Based on the perspectives from the assessment, three Cycle Goals were defined that would work towards Lisa’s Service Program Goal of independence in daily living and the previously established Global Goal of community reintegration. To achieve this, both Lisa and the healthcare providers agreed that mobility and self-care — fundamental aspects of independent living — required further rehabilitative efforts.
In addition, it was agreed that a third Cycle Goal would be added for recreation and leisure in order to focus on promoting Lias’s athleticism and love of sports. Congruent with the benefit that sports can offer SCI patients, this last Cycle Goal would act on a number of rehabilitative levels, hopefully improving functioning, activity and participatory aspects of Lisa’s rehabilitation.
Determination of intervention targets
For each Cycle Goal, intervention targets were determined and assigned goal values. For example, to achieve the Cycle Goal for recreation and leisure the following intervention targets needed to be addressed: choice of sports activities; emotional functions (i.e. Lisa’s fear of falling); maintenance of blood pressure; exercise tolerance and muscle power functions; spasticity; transferring oneself; and maintaining a sitting position.
Many of these targets overlapped the other two Cycle Goals. Additionally, to achieve the Cycle Goals, contextual factors would be involved: body awareness, motivation and selecting an appropriate wheelchair. Figure 3 details the goals, targets and values for this Rehab Cycle.
Figure 1: ICF Categorical Profile: *ICF qualifiers range from 0 = no problem to 4 = complete problem in the components of body functions (b), body structures (s), activity and participation (d) and from 4 = complete barrier to +4 = complete facilitator for environmental factors. Among personal factors (pf), the signs + and - indicate to what extent a pf has a positive or negative influence on the individual’s functioning. °Specific cycle goals are indicated by CG 1, 2 and/or 3; SG = Service Program Goal, G = Global Goal