Low back pain has reached epidemic proportions, being reported by about 80% of the population people at some time in their lives. Seventy-five percent of people with low back pain are between 30 and 59 years of age, i.e. in their most productive years. While not a disease, low back pain is a major cause of disability. The symptoms of low back pain and the associated disability bear only a poor relationship to objective data. Therefore, much effort has been made to try to identify meaningful outcome measures. Condition-specific instruments have been used in clinical studies to address functioning, disability and health of persons with low back pain. However, there is little standardization of the use of these instruments, and comparisons among studies are difficult or impossible. Thus, it would be valuable for teaching, clinical practice and research to define what should be measured to comprehensively represent the experience of patients based on an extensive framework that can serve as a universal language understood by health professionals, researchers, policymakers, patients and patient organizations alike.
To tackle this issue, the ICF Research Branch and the World Health Organisation (WHO) with the scientific support of Ludwig-Maximilian University (Germany), University of Melbourne and Royal Melbourne Hospital (Australia), University of Freiburg (Germany), University Hospital and Maastricht University (The Netherlands), Bone and Joint Decade and the European League against Rheumatism (EULAR), initiated a project to develop internationally-accepted and evidence-based ICF Core Sets for low back pain. This project was part of a larger project examining 12 chronic conditions with a high burden of disease.
The preparatory phase included a systematic literature review, a Delphi exercise and an empirical data collection using the ICF checklist:
An international ICF consensus conference took place from 26-29 April 2002 at a quiet monastery situated in a pleasant landscape far from any city and distractions. The aim of the conference was to establish the Comprehensive and Brief ICF Core Sets for patients with low back pain. Eighteen experts (physicians in various sub-specialities, physiotherapist, occupational therapists) from 15 different countries decided which ICF categories are to be included in the ICF Core Sets for low back pain following a formal, decision-making and consensus process which integrated the results from the 3 preparatory studies.
78 ICF categories were selected for inclusion in the Comprehensive ICF Core for low back pain. These categories can be taken into account when conducting a comprehensive, multidisciplinary assessment. Out of the 78 Comprehensive ICF Core Set categories, 35 ICF categories were selected as categories for the Brief ICF Core for low back pain. The Brief ICF Core Set can be used in assessing patients participating in a clinical study on low back pain.
Validation studies have been conducted.
For more information, feel free to contact the ICF Research Branch (melissa.selb@paranet.ch).
Copyright 2017 ICF Research Branch