Feasibility of the International Classification of Functioning, Disability and Health Rehabilitation Set for inpatient rehabilitation: Selection and validity of a set of categories for inpatients in a convalescent rehabilitation ward.

Funahashi R, Mukaino M, Otaka Y, Senju Y, Yoneda C, Ozeki Y, Shimizu Y, Koike T, Saito E. Feasibility of the International Classification of Functioning, Disability and Health Rehabilitation Set for inpatient rehabilitation: Selection and validity of a set of categories for inpatients in a convalescent rehabilitation ward. Jpn J Compr Rehabil Sci 2020; 11: 1-8. Objective: To evaluate the feasibility of the International Classification of Functioning, Disability and Health (ICF) Rehabilitation Set for inpatients in a convalescent (Kaifukuki) rehabilitation ward. Methods: Overall, 295 inpatients in convalescent rehabilitation wards were rated using the ICF Rehabilitation Set, and the proportion of missing values was investigated. Categories with missing values <10% were selected, and internal construct validity of the total score of the selected categories was examined using Rasch analysis. Results: Missing values were detected in 25 items, of which seven had missing values of ≥10%. No ceiling or floor effects were noted. Rasch analysis of 23 categories with missing values <10% showed a good fit to the model after applying testlet solution and item splitting, which supported the internal construct validity of the ICF Rehabilitation Set. Conclusion: This identified the set of categories of the ICF Rehabilitation Set that could be used for evaluating rehabilitation inpatients. These categories had good internal construct validity based on Rasch analysis.

Rehabilitative intervention and social participation of a case with Balint's syndrome and aphasia.

Balint's syndrome is characterized by three major disorders of spatial analysis: fixed gaze or psychic paralysis, simultagnosia, and optic ataxia or misreaching. Most patients with Balint's syndrome generally do not show all three of these signs. The authors herein reported the more than four-year clinical course of a case (a 43-year-old man) with Balint's syndrome presenting these three disorders. The patient also had a mild type of conduction aphasia, but his attentional, intellectual and memory functions were well preserved. SPECT showed cerebral hypoperfusion in the bilateral parieto-occipital areas. Whereas rehabilitative intervention with process specific approach for the impaired visual cognition seemed to be significantly ineffective, a functional adaptation approach successfully promoted the patient's social participation. However, the present patient could not help having to resign from his job. Additionally, double impairment of visual (including optic ataxia) and language functions made it impossible for him to obtain a new work. Like the present case, those who have a higher brain dysfunction, but retain good physical ability can hardly receive the benefit of the social welfare system in Japan. Legislation addressing this problem is a matter of great urgency.