survivors with upper limb spasticity, instead the Comprehensive Core Set for stroke supplemented with eight clinical-cohort specific second-level-categories should be used.Our findings suggest that rehabilitation may better reflect lived experience if it focuses on Body Function (Chapters 1, 2, 4, 7), Activity and Participation (Chapters 1-9), and Environment (Chapters 1, 2, 3, 5) because Body Structure was rarely mentioned in this or previous post-stroke ICF mapping research.
通过将上肢痉挛的共同体验与国际功能、残疾和健康分类（ICF）联系起来，确定上肢痉挛对脑卒中幸存者的影响。
10 名居住在社区的慢性脑卒中伴痉挛患者完成上肢康复试验后参与半结构式访谈。使用内容分析法对数据进行分析，并使用标准链接规则将数据链接到用于脑卒中的 ICF 综合核心集。
确定了 439 个有意义的概念，这些概念符合链接标准。大多数（ = 178）与身体功能相关，137 个与活动和参与相关，115 个与环境因素相关，9 个与身体结构相关。使用了 130 个综合核心集类别中的 62 个；还需要另外 8 个类别来充分代表体验。上肢痉挛的脑卒中幸存者使用的词语和讨论的主题集中在心理功能、关节和骨骼功能、肌肉和运动、搬运、移动和处理物体、支持以及与直系亲属和卫生专业人员的关系、产品和技术以及卫生服务上。
综合核心集脑卒中类别中有一半是相关的，但为了充分捕捉体验，还需要另外 8 个类别。ICF 类别概况可能是我们参与者所特有的，也可能表明需要进一步研究以确定是否需要对核心集类别进行补充。
我们的 ICF 映射表明，脑卒中简要核心集不足以捕捉上肢痉挛脑卒中幸存者的体验范围，相反，应使用脑卒中综合核心集，并辅以 8 个临床队列特定的二级类别。我们的研究结果表明，如果康复专注于身体功能（第 1、2、4、7 章）、活动和参与（第 1-9 章）和环境（第 1、2、3、5 章），那么康复可能会更好地反映生活体验，因为在本研究或之前的脑卒中 ICF 映射研究中，身体结构很少被提及。
