ArticleFrontiers in rehabilitation sciences2026
ICF rehabilitation set responsiveness after total knee arthroplasty: a retrospective study.
Article in Frontiers in rehabilitation sciences, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Introduction: The International Classification of Functioning, Disability and Health-Rehabilitation Set (ICF-RS) is a standardized tool for multidimensional rehabilitation assessment, but its responsiveness in post-total knee arthroplasty (TKA) inpatient settings remains underexplored. Methods: A retrospective single-center cohort study was conducted on 47 patients who underwent primary unilateral TKA and received inpatient rehabilitation in Changsha, China (January 2023-December 2024). ICF-RS scores (30 categories) were assessed at admission and discharge. Responsiveness was evaluated using Wilcoxon signed-rank tests with Benjamini-Hochberg FDR correction. Response counts (improved/stable/worsened) were the primary outcome presentation. Results: Of 30 ICF-RS categories, 27 showed 100% data completeness; 3 social/sexual items had substantial missingness. Following rehabilitation, 23 categories demonstrated statistically significant improvement after FDR correction. Consistent directional improvement was observed in mobility (d450 Walking: 24/47 improved), self-care (d510-d540), and pain (b280: 26/47 improved) domains. The total score decreased from 47.51 ± 13.59 to 35.81 ± 11.38 (Cohen's d = 1.51). Notably, b710 (joint mobility) showed no responsiveness (0/47 improved, 1/47 worsened), despite expected clinical range-of-motion gains. Discussion: ICF-RS demonstrates responsiveness to post-TKA inpatient rehabilitation for most functional domains. The lack of change in b710 highlights a limitation of generic assessment tools for capturing localized physical impairments in single-joint conditions, suggesting the need for complementary condition-specific measures. The study context-where ICF-RS scores influence reimbursement-underscores the importance of assessment integrity considerations in function-based payment implementations.
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