Journal of Neurology

, 257:103 | Cite as

Characterization of functioning in multiple sclerosis using the ICF

  • Lisa Holper
  • Michaela Coenen
  • Andrea Weise
  • Gerold Stucki
  • Alarcos Cieza
  • Jürg Kesselring
Original Communication


The objective of this study was to explore whether it is possible to describe based on the International Classification of Functioning, Disability and Health (ICF) relevant aspects of functioning and disability affected in multiple sclerosis (MS) as well as environmental factors relevant to persons with MS. The specific aim was to identify most relevant ‘Body functions’, ‘Body structures’, ‘Activities and participation’, as well as ‘Environmental factors’ in patients with MS using the ICF. Additionally, different MS forms were compared with respect to the identified problems. A multi-centre study was conducted in an empirical cross-sectional design. Data from 205 individuals with MS were collected in rehabilitation centres: disease related data, socio-demographic data, single interviews based on the Extended ICF Checklist and a patient questionnaire including ratings on general health and functioning status, Beck Depression Inventory II (BDI-II) and Comorbidity Questionnaire (SCQ). The 129 ICF categories identified represent a comprehensive classification of functioning in MS from the clinical perspective. Differences between MS forms were observed for several ICF categories, EDSS, general health and functioning status, but not for BDI and SCQ. The study showed that it is possible to describe based on the ICF the spectrum in functioning and disability affected in MS as well as environmental factors relevant to persons with MS.


Multiple sclerosis Rehabilitation Relapsing Remitting Progressive Empirical study Clinical perspective International Classification of Functioning, Disability and Health (ICF) 



The project was supported by the Hertie Foundation (“Gemeinnützige Hertie-Stiftung”) as a cooperative project between the Classification, Terminology and Standards (CTS) Team of WHO, Department of Neurorehabilitation, Valens Rehabilitation Centre, Valens (Switzerland), the Institute for Health and Rehabilitation Sciences, ICF Research Branch of WHO at the Ludwig-Maximilian University Munich (Germany), the Multiple Sclerosis International Federation (MSIF), and the International Society of Physical Medicine and Rehabilitation (ISPMR). For the conduction of the statistical analysis the authors thank Cornelia Oberhauser, Institute for Health and Rehabilitation Sciences (IHRS), ICF Research Branch of WHO at the Ludwig-Maximilian University, Munich (Germany). The authors further thank all participating clinics and rehabilitation centers involved in data collection, the University Hospital Zurich (Switzerland), the Swiss Multiple Sclerosis Society, Zurich (Switzerland) and the Neurological Rehabilitation Center Quellenhof, Bad Wildbad (Germany).

Conflict of interest statement



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Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • Lisa Holper
    • 1
  • Michaela Coenen
    • 2
  • Andrea Weise
    • 1
  • Gerold Stucki
    • 3
    • 4
    • 5
  • Alarcos Cieza
    • 2
    • 5
  • Jürg Kesselring
    • 1
  1. 1.Department of Neurology and NeurorehabilitationRehabilitation Centre ValensValensSwitzerland
  2. 2.Institute for Health and Rehabilitation Sciences (IHRS), ICF Research Branch, WHO FIC Collaborating Center (DIMDI)Ludwig-Maximilian UniversityMunichGermany
  3. 3.ICF Research Branch of WHO FIC CC (DIMDI) at SPF Nottwil, Switzerland and at IHRSLudwig Maximilian UniversityMunichGermany
  4. 4.Seminar of Health Sciences and Health PolicyUniversity of LucerneLucerneSwitzerland
  5. 5.Swiss Paraplegic ResearchNottwilSwitzerland

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