JKPT pissn Vol. 27, No. 5, October 2015 J Kor Phys Ther 2015:27(5): eissn X Original Article

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1 pissn Vol. 27, No. 5, October eissn X Original Article Haejung Lee, Jumin Song Department of Physical Therapy, College of Health & Welfare, Silla University, Busan, Korea Purpose: The purpose of this study was to investigate the overview of the use of the ICF in Korea. Methods: An integrative literature review from its publication in 2001 to May, 2015 was conducted; studies published from 2001 to May, 2015 were searched using RISS, KISS, DBpia, KoreaMed, PubMed, and ISI databases. For inclusion in the review, a study had to be published as a scientific article, must have participation of Korean researchers and developed in Korea, and should provide use of ICF. Results: A total of 108 publications were identified, and 89 studies met the inclusion criteria. Most eligible studies were related to clinical fields (n= 41) and areas with the disabled (n= 32). Interestingly, several studies showed how to use and/or adapt ICF in clinical practice e.g. reviews and case studies, whereas in the area of the disabled, descriptive studies reported ICF concepts comparing with the current disability policies and laws in Korea. The usage of ICF was found to be at various levels: introducing the ICF concept and model, collecting data using the ICF checklist, coresets, as well as ICF codes itself and presenting results in the ICF framework, developing measurement tools based on ICF concepts. Conclusion: Since introduction of the ICF in 2001, the use of the ICF in Korea has increased in different professionals as well as in levels of its applications. Keywords: ICF, Functioning, Disability 서론국제기능장애건강분류 (International Classification of Functioning [ICF], Disability and Health) 는 2001 년세계보건기구에의해발표된국제표준분류체계중하나로건강과건강관련상태를표현하기위해통일되고표준화된언어를제공하기위해발표되었다. ICF는질병과이상의범위뿐만아니라장애과정과같은건강상태의결과에대한일관성있는견해를제시하기위해 ICIDH의개정판으로개발되었다. 1 ICF는신체기능, 신체구조, 활동과참여및환경요인의네가지영역으로구성되며, 기능수행 (functioning) 은신체기능, 신체구조및활동과참여에대한포괄적용어로서환경요인과개인요인사이의상호작용에서긍정적인측면을나타낸다. 장애 (disability) 는손상및활동제한과참여제약에대한포괄적용어로서환경요인과개인요인간의부정적상호작용을의미한다. 이러한측면에서장애의개념을설명할때 ICF의개념을활용하여다중적관점에서접근해야한다. 이러한접근은장애가개인의문제이며질병, 외상또는기타건강상태의직접적인영향에의해발생되어개별화된의료관리가필요하다고 설명한의학적모델과는다르게장애가사회적환경에의해발생하며사회참여를위해환경개선이필요하다고보는사회적모델과유사하다. 2 ICF는인구조사와같은통계도구, 삶의질또는환경요인의측정과같은연구도구, 재활과중재효과평가등으로활용할수있는임상도구, 사회보장제도및정책설계와같은사회정책도구또한교육과정계발과같은교육도구로써사용될수있다. 이러한의미에서 ICF는장애가있는사람뿐만아니라모든사람을위해사용될수있는보편성을가진분류체계라할수있다 년이후다양한영역에서 ICF개념에대한소개를시작으로그활용방안에대한연구들이발표되었다. 4 또한국가마다다양한목적으로여러분야에서활용되고있다. 특히임상영역에서 ICF의개념과체계에대한설명, 임상적용, 기존도구와의연결, ICF를활용한데이터수집의분석에대한연구들이활발하게수행되고있으며, 5,6 증가되는추세를보이고있다. 7 국외의활발한 ICF의사용과국가적차원의지원및현황보고와는다르게 2004년 ICF 한글판이개발되어 8 우리나라에보급된이후 Received Sep 18, 2015 Revised Oct 14, 2015 Accepted Oct 19, 2015 Corresponding author Jumin Song jmsong@silla.ac.kr Copylight 2015 The Korea Society of Physical Therapy This is an Open Access article distribute under the terms of the Creative Commons Attribution Non-commercial License ( creativecommons.org/license/by-nc/3.0.) which permits unrestricted non-commercial use, distribution,and reproduction in any medium, provided the original work is properly cited

