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  1. Koehler, Barbara PT, MPTSc
  2. Kirchberger, Inge PhD, MPH
  3. Glaessel, Andrea PT, MPH, MSc
  4. Kool, Jan PT, PhD
  5. Stucki, Gerold MD, MSc
  6. Cieza, Alarcos PhD, MPH


Objective: The "Comprehensive ICF Core Set for Osteoporosis" is an application of the International Classification of Functioning, Disability and Health (ICF) and represents the typical spectrum of functioning problems of patients with osteoporosis. The objective of this study was to validate this ICF Core Set from the perspective of physical therapists.


Methods: Using a 3-round Delphi technique survey, physical therapists, experienced in the treatment of patients with osteoporosis, were surveyed about patient problems, resources, and aspects of the environment relevant to the physical therapy management of individuals with OP. Responses were translated ("linked") into ICF language by using standardized rules.


Results: Fifty-seven physical therapists across 25 countries representing each World Health Organization region named 816 factors (patient problems, available resources, and environmental influences). These 816 factors were linked to 160 ICF categories. Twenty-five categories with an agreement among the participants exceeding 75% were not represented in the Comprehensive ICF Core Set for Osteoporosis. Fifteen concepts were linked to the as yet undeveloped ICF component. Personal Factors and 9 concepts were found not to be covered by the ICF.


Conclusion: The validity of the Comprehensive ICF Core Set for Osteoporosis was largely supported by the participants. Nine concepts (eg, "posture," "alignment," "ergonomics") identified by participants are not covered by the ICF and require further investigation.