Development of the ICF-Incontinence Assessment Form (ICF-IAF) to identify problems and resources of patients with urinary and / or faecal incontinence using the International Classification of Functioning, Disability and Health (ICF) of the World Health Organization: The formal conference for the adoption of the 1st version

Goedl-Purrer B1, Udier E1, von der Heide S2, Rothe C2, de Jong J3, Koenig I3, Radlinger L4, Koehler B5

Research Type

Basic Science / Translational

Abstract Category


Abstract 662
Bowel Dysfunction and Sexual Function
Scientific Podium Short Oral Session 34
Friday 31st August 2018
15:27 - 15:35
Hall D
Incontinence Questionnaire Outcomes Research Methods Rehabilitation
1. Fachliches Netzwerk GUP, Physioaustria, Austria, 2. AG GGUP Physio Deutschland Zentralverband für Physiotherapie (ZVK) e.V., Germany, 3. Pelvisuisse e.V., Switzerland, 4. Bern University of Applied Sciences, Department of Health Professions, Discipline Physiotherapy, Bern, Switzerland, 5. Zurich University of Applied Sciences, Health, Discipline Physiotherapy, Winterthur, Switzerland

Barbara Koehler



Hypothesis / aims of study
The International Classification of Functioning, Disability and Health (ICF) of the World Health Organization (WHO) is a comprehensive classification with 1454 categories. The ICF is based on the integrative biopsychosocial model of the WHO. This model shows the functioning of the human being as a complex interaction between the state of health and positive and negative influencing factors (facilitators and barriers). The influencing factors of the model are the chapters of ICF: Body Functions, Body Structures, Activities and Participation, as well as Environmental Factors. The chapter Personal Factors has not yet been classified.

The purpose of the use of the ICF in this project was that in addition to the diagnosis, which is classified in the International Classification of Diseases (ICD-10), the state of functional health can also be conceived and gathered.

The ICF based Incontinence Assessment Form (ICF-IAF) will be a disease-specific short form of the ICF and could help to standardize protocols for research and practice. The focus on functional health strengthens the aspect of patient orientation in the examination, planning and evaluation of therapy.

The aim of this consensus conference was to define the first version of the ICF-IAF for individuals with urinary and/ or faecal incontinence, using the results of previous subprojects.
Study design, materials and methods
The results of preparatory subprojects were analysed in a consensus conference by a panel of six delegates of groupings specialized in pelvic floor therapy of the respective professional associations of physiotherapy from Germany, Austria, and Switzerland, and compiled in consensus into a first version. These studies were integrated into consensus building (Figure 1): An analysis of 27 level-A recommended disease-specific questionnaires (1), a Delphi survey among 262 physiotherapists form 5 German speaking countries (2), as well as the patients' perspectives determined with 8 focus groups (3) and 89 individual interviews (4).

The categories were selected in country-specific groups (Austria, Germany, and Switzerland), each of which created its own list for each chapter of the ICF. Afterwards, joint results were recorded in the plenary session and different points of view were discussed. The final inclusion of the individual categories in the first version of ICF-IAF was decided by consensus.
The six delegates from the three countries reached a consensus and adopted the first version of ICF-IAF with a total of 65 categories. For Body Functions 24 categories were included, for Body Structures 13, for Activities and Participation 18 and for Environmental Factors 10. A consensus was reached in all cases of discussion.
Interpretation of results
In this consensus conference a first version of the ICF-IAF for individuals with urinary and/ or faecal incontinence has been developed. It can be used worldwide immediately after publication. The more than 100 existing translations of ICF allow application in many countries.
Concluding message
The first version of ICF-IAF will be available after publication and will contribute to the patient-oriented assessment of functional health. It will help to standardize protocols of research and practice.
Figure 1
  1. Kuhn M, Gass S, Radlinger L, Koehler B. The ICF-Incontinence Assessment Form (ICF-IAF) to identify problems and resources in patients with urinary and / or faecal incontinence: Subproject the patients’ perspective. 46th annual meeting of the International Continence Society ICS. 2016;13th-16th September:Tokyo.
  2. Koehler B. The International Classification of Functioning, Disability and Health (ICF) as an assessment tool. The Official Newsletter of the International Urogynecological association IUGA. 2016;Volume 11(Issue 2):11.
  3. Organization WHO. International Classification of Functioning, Disability and Health: Short Version: ICF. Eds.: 1. Geneva: World Health Organization; 2001.
Funding selffunded and Pelvisuisse e.V. Clinical Trial No Subjects Human Ethics not Req'd Expert oppinion was in focus Helsinki Yes Informed Consent No
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