The original classification of impairment, disability and handicap by the World Health Organisation (1980) informs the basis for an understanding of rehabilitation. This was updated in 1997, with the aim of making the tool more capable for use in different countries and cultures, and more acceptable to different sociological and health-care disciplines. The ICF is based on the classification of health and healthrelated domains, and helps describe changes in body structure and function. It describes what a person with a health condition can do in a standard environment (capacity), and what they actually do in their usual environment (performance). In also taking into consideration contextual factors (both environmental and personal), the description of an individual’s functioning is more complete.

ICIDH – (1980)		ICF (1997)
Impairment	stayed	Impairment
Disability	became	Activity
Handicap	became	Participation

Impairment

• loss or abnormality of a body structure or of a physiological or psychological function

Activity

• ‘nature and extent of functioning at the level of the person. Activities may be limited in nature, duration and quality’
• concentrates on doing

Participation

• ‘is the nature and extent of a person’s involvement in life situations in relation to impairments, activities, health conditions and contextual factors’
• concentrates on being
• shifts from emphasising people’s disabilities to their level of health
• acknowledges that every human being can experience a decrement in health
and therefore experience some disability
• thereby ‘mainstreams’ experience of disability as a universal human experience

International Classification of Diseases (ICD-10) and ICF

• ICD-10 & ICF are complementary
• ICD-10 is mainly used to classify causes of death
• ICF classifies health