Issue №5-99, 2020

Original article

https://doi.org/10.38025/2078-1962-2020-99-5-38-45

Application of the International Classification of Functioning, Disability and Health (Children and Youth Version) in the Evaluation of Rehabilitation Measures of Patients with Cerebral Palsy

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1 ORCIDSheiko G.E., 1 ORCIDBelova A.N., 1 ORCIDKuznetsov A.N., 1 ORCIDIsraelyan Y.A., 1 ORCIDDmitrochenkov A.V., 1 Gorshunov E.D.

1 Privolzhsky Research Medical University, Nizhny Novgorod, Russian Federation


ABSTRACT

Rehabilitation of children with cerebral palsy (CP) requires a systematic approach and dynamic evaluation of results. The International Classification of Functioning, Disability and Health for Children and Youth (ICF-CY) is used to describe and measure the extent of health disorders in children with CP. this classification allows to unify the description of the individual functioning child's profile child taking into account environmental and personal factors, to estimate changes of health disorders in the course of rehabilitation. However, at the moment there are no clear quantitative criteria that allow using ICF-CY to determine the effectiveness of medical rehabilitation of patients with CP, which is relevant in clinical practice and research.

Aim. To develop a criterion for evaluating the effectiveness of medical rehabilitation of children with CP based on the use of ICF-CY.

Material and methods. The study included 29 patients (mean age 5.4±1.05) with various forms of CP that received medical rehabilitation courses in the hospital and polyclinic for 12 months. All patients, in addition to general physical and clinical neurological examination, were tested before and after rehabilitation courses using specialized questionnaires and scales, as well as evaluated using a brief core set of ICF-CY for children/youth with CP. Groups of patients with and without improvement in the first stage of the study were identified using expert evaluation. The sensitivity and specificity of the proposed criterion for assessing the effectiveness of rehabilitation are calculated at the second stage. The degree of consistency of experts‘ opinions and the developed evaluation criterion is analyzed.

Results. The rehabilitation effect was determined on the basis of the domain assessment dynamics as of the components of the ICFCY “functions”, “activities and participation” 12 months after the beginning of rehabilitation. The criterion of improvement is the positive dynamics of the child’s condition in at least 3 domains with a change in the assessment, at least 1 point. Improvement was achieved in 18 patients with CP 12 months after rehabilitation, according to the expert method. Improvement was observed in 16 patients with CP according to our criterion for evaluating the effectiveness of medical rehabilitation. The sensitivity of our criterion for assessing the effectiveness of medical rehabilitation of patients with cerebral palsy was 89%, the specificity of 91%, which allows us to recommend the use of this criterion to assess the improvement of the effectiveness of medical rehabilitation of children with CP.



KEYWORDS: international classification of functioning, icf, cerebral palsy, medical rehabilitation, effectiveness, evaluation

For citation: Sheiko G.E., Belova A.N., Kuznetsov A.N., Israelyan Y.A., Dmitrochenkov A.V., Gorshunov E.D. Application of the International Classification of Functioning, Disability and Health (Children and Youth Version) in the Evaluation of Rehabilitation Measures of Patients with Cerebral Palsy. Bulletin of Rehabilitation Medicine. 2020; 5 (99): 38-45. https://doi.org/10.38025/2078-1962-2020-99-5-38-45



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This is an open article under the CC BY 4.0 license. Published by the National Medical Research Center for Rehabilitation and Balneology.