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Brett Sears

Functional Goals in Physical Therapy

By January 30, 2013

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I recently saw a patient with low back pain and left leg pain with some weakness in her left quadriceps. We were discussing her goals for physical therapy and how her current back problem affected her daily life.

My patient stated that she wanted to get her leg stronger so that she can climb up on chairs to change light bulbs in her house. Now this person is a senior citizen, and I feel that perhaps climbing up on chairs is NOT the safest thing for her to be doing.

She insisted that she has used a chair to change her light bulbs for years, and she was not about to stop doing it. I tried to reason with my patient, explaining that a fall while standing on a chair could be devistating. She could be seriously injured, or (gulp) die.

My patient would hear none of it. She wanted her leg better so that she could climb on a chair. I conceded. So we worked on getting her quadriceps stronger. And then I took a chair out from the kitchen at the office, and we practiced safe ways for her to climb up and down from her chair.

Your physical therapist should discuss goals with you while you participate in physical therapy. Your goals should be functional, and, hopefully, safe.

So what do you think? Should I have told my patient never to climb on her chair? Or should I have done what I did and practiced safe ways for her to do it?

January 30, 2013 at 11:11 pm
(1) Jerry Truitt says:

I would have brought out a step ladder too. That would give her the opportunity to compare how much easier, steadier and safer the ladder is compared to the chair. A fall from the chair will come and it will be a disaster when it does.

January 30, 2013 at 11:26 pm
(2) physicaltherapy says:

Good point Jerry. I should get a step ladder for my office. And I’ll keep working with my patient to convince her how dangerous chair climbing can be. Thanks!

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