Applications of ICF-Based Assessments and Interventions in Post-Stroke Rehabilitation: A Narrative Review.

BackgroundThe International Classification of Functioning, Disability and Health (ICF) is widely used as a framework for post-stroke rehabilitation, but its clinical application requires further synthesis.ObjectiveThis narrative review examined the current applications of ICF in post-stroke rehabilitation, benchmarked against the United Kingdom Stroke Guideline (UK Guideline).MethodsThe review followed the Scale for the Assessment of Narrative Review Articles. ICF-based assessments and interventions described by the original study authors from selected studies were extracted.ResultsA total of 546 assessments were mapped to the ICF across 166 studies, overlapping with more than 80% of the UK Guideline topics. These assessments appeared to be primarily Body Function-based (40.7%) and Activity-based (27.1%). For ICF-based interventions, 247 interventions were identified across 66 studies and covered fewer than half of the UK Guideline topics. Mapping based on intervention content covered 36% of the combined Activity and Participation component. Both assessment and intervention mapping allocated less attention to the Participation component and Contextual Factors (CF), indicating limited specificity to community reintegration after stroke.ConclusionsTo promote the holistic ICF framework in post-stroke rehabilitation, more work is needed to address the assessment-intervention mismatch in current practice, particularly for Participation and CF. Resources, such as clinician training and service-level support, should also be mobilized to support the routine clinical application of the ICF.