For the purpose of reporting to the case manager and physician, an additional form is utilized. The information from the worksheet is documented in a SOAP (Subjective; Objective; Assessment; Plan) Note format for each evaluation session. This form is more narrative in nature and provides a picture of the participant's experience during the evaluation session.

If the testing goes smoothly and there are no medical considerations, the physical therapist will refer the individual for regular exercise. If not, it may be decided that additional trials are required to see if there will be improvement or if the participant will be discharged and deemed inappropriate for the protocol. The majority of individuals who do not qualify for the treadmill training program have various maladaptive behaviors. If the individual, for example, requires a sling for safety but learns that he or she can hang in it, then there is little that we as therapists can do to facilitate exercise.

While the physical therapist (PT) is responsible for evaluating participants and determining their inclusion into the wellness program, the physical therapy assistants implement most of the training sessions. The PT should explain to the physical therapy assistants signs and symptoms of distress and enjoyment. It is far easier to pick up concerns once you are familiar with the individual's baseline performance and affect. Any variation from normal would be considered suspect. Additional signs to watch for are noted below.

1. Condition/color of skin (dryness, sweaty, pallor, cyanotic, etc.)
2. Mood of client (cooperative vs. uncooperative, happy vs. sad, etc.)
3. Communication style (verbal, vocal, non-verbal, gestures) - ways of showing pleasure or displeasure; types of reinforcers that are effective
4. Interpretation of facial expressions
5. Preferences/dislikes in possible entertainment (music types, video)