Improvement in functioning is not only caused by reducing disease-specific problems and symptoms, but also by strengthening general resources. This is part of a salutogenic approach, focusing on the factors that contribute to an individual’s health. ^{15, 16, 17} 

These resources must be assessed and, when appropriate, taken into consideration in rehabilitation management. In most cases, each patient possesses valuable resources that can help him or her overcome challenges associated with SCI. ^18,19 

Such resources may include personal attributes and aspects such as coping strategies and environmental factors.²⁰  The resources that each patient brings into rehabilitation will vary, but each will have certain strengths that can be applied to the problems he or she faces.²¹ 

Many of these represent the complete background of the patient’s life and living situation.²²  Each of these patient resources can be elucidated from both the patient and the health professional perspectives throughout the assessment. These resources may then be supported or enhanced by the health care team through specific interventions

In Michael’s case, aspects of his person, personality and environment helped to inform his own goals and the goal-setting by his health team as well as positively impacting his progress towards them. His own intrinsic wishes — to attend university, play sports and engage in social activities — were very clear to him and functioned as both coping strategies and important motivating factors.

These, in turn, helped Michael and his health care team define his global goal of “full independence and university entry” which, for him, was both desirable and realistic. Michael’s own hopes and intentions of the future also had a positive impact on his progress towards his program goal that focused on “independence in the activities of daily living.”

Many of his resources functioned as facilitators for achieving these goals. Above-average skill acquisition, his young age, athleticism and physical fitness (and by extension, competitiveness), a large and supportive social network, health insurance and financial support all helped Michael reach most of his intervention targets. 

Patient resources matter in the rehabilitation process. They help to inform goal-setting and facilitate a patient’s progress towards functional independence.

Consideration should be given to what resources of all types are available to a patient in the assessment phase of the cycle. Such resources have great potential to positively affect both the goals and their interventions, hopefully leading to a patient’s increased independence and subsequent autonomy and self-determination.