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"Functioning"

Original Articles

Cancer rehabilitation

Applying ICF Framework to Explore the Factors That Influence Quality of Life in Patients After Lung Surgery
Xinping Li, Yi Chen, Shuangchun Liu, Mingsheng Zhang
Ann Rehabil Med 2024;48(2):155-162.   Published online April 30, 2024
DOI: https://doi.org/10.5535/arm.23109
Objective
To explore the relationship between pulmonary function, physical activity, and health-related quality of life (QoL) in resected lung cancer patients based on the International Classification of Functioning, Disability, and Health (ICF) framework developed by the World Health Organization to describe health and health-related states.
Methods
A quantitative study was designed with postoperative lung cancer survivors to assess personal characteristics. We also assessed functional impairment related to the lung using forced vital capacity (FVC) and forced expiratory volume at 1 second (FEV1), activity limitations using maximal oxygen consumption (VO2max), anaerobic threshold (AT) and 6-minute walking distance (6MWD), and participation restriction using the 36-item Short Form Health Survey V1 (SF-36). Data analyses were conducted using the multivariate method and Smart- PLS to examine path coefficient among the measures.
Results
Forty-one patients were enrolled in this study. FVC and FEV1 were poorly correlated with QoL, and 6MWD, AT, or VO2max were positively associated with QoL. AT or VO2max showed a significant (p<0.01) direct path with SF-36 in the ICF model. Although age and body mass index were not strongly correlated with QoL, these personal factors had a medium to large effect on perceived QoL.
Conclusion
Disability is a complex in patients with lung resection, and physical activity plays an important role in enabling participation. Improving VO2max and AT is needed to improve the QoL of resected lung cancer patients. We should also pay more attention to contextual factors that have a significant impact on social participation.
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Is WHODAS 2.0 Useful for Colorectal Cancer Survivors?
Hyun Haeng Lee, Eun-Kyoung Shin, Hyung-Ik Shin, Eun Joo Yang
Ann Rehabil Med 2017;41(4):667-676.   Published online August 31, 2017
DOI: https://doi.org/10.5535/arm.2017.41.4.667
Objective

To compare the disability level of colorectal cancer survivors with and without stoma by using the Korean version of the 12-item, interview-administered World Health Organization Disability Assessment Schedule 2.0 (Korean version of WHODAS 2.0).

Methods

This is a multicenter (five tertiary university hospitals and the Korea Ostomy Association) and cross-sectional survey. Colorectal cancer survivors with and without stoma were interviewed. Survey measured disability level using the Korean version of WHODAS 2.0 and health-related quality of life using the SF-36.

Results

A significant difference was observed between patients with and without a stoma in two subdomains: getting around (31.1 vs. 20.3; p=0.013) and participation in society (32.3 vs. 22.2; p=0.028). After adjusting for age, gender, and time since surgery, having a stoma was associated with severe to extreme disabilities in participation (OR=2.72, p=0.045). The Korean version of WHODAS 2.0 showed satisfactory internal consistency (r=0.96) and convergent validity.

Conclusion

Patients with stoma participated less in society than those without stoma. The Korean version of WHODAS 2.0 is a reliable and valid instrument for measuring disability in Korean colorectal cancer patients.