2 10여년이지난현시점에서전반적인한국의 ICF 활용현황에대한보고는부족한실정이다. 이에본연구는국제표준분류인 ICF의국내활용활성화를위하여 2001년이후 ICF의활용분야와활용정도를조사 분석하여그현황을제시하고자수행되었다. 연구방법 1. 연구대상논문선정및자료수집본연구는 ICF가 WHO에의해발표된 2001년이후국내연구및활용이어느분야에서얼마나다양하게활용되고있는지그동향을알아보기위해관련자료를수집하여문헌고찰을실시하였다. 분석대상자료는 2001년부터 2015년 5월까지학술지에발표된논문을전문데이터베이스를활용하여검색하였다. 사용한데이터베이스는 RISS, KISS, NDSL, 교보스콜라, 누리미디어, KoreaMed, Pubmed 와 ISI database (web of science) 를사용하여검색누락을최소화하였다. 논문의제목, 초록, 주제어에검색어 ICF, international classification of functioning, disability and health, 국제기능장애건강분류 가포함된논문을검색하였다. Pubmed와 ISI database (web of science) 의경우 Korea 를추가하여검색하였다. 논문선정은 peer-review를통해학술지에발표된논문으로한국인연구자를포함하고국내에서개발된논문으로연구에 ICF의직접적인활용을반드시포함하고있어야한다. 학술대회발표논문과학위논문은제외하였다. 중복된논문을삭제후총 109개의논문이검색되었다. 먼저각논문의제목과초록을확인하여포함과제외요건을확인하였으며, 검색된논문에서언급한관련참고문헌또한확인하여검색결과에포함하였다. 논문저자에의해확인된중복논문 (1건 ), ICF의정의에대한언급만있는논문 (7건), ICF개념을기반으로개발된도구를사용하였으나직접적인 ICF항목이나모델을활용하지않은논문 (10건 ), 일본에서진행된연구논문 (2건) 으로 20개의논문을연구분석에서제외하여최종 89개의논문을본연구분석에포함하였다. 논문검색은 2명이독립적으로수행하여결과를비교확인하였다. 2. 분석내용본연구에포함된 89편의 ICF 관련논문의분석을위하여코딩의준거분석틀에따라연구자, 게재연도, 연구제목, 연구목적, 평가도구및주요내용을코딩하였다. 코딩은 2명의연구자가독립적으로수행하여비교하였으며내용이동일하지않은코딩결과에대해서는 2명의연구자의합의에의해정리하였다. 이를토대로연도에따른 ICF 관련연구수행빈도를확인하였고 ICF 관련연구가수행된영역을임상영역, 장애인영역, 노인영역, 특수교육영역및기타영역으로분류하여연도에따른연구영역의변화추이도관찰하였다. 영역의 분류는연구대상자를기준으로하였다. 임상영역은임상환자를대상으로연구한논문으로분류하였으며, 장애인영역은임상환자가아닌장애인과장애아동대상논문을포함하였다. 특수교육영역의경우는교육과정개발및교육방향성등장애학생교육관련연구로분류하였으며, 노인영역은지역사회노인인구대상으로실시한연구논문들을포함하였다. 장애인과임상환자를모두포함한논문 (2건) 의경우는연구목적에따라각각분류하였다. 또한연구논문에서활용한 ICF 사용정도를 ICF에대한소개, ICF 모델및체계의적용, ICF 의특정항목과특정질환코어세트와같은항목의적용및 ICF 관련도구개발로분류하여분석하였다. 결과 1. 연도별발표현황선정된논문의연도별발표현황을살펴보면, 2001년 ICF가발표된이후 ICF관련논문들의수가꾸준히증가됨을알수있었다. 2001년 ICF 가발표된이후국내에그개념과장애모델관련하여여러분야에서지속적으로소개되는것을알수있었다. 2002년부터 2004년의논문들은장애및사회복지분야에서 ICF에대한개념및장애모델소개에대한연구보고로이루어졌으며, 2009년이후의학, 물리치료학, 체육학등의다양한분야에서 ICF 개념과장애모델의소개에대한논문이발표되었다. 2007년이후장애인영역과임상영역에서관련데이터수집을통한연구논문이발표되었다. 2011년이후지역사회노인과장애아동및특수교육분야에서 ICF를활용한연구들이보고되었다. 임상영역의경우 2007년이후임상환자의특성과중재효과에대해연구한논문의보고가급속하게증가하였다 (Figure 1). 2. 연구영역별분석 2001년부터 2015 년 5월까지발표된 ICF 관련논문중본연구에포함된 89건의논문중연구분야별빈도는임상영역 (37건 ) 이가장많았으며, 장애인영역 (26건), 노인영역 (7건 ), 특수교육영역 (7건 ) 및기타영역 (1건 ) 순으로나타났다. 분야에상관없이 ICF 개념소개에대한논문은총 11건이었다 (Figure 2). 3. 활용정도분석 ICF 활용정도는 ICF에대한소개 (11건 ), ICF 모델및체계의적용 (12 건 ), ICF의특정항목과특정질환코어세트와같은항목의적용 (31건 ) 및 ICF 관련도구개발 (12건 ) 에이르기까지다양하고세분화되어있었다. 임상영역과장애인영역에서의활용정도는 Table 1과 Table 2에제시되어있다. 노인영역에서의 ICF 활용정도는지역사회노인의건강상태, 9 관절 357

3 The Journal of Korean Physical Therapy Haejung Lee, et al. No. of studies Introduction of ICF Area of the disabled Clinical area Area of the elderly Area of special education Others 5 Figure 1. Publication evolution Year 고찰 Area of the disabled Clinical area Introduction of ICF Others Area of special education Area of the elderly Figure 2. The proportion of included studies in different areas: clinical, the disabled, the elderly, special education and others. Introducing ICF was also added as a separate category due to no actual data was used but only explained its concept. 염노인의여가활동참여제약관련요인, 10 재가노인의우울관련요인 11 및한일노인의생활기능비교에대한연구 12 에서는 ICF 모델과체계 를활용하여분석하였다. 지역사회노인의활동과참여수준, 13 사회 적활동장애와어려움을 14,15 ICF 체크리스트, 특정질환코어세트, 환 경요인및활동과참여영역의코드로분석한연구들이보고되었다. 특수교육영역의경우특수교육분야에서의 ICF 를활용한장애개 념의소개가 2004 년에발표되었다. 