Defining rehabilitation goals after burn injury using the International Classification of Functioning, Disability and Health (ICF) framework.

BACKGROUND

Burn injuries frequently result in long-term functional limitations, making structured, injury-specific rehabilitation essential. Modern rehabilitation emphasizes patient-centered, goal-oriented care, and the International Classification of Functioning, Disability and Health (ICF) provides a standardized framework for classifying and evaluating such goals. This study aimed to characterize individual-defined rehabilitation goals after burn injury and develop a disease-specific ICF core set.

METHODS

Within a prospective, two-center clinical trial in Germany, adult burn survivors undergoing inpatient rehabilitation were interviewed to identify up to 3 personal rehabilitation goals. The goals were inventoried at admission and reviewed during rehabilitation. All reported goals were systematically linked to second-level ICF categories using established rules. Frequencies were analyzed for the full cohort, first-stated goals, and subgroups defined by burn size (>20% vs ≤20% total body surface area, [TBSA]).

RESULTS

A total of 103 participants (96% male, median age 44 years) reported 286 rehabilitation goals. Most goals mapped to Body Functions (67%), particularly neuromusculoskeletal and movement-related functions (27%), joint mobility (19%), and skin functions (22%). Activities and Participation accounted for one-third of goals (33%), dominated by mobility (23%), especially walking (9%). Goals related to mental functions (1%) or cardiovascular functions (5%) were rarely mentioned. The distribution of first-stated goals was consistent with overall results, and no major differences were observed between participants with major and minor burns. During rehabilitation, two-thirds of participants maintained all their initial goals. A short ICF core set comprising 21 categories covered 94% of all goals, including 2 categories not previously represented: Control of voluntary movement functions (B760) and Driving (D475).

CONCLUSION

Burn survivors prioritize rehabilitation goals focused on restoring mobility, muscle function, and skin integrity. Psychological and contextual aspects are less frequently articulated. These findings validate and extend existing expert-derived ICF core sets, emphasizing the importance of incorporating individual perspectives into rehabilitation planning.

DATA REGISTRATION: German Registry for Clinical Trials (DRKS00017702).