Citations

Citations to this article as recorded by  
  • Factors associated with functional ability in patients with esophageal cancer undergoing chemoradiotherapy: a prospective longitudinal study
    Han-Yen Lee, Bing-Shen Huang, Chen-Kan Tseng, Ping-Ching Pai, Tsung-Min Hung, Yin-Kai Chao, Shu-Ching Chen
    Supportive Care in Cancer.2024;[Epub]     CrossRef
  • Effect of a Novel Digital Leakage Notification System (Heylo) for Ostomy Care on Quality of Life and Burden of Living With an Intestinal Ostomy: The ASSISTER Trial, A Randomized Controlled Cross-Over Trial
    Peter Che Ambe, Elin Brunckhorst, Helle Doré Hansen, Johanne Louise Gotfredsen, Martin Vestergaard, Teresa Adeltoft Ajslev
    Mayo Clinic Proceedings: Digital Health.2023; 1(3): 438.     CrossRef
  • Psychometric Properties of the 12-Item World Health Organization Disability Assessment Schedule (WHODAS 2.0), Greek Version: A Cross-Sectional Study on Applicants of Welfare Benefits
    Georgios Theotokatos, Reuben Escorpizo, Theodore J Angelopoulos, Nikolaos K Chrysagis, Jerome Bickenbach, Aikaterini Venieri, Konstantinos Karteroliotis, Eirini Grammatopoulou, Emmanouil Skordilis
    Cureus.2023;[Epub]     CrossRef
  • Psychometric properties of the 12-item WHODAS applied through phone survey: an experience in PERSIAN Traffic Cohort
    Nasrin Shahedifar, Homayoun Sadeghi-Bazargani, Mohammad Asghari-Jafarabadi, Mostafa Farahbakhsh, Shahrzad Bazargan-Hejazi
    Health and Quality of Life Outcomes.2022;[Epub]     CrossRef
  • Measuring health and disability of Ukrainian cadets – translation and cross-cultural adaptation of the WHODAS 2.0
    Kateryna Tymruk-Skoropad, Ostap Muzyka, Iuliia Pavlova
    Physiotherapy Quarterly.2022; 31(4): 49.     CrossRef
  • The 12 items Amharic version WHODAS-2 showed cultural adaptation and used to measure disability among road traffic trauma victims in Ethiopia
    Zewditu Abdissa Denu, Mensur Osman Yassin, Telake Azale Bisetegn, Gashaw Andargie Biks, Kassahun Alemu Gelaye
    BMC Psychology.2021;[Epub]     CrossRef
  • Disability, pain, and wound-specific concerns self-reported by adults at risk of limb loss: A cross-sectional study using the World Health Organization Disability Assessment Schedule 2.0
    Derek J. Roberts, Sudhir K. Nagpal, Alan J. Forster, Timothy Brandys, Christine Murphy, Alison Jennings, Shira A. Strauss, Evgeniya Vishnyakova, Julie Lawson, Daniel I. McIsaac, Kanhaiya Singh
    PLOS ONE.2021; 16(6): e0253288.     CrossRef
  • Patients-centered SurvivorShIp care plan after Cancer treatments based on Big Data and Artificial Intelligence technologies (PERSIST): a multicenter study protocol to evaluate efficacy of digital tools supporting cancer survivors
    Izidor Mlakar, Simon Lin, Ilona Aleksandraviča, Krista Arcimoviča, Jānis Eglītis, Mārcis Leja, Ángel Salgado Barreira, Jesús G. Gómez, Mercedes Salgado, Jesús G. Mata, Doroteja Batorek, Matej Horvat, Maja Molan, Maja Ravnik, Jean-François Kaux, Valérie Bl
    BMC Medical Informatics and Decision Making.2021;[Epub]     CrossRef
  • The World Health Organization Disability Assessment Schedule 2 (WHODAS 2.0): remarks on the need to revise the WHODAS
    Shamyr Castro, Camila Ferreira Leite, Michaela Coenen, Cassia Maria Buchalla
    Cadernos de Saúde Pública.2019;[Epub]     CrossRef
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  • 77 Download
  • 10 Web of Science
  • 9 Crossref

Case Report

A Comprehensive Rehabilitation Approach in a Patient With Serious Neuropsychiatric Systemic Lupus Erythematosus
Yong Jae Ko, Yang Gyun Lee, Ji Woong Park, Sung Ho Ahn, Jin Myoung Kwak, Yoon-Hee Choi
Ann Rehabil Med 2016;40(4):745-750.   Published online August 24, 2016
DOI: https://doi.org/10.5535/arm.2016.40.4.745

Neuropsychiatric systemic lupus erythematosus (NPSLE) involves the central and peripheral nervous system in patients with systemic lupus erythematosus (SLE). It is essential to specify the problems faced by patients with NPSLE because it causes diverse disabilities and impairs quality of life. After performing a comprehensive evaluation, tailored management should be provided for the patient's specific problems. We report here the case of a 30-year-old female with SLE who experienced serious neuropsychiatric symptoms cerebral infarction followed by posterior reversible encephalopathy syndrome and peripheral polyneuropathy. We systemically assessed the patient using the International Classification of Functioning, Disability and Health model as a clinical problem-solving tool and provided comprehensive rehabilitation by focusing on her problems.

