Disability assessment in an Italian cohort of patients with obesity using an International Classification of Functioning, Disability and Health (ICF)-derived questionnaire

BACKGROUND Obesity is a clinical condition that contributes to the development of
related disability in different areas (physical, psychological and social). Multidisciplinary
treatment calls for specific instruments able to evaluate all related functional problems.
We have developed a tool (an ICF-based assessment instrument, the ICF-OB schedule) to
evaluate obesity-related disability, composed of an inventory of 71-items from the WHO
International Classification of Functioning, Disability and Health (ICF). AIM The aim of
the present study was to validate this new tool for the definition of obesity-related
disability. We also sought to examine the relationship between obesity disability, an index
of multimorbidity (Cumulative Illness Rating Scale, CIRS) and a well-validated score of
perceived obesity-related disability (Italian Obesity Society Test for Obesity-Related
Disability, TSD-OC). DESIGN Process validation of the ICF-OB schedule. SETTING
Baseline conditions of out- and in-patients. POPULATION A large cohort of obese
patients recruited from 9 multidisciplinary Centers belonging to the Italian Obesity
Society (SIO) network, which provide specialized obesity care. METHODS A total of
353 patients (F: 70%, age: 50.2±12.7yrs, BMI: 41.4±8.3kg/m2) were enrolled between
January 2017 and June 2018. The ICF-OB was used to define patients’ functioning and
disability profiles in order to set and appraise rehabilitation goals. RESULTS we
described the distribution of body functions (BF), body structures (BS) and activities and
participations (A&P) categories and the agreement rates were significant for the majority
of these. The ICF-OB was more often significantly associated, and with stronger
coefficients, with patients’ comorbidities as described by the CIRS rather than with body
mass index (BMI). The TSD-OC also presented a strong association with A&P indexes.
CONCLUSIONS the complexity of clinical condition, that generates disability in obesity
might be well identified with the use of this new instrument that appear significant related to

the perceived disability for each patients and also with their multimorbidity shows great promise as a tool for goal
setting in the rehabilitation of obese patients