Physical Function and Mobility

Posted In CategoryUsing qualifiers (those in ICF, creating new qualifiers etc.)
  • Anoop Balachandran 10 months ago

     Hello everyone,

    Can anyone give a defnition of physical function and how it relates/unrelates to mobility? It seems like they are often used interchangeably and is very confusing. 

    Any examples would be great. 


    Thank you


  • Catherine Sykes 10 months ago

    Many of the terms used in health and disability are used with specific meaning in ICF and with more general meanings in common parlance. The benefit of using ICF terms is that all people using a term have a common understanding of the meaning.

    Functioning in ICF is defined as ‘an umbrella term for body functions, body structures, activities and participation. It denotes the positive aspects of the interaction between an individual (with a health condition) and that individual's contextual factors (environmental and personal factors)’. It covers human functioning at the level of the body, the person and the person in society; thus includes physical, psychological and social functioning. The issue of delineating physical functioning is that it involves psycho and social functioning. A so called physical function, such as walking, is determined by such things as motivation and purpose and environmental factors such as ground surface and shoe type.

    Mobility in ICF is a whole chapter of categories pertaining to movement and there are some categories in the body functions chapter that also pertain to movement. Mobility includes ‘moving by changing body position or location or by transferring from one place to another, by carrying, moving or manipulating objects, by walking, running or climbing, and by using various forms of transportation’.

    As physiotherapists we tend to talk more about physical elements of functioning and focus on the impairments of body function and activity limitations. However, we probably should, and the ICF model encourages us, to look more broadly and consider the psycho and social elements of human functioning. 

  • Anoop Balachandran 10 months ago

    Thank you so much for the detailed reply. It clears lot of my doubts.

    One question I had is what is the key aspect that separates ‘activity’ from ‘participation’? Is the social aspect (people)? I am seeing a few papers making their own definition of participation since it wasn’t really clear. From what I have read, participation is similar to disability in Nagis model, but different because of the people interaction component.




  • Catherine Sykes 10 months ago

    There is discussion in the ICF about the options for delineating activities from participation in Annex 3.

    Work carried out in Australia suggests the following approaches to delineating activities (A) and participation (P):

    • A focuses on the person’s individual functioning while P emphasises a person’s involvement in society
    • A is externally observable. P refers to the lived experience of the person
    • A can relate to the test environment, with or without equipment. P is confounded with the environment – it cannot be assessed in a ‘test’ environment
    • P shapes expected roles and societal norms - Involvement in society
    • A is fine grained, where P is broader
    • A is about action or process;  P relates to the overall goal of the action.

    An alternative approach, also developed in Australia, is to use qualifiers. The Australian data dictionaries (National metadata standards for disability and data dictionaries include two additional qualifiers (as suggested in ICF, p22, 222, 224, 237); need for assistance with activities and satisfaction with participation which when added to the ICF qualifier of severity of the problem with activities or participation would differentiate the two.

  • Anoop Balachandran 10 months ago

    Hi Catherine,

    Interesting. Does it have to fulfill all the criteria listed above? What about dressing? It doesn't have a social context, but required if they want go out and meet their freinds whic is paricpation. So I do wonder if we can always seperate these.

    Does anyone know if ICF is planning to update the disinction or just have users define their own cut off points for A & P's. If one of the goals of ICf is unversal language, I think issues with A&P needs to be resolved. Or maybe is not as important as people think?





  • Catherine Sykes 8 months ago

    I am inclined to disagree that dressing doesn't have a social context. The act of putting on clothes would be influenced by the type of clothing that is being put on: putting on a sari would be very different from putting on a business suit. So the social context is driving the task or action of dressing. However the example seems a good one to illustrate the difference between activity and participation in dressing. The choices and personal expression in dressing are better represented in by participation or involvement in dressing; the satisfaction with participation qualifier in the Australian national data dictionary is a summary measure in which are embedded the concepts of choice, opportunity and importance

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