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 Table of Contents  
Year : 2019  |  Volume : 2  |  Issue : 1  |  Page : 19-21

ClinFIT: ISPRM's Universal Functioning Information Tool based on the WHO's ICF

1 President of ISPRM, University of Puerto Rico School of Medicine, San Juan, Puerto Rico, USA
2 Vice-President of ISPRM, ISPRM ClinFIT Task Force, University of Campania “Luigi Vanvitelli”, Napoli, Italy
3 ISPRM Council of Past Presidents, ISPRM ClinFIT Task Force, Philadelphia, USA
4 ISPRM Council of Past Presidents, ISPRM ClinFIT Task Force, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
5 President-Elect of ISPRM, ISPRM ClinFIT Task Force, University of Hong Kong, Hong Kong, SAR, China
6 Past-President of ISPRM and ISPRM Council of Past Presidents, Centro de Medicina de Reabilitação da Região Centro, Tocha, Portugal
7 ISPRM Council of Past Presidents, ISPRM ClinFIT Task Force, University of Lucerne, Switzerland, Swiss Paraplegic Research, Nottwil, Switzerland, ICF Research Branch, Nottwil, Switzerland

Date of Web Publication22-May-2019

Correspondence Address:
Prof. Gerold Stucki
Swiss Paraplegic Research, Nottwil
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jisprm.jisprm_36_19

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How to cite this article:
Frontera W, Gimigliano F, Melvin J, Li J, Li L, Lains J, Stucki G. ClinFIT: ISPRM's Universal Functioning Information Tool based on the WHO's ICF. J Int Soc Phys Rehabil Med 2019;2:19-21

How to cite this URL:
Frontera W, Gimigliano F, Melvin J, Li J, Li L, Lains J, Stucki G. ClinFIT: ISPRM's Universal Functioning Information Tool based on the WHO's ICF. J Int Soc Phys Rehabil Med [serial online] 2019 [cited 2023 Mar 31];2:19-21. Available from: https://www.jisprm.org/text.asp?2019/2/1/19/257845

Rehabilitation is the health strategy that aims to optimize functioning of persons with a health condition experiencing or likely to experience disability.[1],[2] Accordingly, physical and rehabilitation medicine (PRM) can be defined as the “medicine of functioning.”[3] The assessment of functioning that involves taking a patient's history, conducting a clinical examination, and interpreting clinical tests, imaging, and laboratory investigations, is therefore essential for both rehabilitation and the medical specialty of PRM.

Currently, rehabilitation and PRM can rely on a wide range of data collection tools suitable for the clinical assessment and reporting of patients' functioning. However, and to the best of our knowledge, none of those tools were systematically developed in an inclusive and transparent process governed by an international society such as the International Society of Physical and Rehabilitation Medicine (ISPRM). Furthermore, no currently existing tool can be tailored for use along the continuum of care from the acute situation to the community and across the life span from children and adolescent to the adult and the elderly. Finally, no tool exists that can be tailored to the different needs of low-, middle-, and high-income countries.

What therefore is missing is a universal and simple-to-use data collection tool that can be tailored to the needs of clinicians all over the world and who serve patients across a range of settings and of all ages. Ideally, the development of a universal tool for the assessment of functioning should be based on a universal classification of functioning that can serve as a reference system. With the International Classification of Functioning, Disability and Health (ICF), a classification endorsed by the World Health Organization (WHO) in 2001, we now have such a reference system we can rely on.[4] The ICF allows for the reporting of functioning, WHO's third health indicator.[5] It complements the International Classification of Diseases (ICD) that allows for the reporting of the two health indicators, mortality and morbidity.[5] The WHO's recognition of the need for a third health indicator and the launching of the ICF represent a paradigm shift in health care.[6] The ICF and its implementation in health systems is fundamental for the strengthening of rehabilitation worldwide,[7] as highlighted by the WHO's “Rehabilitation 2030: A Call for Action.”[2],[8]

Since the launch of the ICF in 2001, the PRM community has spearheaded efforts to implement the ICF in rehabilitation and PRM.[9],[10] The ICF makes it possible to capture functioning across the continuum of care and over the life span.[9],[10] Furthermore, ICF-based clinical tools have been successfully applied in middle- and high-income countries both in rehabilitation and health care at large.[11] An overview of the most recent efforts worldwide has been published in JISPRM, the new electronic journal of ISPRM (http://www.jisprm.org).[11] In light of these efforts, ISPRM's leadership sees a unique opportunity to embark upon an initiative to develop, implement, and maintain an ICF-based clinical tool for the assessment of functioning referred to as ClinFIT.

With this editorial, ISPRM is establishing its copyright for the name “Clinical Functioning Information Tool” and its respective acronym “ClinFIT.” The combination of “clinical functioning information” and “tool” aims to capture what the tool is all about – “Clin” for “clinical” emphasizes the setting of its application, “F” for “functioning” refers to its content, “I” for “information” refers to the relevant building block of the health system, and “T” for “tool,” refers to its purpose. Both “Clinical Functioning Information Tool” and the acronym “ClinFIT” are new terms conceived by ISPRM at its President's retreat from 12 to 13 July 2018 following ISPRM's annual congress held in Paris in July 2018. The present article is the first-ever publication of these terms. ISPRM's copyright of “Clinical Functioning Information Tool” and “ClinFIT” aims to ensure the long-term free use of ClinFIT in clinical practice, clinical quality management, and research. It also ensures the continuous contribution of clinical scientists worldwide to its development, implementation, and maintenance.

