Applications of ICF-Based Assessments and Interventions in Post-Stroke Rehabilitation: A Narrative Review.
Mabel N K Wong, Chetwyn Che Hin Chan
ICF-based stroke assessments cover 84.8% of UK guideline topics, but interventions cover only 45.5%.
Both skew toward body function and activity. Participation and environmental factors are barely addressed in either.
Key findings
1ICF-based assessments in post-stroke rehabilitation map to 84.8% of UK Guideline topics, with the highest frequency in the Body Functions component (40.7%) and the Activity component (27.1%), while Participation (6.6%) and Contextual Factors (5.9%) are substantially underrepresented.
2ICF-based interventions map to only 45.5% of UK Guideline topics, compared with 84.8% for assessments, indicating a gap between what is measured and what is treated.
3Of 247 interventions identified, only 128 (51.8%) had their content structured using ICF components and codes; the remaining 119 used ICF only to label outcomes.
Still to come
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
This is a narrative review, not a systematic one. The authors did not register the review, did not perform a risk-of-bias assessment, and did not independently apply ICF linking rules. They relied on the ICF mappings reported by the original study authors, which may be inconsistent. The search was restricted to English and Chinese publications, and to PubMed, CINAHL, and Google Scholar. Studies in other languages or indexed elsewhere were missed. The review covers outpatient and community rehabilitation only. Acute inpatient practice, where much early stroke rehabilitation happens, is not represented. The authors state that findings cannot support causal conclusions and that a systematic review with PRISMA reporting is needed before practice-change recommendations can be made. Frequency counts reflect what is reported in the literature, not what is actually done in clinics. A topic with many published assessments may still be under-assessed in routine practice.
Declared interests
Partially supported by the Peter T. C. Lee Endowed Professorship fund held by CCH Chan (Grant no. S2006). The authors declared no potential conflicts of interest.
The easy way to misread this
Do not read the 84.8% assessment coverage as evidence that ICF is well-implemented in stroke clinics. This is a mapping of what published studies report, not an audit of what happens in practice. The authors note that clinicians report difficulty applying ICF in routine care because of ambiguous definitions, lengthy administration time, and insufficient training.
Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →