Gerold Stucki

Objective: To map the scope, thematic focus, and contribution of publications based on the International Spinal Cord Injury Community Survey (InSCI), and to identify remaining knowledge gaps in the literature. Design: We conducted a structured evidence map of peer-reviewed publications derived from InSCI. InSCI is a cross-sectional survey of adults with spinal cord injury/disease (SCI/D). Wave 1 (2017 to 2019) included 12,591 participants across 22 countries; wave 2 (2022 to 2024) included 15,249 participants across 32 countries. Publications were tracked and classified into 7 IPSCI-based domains. Results: By April 2026, InSCI generated 117 peer-reviewed publications (including 11 from wave 2). Health care needs were the largest category, followed by epidemiological studies, enabling environments, and education/employment. InSCI-based publications reported cross-country differences in quality of life, health care access, unmet needs, environmental barriers, and employment. Publications also reported a high burden of secondary health conditions, variation in health service use, and lower employment rates among persons with SCI/D compared with the general population. Conclusions: InSCI offers an expanding international data set on the lived experiences of individuals with SCI/D. Although publication activity is high across several IPSCI domains, critical research gaps remain regarding equity, gender, education, younger populations, and general population comparisons.

Rehabilitation physicians worldwide have been called to take action to explore and implement the International Society of Physical and Rehabilitation Medicine’s Clinical Functioning Information Tool - ClinFIT. ClinFIT is an International Classification of Functioning, Disability and Health-based and clinician-administered tool that can be used to systematically assess and report functioning of different patient populations across the care continuum and support the monitoring of rehabilitation outcomes. One essential action step is getting familiar with ClinFIT. It is possible to create a ClinFIT version for your setting and purpose, either by tailoring an existing ClinFIT version or by developing a new version for a specific health condition or context. This paper describes how to create a ClinFIT that works for you. Specifically, it provides you with information about current ClinFIT versions and what to consider when creating the desired ClinFIT version and presents a step-by-step guide for either tailoring an existing ClinFIT version or for developing a new ClinFIT version. This paper also introduces reporting considerations to enhance clinical utility as well as emerging opportunities offered by artificial intelligence and other digital technologies. Lastly, the authors invite all PRM physicians worldwide to join the ClinFIT community as knowledge-brokers and as champions, actively disseminating information about ClinFIT and participating in ClinFIT research.

Background: The aim of this study was to identify the most important and relevant aspects of functioning related to oral health from the patient's perspective. Materials and Methods: In this multicenter cross‐sectional qualitative study, focus groups and semi‐structured interviews were conducted. Adults age 18 years or older with an oral health condition, such as caries, periodontal disease, cancer of the oral cavity or lips, were included. The content of the focus groups and interviews was recorded, transcribed, and analysed using thematic analysis, that is, patterns in the data were identified and broken down into meaningful concepts, which in turn were linked to the most precise categories of the International Classification of Functioning, Disability and Health (ICF). Focus groups and interviews were analysed until saturation was reached. Results: Statements of 36 participants were included in the analysis. Saturation was reached after analysing five focus groups and 3 interviews, 1213 meaningful concepts were identified and subsequently linked to 150 ICF categories (51 in the Body Functions component, 39 in Activities and Participation, 16 Body Structures, 44 in Environmental Factors) and 102 Personal Factors. Thirty‐four concepts were not covered by the ICF and 49 were non‐definable concepts. The results of one focus group comprising of young health professionals are displayed separately. Conclusion: Functioning‐based outcomes for persons with an oral health condition were identified in every component of the ICF, indicating that oral health conditions affect different aspects of an individual's everyday life.

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.

Rehabilitation is increasingly recognized as a key component of health systems worldwide. To meet the growing demand for rehabilitation services, it is essential to strengthen academic capacity in Physical and Rehabilitation Medicine within universities. Academic structures are critical for training future physicians and professionals, and for advancing research and innovation in rehabilitation. In response to this need, a new European organization has been established: the European Organization of University Physical and Rehabilitation Medicine. This organization aims to unite and support university-based educators and researchers in the field, fostering excellence in teaching, research, clinical care, and academic leadership. The initiative has been developed through collaboration with major European and international rehabilitation bodies and is grounded in the values of representativity, inclusiveness, and collaboration. The organization invites current and future university professors in Physical and Rehabilitation Medicine to join as founding members and contribute to shaping its mission, structure, and strategic direction. By building a strong academic network across Europe, this initiative seeks to reinforce the foundations of rehabilitation in health systems and promote the development of a skilled and innovative workforce. This commentary outlines the rationale, development, and goals of the new organization and calls for broad participation from the academic community.

