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Development and implementation of WHO International Classification

Research Center
Research Area


Dott. Andrea Martinuzzi
Neurologist, Research Unit coordinator
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Dott. Gianni De Polo
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Dott.ssa Gabriella Paparella
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Dott.ssa Silvia Pizzighello
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Dott.ssa Monica Pradal
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Dott.ssa Sonia Bortolot
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+39 0438 414242



Since its founding in 1948, the World Health Organization (WHO) has included the preparation, the dissemination and the keeping of international reference systems for the accurate, precise, shared, complete and updated description of the health status of the populations of the member states among its institutional mandates.

A proper classification system is fundamental within WHO’ aims.

The first international classification that has been developed and kept by the WHO is the International Classification of Diseases (ICD), which describes the nosological entities (the diagnoses). This classification, however, does not provide information on the functional consequences of the various diseases or on the interventions that are used in the various health systems and services to cope with these diseases.

In 2001 the International Classification of Functioning, Disability and Health (ICF) was developed and approved by the World Health Assembly and the international classification of health interventions (ICHI) is constantly developing. The three classifications constitute the WHO family of international classifications (WHO-FIC) and have been designed to be used together to deliver a comprehensive understanding of health status and to enable the monitoring of sustainable global development goals (SDGs).

IRCCS Medea – main seat in Veneto Region - is the Research Center of the Italian Collaborating Center for international classifications since its founding in 2006.

It has contributed substantially and directly to the drafting of the version for the evolutive age of ICF (ICF-CY) published in 2007; as part of the steering group, it’s implementing the development of ICHI and has experimented advanced practices of joint use of the ICD and ICF classifications as a guide and documentation of the global rehabilitation process.

The Research Institute has also contributed to the delivery of the national training (ICF project – Region of Veneto, 2004; Progetto Italia Lavoro, in 2006) and of the international training (Kosovo, Macedonia, Brunei, Egypt, Syria, Mozambique, Iran, China) on the use of the classifications (in particular for ICF).

The Research Institute chairs the "Family Development Committee”(FDC) of the Network of the WHO collaborating centers that’s in charge of developing new WHO classifications.
The research in this area’s developed especially to focus the opportunities offered by the WHO-FIC in terms of orientation, documentation and monitoring of rehabilitative projects both in the evolutive and adult age.

