I took this table (my formatting) from Towards a Common Language for Functioning, Disability and Health to illustrate the role physical therapy plays in the ICF framework.
Note that physical therapy is an intervention at the Activity Limitation level of disability.
Most physical therapists would agree that our specific techniques are addressed towards the Impairment (strength, pain, ROM, swelling, etc.) but that our expected outcomes are at the level of the Activity Limitation.
How the ICF levels of disability are linked to three
different levels of intervention
| Intervention | Prevention | |
|---|---|---|
| Health Condition | Medical treatment Medical care Medication | Health promotion Nutrition Immunization |
| Impairment | Medical treatment Medical care Medication Surgery | Prevention of the development of further activity limitations |
| Activity Limitation | Assistive devices Personal assistance Rehabilitation therapy | Preventive rehabilitation Prevention of the development of participation restrictions |
| Participation Restrictions | Accommodations Public education Anti-discrimination law Universal design | Environmental change Employment strategies Accessible services Universal design Lobbying for change |
There are many ways to assess activity limitations but one of the best clinical ways to assess them is to ask your patient...
Then score the patients' response on a 5-point Likert scale: 1 = no difficulty, 5 = cannot do.
"How have you gotten better?"
Record serial measurements of their activity as you progress them through their physical therapy plan of care.
Remember, pain is an impairment level characteristic.
Physical therapy primarily treats activity limitations.
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