The International Classification of Functioning, Disability and Health (ICF) is a framework for describing and organizing information on functioning and disability. The ICF is a useful tool in the field of pediatric physical therapy, where we are increasingly moving toward treating the whole child.
This post will be focusing on body structures and body function. This portion of the ICF describes what is happening at the structural level of a person’s body. Often when reviewing a chart one sees that hearing and vision have been screened and passed. This is and example of functioning. Although the ICF is designed to be as neutral as possible, physical therapists and medical teams must also discuss impairments which often relate to disability. Impairment is the description of body structures that are diminished, weakened or damaged. Management often involves a full medical team. For instance, a team consisting of an orthopedist, a physiatrist and a physical therapist (and parents) will all coordinate different aspects of care for a child with with hip subluxation.
Here is a list of body structures and body functions that are often discussed within the ICF framework. especially as they relate to children and youth:
- Low birth weight and failure to thrive
- Musculoskeletal system
- Special senses and speech (visual, auditory, vestibular)
- Respiratory system
- Cardiovascular system
- Digestive system/gastrointestinal
- Genitourinary disorders
- Hematological disorders
- Skin disorders/ integumentary
- Endocrine disorders/metabolic
- Congenital disorders that affect multiple body systems
- Immune system disorders
- Cancer (malignant neoplastic diseases)
Note that balance and physical endurance are contained within in this domain, as they are considered body functions.
Impairments can be divided into primary and secondary:
- Primary impairments are motor behaviors that are directly related to changes in any system. Examples: muscle tone, postural stability, motor coordination. (2). Primary impairments are any impairments that are present at birth such as heart defects, endocrine diagnoses, visual impairments.
- Secondary impairments develop over time and frequently as a result of the primary impairments. Examples: Decreased range of motion, force production and endurance (2)
Wondering about tests and measures that fit into the body structures and body functions section of the ICF?
- Blood pressure
- Heart rate
- Oxygen saturation
- Range of motion
- Structural integrity tests
- Adam forward bend test
- Manual muscle testing
- 30-Second Walk Test (30sWT),
- 6-minute walk test (6mWT),
- Pediatric Balance Scale (PBS)
- Sensory Profile
- Hypertonia Assessment Test (HAT)
- Segmental Assessment of Trunk Control (SATCo)
- Social Security Administrations listing of Childhood Impairments (Part B)
- Components of Typical and Atypical Motor Development, Lois Bly
- Description of Primary and Secondary Impairments in Young Children With Cerebral Palsy. Lynn Jeffries, PT, DPT, PhD, PCS