COSMIN database

A review of participation instruments based on the International Classification of Functioning, Disability and Health

Noonan, V. K., Kopec, J. A., Noreau, L., Singer, J., and Dvorak, M. F.
PURPOSE: To identify and review instruments which assess participation as defined by the International Classification of Functioning, Disability and Health (ICF).

METHODS: A systematic search of the literature was conducted. Data related to the content, administration, scoring, reliability, validity and responsiveness was abstracted.

RESULTS: Eleven instruments met the inclusion criteria. Seven instruments include questions with content from Chapters 4 to 9 in the ICF activities and participation component. Four instruments exclude Chapter 5 (self-care). Most of the instruments assess subjective aspects of participation. Evidence on reliability was available for 10 instruments and the majority met the criteria for group level comparisons for internal consistency and reproducibility in the health conditions assessed. In terms of validity, dimensionality was assessed in eight instruments, with six using modern measurement methods. Participation instruments have been compared with various generic and/or disease-specific instruments, but they have not been compared with each other. Evidence on responsiveness was only available for four instruments.

CONCLUSIONS: There has been considerable interest in developing instruments to measure participation. To date, the World Health Organisation Disability Assessment Schedule II has undergone the most psychometric testing. Future research must continue to assess these instruments in persons with various health conditions to advance the conceptualisation and measurement of participation.
Disabil Rehabil
0963-8288 (Print)
Publication year:
Functional status:
Physical functioning
Role functioning
Social functioning
Adults (18-65)
Seniors (65+)
Certain infections and parasitic diseases and related symptoms
Diseases of and symptoms related to the circulatory system
Diseases of and symptoms related to the ear and mastoid process
Diseases of and symptoms related to the eye and adnexa
Diseases of and symptoms related to the musculoskeletal system and connective tissue
Diseases of and symptoms related to the nervous system
Diseases of and symptoms related to the respiratory system
Endocrine, nutritional and metabolic diseases and related symptoms
Injury, poisoning and certain other consequences of external causes
Mental and behavioural disorders and related symptoms
Neoplasms and related symptoms
PRO / non-PRO:
Patient Reported Outcome
Type of measurement instrument:
1 - Questionnaires
2 - Interviews
IPA - Impact on Participation and Autonomy   
KAP - Keele Assessment of Participation
PAR-PRO - Participation Profile
PARTS/M - Participation Survey/Mobility
PIPP - Perceived Impact of Problem Profile
PM-PAC - Participation Measure-Post Acute Care (versions: PM-PAC-CAT)
POPS - Participation Objective, Participation Subjective
P-Scale - Participation Scale (versions: P-Scale Short)   
ROPP - Rating of Perceived Participation
WHODAS II - World Health Organization Disability Assessment Schedule II (versions: WHODAS-12)