In light of the demonstrated potential of developing a clinical tool based on the ICF,[11] the expectation is that ClinFIT can be tailored to the needs of (1) rehabilitation service types along the continuum of care, (2) different patient populations across age groups and health conditions, and (3) low-, middle-, and high-income countries. It is expected to be scientifically sound and to importantly contribute to optimal rehabilitation care in clinical practice, clinical quality management, and research. Toward these goals, ClinFIT can make full use of the ICF as a reference system. This enables data interoperability and hence comparison of data across various applications.[12]

The continuous development, implementation, and maintenance of ClinFIT requires a long-term effort in terms of governance, science, and resources that seems best sustained by ISPRM, an international society who serves as umbrella organization of rehabilitation physicians worldwide.[13] This entails an ethical obligation toward a variety of stakeholders, including patients, clinicians, scientists, governmental agencies and nongovernmental organizations, rehabilitation service providers, companies developing rehabilitation products, and funders.

To ensure a sound governance process, ISPRM's leadership has established a task force referred to as “ClinFIT Task Force.” [Table 1] provides an overview of its organization and responsibilities. The mandate of ISPRM's ClinFIT Task Force is to guide the initial and continuous development and implementation of ClinFIT in clinical practice, clinical quality management, and research. To ensure universal usefulness, the Task Force is committed to involve clinician scientists across low-, middle-, and high-income countries and rehabilitation service types.
Table 1: ISPRM's clinical functioning information task force: Organization and responsibilities

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The ClinFIT initiative builds on a range of projects that have been conducted over the past few years and are summarized in the aforementioned paper published in JISPRM.[11] ISPRM recognizes and acknowledges the exemplary contributions made by the scientists and clinicians engaged in these projects. ISPRM also recognizes the need for a joint effort by ISPRM's membership, including national societies and individual members. ISPRM is also looking forward to cooperating with other societies with which it shares a joint work plan under a mutual recognition agreement[13] and with international societies across the rehabilitation professions.

ISPRM member societies and individual members are encouraged to join ISPRM's ClinFIT Task Force. To get acquainted with ClinFIT, prospective project leaders are referred to an introductory paper on ClinFIT.

To foster the development of a scientific community around ClinFIT, ISPRM recommends publishing related articles in journals that are part of ISPRM's web of journals. Articles of universal interest are preferably submitted to JISPRM, while articles of regional or national interest are best published in the web's regional or national PRM journals. To ensure accessibility to the anticipated growth of scientific literature on ClinFIT, ISPRM's ClinFIT Task Force aims to publish regular updates with appropriate referencing of all relevant contributions. Furthermore, the ClinFIT Task Force is planning dedicated workshops and sessions during ISPRM's annual congresses.

ClinFIT provides the international PRM and rehabilitation community with a unique opportunity to jointly develop, implement, and maintain a universal tool for worldwide use.

Financial support and sponsorship


Conflicts of interest

There are no conflicts of interest.

  References Top

Meyer T, Gutenbrunner C, Bickenbach J, Cieza A, Melvin J, Stucki G, et al. Towards a conceptual description of rehabilitation as a health strategy. J Rehabil Med 2011;43:765-9.  Back to cited text no. 1
World Health Organization. Rehabilitation: key for Health in the 21st Century. Rehabilitation 2030: a Call for Action. World Health Organization; 2017. Available from: http://www.who.int/disabilities/care/rehab-2030/en/. [Last accessed on 2019 Mar 18].  Back to cited text no. 2
Gutenbrunner C, Meyer T, Melvin J, Stucki G. Towards a conceptual description of physical and rehabilitation medicine. J Rehabil Med 2011;43:760-4.  Back to cited text no. 3
World Health Organization. International Classification of Functioning, Disability and Health. Geneva: WHO Press; 2001.  Back to cited text no. 4
Stucki G, Bickenbach J. Functioning: The third health indicator in the health system and the key indicator for rehabilitation. Eur J Phys Rehabil Med 2017;53:134-8.  Back to cited text no. 5
Stucki G. Olle Höök Lectureship 2015: The World Health Organization's paradigm shift and implementation of the international classification of functioning, disability and health in rehabilitation. J Rehabil Med 2016;48:486-93.  Back to cited text no. 6
Stucki G, Bickenbach J, Melvin J. Strengthening rehabilitation in health systems worldwide by integrating information on functioning in national health information systems. Am J Phys Med Rehabil 2017;96:677-81.  Back to cited text no. 7
Stucki G, Bickenbach J, Gutenbrunner C, Melvin J. Rehabilitation: The health strategy of the 21st century. J Rehabil Med 2018;50:309-16.  Back to cited text no. 8
Stucki G, Bickenbach J, Selb M, Melvin J. The international classification of functioning, disability and health. In: Frontera W, editor. DeLisa's Physical Medicine and Rehabilitation, Principles and Practice. 6th ed. Philadelphia: Wolters Kluwer; 2018.  Back to cited text no. 9
Stucki G, Prodinger B, Bickenbach J. Four steps to follow when documenting functioning with the international classification of functioning, disability and health. Eur J Phys Rehabil Med 2017;53:144-9.  Back to cited text no. 10
Gimigliano F, Selb M, Mukaino M, Baffone C, Bickenbach J, Engkasan JP, et al. Strengthening rehabilitation in health systems worldwide by implementing information on functioning in rehabilitation practice, quality management and policy. JISPRM. [Epub ahead of print].  Back to cited text no. 11
Prodinger B, Tennant A, Stucki G. Standardized reporting of functioning information on ICF-based common metrics. Eur J Phys Rehabil Med 2018;54:110-7.  Back to cited text no. 12
DeLisa JA, Melvin JL, Stucki G. Developing the international society of physical and rehabilitation medicine (ISPRM). Foreword. J Rehabil Med 2009;41:789-90.  Back to cited text no. 13


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