[Environmental factors and the promotion of participation. The Perspective of medical rehabilitation].

The International Classification of Functioning, Disability and Health (ICF), as well as the main goal of enabling participation, are of fundamental importance for medical rehabilitation. According to the logic of the ICF and its underlying multidimensional model of functioning and disability, the participation of a person can be influenced by modelling environmental factors. This article presents environmental factors as defined by the ICF in the context of medical rehabilitation and aims to answer to what extent environmental factors are already involved in medical rehabilitation and if there are further environmental factors with the potential of being involved in interventions for improvement of participation. An analysis of documents with relevance to medical rehabilitation was done. Text passages that referred to environmental factors were linked to the environmental factor codes of the ICF. The ICF and its underlying model of functioning and disability provide a conceptual framework both for making the current usage of environmental factors apparent and for deriving and developing new intervention approaches with the involvement of environmental factors. The analysis of documents showed that environmental factor codes vary in how well they are represented in these documents. There are environmental factor codes that are barely or not at all represented, but do have potential to contribute to the improvement of participation.