Citations

Citations to this article as recorded by  
  • Recovery of Activities of Daily Living 1 Year after Rehabilitation in a Patient with NPSLE Associated with Multiple Organ Failure
    Naomi Kawai, Tameto Naoi, Toshie Sekine, Takanori Fukuda, Minoru Ojika, Mitsuya Morita
    The Japanese Journal of Rehabilitation Medicine.2025; 62(7): 735.     CrossRef
  • Comprehensive Rehabilitation Training Decreases Cognitive Impairment, Anxiety, and Depression in Poststroke Patients: A Randomized, Controlled Study
    Chunmei Cheng, Xin Liu, Wenjun Fan, Xue Bai, Zhaojun Liu
    Journal of Stroke and Cerebrovascular Diseases.2018; 27(10): 2613.     CrossRef
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  • 63 Download
  • 1 Web of Science
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Original Articles
Monitoring of Functioning Status in Subjects With Chronic Stroke in South Korea Using WHODAS II
Su-Yeon Kwon, Sang-Eun Hong, Ee-Jin Kim, Chang-Hwan Kim, Kyung-Lim Joa, Han-Young Jung
Ann Rehabil Med 2016;40(1):111-119.   Published online February 26, 2016
DOI: https://doi.org/10.5535/arm.2016.40.1.111
Objective

To follow up the long-term functioning in a community through assessing personal background and status based on the International Classification of Functioning, Disability and Health (ICF) after a stroke, by using a Korean version of World Health Organization Disability Assessment Scale II (K-WHODAS II).

Methods

We surveyed 146 patients diagnosed at the first-onset of acute stroke and discharged after Inha University Hospital, and 101 patients answered the K-WHODAS II survey. We analyzed the relationship of six functioning domains of K-WHODAS II with K-MMSE (Korean version of Mini-Mental State Examination) and K-MBI (Korean version of Modified Barthel Index) at admission and discharge, and personal background. All subjects were divided into five groups, according to the disease durations, to assess the functional changes and the differences of K-MMSE and K-MBI at the admission and discharge.

Results

K-MBI and K-MMSE at admission and discharge showed no significant differences in all five groups, respectively (p>0.05), reflecting no baseline disparity for long-term follow-up. All subjects showed positive gains of K-MBI and K-MMSE at discharge (p<0.05). The six functioning domains and total scores of K-WHODAS II had decreasing trends until 3 years after the stroke onset, but rose thereafter. Higher scores of K-MBI and K-MMSE, younger age, women, working status, higher educational level, and living with a partner were correlated with lower scores of K-WHODAS II (p<0.05).

Conclusion

The long-term functioning after stroke was affected not only by cognitive and motor status in hospital, but also by certain kinds of personal background. K-WHODAS II may be used to monitor functioning status in a community and to assess personal backgrounds in subjects with chronic stroke.