16 장애아동의글씨쓰기속도관련 요인분석을위하여활용한측정도구를 ICF 체계를활용하여분류 하였다. 17 지체장애학생의활동과참여수준, 18 장애학생의자립생활 준비를위한활동과참여수준, 19 신체기능과적응유연성의관계, 20 개별화교육계획 21 및교육방향성탐구를 22 위해 ICF 체크리스트를포 함한특정코드를활용하여분석보고하였다. 또한 ICF 의특수교육 활용가능성탐색을위한고찰연구도최근발표되었다. 23 본연구는문헌고찰연구로서 2001년 ICF가 WHO에서발표된이후 ICF 관련국내연구의활용분야및활용정도에대한현황을살펴보고자실시하였다. 검색된 89편의논문을년도별발표현황, 연구영역및그활용정도의결과를분석하여현황을제시하고자한다. 2001년 ICF가발표된이후국내의 ICF 관련연구보고가꾸준히증가됨을알수있었다. 이러한결과는외국의사례에서도비슷한결과가관찰되었다 년보건복지부에서 국제기능장애건강분류 로한글판이출판되었다. 8 한글판의출판이전의 ICF 관련연구는장애와사회복지분야에서 ICF에대한개념과장애모델의소개가주를이루었다. 특히 2009년이후의학, 물리치료학, 체육학등의다양한분야에서 ICF 개념과장애모델의소개와함께그분야에서의활용을제안하는연구들이발표되었다 또한임상, 장애인, 특수교육분야등다양한영역에서 ICF를적용하여데이터를수집하여분석하는전문화되고세분화된연구가수행되고있었다. 지역사회노인과장애아동및특수교육분야에서도최근 ICF를활용한연구들이보고가증가되고있다. 이러한결과로 ICF가여러분야에서활용가능성의여부를확인할수있었으며, 그분야에서 ICF가적용되어유용하게사용될수있는방안을찾고있음을알수있었다. ICF에대한초기연구들이장애인과사회복지영역에서시작되어꾸준히연구가이루어진반면, 임상분야의경우, 최근연구가급격히증가됨이관찰되었다. 임상관련연구는재활의학, 물리치료학, 작업치료학, 간호학등의분야에서환자특성분석, 치료의중재및효과, 평가도구개발등세분화된연구들이수행되었다. 본연구의결과국내임상분야에서활용가능성을확인하였으며유용하게적용할수있는방향의제시가필요할것으로사료된다. ICF 활용에대한선행연구에서도임상적용에대한연구가가장많았다고보고되었으며, ICF 활용을권장하였다

4 Table 1. ICF usage in the clinical areas; see the appendix for included studies (numbers in the contents refer to the appendix s) Usage levels on contents Research areas and/or participants Contents Descriptive studies: Introduction of ICF concept/model Reviews ICF Framework ICF Code developing measurement tools Case studies Medicine, physical therapy Introduction of ICF and application in clinical practice (1, 2) Introduction of the concept of disability and changes in concepts of disability (3, 4), evaluation permanent impairment system in American (5) Patients with stroke, brain injury Children with attention deficit hyperactivity disorder, developmental coordination disorder, cerebral palsy Children with cerebral palsy Patients with stroke, spinal cord injury Children with cerebral palsy The elderly under medical services for their health conditions Persons under visiting rehabilitation service Persons with Parkinson s, stroke, breast cancer, impairments of lower extremity Persons with stroke, spinal cord injury, traumatic brain injury, shoulder pain Analyzing effects of community based rehabilitation program (6), health condition specific interventions, outcome measures (7-10) Investing trends in virtual reality technology (11) Analyzing treatment effectiveness using body function and structure, activity and participation (12) Corset: analyzing needs of rehabilitation services (13, 14), functioning characteristics (15), Checklist: investing factors related to social participation in community (16), effectiveness of intervention using activity and participation, and environmental factors (17, 18), satisfaction o using assistive technology device (19), analyzing characteristics of body function, activity and participation with children with cerebral palsy (20) Specific ICF Codes: effectiveness of functioning status with intervention (21) Linking: Fall risk nursing assessment (22), Functional Independent Measure, Modified Bathel Index (23), information in EMR (24, 25) Prediction model for depression (26), Acute Stroke ICF coreset (27), Brief Stroke ICF coreset (28), ICF-Activity measure (29), Modified Brief ICF coreset for breast cancer (30, 31) Case management frame (32), intervention strategies (33-38), clinical records (39) Table 2. ICF usage in the area of the disabled; see the appendix for included studies (numbers in the contents refer to the appendix s) Usage levels on contents Research areas and/or participants Contents Descriptive studies: Introduction of ICF concept/model Reviews ICF Framework ICF Code developing measurement tools Persons with disabilities Introduction of ICF in general (40) Introduction of the concept of disability in employment policy, social supports and changes in concepts of disability, social attitudes towards disabilities and social work practice (41-43) Definition of mental retardation using ICF (44) Augmentative and alternative communication users Application strategies of the ICF Persons with physical disabilities The disabled under unemployment Persons with disability of internal organs The disabled with spinal cord injury, muscular dystrophy, osteogenesis imperfecta, rheumatoid arthritis University students with disabilities, the disabled living in community, persons with physical disabilities Registered persons with disability in Korea Employment and disability Persons with disabilities, Persons with mental disabilities Classify measurement tools for communication using ICF framework (45) Applicability of ICF: focused on statistics and clinical usage (46) Investing factors influencing social participation (47, 48), activity limitation and participation restriction (49), needs for personal assistance services (50), job search behavior (51) Job accommodation support system and application (52) Relation between environmental factors and social participation (53) Coreset: Analyzing factors influencing work and employment (54), social participation (55) Checklist: Investing environmental factors related to university life (56), disability identity (57) and relationships between body structure, activity and participation (58) Specific ICF codes: Analyzing disability registration system (59), patterns in assistive technology device use (60), Surveying employment for the disabled (61), investing factors influencing employment and satisfaction in life (62), work ability (63) Linking: Items of Functional Independence, Measure and Modified Bathel Index into ICF codes (64) Developing a participation scale for the disabled (65), environmental scale for the disabled (66), ICF corset for mental disabilities (67) mobile application of assistive devices (68), a measuring tool for actual condition and recognition on social participation (69), job functional assessment scale (70) 359

5 The Journal of Korean Physical Therapy Haejung Lee, et al. ICF 활용정도에대한분석에서장애인영역의특성은 ICF framework을사용한연구가다른영역보다많았으며, 활동과참여영역및환경요인이신체기능과신체구조영역보다적극적으로활용됨을관찰하였다. 흥미롭게도연구목적에따라특정항목을추출하여활용하는연구가보고되었다. 필요항목추출은약 1,500개의전체 ICF 항목에서뿐만아니라특정질환관련 coreset과 checklist 및기존의측정도구에서도필요항목을선택하여데이터수집에활용하였다. 또한국내실정에맞게기존의 coreset를수정하여발표한연구도있었다 (Table 1, 2). 표준화된프로토콜과정을통해개발된측정도구는특정영역또는분야에서의사소통을용이하게하고관련통계자료를확보하기위해사용된다. 27 이러한점에서개별연구에서특정질환 coreset나표준화된측정도구를수정하여사용한다면그연구결과를보편화하기에는제한이있을것으로생각된다. 환자특성분석이나장애인의사회참여또는고용에영향을주는요인을분석한연구에서특정영역 ( 예. 활동및참여, 환경요인 ) 을선택적으로사용하는데있어 2단계의분류를활용한경우가대부분이었다. 18,28-30 이는연구대상자의구체적인특성을표현하는데제한이있는것으로판단된다. 