Selected publications

  1. Borgnolo G, Soares IC, Dos Santos Soares B, Gongolo F, Vaz P, Meucci P, Quintas R, Lembo R, Martinuzzi A (2009); Preliminary results of ICF dissemination in primary health care in Mozambique: Sharing the Italian experience; Disability and Rehabilitation, 31(S1):S78-S82
  1. Conclave M, Fusaro G, Sala M, Martinuzzi A, Russo E, Frare M, Gorini G, Leonardi M, Raggi A (2009); The ICF and Labour Policies Project: The first Italian nation-wide experience of ICF implementation in the labour sector; Disability and Rehabilitation , 31(S1): S16-S21
  1. De Polo G, Pradal M, Bortolot S, Buffoni M, Martinuzzi A (2009); Children with disability at school: the application of ICF-CY in the Veneto region; Disability and Rehabilitation, 31(S1):S67-S73
  1. Francescutti C, Frattura L, Troiano R, Gongolo F, Martinuzzi A, Sala M, Meucci P, Raggi A, Russo E, Buffoni M, Gorini G, Conclave M, Petrangeli A, Solipaca A, Leonardi M (2009); Towards a common disability assessment framework: theoretical and methodological issues for providing public services and benefits using ICF; Disability and Rehabilitation, 31(S1):S8-S15
  1. Francescutti C, Fusaro G, Leonardi M, Martinuzzi A, Sala M, Russo E, Frare M, Pradal M, Zampogna D, Cosentino A, Raggi A (2009); Italian ICF training programs: describing and promoting human functioning and research; Disability and Rehabilitation, 31(S1):S46-S49
  1. Griffo G, Leonardi M, Martinuzzi A, Francescutti C, Raggi A, Kosic V, Barbieri PV (2009); Moving towards ICF use for monitoring the UN convention on the rights of persons with disabilities: The Italian experience; Disability and Rehabilitation, 31(S1):S74-S77
  1. Leonardi M, Martinuzzi A (2009); ICF and ICF-CY for an innovative holistic approach to persons with chronic conditions; Disability and Rehabilitation, 31(S1):S83-S87
  1. Petacchi E, Armellin MT, Facchin D, Gubernale M, Moret O, Buffoni M, Salghetti A, Martinuzzi A (2009); The dystonic child treated with deep brain stimulation: ICF reading of a high-tech approach; Disability and Rehabilitation, 31(S1):S159-S169
  1. Salghetti A, Betto S, Russo E, Petacchi E, Pradal M, Martinuzzi A (2009); Projecting and programming rehabilitation based on ICF-CY format in a neuropediatric hospital unit; Disability and Rehabilitation, 31(S1):S55-S60
  1. Francescutti C, Martinuzzi A, Leonardi M, Kostanjsek NFI (2009); Eight years of ICF in Italy: Priciples, results and future perspectives; Disability and Rehabilitation, 31(S1):S4-S7
  1. Martinuzzi A, Salghetti A, Betto S, Russo E, Leonardi M, Raggi A, Francescutti C (2010); The International Classification of Functioning Disability and Health, version for children and youth as a roadmap for projecting and programming rehabilitation in a neuropaediatric hospital unit; J Rehabil Med, 42(1):49-55
  1. Leonardi M, Martinuzzi A, Meucci P, Sala M, Russo E, Buffoni M, Raggi A (2012). A Population Survey in Italy Based on the ICF Classification: Recognizing Persons with Severe Disability. The Scientific World Journal, 2012:189097 Doi:10.1100/2012/189097
  1. Leonardi M, Sattin D, Giovannetti AM, Pagani M, Strazzer S, Villa F, Martinuzzi A, Buffoni M, Castelli E, Lispi ML, Trabacca A, Gennaro L, Raggi A (2012); Functioning and disability of children and adolescents in a vegetative state and a minimally conscious state: identification of ICF-CY-relevant categories; International Journal of Rehabilitation Research, 35(4):352-359
  1. Leonardi M, Sattin D, Raggi A, Italian National Consortium on Functioning Disability in DOCS Patients (Strazzer S, Villa F, Trabacca A, Gennaro L, Martinuzzi A, Buffoni M) (2013); AN ITALIAN POPULATION STUDY ON 600 PERSONS IN VEGETATIVE STATE AND MINIMALLY CONSCIOUS STATE; Brain Injury, 27(4):473-484
  1. Martinuzzi A, Carraro E, Petacchi E, Pasqualotti S, Costalunga M, Betto S (2013); Implementation of an ICF-base project/program in a pediatric neuro-rehabilitation hospital: follow-up evaluation by stakeholders; Disability and Rehabilitation, 35(13):1059-1064
  1. Meucci P, Leonardi M, Sala M, Martinuzzi A, Russo E, Buffoni M, Fusaro G, Raggi A (2014); a survey on feasibility of ICF-cy use to describe persisting difficulties in executing tasks and activities of children and adolescent with disability in Italy; Disability and Health Journal, 7(4):433-441
  1. Martinuzzi A, De Polo G, Bortolot S, Pradal M. Pediatric neurorehabilitation and the ICF. NeuroRehabilitation. 2015;36(1):31-6. doi: 10.3233/NRE-141188. PMID: 25547762
  1. Leonardi M, Sykes CR, Madden RC, ten Napel H, Hollenweger J, Snyman S, Madden RH, Kraus De Camargo O, Raggi A, van Gool CH, Martinuzzi A; Functioning and Disability Reference Group of the WHO-FIC. Do we really need to open a classification box on personal factors in ICF? Disabil Rehabil. 2016;38(13):1327-8. doi: 10.3109/09638288.2015.1089604. Epub 2015 Oct 12.


  • Dr Robert Jacob, WHO, Geneve
  • Dr Alarcos Cieza, WHO, Geneve
  • Dr Lucilla Frattura, General Direction Health Dept., Region of Friuli Venezia Giulia
  • Dr Matilde Leonardi, IRCCS Besta Foundation, Milano
  • Prof. Richard Madden, University of Sydney


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