Citations

Citations to this article as recorded by  
  • Measuring functioning and disability in Korea: comparing general and dedicated surveys using the ICF as a reference framework
    Jiin Kim, Melissa Selb, Youngtae Cho, Wanho Kim, Carla Sabariego, Andrea Martinuzzi
    PLOS One.2025; 20(5): e0323616.     CrossRef
  • Patient- and proxy-perceptions on functioning after stroke rehabilitation using the 12-item WHODAS 2.0: a longitudinal cohort study
    Mia Kilkki, Minna Stolt, Sunna Rannikko, Miko Pasanen, Sinikka Tarvonen-Schröder
    Disability and Rehabilitation.2024; 46(4): 783.     CrossRef
  • Literature Review on the Application of International Classification of Functioning, Disability and Health for Children and Adolescents around the World and in Russian Federation
    Vyacheslav V. Yazev, Dina S. Rusinova, Alexey S. Bezymyanniy
    Pediatric pharmacology.2023; 20(4): 355.     CrossRef
  • Health-related quality of life using WHODAS 2.0 and associated factors 1 year after stroke in Korea: a multi-centre and cross-sectional study
    Hey Jean Lee, Jung-Kook Song, Jiyoung Moon, Keonyeop Kim, Hyeung-Keun Park, Gil-Won Kang, Jun-Ho Shin, Jongsoo Kang, Byoung-Gwon Kim, Young-Hoon Lee, Hye Seon Jeong, Lee Heeyoung, Won Kyung Lee, Seongheon Kim, Young-Kwon Park
    BMC Neurology.2022;[Epub]     CrossRef
  • The experience of continued smoking after stroke in Korean males: A qualitative study
    Jung Hee Youn, Sujin Shin
    Nursing Open.2021; 8(5): 2750.     CrossRef
  • Assessment of functioning using the WHODAS 2.0 among people with stroke in Taiwan: A 4-year follow-up study
    Hsiu-Ju Jen, Chia-Man Kao, Kwang-Hwa Chang, Chia-Feng Yen, Hua-Fang Liao, Wen-Chou Chi, Wen-Kuei Chung, Tsan-Hon Liou
    Annals of Physical and Rehabilitation Medicine.2021; 64(6): 101442.     CrossRef
  • Comparing Activity and Participation between Acquired Brain Injury and Spinal-Cord Injury in Community-Dwelling People with Severe Disability Using WHODAS 2.0
    Seo Yeon Yoon, Ja-Ho Leigh, Jieun Lee, Wan Ho Kim
    International Journal of Environmental Research and Public Health.2020; 17(9): 3031.     CrossRef
  • Effects of Sympathetic Conversation on Electroencephalogram, Stress, Anxiety-Depression, and Muscle Tone in Chronic Stroke Patients*
    Yu-Won Choe, Myoung-Kwon Kim
    Journal of The Korean Society of Physical Medicine.2018; 13(3): 99.     CrossRef
  • Relationship among Stress, Anxiety-depression, Muscle Tone, and Hand Strength in Patients with Chronic Stroke: Partial Correlation
    Myoung-Kwon Kim, Yu-Won Choe, Seong-Gil Kim, Eun-Hong Choi
    Journal of The Korean Society of Physical Medicine.2018; 13(4): 27.     CrossRef
  • Effect of a Caregiver's Education Program on Stroke Rehabilitation
    Sang-Eun Hong, Chang-Hwan Kim, Ee-jin Kim, Kyung-Lim Joa, Tae-Hyun Kim, Sang-Keun Kim, Hee-Jun Han, Eui-Chang Lee, Han-Young Jung
    Annals of Rehabilitation Medicine.2017; 41(1): 16.     CrossRef
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  • 66 Download
  • 7 Web of Science
  • 10 Crossref
Feasibility of Applying the Extended ICF Core Set for Stroke to Clinical Settings in Rehabilitation: A Preliminary Study
Kyu Yong Han, Hyo Jong Kim, Heui Je Bang
Ann Rehabil Med 2015;39(1):56-65.   Published online February 28, 2015
DOI: https://doi.org/10.5535/arm.2015.39.1.56
Objective

To evaluate the potential feasibility of application of the extended International Classification of Functioning, Disability and Health (ICF) Core Set for stroke.

Methods

We retrospectively reviewed the medical records of 40 stroke outpatients (>6 months after onset) admitted to the Department of Rehabilitation Medicine for comprehensive rehabilitation. Clinical information of the patients were respectively evaluated to link to the 166 second-level categories of the extended ICF Core Set for stroke.

Results

Clinical information could be linked to 111 different ICF categories, 58 categories of the body functions component, eight categories of the body structures component, 38 categories of the activities and participation component, and seven categories of the environmental factors component.

Conclusion

The body functions component might be feasible for application of the extended ICF Core Set for stroke to clinical settings. The activities and participation component and environmental factors component may not be directly applied to clinical settings without additional evaluation tools including interview and questionnaire.

