Dominique Van de Velde

Objectives: To systematically examine the methodologies used in the development of International Classification of Functioning, Disability and Health (ICF) Core Sets (CSs) across all developmental phases, and to identify methodological variation in stakeholder involvement, geographical representation, consensus procedures and validation approaches to inform the future development of ICF CSs. Design: Scoping review conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) and Joanna Briggs Institute methodological guidance. Setting: Literature published between January 2001 and July 2024. Publications were identified through PubMed, supplemented by reference list screening and author contact where necessary. Participants: We identified 170 relevant publications related to the development, validation and implementation, covering 34 CS across diverse health conditions. Eligible publications comprised preparatory studies (eg, systematic reviews, patient perspective studies, expert surveys), protocol/discussion papers, consensus conference reports, validation and implementation studies. Results: Most publications originated from Europe. The comprehensive CS averaged 97 ICF categories (SD 29) and the brief CS 26 (SD 12). In 38% of the studies, the focus was only on validity research. Variations were observed in patient and expert involvement during development. Considerable variation was observed in stakeholder involvement, geographical representation, consensus procedures and validation approaches across developmental phases. Conclusion: This review demonstrates substantial methodological diversity in ICF CS development across the different phases. While the developmental framework proposed by Selb et al was generally reflected across studies, considerable variation existed in how developmental phases were operationalised. Future ICF CS developments may benefit from stakeholder involvement, more balanced geographical representation, and continued attention to validation and implementation activities.

Purpose People with chronic low back pain, or more specifically, Persistent Spinal Pain Syndrome Type 2, experience decreased functionality and quality of life, resulting in a heavy personal and societal burden worldwide. Increasing the capacity of a person to participate in meaningful activities, including return to work, has gained substantial attention, but results remain suboptimal. Gaining more insight into stakeholder experiences is crucial to enhance outcomes. This study aims to investigate the lived experiences of rehabilitation professionals in guiding rehabilitation for people with Persistent Spinal Pain Syndrome type 2 in a research context. Methods An interpretative hermeneutic-phenomenological study was conducted to generate an interpretative understanding of rehabilitation professionals’ lived experience in delivering an intervention within a structured research context. Data were collected during semi-structured interviews with 10 rehabilitation professionals. Data analysis followed an interpretative hermeneutic process. Results The following experiences were identified: (1) a structured balance between capacity and demand; (2) leaving the current pain-oriented approach; (3) a catalyst for work-oriented reasoning beyond workability; (4) the emerging need for building towards interdisciplinarity; and (5) multiple layers of personalisation. Conclusion Personalisation is most effective when embedded within a multimodal rehabilitation framework that addresses the physical, psychological, occupational, and contextual domains of functioning. However, it remains a concept that is hard to grasp. Workability-focused protocols may function not only as treatment frameworks but also as catalysts for broader return-to-work reasoning. Although multidisciplinarity is a solid structure, interdisciplinarity is preferred.

Introduction: This study explores the lived experiences of individuals receiving paid home care in Flanders, Belgium. It considers how identity, health uncertainty, and systemic barriers shape opportunities for participation. Reablement is positioned as a conceptual lens through which these experiences are interpreted, offering insight into how person-centered approaches may be meaningfully adapted within the Flemish primary care context. Method: An interpretative phenomenological analysis (IPA) was used and semi-structured interviews were conducted until saturation of the data. In line with the hermeneutic circle, participants’ were informed about reablement as an alternative model of care before the interviews took place. Subsequently, their experiences of their current paid home care were captured. Finally, the team engaged in ongoing reflexive dialogue to critically examine the results and interpreted them in relation to the principles of reablement to explore its potential as an alternative model of care. Findings: Six participants were included. Thirty-six experiential themes were identified and refined into three overarching group experiential themes. Participants described the experiences of their care as the unpredictability of daily life, the centrality of their activities to identity, and limitations imposed by rigid care systems. The analysis generated the following themes: (1) I Am What I Do: Preserving identity through engagement in meaningful activities, (2) I Live with Uncertainty: Continual negotiation of possibilities amidst changing health, and (3) The System Decides, Not Me: Experiencing powerlessness within institutional decision-making. The interpretation of these experiences in relation to reablement suggested a strong alignment between participants’ needs for autonomy, meaningful occupation, flexibility, and participation, and the core principles underpinning reablement. Conclusion: Reablement offers a promising framework for enabling participation, but must be context-sensitive and co-produced with those receiving care. Occupational therapists could challenge ableist assumptions and advocate for flexible, personalized care. Lived experience should guide innovation and implementation to reduce care poverty and support meaningful occupation.

