Using a profile of a modified Brief ICF Core Set for chronic widespread musculoskeletal pain with qualifiers for baseline assessment in interdisciplinary pain rehabilitation

Figures & data

Table 1 ICF categories, ICF codes, assessment methods and rehabilitation team members involved in assessment

Modified Brief ICF Core Set for chronic widespread pain	Code	Operationalization/assessment methods	Professions
Body Functions
Energy and drive functions	b1300	Interview SF®-36: vitality	1,2,3
Motivation	b1301	Interview	1,2,3
Sleep functions	b134	Interview	1,6
Memory functions	b144	AQT	1,2,4
Emotional functions	b152	HAD SF-36: mental functions EQ-5D: anxiety and depression Interview	1,2,3
Sensation of pain	b280	VAS SF: bodily pain EQ-5D: pain and discomfort Pain drawing Clinical assessment Interview	1,5,6
Exercise tolerance functions	b455	TIPPA Valpar Component Work Sample	4,5
Muscle power functions	b730	Clinical tests	1,5
Activity and Participation
Carrying out daily routines	d230	Interview SF-36: role-physical SF-36: role-emotional COPM EQ-5D: usual activities and self care MPI: activity index	4
Handling stress and other psychological demands	d240	Interview	1,2,3
Lifting and carrying objects	d430	TIPPA Valpar Component Work Samples SF-36: physical function	4,5
Fine hand use	d440	Valpar Component Work Samples	4
Walking	d450	SF-36: physical functioning TIPPA	5
Doing housework	d640		4
Family relationships	d760		1,2,3
Intimate relationships	d770		1,2,3
Remunerative employment	d850		1,3,4
Recreation and leisure	d920		3,4,5
Environmental Factors
Support from immediate family	e310		2,3
Individual attitudes from immediate family	e410		2,3
Social security service and policies	e570		1,3

Notes: 1 = physician, 2 = psychologist, 3 = social worker, 4 = occupational therapist, 5 = physiotherapist, and 6 = nurse.

Abbreviations: AQT, A Quick Test; COPM, Canadian Occupational Performance Measure; HAD, Hospital Anxiety and Depression scale; ICF, International Classification of Functioning, Disability and Health; MPI, Multidimensional Pain Inventory; SF®-36, Short Form-36 Health Survey; TIPPA, Test Instrument for Profile of Physical Ability; VAS, visual analog scale.

Table 2 Sociodemographic data and self-assessment outcomes

Variables	N	Median	Percentiles
			25	75
Personal factors
Native country
Sweden	25
Other Nordic country	2
Other European country	2
Other country	24
Education level
Nine-year compulsory school	12
Upper secondary school	23
University	15
Other	3
Work situation
Employed	37
Unemployed	16
Age (years)	53	47	39	52
HAD
Anxiety
0–10 points	24
11–21 points	23
Depression
0–10 points	21
11–21 points	25
TSK	44	43.5	31.3	50.8
EQ-5D
Index	46	0.04	0.00	0.19
VAS	46	30	24	40
Health-related quality of life (SF-36)
Physical functioning	47	50	30	60
Role – physical	46	0	0	0
Bodily pain	47	22	12	22
General health	46	35	20	45
Vitality	47	15	10	35
Social functioning	47	38	25	50
Role – emotional	45	0	0	33
Mental health	47	44	32	66
PCS	43	29	24	33
MCS	43	30	23	40

Abbreviations: HAD, Hospital Anxiety and Depression scale; SF®-36, Short Form-36 Health Survey; MCS, Mental Component Summary; PCS, Physical Component Summary; TSK, Tampa scale for kinesiophobia; VAS, visual analog scale.

Table 3 Main diagnoses, according to ICD-10, of the patients with widespread pain conditions and the number of pain locations as an indicator of the spreading of pain

Primary diagnosis/ICD-10 diagnosis group	ICD chapter + code	Number of patients	Number of pain locations, mean	Number of pain locations, median
Generalized pain	R52.9	14	13.5*	12*
Fibromyalgia	M79.0	6	28.2	32
Arthropathy	M12.8	1	27
Osteoporosis	M81.0	1	15
Chronic pain or ache	R52.2	4**	17***	16***
Subtotal		26
Section spinal diseases, M-chapter musculoskeletal and connective tissue diseases	M43.6, M47.2, M51.0, M53.1, M54.2, M54.5, M54.8	13	12.6#	12.5#
Section diseases in shoulder, M-chapter musculoskeletal and connective tissue diseases	M75.1, M75.4	2	15
Primary gonarthrosis	M17.1	2	14
M-chapter: other musculoskeletal and connective tissue diseases	M96.0, M99.0	2	4
Diseases in nerve roots and plexuses	G54.0	1	14
Depression, anxiety	F32.2, F41.1, F41.2, F41.9	6	19.5	17.5
Pain from abdomen and pelvis	R10.3	1	7
Subtotal		27
Total		53

Notes: N = 53.

* Due to some uncertainty as regards the documentation, two patients were not included in the calculation, n = 12;

** for one patient, the documentation was unclear;

*** calculated on n = 3;

# due to some uncertainty as regards the documentation, three patients were not included in the calculation, n = 10.

Abbreviations: ICD, International Classification of Disease; M-chapter, diseases of the musculo-skeletal system and connective tissue.

Figure 1 (A) Body Functions categories: b1300: energy and drive, b1301: motivation, b134: sleep, b144: memory, b152: emotional, b280: pain, b455: exercise tolerance, b730: muscle power. (B) Activity and Participation categories: d230: carrying out daily routines, d240: handling stress, d430: lifting and carrying, d440: fine hand use, d450: walking, d640: doing housework, d760: family relationships, d770: intimate relationships, d850: remunerative employment, d920: recreation and leisure. (C) Environment and the categories: e310: support from immediate family, e410: individual attitudes from immediate family, e570: social security service and policies.

Abbreviation: ICF, International Classification of Functioning, Disability and Health.

Figure 2 The percentage of patients in each ICF category of Activities and Participation.

Abbreviation: ICF, International Classification of Functioning, Disability and Health.

Figure 3 The percentage of patients in each ICF category of Body Functions.

Abbreviation: ICF, International Classification of Functioning, Disability and Health.

Figure 4 The percentage of patients in each ICF category of Environmental Factors.

Abbreviation: ICF, International Classification of Functioning, Disability and Health.