Functional assessment in rehabilitation
Understand a patient's abilities, limitations, and environment to set goals that are achievable, meaningful, and aligned with their personal priorities.
Kompass uses the International Classification of Functioning, Disability & Health (ICF) as the functional assessment within the platform. The ICF is a framework developed by the World Health Organisation (WHO, 2001) to standardise the description of a person's functioning. Like other WHO frameworks, the ICF organises over 1,000 categories into core sets specific to conditions, such as Traumatic Brain Injury. These are divided into:
- Brief Core Sets (e.g., 39 categories).
- Comprehensive Core Sets (e.g., 139 categories).
- Non-specific core sets like 'Generic' and 'Rehabilitation' can be used for quick assessments or limited timeframes.
Kompass incorporates core sets tailored to a wide range of rehabilitation services, covering healthcare areas such as stroke, cardiology, mental health, addiction services, orthopaedics, and respiratory care. These core sets are designed to address the unique needs of each field, enabling targeted assessments and personalised rehabilitation plans.
Body Structures
Anatomical parts of the body including the nervous system, musculoskeletal structures, organs and limbs. In rehabilitation, clinicians assess impairments such as muscle weakness, joint limitations, neurological damage or structural changes following injury or illness. Recording these provides a baseline for tracking physical recovery and identifying targets for intervention.
Body Functions
Physiological and psychological functions of body systems — covering mental functions such as memory, attention and emotion, as well as sensory, cardiovascular, respiratory and movement functions. Deficits in these areas directly affect a patient's ability to carry out daily tasks. Kompass captures these function-level difficulties to ensure goal setting is grounded in real clinical need.
Activity & Participation
How a person executes tasks and engages in life situations — from basic self-care and mobility to communication, work, education and social life. The ICF distinguishes between what a person can do in a controlled environment (capacity) and what they actually do in daily life (performance). This distinction is central to meaningful rehabilitation goal setting in Kompass.
Environmental Factors
The external world that influences how a person functions — including the built environment, assistive technology, support from family and carers, social attitudes and healthcare systems. Environmental factors can act as facilitators that support functioning or as barriers that restrict it. Identifying these in Kompass helps clinicians design realistic, context-aware rehabilitation plans.
This allows for a holistic assessment of a patient, taking into account the factors around them, their facilitators and barriers, and the functional problems they are presenting with — enabling tailored goal-setting based on unique client needs.
Understanding the ICF
The ICF uses a structured coding and scoring system to bring consistency and precision to functional assessment across all clinical settings.
ICF Codes
Every category within the ICF is assigned a unique alphanumeric code made up of a letter prefix indicating its domain, followed by a numeric identifier. These codes give clinicians a shared, internationally recognised language for documenting functional status.
- b730— Muscle power functions (Body Functions)
- s320— Structure of mouth (Body Structures)
- d450— Walking (Activity & Participation)
- e115— Products for personal use in daily living (Environmental Factors)
The letter prefix tells you which ICF component the code belongs to: 'b' for Body Functions, 's' for Body Structures, 'd' for Activity & Participation, and 'e' for Environmental Factors.
ICF Scoring
Each ICF code is rated using a standardised 5-point qualifier scale that describes the extent of a problem in that area. The scale runs from 0 (no impairment) to 4 (complete impairment), with percentage ranges providing objective boundaries.
- 0— No impairment (0–4%)
- 1— Mild impairment (5–24%)
- 2— Moderate impairment (25–49%)
- 3— Severe impairment (50–95%)
- 4— Complete impairment (96–100%)
For Environmental Factors, the same scale is used but with a '+' prefix to indicate a facilitator rather than a barrier — for example, e115+1 denotes a mild facilitator.
Performance & Capacity
Within the Activity & Participation domain, every ICF category can be scored across two distinct qualifiers. This dual-scoring approach is one of the most clinically powerful features of the framework — it separates what a person is theoretically capable of from what they actually achieve in their real-world context.
What a person can do in a standardised or controlled environment, without any assistance. Capacity represents the highest probable level of functioning and is typically measured in a clinical setting.
What a person actually does in their own environment and daily life, with all the facilitators and barriers that exist in reality. Performance reflects lived experience rather than clinical potential.
The gap between capacity and performance is clinically significant. A wide gap often signals that environmental barriers — such as inaccessible housing, lack of assistive technology, or limited social support — are preventing a person from realising their full potential. Identifying and closing this gap is central to how Kompass supports clinicians in setting meaningful, achievable goals.
Functional Problems
Identifying the Problem
Functional problems are the difficulties a person experiences in body functions, structures, activities, or participation. Kompass helps clinicians systematically identify these using standardised ICF core sets relevant to the patient's condition.
Beyond the Diagnosis
A diagnosis alone does not describe how a condition affects a person's life. Functional problems capture the real-world impact — from reduced muscle strength and limited walking ability to barriers in returning to work or social engagement.
Grounding Goal Setting
By documenting functional problems at assessment, clinicians have an objective baseline from which to set meaningful rehabilitation goals. Goals become directly tied to the problems that matter most to the patient.
Tracking Progress
Reassessing functional problems at regular intervals allows clinicians to measure change over time. Improvements in ICF qualifier scores provide clear, quantifiable evidence of rehabilitation outcomes.
Facilitators & Barriers
Environmental factors play a critical role in shaping how a person functions day to day. The same condition can have vastly different impacts depending on the environment a person lives and works in. Kompass helps clinicians document these factors systematically so that rehabilitation plans are grounded in the patient's real-world context.
Facilitators
Factors in a person's environment that improve functioning and reduce disability. When identified, clinicians can actively build on these to support recovery and independence.
- Assistive technology and adaptive equipment
- Supportive family members or carers
- Accessible housing and workplace adaptations
- Access to community rehabilitation services
Barriers
Factors that limit functioning and create disability. Identifying barriers allows clinicians to target interventions that remove or reduce their impact on the patient's daily life.
- Inaccessible physical environments
- Limited social or family support
- Negative societal attitudes or stigma
- Gaps in available healthcare or equipment
Getting Started with Kompass
Kompass is built around the ICF workflow — from initial assessment through to goal setting and outcome measurement. Getting started takes minutes, and the platform guides clinicians through each step with condition-specific core sets and structured templates.
- 1
Select a Core Set
Choose the ICF core set that matches your patient's condition — from stroke and traumatic brain injury to orthopaedics, cardiology, and mental health.
- 2
Conduct the Assessment
Score each ICF category using the 0–4 qualifier scale. Kompass records both capacity and performance qualifiers where applicable.
- 3
Identify Functional Problems
The platform highlights areas of significant impairment, helping clinicians pinpoint the problems most relevant to the patient's rehabilitation needs.
- 4
Set Goals & Objectives
Use the identified problems to generate structured, patient-centred goals and short-term objectives directly linked to ICF codes.
Steps to Effective Rehabilitation
- 1
Functional Assessment
Conduct a standardised ICF assessment using condition-specific core sets to establish the patient's baseline functional status.
- 2
Identify Problems
Review the scored ICF codes to surface the functional problems most relevant to the patient's rehabilitation needs.
- 3
Goal Setting
Set patient-centred rehabilitation goals that are specific, measurable, and directly tied to identified ICF problems.
- 4
Objective Setting
Break goals into short-term objectives and actionable steps that guide the day-to-day rehabilitation plan.
- 5
Reporting
Generate structured outcome reports from ICF reassessment data to evidence progress, support handovers, and inform future care planning.