Objective: to identify the leading domains of functioning in patients with Parkinson’s disease (PD) based on the International Classification of Functioning, Disability and Health (ICF).

Background: The ICF represents a modern framework for analyzing the barriers encountered by individuals with PD. It facilitates a shift in the clinical perspective from the traditional question, “What is wrong with this person?” to “Which of surrounding barriers hinder his functioning, and how can it be overcome to achieve a higher quality of life?”

Method: A prospective cohort study included 108 patients mean age 62.9 ± 10.9 years and PD stages 1–3 according to the Hoehn and Yahr scale. The study followed the MHADIE methodology, which identifies a category as relevant if at least 20% of participants reported a problem or in the case of environmental factors as a facilitator.

Results: The threshold values across all ICF categories exceeded in 56 cases: 21 – Body Functions (BF), 27 – Activities & Participation (AP), 8 – Environmental Factors (EF).

The most significant facilitators: products or substances for personal consumption e110 98%; support from immediate family e310 60%; friends e320 48% and the effectiveness of social security services, systems and policies e570 41%.

The main barriers: inadequacy of social security services, systems and policies e570 44%; insufficient support or negative attitudes from health professionals e355 40%; lack of support/ problematic family relationships e310 35%, adverse climate e225 25%.

Statistical analysis revealed several significant associations (p=0.01-0.001) between EF and BF/AP categories, with the greatest number of such influences observed in the domains “Products or substances for personal consumption” e110 and “Transportation services, systems, and policies” e540.

The study highlighted the ambivalent role of certain ICF categories such as “Immediate family” e310, “Health professionals” e355 [Figure 1], and “Social security services, systems, and policies” e570 [Figure 2], in the life of PD patients. Depending on specific circumstances, these factors can act as either facilitators or barriers, underscoring the complexity and contextual dependence of patient interactions with EF.

Conclusion: The study shows crucial domains for PD patients that could be included in the national ICF Core Sets.

Influence EF 355 on d440

Influence EF e570 on d870

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MDS Abstracts - https://www.mdsabstracts.org/abstract/health-related-quality-of-life-in-patients-with-parkinsons-disease-based-on-the-icf-model/