The misuse of the lower extremities during mobility activities can affect individuals with different health conditions and directly impact their daily routines. Thus, it is essential to assess the performance of individuals in these activities for an accurate diagnosis of the limitation. The Lower Extremity Motor Activity Log (LE-MAL) is an instrument developed to assess the use of the lower extremities in mobility activities. However, how the content of the LE-MAL items is related to the framework of the current biopsychosocial functioning model is unknown.

To link the LE-MAL items with the International Classification of Functioning, Disability, and Health (ICF) and identify the contents of the LE-MAL items.

Concepts within each item of the LE-MAL were linked to the best-matched ICF categories using established linking rules. Two independent researchers performed the initial linkage of the items, and the final consensus was reached after a meeting with the other researchers involved in the study.

Ten concepts were identified. The two-level main concepts identified were d410 (changing basic body position), d450 (walking), d455 (moving around), and d460 (moving around in different locations). All items assess performance through information about need or dependence, personal and environmental factors, and appraisal. All items are covered in the Mobility domain (d4) of the Activity and Participation component. Moderate agreement was obtained between researchers.

The LE-MAL fits into the mobility domain of ICF, and the items' general construct is the performance evaluation. The study highlighted the conceptual connection between the LEMAL and the ICF framework.

The use of the functioning model proposed as a framework – the ICF, enables the use of the LE-MAL as a tool that supports clinical professionals' use of ICF coding in clinical settings. This allows the common language between professionals and the classification of patients with different conditions. Moreover, the LE-MAL was developed for people with gait dysfunction and might represent a comprehensive way to analyze the lower extremity use during mobility activities in different health conditions.