ICF classification of therapeutic goals for outpatient episodes of neurorehabilitation in post-stroke and Parkinson disease.
Marghuretta D Bland, Carey L Holleran, Caitlin A Newman and 7 others
PMID 38059563WHAT IT FOUND
Clinicians mostly set goals for what patients can do in the clinic, not in daily life.
Only 21% of goals targeted real-world performance, and fewer than 1% used direct measurement. This disconnect may explain why capacity improves but daily function does not.
Key findings
01Most therapeutic goals focused on activity capacity in the clinic rather than activity performance in daily life.
02Direct measurement of daily life performance was almost entirely absent from goal setting.
03A significant portion of goals were tied to standardized assessment scores rather than functional outcomes.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
Goals were only extracted from initial evaluations, so any modifications made during therapy were not captured. Patient preferences and goals were not known, so alignment between clinician and patient priorities could not be assessed. Classification of goals containing mixed components (e.g., strength and activity) was subjective, potentially overestimating activity-level goals. Data were missing for 52 of the 156 enrolled participants due to record access issues.
Declared interests
The authors report no competing interests.
The easy way to misread this
Do not conclude that clinicians are failing to address daily life function; this study only shows how goals were written at the initial evaluation. Goals may have been modified later in therapy to address performance, but that data was not collected.