The concept of functioning stands for a comprehensive understanding of health – what we can do or what we cannot do in life and how we live with our health in everyday life. Functioning (see figure) includes:

  • All body functions and structures, e.g. muscle strength and muscle tone,
  • Activities, actions and skills of a person, e.g. moving around in one’s apartment, and
  • Participation in various areas of life, e.g. pursuing gainful employment.



The International Classification of Functioning, Disability and Health (ICF) by the World Health Organization (WHO) serves as international and interdisciplinary uniform language to describe functioning. Functioning is a concept that stands for a comprehensive understanding of health – what we can do in life and what we cannot do as well as how we live with our health in everyday life.

The ICF model (see figure) shows the various components of functioning. More precisely, it shows the interactions between a health condition and the body functions and body structures, activities of everyday life, participation in various areas of life together with contextual factors. Contextual factors include personal and environmental factors. Personal factors are, e. g., coping with stress and fellow humans, integration in the family, life events, personal goals or convictions. Environmental factors make up the physical, social and attitudinal environment in which people live and conduct their lives. These can be, e.g., products or technologies (medication, technical aids) or accessible buildings or means of transport. Environmental factors also include climatic conditions as well as physical and emotional support, care and support by others. However, the environment also includes attitudes, values, ideologies of a society as well as the kind of services that are available on a public, private, local and national level (e.g. within the health system of a country).

The ICF also is, however, a classification system which allows creating a detailed, standardized and systematic status description of a person’s functioning. Comparisons within the health system but also between countries and over the course of time can thus be made.

Glossasry ICF Swiss Paraplegic Research
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