Intervention’s capacity. Having a clear knowledge of the intervention’s
purpose as understood through the lens of the International Classification of Functioning, Disability and
Health (ICF)46,47 is essential to predicting outcomes. Many
rehabilitation providers and families hope, claim and
expect that physical improvements at the ‘‘body structures
and functions’’ level of the International Classification of
Functioning will translate to upstream benefits in task
‘‘activities’’ performance and social ‘‘participation.’’ Rehabilitation
for children with cerebral palsy is not a ‘‘fix’’ but
rather should focus on developing function.48 Recent systematic
review evidence indicated that effective body
structures and functions interventions lead to clinically
meaningful body structures and function gains but these
gains unfortunately do not yet for the most part transfer
upstream to improved outcomes in activities and participation
performance.1 Also, on the contrary, effective activities
interventions result in clinically meaningful gains at
the activities level of the International Classification of
Functioning, but these gains do not yet translate downstream
to better body structures and functions, nor upstream
to better life participation.1 Therefore, if a body structures
and function outcome is desired, the intervention must be
selected from the suite of evidence-based body structures
and function interventions. Conversely, if an activitieslevel
outcome is sought, child-active learning-based interventions
acting at the activities-level must be applied.1 In
clinical practice, this means professionals must clearly
understand what intervention gain is desired by the child
and family, and it’s corresponding level of the International
Classification of Functioning, and then must choose interventions
operating from the same level of the International
Classification of Functioning.