Identification of limitations in functioning in patients with Multiple Sclerosis using the International Classification of Functioning, Disability and Health

Objective: To identify limitations in areas of functioning (body functions and structures activities and areas of participation) and relevant environmental factors in patients with Multiple Sclerosis (MS) using the International Classification of Functioning, Disability and Health (ICF).

Methods: A multi-centre cross-sectional study was performed at at the Valens Rehabilitation Centre (Switzerland) and at additional collaborating centres in Switzerland and Germany. A physician experienced in MS collected ICF-based data of 205 patients with MS based on the medical records and an interview performed with the patients. In addition, the patients filled in a Case Record Form containing the following questionnaires: EuroQol (EQ 5-D), WHOQol (selection of 5 questions to assess the subjective appraisal of health and well-being), Beck Depression Inventory II (BDI-II), Comorbidity Questionnaire (SCQ).

Results: The ICF categories in which the patients presented problems most frequently were related to 'structure of brain', 'spinal cord and related structures', 'structure of urinary system', 'muscle power functions', 'gait pattern functions', 'walking', 'doing housework' and 'recreation and leisure'. In addition, the environmental factors reported as relevant were mostly related to 'immediate family: support and relationship' and 'attitudes of immediate family'.

Conclusions: It is possible to describe the limitations in functioning and relevant environmental factors in patients with MS based on the ICF. The ICF categories potentially facilitate the description and classification of all aspects of functioning and health in persons with MS in a comprehensive and systematic way.