Goal Setting &

Treatment Plan


BY: DR. ANUM NAZ

 Contents

• Long term goals.
• Short term goals.
• Treatment planning.
• Criteria for discharge.
• Care of orthoses.
 Long Term Goals

 It refer to restoring the individual to his/ her desired
role in society.
 Orthoses designed to minimize functional
limitations.
 It assist balance and promote better performance of
activities of daily living.
 Example of long term goals that improve dynamic
equilibrium include independence in walking of
level surface, transferring from bed to wheel chair.
 Long Term Goals Cont.

Long term goals include:
 Reducing pain.
 Prevent soft tissue contracture.
 Restoring full joint range of motion.
 Prevent deformity.
 Increase strength.
 Increase stability.
 Achieve maximal level of independent.
Long Term Goals (Cont.)

 Performing all daily activities e.g. feeding, dressing,
grooming and personal hygiene.
 Operate a motor vehicle independently.
 Function in the role of parent.
 Resume the role of high school student.
 Short Term Goals

 Short term goals are derived from long term goals.
 Each short term goal must be observable,
measurable, and have a designated duration.
 E.g. of short term goal is “Patient will be able to
ambulate safely on a level surface with an AFO-PLS
for 35meters twice daily with contact guarding in 2
weeks.
 Treatment Planning

 After long & short term goal, the next step in
rehabilitation is developing a treatment plan.
 Training of donning & doffing.
 Education about proper care of the orthoses.
 The clinician should explain to the patient that an
accommodation period is necessary so that the skin
and underlying tissue can adapt orthosis.
 Initially after the orthosis is evaluated and delivery is
accepted the patient should wear the orthosis for no
longer than 2hours.
Treatment Planning Cont.

 If the person tolerates wearing the orthosis on a
limited basis, the wearing time can then be increased.
 Clinician should become familiar with the various
places that their patient frequent , then discuss with
the patient the challenges that each places pose.
 Criteria For Discharge

 Discharge is appropriate when the patient achieves
the long-term goals.
 Some people refuse to wear orthoses because they
find it unattractive, heavy, or difficult to use.
 Those who refuse to use their orthosis may be
discharged from treatment because they are no longer
getting benefit from orthotic intervention.
 Good communication between patient and all the
members can result a discharge that is mutually
agreeable.
 Care of orthoses

 SHOES:
 Use shoe trees to maintain the original shape of the
shoes.
 Keep heels and soles in good condition.
 Inspect the interior of the shoe for any protruding
nails from the sole.
 Protect the shoe from mud,
snow and rain, if it becomes
wet insert shoe trees.
Care of Orthoses (Cont.)
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 PLASTIC SHELLS:
 Wipe with a moistened fabric with diluted solution
of mild soap & water.
 Do not soak the orthosis in cold or hot water.
 Avoid contact with heat, such as
leaving it in a car parked in the sun.
 Check for surface blemish,
which may indicate exposure
to heat.
Care of Orthoses (Cont.)

 METAL JOINTS:
 Keep joint surface clean, inspect and remove debris
with cotton swab or fine wire, such as a hairpin.
 Once a week, lubricate joint with a drop of machine
oil.
 Check the locking mechanism to
make functions smoothly.
Care of Orthoses (Cont.)

 METAL UPRIGHTS:
 Inspect the orthoses weekly to check for loose or
missing screws or bolts.
 In a child’s orthosis, check every 3 months to check
orthosis still fits properly.
Care of Orthoses (Cont.)

LAETHERS:
 Wipe with a cloth moistened with a diluted of mild
soap & water.
FABRIC:
 Wear clean fabric between the orthosis and the skin,
 For lower limb orthoses, cotton is suitable because
the fabric absorbs perspiration.
Care of Orthoses (Cont.)
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BUCKLES:
 Inspect buckle to make certain they are in good
repair.
LACES:
 Check laces particularly at place in which laces
contact rigid surface.
 Replace laces every 6months to avoid breakage.
Care of Orthoses (Cont.)
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 STRAPS:
 Clean hook and pile straps with a tooth brush.
 WIRE:
 Protect wires from moisture.
THANK YOU
