Biomechanical Frame of Reference (FOR): Goals and treatment for George can be appropriately developed around this FOR as his stroke has directly impacted his strength, endurance, and coordination of his R facial, R upper, and R lower extremities. This FOR focuses on proper body mechanics and positioning for function in specific, client chosen occupations (Cole & Tufano, 2008). Change occurs with a change in positioning, exercises, repetition, practice, and manipulation of the environment (possible changes in food texture). Physical agent modalities (PAMs) such as vital stimulation are often used with this FOR (Cole & Tufano, 2008).