Citations

Citations to this article as recorded by  
  • Effectiveness of a rehabilitation program involving functional proprioceptive stimulation for postural control and motor recovery among stroke patients: a double-blinded, randomized, controlled trial
    Agnieszka Wiśniowska-Szurlej, Justyna Leszczak, Justyna Brożonowicz, Gabriela Ciąpała, Héctor Hernández-Lázaro, Agnieszka Sozańska
    Journal of NeuroEngineering and Rehabilitation.2025;[Epub]     CrossRef
  • Content Analysis of Assessment Tools Used in Post-Stroke Rehabilitation: A Scoping Review with Linkage to the International Classification of Functioning
    Maria Heloiza Araujo Silva, Thaissa Hamana de Macedo Dantas, Ana Cecília de Medeiros Araújo, Diego de Sousa Dantas, Maria Isabelle de Araújo Dantas, Beatriz Cristina Medeiros de Lucena, Isabelly Cristina Rodrigues Regalado Moura, Aline Braga Galvão Silvei
    International Journal of Environmental Research and Public Health.2025; 22(8): 1277.     CrossRef
  • Development of a clinical tool for rating categories of the ICF Rehabilitation Set in Polish practice
    Agnieszka Wiśniowska-Szurlej, Agnieszka Ćwirlej-Sozańska, Anna Wilmowska-Pietruszyńska, Bernard Sozański
    Scientific Reports.2023;[Epub]     CrossRef
  • Goal-setting and personalization under the International Classification of Functioning, Disability, and Health framework: Community reintegration program for post-stroke patients
    Mabel Ngai-Kiu Wong, Horace Tong, Mike Kwun-Ting Cheung, Yuk-Mun Ng, Huan-Ling Yuan, Bess Yin-Hung Lam, Siu Ngor Fu, Chetwyn Che Hin Chan
    Frontiers in Rehabilitation Sciences.2023;[Epub]     CrossRef
  • Supervised teaching and feedback improve physiotherapists' reporting of the International Classification of Functioning, Disability and Health in physiotherapeutic electronic patient records: A proof‐of‐concept randomized controlled trial
    Liesbeth Lamsens, Lotte Janssens, Koenraad Peers, Kim Caluwé, Carlotte Kiekens, Johan Van Eldere, Kris Vanhaecht, Luk Bruyneel
    Journal of Evaluation in Clinical Practice.2020; 26(1): 357.     CrossRef
  • Effectiveness of physiotherapy interventions in brain plasticity, balance and functional ability in stroke survivors: A randomized controlled trial
    Umi Budi Rahayu, Samekto Wibowo, Ismail Setyopranoto, M. Hibatullah Romli
    NeuroRehabilitation.2020; 47(4): 463.     CrossRef
  • Application of the International Classification of Functioning, Disability and Health system to symptoms of the Duchenne and Becker muscular dystrophies
    Kristin M. Conway, Emma Ciafaloni, Dennis Matthews, Chris Westfield, Kathy James, Pangaja Paramsothy, Paul A. Romitti
    Disability and Rehabilitation.2018; 40(15): 1773.     CrossRef
  • Acute Phase Predictors of 6-Month Functional Outcome in Italian Stroke Patients Eligible for In-Hospital Rehabilitation
    Marco Franceschini, Stefania Fugazzaro, Maurizio Agosti, Carlotta Sola, Antonio Di Carlo, Lorenzo Cecconi, Salvatore Ferro
    American Journal of Physical Medicine & Rehabilitation.2018; 97(7): 467.     CrossRef
  • Responsiveness of the functioning and disability parts of the International Classification of Functioning, Disability, and Health core sets in postacute stroke patients
    Shoji Kinoshita, Masahiro Abo, Takatsugu Okamoto, Wataru Kakuda, Kohei Miyamura, Ikuo Kimura
    International Journal of Rehabilitation Research.2017; 40(3): 246.     CrossRef
  • Clinical Application of ICF Core Sets for Rehabilitation of Patients after Stroke
    Izumi Kondo, Naoki Ito, Masahiko Mukaino
    The Japanese Journal of Rehabilitation Medicine.2016; 53(9): 681.     CrossRef
  • Information on functioning found in the medical records of patients with stroke
    Haejung Lee, Sunghwa Seo, Jumin Song
    Journal of Physical Therapy Science.2016; 28(10): 2722.     CrossRef
  • 8,258 View
  • 58 Download
  • 10 Web of Science
  • 11 Crossref
Historically WHO has concentrated on infection control and mortality reduction. However, diagnosis alone does not explain what patients can do, what their prognosis will be. To answer these questions, significant challenges are presented in model the International Classification of Impairment, Disability and Handicap (ICIDH) announced in 1980. Following several revisions of ICIDH, WHO (2001) finally approved the International Classification of Functioning, Disability and Health (ICF), which is universal and clear terminology with qualifiable assessment measures. The ICF is a new form which (1) is not based on disability, rather on human function, (2) is interactive rather than linearly progressive, and (3) is not medical or social model, rather integration model. Also, the new language ICF is an landmark event for rehabilitation. Key to successful rehabilitation management is the understanding and proper assessment of the relationship between disease (ICD-10) and impaired body functions and structures and psychosocial and environmental factors(ICF). (J Korean Acad Rehab Med 2004; 28: 401-411)
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Evaluation of Sexual Function in Adults with Cerebral Palsy.
Cho, Sung Rae , Park, Eun Sook , Park, Chang Il , Kwak, Eun Hee , Kim, Mi Kyung
J Korean Acad Rehabil Med 2002;26(5):519-525.

