The International Classification of Functioning as an explanatory model of health after distal radius fracture: a cohort study.
BACKGROUND
Distal radius fractures are common injuries that have an increasing impact on health across the lifespan. The purpose of this study was to identify health impacts in body structure/function, activity, and participation at baseline and follow-up, to determine whether they support the ICF model of health.


METHODS
This is a prospective cohort study of 790 individuals who were assessed at 1 week, 3 months, and 1 year post injury. The Patient Rated Wrist Evaluation (PRWE), The Wrist Outcome Measure (WOM), and the Medical Outcome Survey Short-Form (SF-36) were used to measure impairment, activity, participation, and health. Multiple regression was used to develop explanatory models of health outcome.


RESULTS
Regression analysis showed that the PRWE explained between 13% (one week) and 33% (three months) of the SF-36 Physical Component Summary Scores with pain, activities and participation subscales showing dominant effects at different stages of recovery. PRWE scores were less related to Mental Component Summary Scores, 10% (three months) and 8% (one year). Wrist impairment scores were less powerful predictors of health status than the PRWE.


CONCLUSIONS
The ICF is an informative model for examining distal radius fracture. Difficulty in the domains of activity and participation were able to explain a significant portion of physical health. Post-fracture rehabilitation and outcome assessments should extend beyond physical impairment to insure comprehensive treatment to individuals with distal radius fracture.
Harris
Jocelyn E
JE
School of Rehabilitation Sciences, University of British Columbia, T325-2211 Wesbrook Mall, Vancouver, British Columbia, V6T 2B5, Canada. jocellen@interchange.ubc.ca
MacDermid
Joy C
JC
Roth
James
J
D000203:Activities of Daily Living / Q000145:classification; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000379:methods*; D010146:Pain / Q000145:classification / Q000503:physiopathology; D011446:Prospective Studies; D011885:Radius Fractures / Q000503:physiopathology* / Q000534:rehabilitation; D016059:Range of Motion, Articular; D020127:Recovery of Function / Q000502:physiology; D015203:Reproducibility of Results; D018434:Sickness Impact Profile; D013997:Time Factors; D014953:Wrist / Q000503:physiopathology*