How to Write NDIS Goals for Physiotherapy

Getting your NDIS goals for physiotherapy worded well matters more than most participants expect. The NDIA funds supports it considers reasonable and necessary in relation to the goals in your plan. A goal written as "improve my health" gives a planner very little to attach funding to. A goal written around a specific activity, with a functional reason behind it, gives your physiotherapist something to build a program from and something to report against at your next plan reassessment.

This is written for participants and support coordinators in Sydney's Inner West and Lower North Shore, though the structure applies anywhere.

Plan goals and therapy goals are different things

Your plan contains a handful of broad goals in your own words. They are meant to be broad. Under each one sits a set of therapy goals that your physiotherapist or exercise physiologist writes with you, and those need to be specific and measurable.

A plan goal might read: "I want to be more active and be part of a sports club."

The therapy goals underneath might read:

• Walk 800 metres on uneven ground without a rest stop, by the end of the plan period
• Complete a 60 minute club training session including warm-up and drills
• Perform a sit-to-stand from a standard chair without using arms, five repetitions
• Independently get down to and up from the floor, both directions

Each one has a number, a task and a context. Each one is something a physiotherapist can measure at the first appointment and measure again six months later.

Write the activity in, not out

Participants often soften their goals because they assume sport will be knocked back as recreation. The stronger approach is to write the activity in and make the functional link explicit.

Compare these two:

"I want to play basketball."

"I want to build the strength, balance and endurance to take part in weekly wheelchair basketball training with my club, so I can maintain my fitness and my social connections independently."

The second version names the capacity being built. The physiotherapy is the support. The basketball is the reason the capacity matters. That is the relationship the NDIA is looking at.

The same works for a teenager. "Improve coordination" is weak. "Develop the running, jumping and ball skills to keep up with peers at Saturday morning junior soccer, and manage the physical demands of a full season" is much easier to fund and much easier to program.

The measures a physiotherapist reports against

At a first appointment we take baseline numbers, because progress reports written on impressions are hard to act on. Depending on your presentation and your goal, that might include:

• Ten metre walk test and six minute walk distance
• Five times sit-to-stand
• Timed up and go
• Single leg stance time, eyes open and closed
• Grip strength or handheld dynamometry for specific muscle groups
• Joint range measured in degrees
• Load lifted for key gym exercises, tracked session by session
• Session attendance and tolerance, including how fatigue behaves over the following 24 hours

Six or twelve months later, those same tests get repeated. A report that says a participant moved from 14 seconds to 9 seconds on a timed up and go, and from 220 metres to 340 metres on a six minute walk, describes what happened. A report that says a participant is "progressing well" does not.

Which budget the support sits in

Physiotherapy usually comes from Capacity Building, Improved Daily Living. Exercise physiology may sit in Improved Daily Living or in Improved Health and Wellbeing, depending on how your plan is written and what the funding is intended to address.

Core supports can sometimes cover a support worker to attend gym sessions between your physiotherapy appointments. For participants training two or three times a week, that combination is often what makes the schedule work: one session with the physiotherapist, two sessions running the same program with support.

If your plan is NDIA-managed, you need a registered provider. Plan-managed and self-managed participants have more flexibility in who they see. Worth checking before you book.

Common problems with goal wording

Goals with no timeframe. "Improve strength" never finishes. "Increase leg press load and complete a full training session by the end of this plan" does.

Goals written by someone else. If the wording does not sound like you, it usually does not survive contact with a real week. The goal has to be something you will actually turn up for.

No baseline. If nothing was measured at the start, the report at the end has nothing to compare against.

Too many goals. Four or five well-chosen goals beat twelve vague ones. Physiotherapy time is finite and split attention shows up in the results.

When to get goals reviewed

Bring your goals back to your physiotherapist if your sport or club changes, if you have had surgery or a hospital admission, if your plan reassessment date is within three months, or if you have already met a goal and nothing has replaced it. A goal you passed eight months ago is dead weight in a plan.

Bring a copy of your current plan to the first appointment. We will work through your goals, take baseline measures and put together a written program that matches what you are training for.

Book an assessment at Five Dock or Gladesville to get started.