The impact of accidents, injuries, and health conditions that prevent workers from engaging in employment is a major issue in the area of work disability. Vocational rehabilitation (VR) aim to facilitate return-to-work process but there is no universal description of functioning for patients who participate in VR. To tackle this issue, the Swiss Accident/Injury Insurance (SUVA) funded a project to develop an ICF-based Core Set to describe the functioning and health of individuals who participate in multidisciplinary VR. The project was a collaborative effort between the ICF Research Branch, World Health Organisation (WHO), International Labour Organization (ILO), World Confederation for Physical Therapy (WCPT), World Federation of Occupational Therapists (WFOT), and the International Society of Physical Medicine and Rehabilitation (ISPRM). A Local Advisory Group made up of individuals from the study centres and a patient advocacy group contributed greatly to the success of the project.

The preparatory phase of the project included the following studies:

• A systematic literature review was performed to identify aspects of functioning and contextual factors (personal and environmental) in outcomes based on the literature in VR published from 2004 to2008 using the ICF as a reference.
• A qualitative study (7 focus groups with 26 participants) was performed to identify relevant aspects of functioning and contextual factors from the patient perspective.
• A worldwide survey was performed to gather the opinion of international experts (pool of 295 experts from 47 countries) working in VR settings (vocational counsellors, case managers, nurses, occupational therapists, physicians, physical therapists, psychologists, social workers) on aspects of functioning and contextual factors that are important in individuals undergoing VR.
• To describe common problems experienced by individuals participating in VR from the clinical perspective, a multicentre cross-sectional study with 152 participants was performed at 4 study centres in Switzerland (Rehaklinik Bellikon, Clinique romande de réadaptation Sion, University Hospital Zurich and ESPAS Zürich/Winterthur, Swiss Paraplegic Center Nottwil) and 1 centre in Germany (Berufsförderungszentrum München Kirchseeon).

The information collected from these preparatory studies was presented at the international consensus conference, a multi-stage, iterative, decision-making and consensus process that took place at the Swiss Paraplegic Research (Switzerland) from 19-21 May 2010. At this consensus conference, 23 experts from 12 professions and from 15 countries worldwide decided which ICF categories are to be included in the first version of the ICF Core Sets for VR.

90 ICF categories were selected for inclusion in the Comprehensive ICF Core for VR. These categories can be taken into account when conducting a comprehensive, multidisciplinary assessment of persons undergoing multidisciplinary VR. Out of the 90 Comprehensive ICF Core Set categories, 13 ICF categories were selected for the Brief ICF Core for VR. The Brief ICF Core Set can serve as a minimal international standard for reporting functioning of persons undergoing VR. These ICF Core Sets could serve as a guide on measures to help clinicians and researchers implement optimal rehabilitation programs for individuals of working age with limited or restricted work participation due to disease, injury, or health-related event. In addition, the Core Sets are meant to cover a broad spectrum of health conditions and types of job. Validation studies have been conducted and publications are being finalized.

Based on the ICF Core Sets for VR, the Work Rehabilitation Questionnaire or WORQ was developed. WORQ can be used to assess and evaluate functioning in VR settings. To access WORQ, go to http://www.myworq.com/

For more information about the ICF Core Sets for VR, feel free to contact the ICF Research Branch or monika.finger@paraplegie.ch.

• Comprehensive ICF Core Set for VR (Download PDF)
• Brief ICF Core Set for VR (Download PDF)