S.V. SHTAIMETS^1, 2, N.G. ZHUKOVA², I.A. ZHUKOVA², A.E. AGASHEVA², D.A. NOVOTNYY³, Z.F. SAYFITDINKHUZHAEV²

 ¹Omsk Сity Сlinic No. 3, Omsk

²Siberian State Medical University, Tomsk

³Novosibirsk Сity Clinic No. 1, Novosibirsk

Contact details:

Shtaimets S.V. — Head of the Day Hospital, neurologist

Address: 26а Vilyams St., 644060 Omsk, Russian Federation, tel.: +7-904-321-59-76, e-mail: steinmetz_stas@mail.ru

 The International Classification of Functioning, Disability and Health (ICF) is a modern tool for comprehensive assessment of limitations in patients with Parkinson’s disease (PD). Its use promotes the transition from the traditional medical model to the biopsychosocial one, shifting the focus from the question «What is wrong with a person?» to searching for the answer: what environmental factors limit his/her functioning and how they can be changed to optimize the quality of life? This paradigm shift represents a key challenge in the management of patients with chronic neurodegenerative diseases.

The purpose — to identify key (leading) ICF domains that constitute the basis of functioning disorders in Parkinson’s disease.

Material and methods. The study included 108 patients with an established diagnosis of PD. The assessment of functioning limitations was carried out in accordance with the European concept of health and disability measurement (within the ICF biopsychosocial model). For this purpose, we used a standardized set of assessment techniques recommended by the Russian Union of Rehabilitation Specialists.

Results. The analysis included 56 ICF categories, with the corresponding problems identified in 20% or more of the study participants. From the total number of ICF categories (1424), a clinically significant basic set was selected, reflecting the specific PD disorders. The selected categories were distributed by ICF component as follows: body functions (b): 20 categories; body structures (s): 1; activity and participation (d): 27; environmental factors (e): 8 categories. Various levels of statistically significant relationships between them were established.

Conclusions. The study confirmed that the ICF is an effective tool for building a personalized biopsychosocial model of rehabilitation for PD. The key conclusion is the proven statistically significant influence of environmental factors on the structure of functional limitations and specific difficulties in patients’ daily lives.

Key words: Parkinson’s disease, International Classification of Functioning, Disability and Health, Core Sets (ICF Core Sets), quality of life.

