To illustrate the use of the International Classification of Functioning, Disability and Health in rehabilitation practice Swiss Paraplegic Research initiated the project ‘Case studies describing persons with spinal cord injury and their health care based on the ICF and the Rehab-Cycle®’. The outcome of the project is presented on this website.

ICF and ICF Core Sets

In 2001, the International Classification of Functioning, Disability and Health (ICF) was approved by the World Health Assembly. Since then, all member states have been asked to implement the ICF as a statistical, research, social policy, clinical and educational tool. To learn more about the ICF see “Introduction to the ICF”.

To facilitate the use of the ICF in clinical practice, it is essential to have ICF-based tools that could be integrated into the existing processes. The first step toward providing ICF-based tools for clinical practice was the development of ICF Core Sets. ICF Core Sets are shortlists of ICF categories that are considered to be most relevant for describing persons with a specific health condition or in a particular setting. In a rehabilitation setting an ICF Core Set can help guide the rehabilitation management process. ICF Core Sets have been developed for several health conditions e.g. for spinal cord injury, health condition groups e.g. for neurological conditions and for various settings e.g. acute care, post-acute care and long-term care. ICF Core Sets can serve as a basis when using the ICF-based documentation tools that follow the Rehab-Cycle®. To learn more about ICF Core Sets see “Introduction to ICF Core Sets”.

Rehab-Cycle® and ICF-based Documentation Tools

The Rehab-Cycle® is one approach that reflects the structured processes inherent in multidisciplinary rehabilitation management. The Rehab-Cycle® consists of an assessment phase, an assignment phase, intervention phase and evaluation phase. An ICF-based documentation tool has been develop to guide each of the Rehab-Cycle® phases: the ICF Assessment Sheet, the ICF Categorical Profile, ICF Intervention Table and ICF Evaluation Display. These tools can help a multidisciplinary rehabilitation team to better understand the role of functioning within the rehabilitation process and to more comprehensively describe a patient's functioning - hence support ICF-based rehabilitation management. To learn more about the Rehab-Cycle® and ICF-based documentation tools see “Introduction to ICF-based Documentation Tools and Rehab-Cycle®”.

Spinal Cord Injury (SCI)

One chronic health condition in which patients experience a variety of functional problems is spinal cord injury (SCI). People of all ages and all health status, from extraordinary fitness to severe illness, can be struck by SCI. Persons living with SCI have limitations in many areas of functioning depending on the level and severity of the health condition and, most importantly, the impact of environmental and personal factors. Thus, having a broad understanding of functioning in SCI is essential for comprehensive and multidisciplinary rehabilitation. To facilitate a broad understanding of functioning of rehabilitation patients with SCI ICF Core Sets for SCI in post-acute and long-term settings were developed in 2007. Go to to download the ICF Core Sets for SCI.

ICF-based Case Studies

To illustrate the use of the the Rehab-Cycle® and ICF-based documentation tools in a chronic condition like SCI, Swiss Paraplegic Research (SPF) together with Swiss Paraplegic Centre (SPZ), one of Europe's leading (acute and rehabilitation) centres for paraplegia, SCI and spinal cord diseases, conducted a series of case studies. Conducting ICF-based case studies was one approach to address SPF's aim to contribute to optimal functioning, social integration, health and quality of life of persons with SCI through clinical and community-oriented research. The ICF-based case studies project began in October 2006.

In this project, persons of different age groups and gender and who are living with SCI of varying etiology and levels of severity, were accompanied during their rehabilitation at SPZ. The rehabilitation process was then described using the Rehab-Cycle® and the corresponding ICF-based documentation tools.

Aims of the case studies:

  • To Illustrate the use of ICF-based documentation tools in structured rehabilitation management based on the Rehab-Cycle®
  • To provide insight into the perspective of persons living with SCI
  • To demonstrate problems and personal resources of persons with SCI
  • To improve the reader's knowledge about using the ICF, Rehab-Cycle® and corresponding ICF-based documentation tools in rehabilitation management

Since persons with SCI are faced with a number of physical, psychological and social challenges, the case studies aimed to cover a broad spectrum of these challenges. All the cases studies are published on this website.

Architecture of the Case Studies

Each case study highlights a specific theme of SCI rehabilitation. The case studies are unique in that each case study not only presents the clinical perspective of rehabilitation management but also emphasizes the individual's experience of functioning following SCI. Information from the person with SCI and the health professionals in the person's rehabilitation team is gathered through interviews in the beginning and at the end of each observation period. In each case study, the rehabilitation management process is illustrated in the context of the Rehab-Cycle® and using the ICF-based documentation tools.

Each case study begins with a general introduction of the highlighted theme. It then provides a general introduction of the person's story, including information about the onset of SCI and proceeds with the description of the person's rehabilitation management process. Also provided are boxes with more detailed information about certain topics that further highlight the specific theme or clarify the person's specific situation.

Educational Aspect of the Case Studies

Questions are given at the end of each case. These questions offer the reader the opportunity to check what he or she has learned from each case study.