Identification of International Classification of Functioning, Disability and Health categories in a multifaceted rehabilitation program for degenerative cerebellar ataxia: a descriptive analysis of real-world clinical practice

Abstract

Purpose: To identify the International Classification of Functioning, Disability and Health (ICF) categories addressed by multifaceted rehabilitation interventions for patients with degenerative cerebellar ataxia (DCA).

Materials and methods: We retrospectively analyzed a short-term, intensive inpatient rehabilitation program in 55 patients with DCA, including spinocerebellar ataxia types 3, 6, 17, 31, and others. Rehabilitation interventions by physical, occupational, and speech therapists targeting functioning, contextual factors, and self-directed exercises were collected through a retrospective questionnaire completed by the treating therapists, with reference to medical records. Interventions were linked to the ICF and Deutsche Gesellschaft für Sozialmedizin und Prävention categories. Categories were analyzed based on the severity of ataxia using the Scale for the Assessment and Rating of Ataxia.

Results: Overall, 1,258 interventions were linked to 1,341 s-level ICF categories: 13 body functions, 23 activities and participation, 6 environmental, and 1 personal factor. Activities and participation categories related to mobility and self-care were identified in severe cases, whereas no body function categories related to ataxia severity were identified.

Conclusions: Multifaceted rehabilitation for DCA corresponds to multiple ICF domains. Interventions targeting activity and participation vary with ataxia severity, suggesting that tailored combinations may improve specific activities of daily living.

Keywords: Degenerative cerebellar ataxia; ICF coding; ICF linking; descriptive analysis; multifaceted rehabilitation interventions.