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Process for Applying the International Classification of Functioning, Disability and Health Model to a Patient With Patellar Dislocation

K Helgeson, PT, DHSc, is Assistant Professor, Physical and Occupational Therapy Department, Idaho State University, Campus Stop 8045, Pocatello, ID 83209-8045 (USA).
AR Smith Jr, PT, EdD, OCS, FAAOMPT, is Chair, Athletic Training and Physical Therapy Department, Brooks College of Health, University of North Florida, Jacksonville, Florida.

Address all correspondence to Dr Helgeson at: helgkevi{at}isu.edu

Background and Purpose: The International Classification of Functioning, Disability and Health (ICF) has been proposed as a possible framework for organizing physical therapist practice. The purpose of this case report is to describe an evaluative and diagnostic process that is based on the ICF framework for a patient with a patellar dislocation.

Case Description: The patient was a 23-year-old woman who sustained a right knee and patellofemoral joint injury, resulting in a sprain of the medial collateral ligament and a suspected sprain of the medial patellofemoral ligament. Evaluation at 4 weeks demonstrated a primary impairment of patellar instability associated with the primary activity limitation of limited walking distances. A plan of care to address impairments, activity limitations, and participation restrictions was developed, with modifications made on the basis of the patient's health condition and personal and environmental factors.

Outcomes: The patient attained all of her goals for therapy and was able to return to her normal activities and recreational pursuits without a recurrence of a patellar dislocation. Lower-Extremity Function Scale scores increased from 30 out of 80 to 76 out of 80 during the course of treatment.

Discussion: The ICF model has been proposed as a framework for developing diagnostic classifications for rehabilitation professionals. The ICF model also should be assessed with regard to whether it provides a useful process for clinical decision making. The ICF model directs practitioners to address patients’ problems at the level of the whole person, with modifications made on the basis of health conditions and personal and environmental factors.