title: Identification of the most common problems by patients with ankylosing spondylitis using the international classification of functioning, disability and health.
abstract: OBJECTIVE
  The International Classification of Functioning, Disability and Health (ICF) aims to classify functioning and health by a number of categories divided over 3 components: body functions and body structures, participation and activities, and environmental factors. We identified the common health problems of patients with ankylosing spondylitis (AS) based on the ICF from the perspective of the patient.
  
  
  METHODS
  During structured interviews with the extended ICF checklist, trained assessors collected data from 111 patients with AS. ICF categories identified by more than 5% of the patients as at least mildly impaired or restricted were selected. Categories identified by less than 5% were removed. Additional impairments/restrictions reported by more than 5% of the patients, after the structured interviews and not yet included in the checklist, were added.
  
  
  RESULTS
  One hundred nineteen (72%) out of 165 categories of the extended ICF checklist were identified to be at least mildly impaired or restricted. Within each of the 4 components of the ICF, at least one-third of the categories were impaired or restricted for more than 50% of the patients. Thirty-nine (33%) categories were related to movement and mobility. Within the component "environmental factors" the categories "support of immediate family" and "health professionals" were the most important facilitators, "climate" was the most important barrier. Eight impairments were additionally mentioned as relevant. These were hierarchically lower levels of ICF categories previously included and they were added.
  
  
  CONCLUSIONS
  One hundred twenty-seven ICF categories represent the comprehensive classification of functioning in AS from the patients' perspective. The results underscore the need to address the 4 ICF components when classifying functioning and to emphasize that functioning implies more than physical functioning.
authors.affiliation: Department of Physical Medicine and Rehabilitation, Ludwig-Maximilians-University, Munich, Germany.
authors.forename: Irene
authors.initials: I
authors.lastname: van Echteld
authors.forename: Alarcos
authors.initials: A
authors.lastname: Cieza
authors.forename: Annelies
authors.initials: A
authors.lastname: Boonen
authors.forename: Gerold
authors.initials: G
authors.lastname: Stucki
authors.forename: Jane
authors.initials: J
authors.lastname: Zochling
authors.forename: Jürgen
authors.initials: J
authors.lastname: Braun
authors.forename: Désirée
authors.initials: D
authors.lastname: van der Heijde
mesh_terms: D000203:Activities of Daily Living; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D005260:Female; D005858:Germany / Q000453:epidemiology; D006304:Health Status; D006801:Humans; D038801:International Classification of Diseases; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D013167:Spondylitis, Ankylosing / Q000453:epidemiology* / Q000473:pathology / Q000503:physiopathology; D011795:Surveys and Questionnaires