그러므로연구의목적에맞는 ICF 영역선택뿐만아니라해당항목의수준이알맞게선택되어야할것으로사료된다. 임상영역에서는사례를통한 ICF 적용이특징적이었으며, 문헌고찰을통해서현재적용하고있는중재와측정도구에대하여 ICF framework을이용하여분류하는연구가보고되었다. 대부분의연구에서환자의특성을이해하기위하여 ICF coreset나체크리스트를활용하여데이터수집이이루어졌으며, 또한기존의측정도구와임상환자정보를 ICF의항목과개념비교및연결에대한시도가있었다. 이는 ICF를표준분류체계로두고현재수행하고있거나활용하는정보를이표준에연결하여임상에서 ICF를활용하는데기초를제공하는작업으로생각할수있다. 지역사회노인영역과특수교육영역, 체육학에서는비교적최근에연구자료들이발표되었다. 노인영역에서는신체기능과환경요인이사회참여와활동에미치는영향에대한연구로 framework, 체크리스트, 특정질환코어세트, 환경요인및활동과참여영역의항목을다양하게활용하였다. 특수교육영역의경우장애학생의개별화교육계획및교육방향성을위하여특수학교교사들의의견수렴과학부모를대상으로데이터수집을하였다. ICF의특수교육활용가능성에대한제안도있었다. 31 이들보고에대한분석결과는교육분야와건강한사람들을대상으로 ICF가확대적용될수있음을시사한다. 현재국내의 ICF 관련연구는임상영역, 장애인영역, 특수교육, 지역사회노인및체육학등다양한영역에서수행되었고, framework 를활용한 4개의영역 ( 신체기능, 신체구조, 활동과참여, 환경요인 ) 이나 체크리스트, 특정질환코어세트를활용한연구가대부분이었다. 그 러나적용에있어서표준화된과정을따르기보다연구자의연구목 적에맞추어수행되는것을알수있었다. ICF 는기능수행에대한국제표준분류이므로학제간의의사소통, 기관사이의정보교류, 전문분야간의팀워크, 국가간관련자료비교 를위해사용되어야하며, 이를위해앞으로의연구에서는다양한영 역에서 ICF 의활용방안이나활용지침의개발이필수적이라사료된 다. 활용방안이나활용지침은국가적차원에서개발되어야하며, 다 양한전문분야의전문가들의합의에의한표준화된프로토콜에따 라개발되어야할것으로생각된다. 개발된활용지침을토대로한 ICF 교육은바른 ICF 사용을위해필수적이다. ACKNOWLEDGEMENTS This study was supported by a grant of the Korea Healthcare technology and Korean Medicine R&D Project, Ministry of Health & Welfare, Republic of Korea (HI12C0566). REFERENCES 1. WHO. International classification of functioning, disability and health WHO. Toward a common language for functioning, disability and health WHO. How to use the icf: A practical manual for using the international classification of functioning, disability and health (ICF). Exporsure draft for comment. Geneva, WHO, Stucki G. International classification of functioning, disability, and health (ICF): A promising framework and classification for rehabilitation medicine. Am J Phys Med Rehabil. 2005; 84(10): Jelsma J. Use of the international classification of functioning, disability and health: A literature survey. J Rehabil Med. 2009; 41(1): Maini M, Nocentini U, Prevedini A et al. An italian experience in the icf implementation in rehabilitation: Preliminary theoretical and practical considerations. Disabil Rehabil. 2008;30(15): Ruaro JA, Ruaro MB, Souza DE et al. An overview and profile of the icf s use in Brazil - a decade of history. Brazilian J Phys Ther. 2012;16(6): Ministry of Health & Welfare. International classification of functioning, disability and health-korean version. WHO, Ko HE, Oh MH, Baek JY et al. A comparative study of communitydwelling elderly people body functions and activities & participations based on ICF. J Kor Soc Occup Ther. 2012;20(4): Lee SE. Factors affecting leisure participation of older adults with arthritis J Leisure Studies. 2013;11(1): Han SJ, Kim HS. Factors influencing depression in low-income elderly living at home based on icf model. J Kor Pub Health Nur. 2014;28(2): 360

