Demonstration of the use of the ICF framework in detailing complex functional deficits after major burn T.L. Grisbrook a , S.M. Stearne a , S.L. Reid a , F.M. Wood b,c,d, *, S.M. Rea c,d , C.M. Elliott e a School of Sport Science, Exercise and Health, The University of Western Australia, Australia b The McComb Research Foundation, Australia c Burn Service of Western Australia, Royal Perth Hospital, Australia d BIRU School of Surgery, The University of Western Australia, Australia e School of Paediatrics and Child Health, The University of Western Australia, Australia 1. Introduction Burns are one of the most devastating conditions encountered in medicine and can result in long term impairments, activity limitations and participation restrictions in a patient’s life. The World Health Organisation (WHO) has developed a classification; the International Classification of Functioning, Disability and Health (ICF); with the aim of unifying the classification of functioning and disability [1]. The ICF conceptualises an individual’s health as a complex relation- ship between health status, the impact this has on body functions, body structures and activity, and how environmen- tal and personal factors can influence the level of participation in everyday settings [1] (Fig. 1). Body function and structures refers to the physiological functioning of all body systems, where problems such as deviations or loss are referred to as impairments. The activity and participation level refers to ones ability to execute tasks or activities and ones involve- ment in life situations (participation). Information can be collected about each dimension of disability for an individual; yet it is only when information on all three dimensions (impairment, activity limitations and participation restric- tions) are collected that we gain a complete understanding of disability for a particular person. As a person’s functioning and disabilities occur within specific contexts, the ICF includes contextual factors, which takes into consideration the impact of one’s personal and environmental background. Where, personal factors refer to ones attributes such as gender, marital status, nationality and environmental factors refer to b u r n s 3 8 ( 2 0 1 2 ) 3 2 – 4 3 a r t i c l e i n f o Article history: Accepted 1 April 2011 Keywords: Functional limitation ICF Outcome assessment a b s t r a c t Burns can result in long term impairments, activity limitations and participation restric- tions in a patients’ life. The focus of current surgeries and therapy is to improve body functions and structures. However, often this does not translate to an improvement in activity and participation for the patient. Improvement in activity and participation is the ultimate goal of all therapy to enhance patient’s quality of life. The incorporation of assessment measures at all levels of the International Classification of Functioning, Dis- ability and Health (ICF) can assist in a holistic, patient centred approach to identify the complex impairments that impact on activity and participation, with a view to appropriately targeting future therapeutic interventions. This paper presents an example case of how implementing measures at all levels of the ICF can improve our understanding of a patient’s body functions and structures, activity and participation. A number of the outcome mea- sures utilised in this study are novel in the burns population, such that video footage supplements the methodology where relevant. # 2011 Elsevier Ltd and ISBI. All rights reserved. * Corresponding author: Postal PO Box 4101, Wembley, WA 6913, Australia. Tel.: +61 08 9202 1145; fax: +61 08 9202 1145. E-mail address: fiona.wood@uwa.edu.au (F.M. Wood). available at w ww.s c ienc ed irec t.c o m journal homepage: www.elsevier.com/locate/burns 0305-4179/$36.00 # 2011 Elsevier Ltd and ISBI. All rights reserved. doi:10.1016/j.burns.2011.04.001