Content » Vol 51, Issue 4

Special report

A European Academy of Rehabilitation Medicine Academic Debate: Describing Experienced Health on the Basis of the WHO's Model of Functioning (ICF) or on the Theory of Social Productivity

Carlotte Kiekens, Jean-Pierre Didier, Antti Malmivaara, Stefano Negrini, Christoph Gutenbrunner
Department of Development and Regeneration / Physical and Rehabilitation Medicine, KU Leuven University of leuven - University Hospitals Leuven, BE-3000 Leuven, Belgium. E-mail:
DOI: 10.2340/16501977-2533


The first Academic Debate was held within the European Academy of Rehabilitation Medicine (EARM) in Budapest in 2016. The question debated was: is it possible to provide a theory neutral framework to describe the lived experience of health or is there an appropriate theory to understand what constitute the most relevant factors in health (and well-being). First the link between the International Classification of Functioning, Disability and Health (ICF) and rehabilitation as a key health strategy was explained. It was then argued that supplementing the ICF by theory-based approaches (e.g. a theory of social productivity) may advance explanations with regard to participation and links with health and well-being. Thirdly, it was recalled that one of the strengths of the ICF is exactly being “theory neutral”. There was no doubt that there is a need for scientific theories to describe functioning and health. The theory of social productivity seems to be an important contribution towards this goal. However, the definition of well-being in relation to the operationalization of functioning and health needs to be further developed. The conclusion cannot be an “either-or” (classification vs theory). Projects should be set up both to further develop the ICF and to refine (or develop new) theories.

Lay Abstract

In the European Academy of Rehabilitation Medicine a debate was held on whether it is possible to describe the lived experience of health in a neutral way, or if we need theories to understand what the most relevant factors of health (and well-being) are. This was illustrated with the case of creating better social relationships by being productive, for example through work. The international Classification of Functioning, Disability and Health (ICF) provides a framework and classification to describe health and functioning and is “theory neutral” over cultures. However, ICF should be further developed and scientific theories are needed to be able to better measure, describe and explain health, functioning and well-being. The debate raised important questions that require more study and discussions.


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