ICF-based comparison of disease-specific instruments measuring physical functional ability for ankylosing spondylitis

Tanja Sigl ¹, Alarcos Cieza ², Désirée van der Heijde ³ and Gerold Stucki ^1*

¹ Department of Physical Medicine and Rehabilitation, University Hospital Munich, Germany
² ICF Research Branch, WHO FIC CC (DIMDI), IMBK, Germany
³ Department of Rheumatology, University Hospital Maastricht, Netherlands

^* To whom correspondence should be addressed. E-mail: gerold.stucki{at}med.uni-muenchen.de.

Accepted 14 April 2005

Abstract

Objectives: The objectives were to link validated and widely used instruments measuring physical functional ability in ankylosing spondylitis (AS) to the International Classification of Functioning, Disability and Health (ICF) and to compare their contents based on the results of the linking process.

Methods: The Bath Ankylosing Spondylitis Functional Index (BASFI), Dougados Functional Index (DFI), Health Assessment Questionnaire modified for the spondylarthropathies (HAQ-S) and the Revised Leeds Disability Questionnaire (RLDQ) were linked to the ICF separately by two trained health professionals according to ten linkage rules.

Results: All concepts contained in the items of the selected instruments could be successfully linked to the ICF except for "illness" included in the HAQ-S. Altogether 55 different ICF-categories have been linked. 7 categories belong to "body functions", 43 to "activities and participation" and 5 to "environmental factors". The component "body structure" is not contained in any of the four instruments. There are only 2 ICF-categories common to all selected questionnaires, whereas a high level of concordance concerning the concepts represented in them could be revealed. However, especially in terms of "activities and participation", the emphasized aspects differ.

Conclusions: The ICF provides an excellent common framework for the comparison of disease-specific instruments for AS. For a future revision of the ICF the specification of major limitations in patients with AS is suggested.

Keywords: BASFI, DFI, HAQ-S, ICF, RLDQ

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