Application of ICF Framework in the Assessment of Children and Adolescents with Cerebral Palsy: A Systematic Review

Purpose: The International Classification of Functioning, Disability and Health (ICF) being a standardized, biopsychosocial approach to understanding disability, serves as a basis for assessing functioning and disability beyond a mere medical diagnosis of cerebral palsy.The purpose of this review is to critically analyze application of ICF framework in CP assessment by identifying most commonly measured ICF domains and evaluating clinical utility of assessment tools and outcome measures linked with ICF.Methods: Studies between January 2015 and January 2025 from 4 databases were retrieved, out of 339 records,209 records were screened.Nine studies that met inclusion criteria of Children & adolescents with CP (4 to 18 years) and outcome measures mapped with ICF were included.Results: Total 74 outcome measures linked with ICF domains were identified (33"Body Structure/Function", 22 "Activities", 12 "Participation" and 3 as classification system).GMFM, COPM, and PEDI were the most common outcome measures."Contextual factors" was the least measured domain of ICF (only one study addressing "personal factors").The most frequently addressed category across all domains were Muscle tone functions (b735) 66.7% in Body function/structure, Walking (d450) 59% in activity, and Recreation & leisure (d920) 35% in participation.Conclusion: Participation and personal factors are currently underrepresented but critical for improving outcomes as interventions directly targeting participation (rather than impairment/activities) were significantly more effective at improving participation outcomes.ICF-CY needs to be explored and cross culturally validated in future studies.