Functional Goals &amp; Objectives

Goals=3 wks; Objectives=1 wk
THINGS TO KNOW
1. Goal=progression of Objective
2. The Goal is LT, it's where we want to end up
3. Goals & Objectives Help gauge whether ur treatments are making change in the major areas that u think needs intervention
4. Assistance
  1. State where it's applied and for what purpose
  2. ie: For LE advancement, for pelvic stability etc ; contact for bal at the hip, shoulders
5. Phrases to use:
  1. Pt. will demonstrate the ability to....
6. Make the goals and objectives as simplistic as possible b/c that's easier for charting; then go crazy with the interventions
7. When writing objectives, keep the same distance but manipulate the surface and for the goal, increase the distance and keep the surface or even change the surface or add a task
8. When observing a pt. u must look at the pt and the impairments and make goals & objects; don’t want to see the same thing the pt is doing, u want to challenge them. Are all 4 limbs moving, are they cognitive; then if pt looks oriented and moving extremities even if it’s a little bit or just moving 3 and 1 isn’t, u will want to push them w/wait shifting, stairs etc
WALKING
1. Distance
2. Time
3. Surface
4. Assistance
  1. Where & for what
5. Devices
  1. incld. railing use if used
6. Condition:
  1. Reciprocally vs non-reciprocally
7. EXAMPLES:
  1. Pt will ambulate x distance at x time w/o scissoring gait (if u want to works towards a larger BOS)
  2. OBJECTIVES:
    1. Pt. will ambulate 50 ft with L hand on railing Pt. will ambulate 50 ft on uneven surface (grass)
  3. GOALS:
    1. Pt. will ambulate 100 ft on uneven surface (1 in foam mat) while carrying a 5 lb ball in L hand in 60 seconds
  4. TREATMENT
    1. Take 3 steps, stop and roll it (as tx for controlled movement)
    2. Walking, walking backwards
    3. Work on standing dynamic balance and weight shifting
    4. Have pt step over some objects in straight path and initiate movement with bad leg
    5. Pt carry cub full of water w/or w/o handle and must walk w/o spilling (thus helping control & balance )
    6. Have pt lean forward (modified plantigrade) into the stool and walk with it
Transfers
1. Type
2. Assistance
3. Surface
4. Time
5. Device
6. EXAMPLES:
  1. OBJECTIVES:
  2. GOALS:
  3. TREATMENT
TRANSITIONS
1. Meaning: bed mobility, sidelying to side sitting; supine to prone; supine to sitting etc
2. Type
3. Assistance
4. Surface
5. Time
6. Device
7. EXAMPLES
  1. OBJECTIVES:
  2. GOALS:
  3. TREATMENT
    1. Make pt sit down holding a cup in her good hand, thereby forcing her to use her involved side to reach behind her and sit
STAIRS
1. Ascending & Descending (2 types)
2. Number of Stairs
3. Type of stairs (standard) or give dimensions
4. Time
5. Device
6. Assistance
7. UE use
8. Reciprocal or non-reciprocal movements
9. EXAMPLES
  1. Pt. will be able to reciprocally ascend and descend a standard flight of 10 steps with 4 small 2x2 boxes placed on the steps in 40 seconds in 3 weeks
  2. OBJECTIVES:
  3. GOALS:
  4. TREATMENT
    1. Stairs, stairs backwards (focus on control, get upright)
    2. Stairs w/involved arm on rail
    3. Have pt step on foam bad w/involved foot, then step down w/involved; then go backwards, stepping back starting w/noninvolved side
CURBS/RAMPS
1. Ascend/Descend
2. Distance (ramp)
3. Time
4. Device
5. Assistance
6. EXAMPLES
  1. OBJECTIVES:
  2. GOALS:
  3. TREATMENT
Others:
1. Dual Tasks:
  1. Type: cognitive, motor, both
2. Reach & Grab
  1. Object, size, texture
3. EXAMPLES
  1. OBJECTIVES:
    1. Pt will perform graded control of the LE 10 times (heel strike)
    2. Pt. will use left foot to press on a 2 gram pedal 10 times
    3. Pt. will perform 10 graded controlled toe taps on a 5in buzzer (if it buzzes, that indicates that he didn’t do so in a controlled fashion) without making it buzz
    4. Pt. will be able to carry a 3 lb(ball or dumbell) weight in L hand while scooting in a wheel chair using his L leg only for 20 feet in 60 secs
  2. GOALS:
    1. Pt. will pick up six (4in 4lb) balls from floor and place into a 6”x6” in basket on a wall 4 feet from the ground in 20 secs
  3. TREATMENT
    1. • Step up on a box with uninvolved foot, hold before standing completely on box then try and flex left hip • Rocker board (BABS) to work on dorsiflexion while using involved hand to grasp a small ball out of right hand raise it diagonally • Toe taps on buzzer while holding a medicine ball and bimanually bringing ball over head, progress to 1 hand or use
    2. Hula-Hoop
      1.  Do reciprocal work w/pt inside it  Do rom  Have pt step the hoop then bring it over the head  Be in the hoop and just turn the hoop crossin hands over ; standing on 1 foot and doing it
    3. HUGE BOLSTER
      1.  To kick it as walking  Or use it to kick it based on the lines on the huge thing  Have him pick it up and down  Play pass with it
    4. Use squeeze ball, work on over pressure and squeeze ball then open their hands squeeze and open hands. Then have 2 balls, 1 that makes a sound and another that doesn’t, say “squeeze” sound, squeeze, sound, then use other hand to squeeze ball w/no sound, squeeze, squeeze…then say Mr. xyz, squeeze and make a sound…..if pt makes sounds with correct ball then that’s good
    5. o PT provided direction to him or co….tell him to pick up 3 things from floor; or bing up cone, ball and block (doing w/so w/o giving him the cues; so that he can do it himself instead of u giving them the info and them relying on u to provide them with that info ); have him carry basket (dual task, stability, own internalization ) o Pick up 3 cones (instead of diff objects) o As we’re walking if u see something, I want u to step over it o During the obstacle course, throw something on floor and as pt on no, what should we do
    6. Pt will reach for 4 individual horizontally placed plastic cups at eye level w/involved UE while standing on foam mat and place them on counter height table
    7. Do it in modified tandem stance,, change the distance from the wall, thus increasing hip strategy (pt will stand w/toes 3 ft from wall and be able to stretch involved arm forward to the tap at waist height and travel up to eye height)
    8. Have pt pick up object, cross midline and place into another cup
    9. Kick ball when it comes back stop it with hands and kick again
    10. Have pt sit on foam bad and then have them push a stool to the left with uninvolved hand over involved hand ; PT could have pt hold onto stool don’t let me pull it back and PT can perform quick stretch
    11. Have pt stand on foam pad, squat to pick up ball w/uninvolved side then drop the ball w/the involved side