ICF Core Set–based Rehabilitation of a Rural Shopkeeper with Right Hemiparesis: A Case Report

Abstract

Aims: To document functional and vocational recovery achieved through an ICF Core Set–anchored, work-extended community-based rehabilitation programme for a rural shopkeeper following recurrent stroke. Presentation of Case: A 54-year-old rural grocery shopkeeper from Ahilyanagar district, Maharashtra, India, and the sole earner for his family, developed right hemiparesis, impaired balance, gait difficulty and slurred speech following a recurrent lacunar stroke, in the context of poorly controlled hypertension. Rehabilitation was structured using the Brief ICF Core Set for Stroke, extended with work-related Activity/Participation and Environmental codes, and integrated with community-based physiotherapy, workplace ergonomic assessment, job task analysis, job simulation, work conditioning, work hardening and assistive-device provision. A three-month physiotherapist-led programme was delivered across home and workplace settings with caregiver participation. Discussion: Functional recovery was tracked using ICF qualifiers, work-ability measures and ergonomic risk assessment. Improvements were observed in muscle power, balance, walking, upper-limb function, speech clarity and work participation, with the ICF code for paid work (d850) improving from 4 (unable) to 1–2 (graded return). Combining a work-extended ICF framework with occupational-ergonomics methods (REBA/NIOSH-based load analysis and structured job/task analysis) was associated with a low-cost, community-adapted pathway from clinic-based therapy to job re-entry in a setting without dedicated occupational-therapy infrastructure; as a single-case report with multiple concurrent interventions, this pathway cannot be causally attributed to the ICF framework alone. Conclusion: A work-focused ICF Core Set approach, translated into workplace ergonomic assessment, job task analysis, job simulation, work conditioning, work hardening and assistive-device provision, can facilitate functional recovery, workplace adaptation and vocational reintegration for self-employed workers in low-resource rural environments.