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7 The Journal of Korean Physical Therapy Haejung Lee, et al. Appendix. List of references in the table 1 and 2 No Authors (year) Title of the study 1 Lee MK, Kim TY (2009) Applying ICF model into practice in PNF. 2 Jung HY (2002) The concept of ICF for effective disability classification and its application in Korea. 3 Rah UW, Jung HY (2009) Changing concepts and classifications of disablement. 4 Jung HY (2004) Impact and application of the internal classification functioning, disability and health in the medical rehabilitation. 5 Park DS, Lee SG (2009) A comparative study on evaluation methods of permanent impairment in Korea. 6 Cha YJ, Kim SY (2014) Effect of community-based rehabilitation on patients with brain injury: Meta-analysis based on the ICF model. 7 Lee NH, Kim KM (2014) The intervention and outcome measurement tools of children with attention deficit hyperactivity disorder: A systematic review. 8 Jung HY, Kim KM, Chang MY (2009) Measurement tools for occupational therapy for stroke patients: A systematic review. 9 Choi YJ, Kim KM (2009) A review on the use of a goal attainment scale as measurement tool fot the effectiveness of rehabilitation intervention of children. 10 Park SY (2015) The effects of robot-assisted gait training for the patient with post stroke: A meta-analysis. 11 Kim MJ (2015) Research trends in rehabilitaiton program for disabled applying virtual reality technology in Korea. 12 Kim JY, Kim JM, Ko EY (2014) The effect of the action observation physical training on the upper extremity function in children with cerebral palsy. 13 Kang EK, Kim WS, Han TR et al. (2007) Desire for rehabilitation services of stroke patients admitted in post-acute rehabilitation facilities. 14 Kim WS, Kang EK, Shin HI et al. (2008) Desire for rehabilitation services of patients with spinal cord injury admitted in post-acute rehabilitation facilities. 15 Song JM, Lee HJ (2014) Investigating functional level in patients with stroke using ICF concept. 16 Park HJ, Bang YS, Kim HY (2014) Factors relating community living participation in elderly people with stroke using international classification of functioning, disability and health. 17 Ko IH, Kim JH, Lee BH (2013) Relationships between lower limb muscle architecture and activities and participation of children with cerebral palsy. 18 Park SK, Hur JW, Yang DJ et al. (2012) Effects of home visiting physical therapy and environmental factors analysis using International Classification of Functioning, Disability and Health (ICF). 19 Chang MY, Jung HY (2010) A study on elderly people's level of satisfaction with assistive technology devices based on occupational therapy intervention. 20 Lee JW, Chung EJ, Lee BH (2013) A comparison of the functions, activities and participation in school-aged children with cerebral palsy by GMFCS. 21 Kim K, Lee B, Lee W (2014) Effect of gross motor group exercise on functional status in chronic stroke: A randomized controlled trial. 22 Cho S, Lee E, Kim H et al. (2008) Fall risk nursing assessment according to the international classification of functioning, disability, and health. 23 An SH, Park DS, Lee SM (2009) The clinical application of ICF (international classification of functioning, disability and health) for functional ability analysis of stroke patients. 24 Nam HS, Kim KD, Shin HI (2012) ICF based comprehensive evaluation for post-acute spinal cord injury. 25 Han KY, Kim HJ, Bang HJ (2015) Feasibility of applying the extended ICF core set for stroke to clinical settings in rehabilitation: A preliminary study. 