Multidisciplinary Management of Knee Osteoarthritis using the International Classification of Functioning, Disability and Health

Shankar Ganesh, Patitapaban Mohanty, Sakti Prasad Das, Risheekumar Patel, Ram Naresh Pandey, Ananya Satapathy


Purpose: To identify the role of environmental, cultural and accessibility factors in community reintegration and to assess how a healthcare team can provide complete rehabilitation to a client with knee osteoarthritis (OA).

Method: A 57-year-old woman with bilateral knee OA was assessed using the ICF core set for OA. The components identified were linked to ICF categorical profile and assessment sheet. ICF allowed the team to identify the global, service programme and cycle goals. The client’s clinical status was followed over a 4 month period.

Results: At 16 weeks, the client was able to walk faster and reported an increased ability to sit continuously, climb stairs and carry out her routine activities for a full day without increase in pain. Though she is satisfied with the outcome of the treatment, her engagement with public sphere continues to pose a problem in her attempts to reintegrate in to community. She is also concerned that her pace of doing activities has decreased within the household and outside world.

Conclusion: The social construct of disability needs to be emphasized more seriously for complete rehabilitation, failing which there may not be any success at the level of functioning.

Implications: This method of depicting the problems from both the client’s and health professionals’ perspective ensured that the process of goal setting is shared between the client and rehabilitation team. Some of the non-modifiable goals identified by the team revolved around environmental factors and social policy development. These factors have to be considered by policy makers to improve functioning of persons with OA at the community and society level.


Osteoarthritis; International Classification of Functioning; disability and health; patient-centered care; interdisciplinary health team

Full Text:



Arden N, Nevitt MC (2006). Osteoarthritis: epidemiology. Best Practice and Research. Clinical Rheumatology; 20(1): 3-25.

Blixen CE, Kippes C (1999). Depression, social support, and quality of life in older adults with osteoarthritis. Image: The Journal of Nursing Scholarship; 31(3): 221–226. doi:10.1111/j.1547-5069.1999.tb00484.x

Bowling A, Browne PD (1991). Social Networks, Health, and Emotional Well-being among the Oldest Old in London. Journal of Gerontology; 46(1): S20–S32. doi:10.1093/geronj/46.1.s20

Brooks PM (2002). Impact of osteoarthritis on individuals and society: how much disability? Social consequences and health economic implications. Current Opinion in Rheumatology; 14(5): 573-577.

Creamer P (2000). Factors associated with functional impairment in symptomatic knee osteoarthritis. Rheumatology; 39(5): 490–496. doi:10.1093/rheumatology/39.5.490

Dreinhöfer K, Stucki G, Ewert T, Huber E, Ebenbichler G, Gutenbrunner C, Kostanjsek N, Cieza A (2004). ICF Core Sets for osteoarthritis. Journal of Rehabilitation Medicine (supplement); 36(0): 75–80. doi:10.1080/16501960410015498

Elders MJ. (2000). The increasing impact of arthritis on public health. The Journal of Rheumatology. Supplement; 60: 6-8. PMid: 11032095.

Gabriel SE, Crowson CS, Campion ME, O'Fallon WM (1997). Indirect and nonmedical costs among people with rheumatoid arthritis and osteoarthritis compared with nonarthritic controls. The Journal of Rheumatology; 24(1): 43-8. PMid:9002009

Kendig H, Browning CJ, Young AE (2000). Impacts of illness and disability on the well-being of older people. Disability and Rehabilitation; 22(1-2): 15–22. doi:10.1080/096382800297088

Lambert VA, Lambert CE, Klipple GL, Mewshaw EA (1990). Relationships among hardiness, social support, severity of illness, and psychological well‐being in women with rheumatoid arthritis. Health Care for Women International; 11(2): 159–173. doi:10.1080/07399339009515886

Lapsley HM, March LM, Tribe KL, Cross MJ, Brooks PM (2001). Living with osteoarthritis: patient expenditures, health status, and social impact. Arthritis & Rheumatism; 45: 301–306. doi: 10.1002/1529-0131(200106)45:3<301::AID-ART264>3.0.CO;2-I

National Collaborating Centre for Chronic Conditions (NCC-CC) (2014). Osteoarthritis: National clinical guideline for care and management in adults. London: Royal College of Physicians. Available from / [Accessed on 30-10-14]

National Institute for Health and Clinical Excellence – Osteoarthritis (NICE) (2008). The care and management of osteoarthritis in adults. Available from / [Accessed on 6 Jan 2014]

Rabenda V, Manette C, Lemmens R, Mariani AM, Struvay N, Reginster JY (2006). Direct and indirect costs attributable to osteoarthritis in active subjects. The Journal of Rheumatology; 33: 1152-8. PMid:16755664

Rauch A, Cieza A, Stucki G, Melvin J (2008). How to apply the ICF for rehabilitation management in clinical practice. European Journal of Physical Rehabilitation Medicine; 44: 329-42. PMid:18762742

Reginster JY (2002). The prevalence and burden of arthritis. Rheumatology (supplement); 1:3-6. doi:10.1093/rheumatology/41.suppl_1.3

Santrock JWA (2007). Topical approach to human life-span development (3rd ed.). St. Louis, MO: McGraw-Hill

Wendell S (1996). The social construction of disability. In The Rejected Body. New York: Routledge; 57-59. doi: 10.4324/9780203724149.

Woolf AD, Pfleger B (2003). Burden of major musculoskeletal conditions. Bulletin of the World Health Organization; 81(9): 646–656. PMid: 2572542



  • There are currently no refbacks.

Copyright (c) 2016 Shankar Ganesh

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Supported by:


© Disability, CBR & Inclusive Development