OT Goals for Functional Mobility

Occupational therapy practitioner CAN treat the lower body! In fact, in many ways, an occupational therapy practitioner is the BEST practitioner to take lead on lower body rehabilitation and restorative therapy. Despite what you may have learned…or maybe never learned in school…an occupational therapy practitioner should know just as much, if not more about the lower body as they do about the upper body! Occupational therapy practitioners treat the entire body! If your patient wants to do any of the activities found within the 8 domains of occupational therapy, they will need their occupational therapy practitioner to address mobility including restoring function, restoring structures, enhancing performance skills, and maximizing independence. This is a continuum! 

The patient will demonstrate safe bed mobility from supine to side, supine to sit, EOB to stand, EOB to supine, achieving proper positioning at rest, etc. with [graded level of assistance] as evidenced by physical demonstration of skill during [xx] sessions with [xx] weeks.

The patient will transfer safely in/out of the tub/shower with [graded level of assistance] after improving sufficiency of body functions, structures, and performance skills required for this transfer as evidenced by physical demonstration of skill during [xx] sessions with [xx] weeks.

The patient transfers safely in/out of wheelchair with [graded level of assistance] after improving sufficiency of body functions, structures, and performance skills required for this transfer as evidenced by physical demonstration of skill during [xx] sessions with [xx] weeks.

The patient transfers safely in/out of car with [graded level of assistance] after improving sufficiency of body functions, structures, and performance skills required for this transfer as evidenced by physical demonstration of skill during [xx] sessions with [xx] weeks.

The patient will ambulate and clears steps/curbs, both ascending and descending, with [graded level of assistance] after improving sufficiency of body functions, structures, and performance skills required for this aspect of functional mobility as evidenced by physical demonstration of skill during [xx] sessions with [xx] weeks.

The patient will ambulate on uneven surfaces with various environmental lighting conditions with [graded level of assistance] after improving sufficiency of body functions, structures, and performance skills required for this aspect of functional mobility as evidenced by physical demonstration of skill during [xx] sessions with [xx] weeks.

The patient [or caregiver] will demonstrate competent use of durable medical equipment and/or effective adaptive mobility patterns used for functional mobility [i.e.xxxxxx]  for the successful completion of activities included in the 9 domains of occupation within [xx] weeks. 

See BOT Portal for more.

Star Excursion Balance Test

The patient will demonstrate maintained or improved transitional balance and increased ankle stability during the performance of moving from static to dynamic balance capabilities in multiple planes of movement as evidenced by maintenance or increase or established score on the Star Excursion Balance Test.

Checkpoints :

• Complete initial SEB Test 25%
• Complete 2-4+ training sessions using star grid 50%
• Demonstrate improvement of score in 6 weeks 75%
• Demonstrate maintenance of 6 week outcomes in 12 weeks 100%

BERG Assessment

The patient will demonstrate an increase in numerous aspects of functional balance performance as evidenced by achieving at least 54/56 [or max outcome] on the BERG objective measurement assessment in order to ensure safety and limit fall risk during community/home mobility.

Checkpoints:

• Complete BERG (10 %) Note Deficits in Progress Note
• Complete Star Point Assessment (15 %) – video record
• Demonstrates ability to step out in ipsilateral anterior diagonal stance alternating RLE and LLE while holding 5 seconds and returning to starting position x5 trials each movement for a total of 20 trials without LOB or CGA (50%%) [Progress starting position from wide BOS to narrow BOS]
• Maintain 5 second one-leg stance on both right and left leg without LOB (75%)
• Completion of goal – BERG retest (100%)

Lower Extremity Functional Scale

The patient will demonstrate an improvement in occupations of the lower extremities as evidenced by an increase of 60 points on the Lower eE within 18 weeks. 

Deficits: All activities are extremely difficult or quite a bit difficulty

Checkpoints: 

1. (4.5 weeks) Improvement by 15 points – 25%
2. (9 weeks) Improvement by 30 points – 50%
3. (13.5 weeks) (Improvement by 45 points – 75%
4. (18 weeks) Improvement by 60 points – 100% 

Lower Body Strength for Functional Mobility

The patient will demonstrate improved lower body strength and muscle stamina as evidenced by…. See BOT Portal for more.

Gross Motor Coordination

The patient will independently demonstrate improved gross motor coordination as evidenced by ….See BOT Portal for more.

Sitting Balance

The patient will demonstrate improved sitting balance as evidenced by an a score of 43/44 on the ‘Sitting Balance Scale’ within 12 weeks. 

Checkpoints: 

• Complete Sitting Balance Scale 15%
• 2-4 Unsupported sitting for 10 minutes without support demonstrating self-correction of posture (25%) 
• 2-6 session of linear and dynamic reach activity while seated (50%)
• 2-4 sessions of lateral lean and rotational trunk activities plus gaze shift training (75%)
• Final execution of scale at 12 weeks (100%) 

Once the patient scores greater than 43 on the Sitting Balance Scale, this goal will progress to static/dynamic standing balance continuum. 

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