26 Bae ES, Cheun SM, Kim JW et al. (2013) A prediction model for depression in patients with Parkinson's disease. 27 Park MJ, Kang JY (2012) ICF core sets for measuring functional status of acute stroke patients. 28 Kang JY, Gong J, Park MJ et al. (2013) Assessing the functional status of acute stroke patients using ICF core set-short form. 29 Choi BS (2013) A comparative study of item difficulty hierarchy of self-reported activity measure versus metabolic equivalent of tasks. 30 Yang EJ, Kim BR, Shin HI et al. (2012) Use of the international classification of functioning, disability and health as a functional assessment tool for breast cancer survivors. 31 Yang EJ, Shin EK, Shin HI et al. (2014) Psychometric properties of scale constructed from the international classification of functioning, disability and health (ICF) core set for breast cancer based on Rasch analysis. 32 Kwak NH, Chang KY, Ahn KH et al. (2012) Study on the application of ICF-based SPG case-management frame with a focus on SCI. 33 Bang YS, Kim HY (2010) Clinical application of the international classification of functioning, disability, and health tools in occupational therapy. 34 Bang YS, Kim HY (2011) Application of rehabilitation problems solving form for a person with spinal cord injury. 35 Kang TW, No HJ (2012) A case report of progressive intervention strategy applied ICF tool about gait for TBI patient. (Continued to the next page) 362

8 Appendix. Continued No Authors (year) Title of the study 36 Kang TW, Song MS, Kim CH (2012) Case report of intervention strategy applied ICF tool on patient with low back pain. 37 Yoon TW, Kim TY (2011) A case report of intervention strategy applied ICF tool about floor to stand and stand to floor for stroke patient. 38 Gong SW, Kim JS, Bae SJ et al. (2013) Using ICF model rehabilitation management case report on patients with cerebellum disorder 39 Gong SW, Lim HC, Chung YW (2011) ICF tool applied intervention strategy and charting on upper extremity functional recovery of the frozen shoulder patient-case study. 40 Shin EK (2004) ICF usage in Korea. 41 Kim YD (2002) Changes in the concept of disability and its implications for social work practice. 42 Hwang SK (2004) Understanding the new international classification of disability and introduction of the concept of functional disability. 43 Kim CH (2010) How to conceptualize and measure disability in the employment policy-the comparison of common approaches and the application of ICF. 44 Oh SW (2003) The comparison analysis of the mental retardation classification systems. 45 Jeong SY, Kim SS (2014) Literature review on communication assessment scales for AAC user. 46 Shin EK (2013) A study on the application strategies of ICF on the functioning, disability and environmental factors in Korea - focused on the application of ICF in Japan. 47 Kim DK, Kim SY, Lee SJ (2010) Predictors of social participation of people with severe physical disabilities based on ICF framework. 48 Lee JE, Shin EK, Shin HI (2014) Social participation and the effect of environmental factor among persons with disability of internal organs- using whodas Park SS, Kim CJ (2013) Participation of the people with physical disabilities according to the stage of change. 