ICF-Based Assessment of Functioning Problems in Parkinson's Disease: Findings From a Cross-Sectional Survey in Southern Ghana.

Abstract

Background: Most assessment tools may not be comprehensive enough to measure all relevant problems associated with Parkinson's disease (PD) and may focus only on activity. While specific performance-based outcome assessments are crucial for intervention design, it is important to establish the epidemiology of functioning problems, to understand the broad range of disability associated with a disease.

Objectives: This study aimed to describe the prevalence and nature of functional problems and the contextual factors experienced by persons with PD (PwPD) using the International Classification of Functioning, Disability and Health (ICF) framework. The distribution of substantial functioning problems across selected demographic and clinical variables was also assessed.

Methods: A cross-sectional survey was conducted among PwPD attending one primary and two tertiary hospitals in southern Ghana. The ICF Checklist (Clinician Form) was adapted to record impairments, activity limitations, participation restrictions, and environmental facilitators and barriers. Descriptive and inferential analyses were performed, with significance set at p < 0.001 for multiple comparisons using the Hochberg correction.

Results: The study included 75 PwPD (61.3% male) with a mean (SD) age of 66.8 (9.6) years. The most frequently reported issues were impairments in body functions and participation restrictions, with the top 10 problems reported by 68%-91% and 67%-88% of participants, respectively. Participants reported more facilitators, while challenges with general social support were the most frequently reported barrier among 60% of participants. Women and individuals with advanced PD were significantly more likely (p < 0.001) to report substantial functioning problems.

Conclusion: This study highlights critical functioning problems faced by PwPD in a resource-limited setting and underscores the value of using the ICF framework in rehabilitation assessment and planning. The findings may inform gender- and disease-stage-sensitive interventions for PwPD across diverse healthcare contexts.