Comparison based on the ICF provides insight into both the breadth of health dimensions measured as well as the thoroughness and depth of measurement. Therefore, it can be a useful tool when selecting specific measures for a study. Compared with other types of qualitative review, the most important advantage of the content comparison of measures based on the ICF is the use of an external and independent reference to which all the instruments can be linked and by which all the instruments can be compared. The three back-specific measures are comparable, with their common focus on physical aspects of body functions and activities and participation.

The ICF provides a useful reference to identify and quantify the concepts contained in outcome measures used in stroke trials. Outcome measurement in stroke refers to an enormous variety of concepts; for comparability of research findings agreement on what should be measured is needed.

The ICF provides a useful reference to identify and quantify the concepts contained in outcome assessment used in clinical trials.

Systematic reviews have shown that as non-operative treatments exercise, behavioural and multimodal treatment programs are effective for chronic low back pain. There is, however, a lack of knowledge concerning the association between changes in treatment process variables and changes in outcome for the three treatment forms. The objective of this systematic review was to evaluate which changes in treatment process variables predict outcome of exercise, behavioural and multimodal treatment of chronic low back pain. Medline, Embase and PsychInfo were systematically searched. A descriptive analysis was used to summarize the results regarding the outcomes pain, disability and return to work (RTW). 13 studies were identified. The results showed that functional coping mechanisms and pain reduction were associated with a decrease in disability and increase in RTW, and physical performance factors were not. Related to pain reduction decreases in disability, functional coping mechanisms as well as physical performance factors were associated. Strong conclusions cannot be drawn from this review, because of the heterogeneity and the limited number of studies. The results of this review raise the question if changes in behavioural variables and reductions of disability which facilitate an improvement in function, may be more important than physical performance factors for successful treatment of chronic low back pain. This is relevant for the refinement of future treatment programs.

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