BACKGROUND Previous research on patient experiences with generative artificial intelligence (GenAI) has primarily relied on static technology acceptance models to evaluate the use of AI tools in healthcare. However, it has been poorly studied which mechanisms shape acceptance, empowerment, resistance, and the changing relationship with healthcare professionals. OBJECTIVE This Systematic Literature Review (SLR) evaluates patient experience with GenAI in healthcare, thereby aiming to understand the patient– GenAI interaction in healthcare and frame the dynamics in patient experience. METHODS The review consists of empirical studies published in 2022–2026 across six major databases and records. It is conducted following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA-2020) guidelines. It synthesised diverse methodologies and tools. Records were screened using Rayyan. Researchers assessed study quality using the Mixed Methods Appraisal Tool (MMAT), evaluated theme confidence using the Confidence in the Evidence from Reviews of Qualitative Research (GRADE-CERQUAL) framework, coded data with MAXQDA, and synthesised data using the Thomas and Harden (2008) framework. RESULTS Key findings suggest differing patterns of Patient – GenAI interactions according to their control over GenAI, the authority the GenAI assumes, experience, agency and literacy of the patient. Across studies, prior experience and health/AI literacy were associated with differences in perceptions of empathy, privacy, trust, and clinical autonomy, although the direction and strength differed by context. Furthermore, patients appear to value conversational anonymity while often having limited awareness of data handling. As GenAI tools transition from administrative tasks to clinical operations, some patients become more selective or resistant to the autonomous clinical roles, favouring the human-to-human diagnostic relation. The review proposes the Dual-Pathway Patient-GenAI Conceptual Model (DP-PGCM) to map patient-controlled and provider-deployed/controlled interaction trajectories. CONCLUSIONS Patients’ GenAI use is a dynamic process. It is role-dependent rather than technology-wide. Patient experience appears to be structured by who controls the tool/system, what clinical authority the tool is granted, and how patients interpret its empathy, privacy, and epistemic reliability. CLINICALTRIAL PROSPERO registration number: (CRD420261362444). The title and keywords are revised to include the conceptual model.

This study explores how adults and the elderly experience living with vision loss in the Flanders region of Belgium. As part of a mixed-method design, five focus groups were conducted with 18 Dutch-speaking participants. Thematic analysis and International Classification of Functioning, Disability and Health (ICF) linking rules were applied, resulting in 409 concepts mapped to 119 ICF categories. Most concepts related to activities and participation (53%), followed by environmental factors (30%) and body functions (17%). Key challenges included emotional well-being, mobility, self-care, household tasks and access to information. Participants also highlighted barriers such as limited job opportunities, insufficient social support and restricted access to leisure activities. These findings underscore the complexity of functioning with vision loss and the importance of addressing both personal and environmental factors. This research provides essential input for a client-centered ICF Core Set for Vision Loss that reflects the real-world needs of people with vision loss.

Background: Communication of healthcare professionals (HCPs) plays an important role in patient therapy experiences. According to Self-Determination Theory, HCPs’ motivating interaction styles foster these experiences. However, empirical evidence on how patients perceive their HCP’s interaction styles and how these perceptions relate to their basic psychological needs, therapy motivation, and therapy adherence remains limited. Methods: This cross-sectional study included patients who received physiotherapy or occupational therapy (N=346). Participants completed valid and reliable questionnaires to assess their perceptions of their HCP’s motivating (autonomy-support, structure) and demotivating (control, chaos) interaction styles, their basic psychological needs (satisfaction, frustration), motivation toward therapy (intrinsic motivation, integrated, identified, introjected, external regulation, amotivation), and therapy adherence. Data were analyzed using Structural Equation Modeling (SEM)-analysis. Results: The SEM analysis revealed that perceived autonomy-support was positively related to need satisfaction and negatively to need frustration. Perceived control was positively related to need frustration. Need satisfaction, in turn, was positively related to intrinsic motivation, integrated, identified and introjected regulation, while need frustration showed a negative relationship with intrinsic motivation and introjected regulation, and a positive association with external regulation and amotivation. Integrated and identified regulations were positively related to adherence, while external regulation and amotivation showed negative associations. Conclusion: These findings suggest the importance of HCPs adopting an autonomy-supportive interaction style to foster patients’ need satisfaction, promote self-determined motivation, and enhance therapy adherence. Conversely, controlling interaction style undermines patient therapy experiences by increasing need frustration, reducing self-determined motivation and lowering adherence. It is recommended to focus on these components during training. Plain Language Summary: What is this summary about? This research gathered insights among people receiving physiotherapy or occupational therapy. The study examined how patients experience the motivating and demotivating interaction styles of their therapist. It also looked at how these experiences relate to patients’ basic psychological needs (feeling supported or frustrated in their autonomy, competence, and relatedness), their motivation for therapy, and therapy adherence. What are the key takeaways?Patients who experienced their therapist as autonomy-supportive experienced more satisfaction of their basic psychological needs and less frustration. Patients who felt controlled by their therapist experienced more frustration.When patients felt their basic needs were satisfied, they were more qualitatively motivated, for example, because they found therapy meaningful or personally valuable. When their needs were frustrated, they felt more pressured or even unmotivated.The type of motivation matters: patients experiencing more qualitative or self-determined forms of motivation were more likely to adhere to their treatment. Those who felt pressured or unmotivated were less likely to adhere. What are the main conclusions?The research concludes that an autonomy-supportive approach is related to more positive patient experiences, stronger self-determined motivation, and better therapy adherence, while a controlling approach is related to more less favorable variables.This highlights the importance of healthcare professionals’ communication from the patient’s perspective.