REFERENCES

1. Andriyenko O.A., Trinitatskiy Yu.V. Population and clinical aspects of Parkinson’s disease in residents of the Rostov region. Klinicheskaya praktika, 2017, no. 4 (32), pp. 44–49 (in Russ.).
2. Rosinskaya A.V., Vasenina E.E., Khaybullin T.N., Levin O.S. The rate of progression of Parkinson’s disease with early and delayed administration of levodopa drugs. Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova, 2018, vol. 118, no. 62, pp. 77–81 (in Russ.).
3. Li Z., Jiang X., Yang M., Pan Y. Association between falls and nonmotor symptoms in patients with Parkinson’s disease. J. Clin. Neurosci, 2023, vol. 118, pp. 143–146. DOI: 10.1016/j.jocn.2023.10.013
4. Poewe W., Seppi K., Tanner C.M. et al. Parkinson disease. Nat. Rev. Dis. Primers, 2017, vol. 3. Art. 17013. DOI: 10.1038/nrdp.2017.13
5. Scorza F.A., do Carmo A.C., Fiorini A.C. et al. Sudden unexpected death in Parkinson’s disease (SUDPAR): a review of publications since the decade of the brain. Clinics (Sao Paulo), 2017, vol. 72, no. 11, pp. 649–651.
6. Shtaymets S.V., Zhukova N.G., Katina M.M. et al. Integrative analysis of predictors of an unfavorable course of Parkinson’s disease based on data from medical care quality assessments: a retrospective cohort study. Kubanskiy nauchnyy meditsinskiy vestnik, 2023, vol. 30, no. 1, pp. 69–77 (in Russ.). DOI: 10.25207/1608-6228-2023-30-1-69-77
7. Leonardi M., Bickenbach J., Ustun T.B. et al. MHADIE Consortium. The definition of disability: what is in a name? Lancet, 2006, vol. 368 (9543), pp. 1219–1221. DOI: 10.1016/S0140-6736(06)69498-1
8. van Uem J.M., Marinus J., Canning C. et al. Health-Related Quality of Life in patients with Parkinson’s disease—A systematic review based on the ICF model. Neurosci. Biobehav. Rev, 2016, vol. 61, pp. 26–34. DOI: 10.1016/j.neubiorev.2015.11.014
9. Raggi A., Leonardi M., Ajovalasit D. et al. Functioning and disability in Parkinson’s disease. Disabil. Rehabil, 2010, vol. 32 (suppl. 1), pp. S33–41.
10. Smolentseva I.G., Amosova N.A. Application of the International Classification of Functioning in Rehabilitation of Parkinson’s Disease. Kremlevskaya meditsina. Klinicheskiy vestnik, 2018, no. 3, pp. 49–54 (in Russ.).
11. Mel′nikova E.V., Buylova T.V., Bodrova R.A. et al. Application of the International Classification of Functioning (ICF) in Outpatient and Inpatient Medical Rehabilitation: Instructions for Specialists. Vestnik vosstanovitel′noy meditsiny, 2017, no. 6 (82), pp. 7–20 (in Russ.).
12. Vojciechowski A., Zotz T., Loureiro A., Israel V. The International Classification of Functioning, Disability and Health as Applied to Parkinson’s Disease: A Literature Review. Advances in Parkinson’s Disease, 2016, vol. 5 (2), pp. 29–40. DOI: 10.4236/apd.2016.52005
13. Shmonin A.A., Mal′tseva M.N., Nikiforov V.V., Mel′nikova E.V. Preliminary results of the implementation of the Pilot Project «Development of the Medical Care System in Russia» in St. Petersburg City Hospital No. 26. Using the ICF-reader program to establish a rehabilitation diagnosis. Uchenyye zapiski SPbGMU im. akad. I.P. Pavlova, 2016, vol. 23, no. 4, pp. 54–60 (in Russ.).
14. Shmonin A.A., Kasatkina V.M., Mal′tseva M.N. et al. Analysis of problems in rehabilitation diagnosis in the categories of the International Classification of Functioning in patients with stroke participating in the Pilot Project «Development of the medical rehabilitation system in Russia». Regionarnoye krovoobrashcheniye i mikrotsirkulyatsiya, 2017, vol. 16, no. 2 (62), pp. 17–24 (in Russ.).
15. Lampe K., Mäkelä M., Garrido M.V. et al. The HTA core model: a novel method for producing and reporting health technology assessments. Int. J. Technol. Asses. Health Care, 2009, vol. 25 (suppl. 2), pp. 9–20.
16. Reabilitatsiya pri bolezni Parkinsona i sindrome parkinsonizma pri drugikh zabolevaniyakh. Klinicheskiye rekomendatsii. Nats. o-vo po izucheniyu bolezni Parkinsona i rasstroystv dvizheniy; Soyuz reabilitologov Rossii, 2018 [Rehabilitation in Parkinson’s disease and parkinsonism syndrome in other diseases. Clinical guidelines. National Society for the Study of Parkinson’s Disease and Movement Disorders; Union of Rehabilitologists of Russia, 2018]. 129 p., available at: https://rehabrus.ru/Docs/2018/06/Rec_po_reab_parkinson_Smolenceva.pdf
17. Bubnova M.G., Aronov D.M. Cardiac rehabilitation: stages, principles and international classification of functioning (ICF). Profilakticheskaya meditsina, 2020, no. 23 (5), pp. 40–49 (in Russ.). DOI: 10.17116/profmed20202305140
18. Nurgazizova A.K., Sergeyeva V.V., Rodionova A.Yu. Application of the international classification of functioning, disabilities and health to assess the rehabilitation of patients with cardiovascular diseases. Prakticheskaya meditsina, 2014, no. 6 (82), pp. 29–36 (in Russ.).
19. Kochubey A.V., Filyuk S.A. Analysis of the information content of case histories of dental orthopedic patients from the standpoint of the international classification of functioning, limitations of life activity and health. Kubanskiy meditsinskiy vestnik, 2012, no. 3, pp. 88–91 (in Russ.).
20. Wynia K., Middel B., van Dijk J.P. et al. Broadening the Scope on Health Problems among the Chronically Neurologically Ill with the International Classification of Functioning (ICF). Disabil. Rehabil, 2006, vol. 28 (23), pp. 1445–1454. DOI: 10.1080/09638280600638356
21. Leonardi M., Meucci P., Ajovalasit D. et al. ICF in neurology: functioning and disability in patients with migraine, myasthenia gravis and Parkinson’s disease. Disabil. Rehabil, 2009, vol. 31 (suppl. 1), pp. S88–99. DOI: 10.3109/09638280903317732
22. Raggi A., Leonardi M., Ajovalasit D. et al. Disability and profiles of functioning of patients with Parkinson’s disease described with ICF classification. Int. J. Rehabil. Res, 2011, vol. 34 (2), pp. 141–150. DOI: 10.1097/MRR.0b013e328344ae09