Objective: To investigate current status of psychosexual function in adults with cerebral palsy (CP) by Derogatis Sexual Functioning Inventory (DSFI), which is a widely used multidimensional measure of sexual functioning.

Method: Forty-two adults with CP and 150 healthy controls participated in this study. All participants were interviewed with DSFI, which consisted of 10 domains such as sexual information, experience, drive, attitude, psychological symptoms, affect, gender role, fantasy, body image and satisfaction.

Results: Adults with CP showed significantly lower scores in sexual information, experience and satisfaction, and higher scores in psychological distress symptoms and conservative attitude, compared with controls (p<0.05). Especially, unmarried men with CP had a significant sexual dysfunction in most substantive domains of DSFI (p<0.05). However, there was no statistical difference in married men, unmarried women and married women, compared with normal controls. Sexual experience, drive, body image and satisfaction were significantly distressed in non-ambulatory CP, compared with functional ambulators (p<0.05). The score of sexual satisfaction had a significant relationship with those of sexual experience, attitude, psychological symptoms and body image in adults with CP (p<0.05).

Conclusion: Adults with CP showed a distress in psychosexual functioning, especially in unmarried men and non- ambulators. Therefore, active interventions of sexual counseling and education will be helpful for enhancing their sexual function. (Korean Acad Rehab Med 2002; 26: 519-525)

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Evaluation of Sexual Function with Derogatis Sexual Functioning Inventory (DSFI) in Spinal Cord Injured Men.
Park, Chang Il , Shin, Ji Cheol , Kim, Deog Young , Cho, Sung Rae , Kwak, Eun Hee
J Korean Acad Rehabil Med 2000;24(3):469-476.

Objective: To investigate the current state of the psychological aspects for the sexual function in spinal cord injured (SCI) men and to provide a basis of sexual rehabilitation program.

Method: Seventy-seven spinal cord injured men and 87 healthy adults participated and completed Derogatis Sexual Functioning Inventory (DSFI). This questionnaire consisted of 10 subtests such as sexual information, experience, drive, attitude, psychological symptoms, affect, gender role, sexual fantasy, body image, and sexual satisfaction.

Results: Compared with healthy adults, SCI men had lower sexual experience, drive and satisfaction with a statistical significance (p<0.05). They also had more psychological distress symptoms, negative affect, and negative body image (p<0.05). There was no significant differences between tetraplegia and paraplegia, complete and incomplete injury, nor inpatient and outpatient. However, the SCI men with independent mobility had significantly greater sexual satisfaction, compared with the SCI men with dependent mobility (p<0.05).

Conclusion: Most SCI men had psychologic sexual dysfuctions as well as organic problems, especially among the married men with dependent mobility. We suggest that more aggressive intervention of sexual rehabilitation need to be provided for this group.

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