Defining rehabilitation goals after burn injury using the International Classification of Functioning, Disability and Health (ICF) framework

BACKGROUND: Burn injuries frequently result in long-term functional limitations, making structured, injury-specific rehabilitation essential. Modern rehabilitation emphasizes patient-centered, goal-oriented care, and the International Classification of Functioning, Disability and Health (ICF) provides a standardized framework for classifying and evaluating such goals. This study aimed to characterize individual-defined rehabilitation goals after burn injury and develop a disease-specific ICF core set. METHODS: Within a prospective, two-center clinical trial in Germany, adult burn survivors undergoing inpatient rehabilitation were interviewed to identify up to 3 personal rehabilitation goals. The goals were inventoried at admission and reviewed during rehabilitation. All reported goals were systematically linked to second-level ICF categories using established rules. Frequencies were analyzed for the full cohort, first-stated goals, and subgroups defined by burn size (>20% vs ≤20% total body surface area, [TBSA]). RESULTS: A total of 103 participants (96% male, median age 44 years) reported 286 rehabilitation goals. Most goals mapped to Body Functions (67%), particularly neuromusculoskeletal and movement-related functions (27%), joint mobility (19%), and skin functions (22%). Activities and Participation accounted for one-third of goals (33%), dominated by mobility (23%), especially walking (9%). Goals related to mental functions (1%) or cardiovascular functions (5%) were rarely mentioned. The distribution of first-stated goals was consistent with overall results, and no major differences were observed between participants with major and minor burns. During rehabilitation, two-thirds of participants maintained all their initial goals. A short ICF core set comprising 21 categories covered 94% of all goals, including 2 categories not previously represented: Control of voluntary movement functions (B760) and Driving (D475). CONCLUSION: Burn survivors prioritize rehabilitation goals focused on restoring mobility, muscle function, and skin integrity. Psychological and contextual aspects are less frequently articulated. These findings validate and extend existing expert-derived ICF core sets, emphasizing the importance of incorporating individual perspectives into rehabilitation planning. DATA REGISTRATION: German Registry for Clinical Trials (DRKS00017702).