BRAZILIAN CLASSIFICATION OF PHYSIOTHERAPEUTIC DIAGNOSES: STANDARDIZED CLASSIFICATION BASED ON THE BIOPSYCHOSOCIAL AND FUNCTIONAL MODEL OF HEALTH

R. Mattar Cepeda¹, F.M. Muniz Ferreira², B. Prata Martinez³, F. Ferrari², F. Massa², S. De Andrade Melo Knaut⁴, E. Caldeira de Oliveira Guirro⁵, C. Homsi Jorge⁶

¹Brazilian Federal Council of Physiotherapy, Brasilia, Brazil, ²Federal Council of Physiotherapy, Brasilia, Brazil, ³Federal University of Bahia, and College of Physiotherapy, State University of Bahia, Salvador, Brazil, ⁴Universidade Estadual do Centro-Oeste (UNICENTRO), Physical Therapy, Guarapuava, Brazil, ⁵Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil, ⁶Ribeirão Preto Medical School, University of São Paulo, Health Sciences, Ribeirão Preto, Brazil

Background: In Brazil, Physiotherapy is a recognized and regulated higher education profession since 1969 (Decree-Law 938/69, Law 6316/75, COFFITO Resolutions, Decree 9640/84, Law 8856/94). The Federal Council of Physiotherapy and Occupational Therapy (COFFITO) is a Federal Autarchy created by Law No. 6316, of December 17, 1975; with constitutional objectives of standardizing and exercising ethical, scientific and social control of the professions of Physiotherapy and Occupational Therapy. Although the definition of the profession in Brazil makes clear the role of the physiotherapist in the construction of the diagnosis of human movement disorders to guide the prescription and application of physiotherapy procedures, there was no specific resolution offering guidance to the physiotherapeutic diagnosis through a standardized system of classification.

Purpose: To describe the work process, the rationale and proposal for a standardization of physiotherapeutic diagnosis in Brazil.

Methods: The COFFITO set up a specific commission whose objective was to create a classification as a standard for the description and codification of the terms of Physiotherapeutic Diagnoses, based on the terminology International Classification of Functionality(ICF), in order to make the nomenclatures of diagnoses compatible with the WHO guidelines.

Results: In the first stage the commission developed a list of terms grouped by organic systems and identifier codes as a model of physiotherapeutic diagnosis and developed an application(App) to make feasible a standardized online system. In the second stage this proposal was sent to 15 speciality associations, recognized by COFFITO and affiliated to the physiotherapist´s Brazilian association, for opinion, to 18 regional councils for physiotherapy and occupational therapy and to group of experts in human functionality from Federal University of Sergipe. In the third stage a working group of specialists gather to make to refine the proposal and the app. In October 2022,a resolution was published by COFFITO establishing the Brazilian Classification of Physiotherapeutic Diagnosis. In this document, the classification of the physiotherapeutic diagnosis based on the domains of body function and structure was detailed, with the physiotherapist being able to code physiotherapeutic diagnoses of people with good kinetic-functional health, without alterations of structure and/or function of the body as well as physiotherapeutic diagnoses of kinetic-functional deficiencies, in 10 different characterizers based on body systems, including central and peripheral nervous systems, cardiovascular, digestive, genital, integumentary, musculoskeletal, respiratory and metabolic. A few weeks after publication, the app system was available to all physiotherapists.

Conclusions: The work of the commission of COFFITO resulted in a regulation document providing detailed information to the professionals about how to use adequately the Brazilian classification of physiotherapeutic diagnosis, with further guidance to use the App.

Implications: The diagnostic classification system is a great advance for Physiotherapy because it allows, in a simple, fast and unified way, the identification of structural and/or functional alterations, from the perspective of physiotherapists related to movement deficiency, where the codes to limitations and restrictions to social participation are in the final stages of construction. This system of classification will be biannually reviewed for update based on the professional’s opinions and new researches.

Funding acknowledgements: To the Brazilian Federal Council of Brazil.

Keywords:
Diagnosis
Physiotherapy
Policies

Topics:
Globalisation: health systems, policies & strategies
Community based rehabilitation
Professional practice: other

Did this work require ethics approval? No

Reason: There was not data collection. This abstract reports the work of Federal Council of Physiotherapy in Brazil that resulted in a new regulation. The first author is the President of the Federal Council.