The ICF Core Set for stroke from the perspective of physicians: a worldwide validation study using the Delphi technique

Eur J Phys Rehabil Med. 2010 Sep;46(3):377-88. Epub 2010 May 14.


Background: The ICF Core Set for stroke is an application of the International Classification of Functioning, Disability and Health (ICF) and represents the typical spectrum of problems in functioning of patients with stroke.

Aim: The aim of this study was to validate the ICF Core Set for stroke from the perspective of physicians.

Design: Observational.

Setting: Other.

Population: Physicians experienced in stroke treatment.

Methods: Physicians experienced in stroke treatment were asked about the patients' problems, patients' resources and aspects of environment that physicians take care of in a three-round electronic mail survey using the Delphi technique. The responses were linked to the ICF by two persons. The degree of agreement was calculated using Kappa statistic.

Results: Eighty-eight physicians in 30 countries named 2142 patients' problems that covered all ICF components. Two hundred seventy-seven ICF categories were linked to these. Kappa statistic for agreement reached 0.68 with a 95% confidence interval of 0.66-0.69. Although 28 ICF categories were not represented in the ICF Core Set for stroke, only four of them were considered as important by at least 75% of the participants. Those categories addressed sensations associated with cardiovascular and respiratory functions, urinary excretory functions, involuntary movement functions and sensations related to muscle and movement functions.

Conclusion: The validity of the ICF components Body structures, Activities and Participation, and Environ-mental Factors was fully supported. Only some body functions were identified that were not covered and need to be investigated further.

Publication types

  • Validation Study

MeSH terms

  • Activities of Daily Living*
  • Delphi Technique
  • Disability Evaluation*
  • Humans
  • International Classification of Diseases
  • Observation
  • Physicians
  • Reproducibility of Results
  • Severity of Illness Index
  • Stroke / classification*
  • Stroke / physiopathology
  • Stroke Rehabilitation