I’ve improved so much — my muscle power, using my wheelchair, transferring myself, and especially in sports. Immediately after the accident, I absolutely knew that sports would continue to be a very big part of my life. It offers me an opportunity to move, to feel joyful, to meet other people and to really experience my improvements as I recover.

I feel like my fear of falling is almost gone; I think the Feldenkrais helped the most with this.

Lisa, at the end of the Rehab Cycle

I absolutely knew that sports would continue to be a very big part of my life.

Two months later, Lisa had progressed well, meeting the goals set for two of her three Cycle Goals: self-care and recreation and leisure. Her SCIM score increased to 60 and remained there, likely reflecting the physical limitations of her injury (see table XX). Her mobility had improved, but did not reach the level that her healthcare team had hoped for.

While improvements to her mobility were made, a number of factors resulted in Lisa falling short of the goals set by the team. Fear, although greatly decreased, continued to work against her mobility. Likewise, ongoing pain, an increasing and significant degree of spasticity and poor arm support functions all contributed to the difficulties Lisa had in transferring and changing body positions.

Also, she still needed to take an examination in order to obtain a driver’s license — clearly a prerequisite to her being mobile with a modified car. It was hoped that each of these contributing factors would improve over time and with them, naturally, Lisa’s mobility.

Lisa improved in many areas of physical functioning, but her fear limits some activities — she still has difficulties transferring to her wheelchair; I think absent the fear she could have made even more gains.

Lisa’s physical therapist

The art therapy class, spiritual guidance and Feldenkreis therapy that she received were valuable to her recovery. From her own perspective, Lisa felt that these interventions qualitatively had an introspective and calming effect, helping her to adapt to her new life situation and even to alleviate some of her falling fear.

Regarding her occupation, Lisa’s former employer readily agreed to take her back; she could continue teaching geography and potentially other subjects. Given her love of sports, she hoped someday to be able to integrate into her career her athletic enthusiasm and passion for teaching, possibly as a motivational sports instructor. She planned on returning to work as soon as she was able, though feelings of insecurity remained and her occupational therapist would continue to offer support.

In pursuing the Cycle Goal for recreation and leisure, Lisa was highly motivated and pro-active in both sports-related and non-athletic interventions. She made gains achieving her objectives physiologically in both exercise tolerance and muscle power, as well as in the area of mobility, learning to better use a wheelchair — a prerequisite for many other athletic interventions.

Not only do sports benefit her physically, but they also help to support her emotionally and socially...

Although her muscle endurance fell short of the stated goal, she still made significant strides in all of the sporting activities she undertook. Throughout this Rehab Cycle, Lisa’s love of sports and athletic history shined through in all she tried. By admission of her sports therapist, she excelled in swimming, archery and tennis, while also performing well in team sports such as basketball.

Her canoeing test went well and she planned on pursuing this activity with her boyfriend, who had been highly supportive. She even discovered a new passion for hand biking. She now planned on purchasing her own bike and intended to compete.

Sports are extremely important to Lisa. Not only do they benefit her physically, but they also help to support her emotionally and socially — with her boyfriend and others.

Lisa’s sports therapist

Table 4: ICF Evaluation Display

Figure 4: ICF Evaluation Display, 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 in the environmental factors. In personal factors, the sign + and – indicates to what extent a determined pf has a positive or negative influence on the individual’s functioning. 1, 2, 3 show the relations to Cycle Goals 1, 2, 3; SG is related to the Service Program Goal, G is related to the Global Goal.