50 Lee I, Choi J, Kim D (2008) A study on the influential factors on the pas need of people with physical disability - adapting ICF Kang EN, Maeng JY (2011) A study on the factors influencing on job search behavior among people with disabilities under the unemployment - adapting ICF framework. 52 Nam SH (2014) A study on the enhancing job accommodation support system and its application in Korea. 53 Lim HK, Park JK, Kim ER et al. (2015) Relationship between the environmental factors and social participation of individuals with disabilities based on the ICF. 54 Shin EK, Tak SJ (2012) Study on affecting factors on work and employment of the persons with spinal cord injury: The application of icf coresets. 55 Shin EK, Lee HN (2013) Factors influencing social participation in people with musculoskeletal conditions - applying ICF relevant categories. 56 Son BY, Bang YS, Kim HY et al. (2013) ICF environmental factors related to university life adjustment of students with disabilities. 57 Lee I, Kim S, Choi J (2007) A exploratory study on factors affecting disability identity of people with physical disabilities. 58 Park S, Heo J (2014) Correlation between structures related to movement, activity and participation in disabled persons living at home. 59 Shin EK, Shin HI, Lee HN (2012) A study on the application of relevant ICF 2 level codes in Korea. 60 Jun YH (2012) Analysis of change patterns in assistive technology device use of the workers with disabilities. 61 Yoo W, Kwon K (2014) A comparison of the functional criteria of disability with the medical criteria by their effects on disability employment probability. 62 Jeon BY, Kwon SM, Cho BH et al. (2010) Factors associated with employment and life satisfaction of occupationally injured people. 63 Lee SW (2011) Effects of work ability on the employment status of people with disabilities: Comparing degrees of disability, icf activity limitations & participation restriction, levels of assistance needed for daily activities, and self-assessed health status. 64 Kim WH, Ahn MR, Kim ES et al. (2008) Function and environmental factors analysis using ICF (international classification of functioning, disability and health) for people with disabilities. 65 Kim KM, Yoon JY (2010) Development of a scale to measure participation according to the International Classification of Functioning, Disability and Health (ICF). 66 Kim KM, Yoon JY (2013) Development of a scale to measure environmental factors. 67 Shin EK (2012) An exploratory study on ICF core set development for people with mental disabilities and schizophrenia. -focused on "activity and participation" and "environmental factors"-. 68 Jung BK, Lee SA, Min SD (2014) Development of mobile application based on ICF (International Classification of Functioning, Disability and Health) for provision of assistive devices for people with disabilities. 69 Lim HK, Park JK, Kim ER (2014) Actual condition and recognition on social participation of individuals with disabilities. 70 Shin HW, Kang BN (2014) A study on development of the job functional assessment scale for people with disabilities