Objective: Interdisciplinary interventions for chronic low back pain are diverse, and there is a need to reach consensus on the content of rehabilitation. Design: A three-round Delphi survey was conducted across international networks, a world physiotherapy specialty group, and the research team. The first round contained a checklist, based on previous research on interdisciplinary rehabilitation for people with chronic low back pain. Participants rated all items, subitems, clarifications, and questions on three content-validity indicators: (a) clarity and comprehensibility, (b) unique value, and (c) alignment with the goal. General questions were asked, together with qualitative feedback and missing items. A sensitivity analysis was conducted in anticipation of a possible overrepresentation of participants from a specific region. Setting: Clinical practice and research. Participants: Clinicians or researchers with knowledge and/or experience in the field of chronic low back pain and/or rehabilitation. Main measures: Consensus scores and qualitative feedback. Results: After three rounds, consensus was reached on all subitems. There was an overrepresentation of Belgian participants. The sensitivity analysis, removing Belgian responses, showed no or little differences in consensus scores. Consensus was reached on a comprehensive checklist comprising 11 items essential to rehabilitation for people with chronic low back pain. Additionally, 32 subitems with corresponding questions were identified, ensuring coverage of all aspects of rehabilitation for people with chronic low back pain. Conclusion: This study developed an evidence- and consensus-based checklist for interdisciplinary rehabilitation in people with chronic low back pain. Future work should assess implementation and uptake in research and clinical practice.

Objective: This study aimed to develop Clinical Functioning Information Tool–musculoskeletal, an International Classification of Functioning, Disability and Health–based clinical tool for the assessment and reporting of the functioning and rehabilitation potential of patients with a musculoskeletal condition. Design: This multistep, mixed-methods tool development process encompassed developing an initial shortlist of International Classification of Functioning, Disability and Health categories (comprising the aggregation of the International Classification of Functioning, Disability and Health Core Sets for musculoskeletal conditions and a literature search), identifying the Clinical Functioning Information Tool–musculoskeletal items feasible for clinical use via a two-round Delphi survey, developing a simple description for each item and deciding on the rating scale through development working group consultations. These consultations were also instrumental at each step of tool development. Results: Based on a shortlist of 33 categories, the Delphi survey generated 17 items (7 body function and 10 activity and participation categories), which can be rated with a 0–4 scale (0 = no problem to 4 = complete problem) accompanied with rating specifications or with a 0–10 numeric rating scale without specification. Conclusions: Clinical Functioning Information Tool–musculoskeletal can be used by rehabilitation professionals to support individualized care and track functional outcomes. It can also be employed in research and public health. Psychometric testing and cross-cultural validation will be pursued to ensure Clinical Functioning Information Tool–musculoskeletal’s scientific robustness and applicability across diverse settings.

Developmental Coordination Disorder (DCD) is a neurodevelopmental condition affecting coordinated motor skill acquisition usually diagnosed after 5y. However, parents and clinicians report poorer movement quality at earlier ages. Using the ‘Observable Movement Quality’ scale (OMQ), we compared movement quality between children with typical development (TD), with DCD, and with DCD and Autism Spectrum Disorder (ASD). Using blinded retrospective video analysis, a trained physical therapist observed 5-min compilations of home videos at 6-12 m (n = 53), 12-18 m (n = 54), and 18-24 m (n = 47) followed by OMQ-scoring and a three-point scale for clinical judgement (will/might/will not develop DCD). A 15% sample was re-evaluated to assess intra-rater reliability using Spearman coefficients. OMQ group performance was assessed using Kruskal–Wallis tests, while dichotomized (good/poor quality) data were examined with Fisher exact tests. OMQ scores’ association with later motor performance (MABC-2 and DCDQ) was analysed via Spearman coefficients. Cramer’s V determined the strength of association between clinical judgment and diagnostic outcome. Intra-rater reliability for total OMQ score was strong (r_s = 0.79, p ≤ 0.001). Reduced movement quality was found at 18-24 m in children with DCD (median 69, interquartile range [IQR] 10) and DCD+ASD (median 69, IQR 14) compared to TD children (median 74, IQR 2) (p ≤ 0.001). Five times more compilations in the DCD groups demonstrated poor overall movement quality at 18-24 m. At 18-24 m, movement quality correlated strongly with MABC-2 (r_s = 0.66) and DCDQ (r_s = 0.67). The therapist correctly identified 63–67% of DCD and DCD+ASD children respectively (Cramer's V = 0.62, p ≤ 0.001). These findings underscore the importance of investigating movement quality as a potential early feature of DCD.