{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T17:32:14Z","timestamp":1786642334996,"version":"build-2736575974"},"reference-count":41,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T00:00:00Z","timestamp":1786320000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T00:00:00Z","timestamp":1786320000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Neurorehabil Neural Repair"],"abstract":"<jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>Accurate evaluation of upper limb recovery after stroke is essential for guiding rehabilitation targeting specific impairments and activity limitations. To achieve this, outcome measures must clearly reflect what they assess, whether neuromuscular impairments or activity limitations. However, classification of measures is not always clear-cut, which can lead to misinterpretation of recovery progress and reduce rehabilitation planning effectiveness.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Problem:<\/jats:title>\n                    <jats:p>Current classification practices often prioritize item content over the scoring criteria that define what is being quantified. This becomes particularly problematic when task-based items are scored using impairment-oriented criteria (e.g., range of motion), blurring whether change reflects impairment recovery or activity-level improvement. This ambiguity can mislead clinical decision-making and the interpretation of research findings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Solution:<\/jats:title>\n                    <jats:p>We propose a construct-driven application of the International Classification of Functioning, Disability and Health (ICF) in which component-level attribution is determined by the construct operationalized through scoring rather than inferred from item content. As scoring structures differ, three strategies are suggested based on item-level scoring attribution where feasible: (1) proportional classification for measures in which one ICF component predominates (with a pragmatic, provisional \u226560% dominance guideline for near-boundary cases), otherwise (2) dual-component reporting for mixed measures; and (3) non-proportional interpretation for measures exhibiting construct shifting across score levels or using dominant-construct scoring with embedded grading criteria.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Grounding classification in the construct operationalized by scoring criteria provides a more defensible basis for outcome selection and interpretation. This supports clearer interpretation of intervention effects, more targeted rehabilitation, and stronger comparability across trials and evidence synthesis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/15459683261469063","type":"journal-article","created":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T11:56:04Z","timestamp":1786362964000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Applying the International Classification of Functioning, Disability and Health to Classify Upper Limb Outcome Measures in Stroke Rehabilitation: A Construct-Driven Perspective"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2645-3855","authenticated-orcid":false,"given":"Canan","family":"Yuksel-Haji","sequence":"first","affiliation":[{"name":"School of Health Sciences, University of East Anglia, Norwich, UK"},{"name":"Faculty of Health Sciences, Sivas Cumhuriyet University, Sivas, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4850-3152","authenticated-orcid":false,"given":"Nicola","family":"Hancock","sequence":"additional","affiliation":[{"name":"School of Health Sciences, University of East Anglia, Norwich, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2965-8941","authenticated-orcid":false,"given":"Allan","family":"Clark","sequence":"additional","affiliation":[{"name":"Norwich Medical School, University of East Anglia, Norwich, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4487-823X","authenticated-orcid":false,"given":"Valerie M.","family":"Pomeroy","sequence":"additional","affiliation":[{"name":"School of Health Sciences, University of East Anglia, Norwich, UK"},{"name":"Department of Clinical Neurosciences, University of Cambridge, UK; NIHR HealthTech Research Centre in Brain Injury, UK; Professor Emeritus, University of East Anglia, Norwich, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,8,10]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1177\/1747493017711813"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2019.00567"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2020.00875"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(12)70029-7"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2024.1449729"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1177\/15459683211028240"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1177\/15459683241229676"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12883-023-03419-9"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0115375"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.3109\/09638288.2012.683233"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1017\/cbo9780511995583.044"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1177\/23969873231191304"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0154792"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pmrj.2011.03.014"},{"key":"e_1_3_2_16_2","unstructured":"World Health Organization. Towards a Common Language for Functioning Disability and Health: ICF. World Health Organization; 2002:1-22. Accessed April 14 2023. http:\/\/www.who.int\/classifications\/icf\/training\/icfbeginnersguide.pdf"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1080\/14038190802331401"},{"key":"e_1_3_2_18_2","unstructured":"World Health Organization. How to Use the ICF: A Practical Manual for Using the International Classification of Functioning Disability and Health (ICF). Exposure Draft for Comment. WHO. Accessed April 14 2023. https:\/\/cdn.who.int\/media\/docs\/default-source\/classification\/icf\/drafticfpracticalmanual2.pdf?sfvrsn=8a214b01_4&download=true"},{"key":"e_1_3_2_19_2","unstructured":"Merriam-Webster. Neuromuscular. 2011. 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