Content area
Full Text
Motor learning research, health care policies, reimbursement practices, and the standards of accrediting bodies all support writing patient-centered functional goals of physical therapy. This article defines patient-centered functional goals within the context of the Guide to Physical Therapist Practice and provides a rationale for incorporating functional goals into physical therapy for patients in all areas of practice. The article also describes how physical therapists can collaborate with patients to identify functional goals that are meaningful to them and describes a 5-step process for writing functional goals that are measurable. [Randall KE, McEwen IR. Writing patient-centered functional goals. Phys Ther. 2000;80:1197-1203.]
Key Words: Functional goals, Outcomes, Patient-centered services.
In 1982, O'Neill and Harris1 published "Developing Goals and Objectives for Handicapped Children" in Physical Therapy. The purpose of this now-classic article was to help physical therapists implement Public Law 94-142, the Education for All Handicapped Children Act2 (now the Individuals With Disabilities Education Act), which required teachers, physical therapists, and other school personnel to write measurable goals and objectives for children with disabilities receiving special education and related services. Since the article was published, measurable, functional goals have become advocated or required in many other areas of practice,3-9 and the definition of a functional goal has changed. O'Neill and Harris promoted functional goals, but their examples reflected the neuromaturational orientation of pediatric physical therapy at the time. Their goals focused on presumed components of functional skills, such as maintaining a prone-on-elbows position with the head in midline or righting the head when tipped laterally while sitting on a therapy ball.1 Although therapists may need to address impairments during treatment, there is increasing agreement that the measured goals of therapy should relate to functional limitations and disabilities that are individually meaningful to patients.10,11
This article updates O'Neill and Harris' article by describing a patient-centered approach to writing measurable functional goals that therapists can apply to patients receiving physical therapy in all areas of practice. We will define "functional goal" within the context of the Guide to Physical Therapist Practice (the Guide),3 present a rationale for incorporating functional goals into everyday practice, and provide suggestions for identifying and writing functional goals.
What Are Patient-Centered Functional Goals?
The Guide to Physical Therapist Practice3 provides a context for defining...