Objective: This paper introduces the “360° Model of Research”, a novel framework designed to prioritize functioning as a primary health indicator, particularly for individuals living with health conditions. The goal is to promote this model as a comprehensive, person-centred, and interdisciplinary approach to health research, moving beyond the traditional siloed and disease-based methodologies. Methods: The paper is conceptual, integrating existing scientific literature and theoretical frameworks to build the 360° Model. It draws on interdisciplinary perspectives from rehabilitation, social sciences, health services research, and ethics, among others, to create a unified health science focused on optimizing functioning. Results: The 360° Model emphasizes functioning as a key health indicator, combining biological health with lived experience. The Model provides a reference framework for data collection, but does not presume any particular explanatory theory about how lived experience is created or interpreted by the individual. It has been successfully applied in the Swiss Spinal Cord Injury Cohort Study (SwiSCI), demonstrating its value in addressing the comprehensive needs of individuals with spinal cord injury through interdisciplinary collaboration and a learning health system theory. Conclusion: The 360° Model offers a transformative approach, highlighting the importance of functioning in health research. It provides a robust foundation for a new interdisciplinary field of Human Functioning Sciences, aimed at optimizing health and well-being across diverse populations.

Objective: The aim of the study is to model the health indicator of functioning for persons with spinal cord injury or disorder living in Switzerland in the long-term context, considering chronological age, time since injury, and age at injury. Design: This is a longitudinal analysis of three waves of a community survey. An interval-scaled functioning metric was constructed using modern test theory. Random effects within-between mixed models were used to investigate trends in functioning over time. Results: Persons with complete injuries have lower levels of functioning than persons with incomplete injuries, and persons with complete tetraplegia have the lowest levels of functioning. The person’s age when injured, the level and completeness of the injury, the presence of secondary health conditions, and various combinations of these factors significantly influenced how functioning changed over time. Conclusions: Our study shows that chronological age is not necessarily the best time variable for understanding the aging process of people with spinal cord injury in terms of changes in functioning over time and that modeling functioning over time since injury provides important insights into how functioning of people with complete or incomplete injuries declines with increasing time living with the injury.

Objectives: The aims of the study are to determine the cardiovascular risk burden rehabilitation discharge and to explore the association between recovery during rehabilitation and cardiovascular disease risk profile. Methods: We included adults without cardiovascular disease admitted for rehabilitation. We evaluated rehabilitation outcomes on admission and discharge. Cardiovascular disease risk profile was assessed by Framingham risk score, high-density lipoprotein, and fasting glucose level. Results: We analyzed data from 706 participants (69.6% men) with a median age of 53.5 yrs. The median time since injury was 14 days, and the admission length was 5.2 months. Majority had paraplegia (53.3%) and motor incomplete injury (53.7%). One third of the cohort had high cardiovascular risk profile before discharge. At discharge, poorer anthropometric measures were associated with higher Framingham risk score and lower high-density lipoprotein levels. Individuals with higher forced vital capacity (>2.72 l) and peak expiratory flow (>3.4 l/min) had 0.16 mmol/l and 0.14 mmol/l higher high-density lipoprotein compared with those with lower respiratory function, respectively. Individuals with higher mobility score (>12.5) and functional independence score (>74) had 0.21 and 0.18 mmol/l higher high-density lipoprotein compared with those with lower scores. Conclusions: There is high cardiometabolic syndrome burden and cardiovascular disease risk profile upon rehabilitation discharge. Higher respiratory function, mobility, and overall independence were associated with better cardiovascular disease risk profile, although with study design limitations and short follow-up. Future studies should explore whether rehabilitation outcomes could be used to prioritize screening. To Claim CME Credits: Complete the self-assessment activity and evaluation online at http://www.physiatry.org/JournalCME CME Objectives: Upon reading this journal article, the reader is expected to: (1) Determine the burden of cardiometabolic disease in the early phase of spinal cord injury (SCI); (2) Differentiate the proposed SCI cutoff for high-risk obesity from the able-bodied population; and (3) Increase physicians’ acuity for detecting cardiometabolic disease in their practice. Level: Advanced Accreditation: The Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The Association of Academic Physiatrists designates this Journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.