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Goal attainment scaling as a measure of treatment success after physiotherapy for chronic low back pain


Mannion, A F; Caporaso, F; Pulkovski, N; Sprott, H (2010). Goal attainment scaling as a measure of treatment success after physiotherapy for chronic low back pain. Rheumatology, 49(9):1734-1738.

Abstract

Objectives. In some chronic conditions, patient-specific tools with individualized items have proved to be
more sensitive outcome instruments than fixed-item tools; their use has not yet been investigated in
chronic low back pain (cLBP).

Methods. Eleven males and 21 females [mean age 44.0 (12.3) years] with cLBP, undergoing a spine-stabilization physiotherapy programme, completed the Roland Morris (RM) Disability Scale and a 0-10 pain scale pre- and post-therapy. Post-therapy, goal attainment scaling (GAS) scores were calculated regarding achievement of 26 priority GAS goals established pre-therapy; global outcome of therapy
was assessed on a 5-point Likert scale.

Results. Approximately one-fifth of the individualized goals were not covered by items of the RM. Of the
121 individualized goals, 41 (34%) were achieved at the expected level, 42 (35%) were exceeded and 38 (31%) were not reached. GAS scores correlated with change scores for pain (r = 0.61, P<0.0001) and RM (r = 0.49, P = 0.006). Sixty-five per cent of the patients had a successful outcome according to GAS(i.e. a score 550); 55%, according to global outcome (therapy helped/helped a lot); 39%, according to the RM score change (score decrease 530%); and 44%, according to the pain score change (score decrease
530%).

Conclusions. GAS demonstrates the achievement of important goals undetected by fixed-item measures and is a valid and sensitive outcome measure for assessing the success of rehabilitation in patients with cLBP.

Objectives. In some chronic conditions, patient-specific tools with individualized items have proved to be
more sensitive outcome instruments than fixed-item tools; their use has not yet been investigated in
chronic low back pain (cLBP).

Methods. Eleven males and 21 females [mean age 44.0 (12.3) years] with cLBP, undergoing a spine-stabilization physiotherapy programme, completed the Roland Morris (RM) Disability Scale and a 0-10 pain scale pre- and post-therapy. Post-therapy, goal attainment scaling (GAS) scores were calculated regarding achievement of 26 priority GAS goals established pre-therapy; global outcome of therapy
was assessed on a 5-point Likert scale.

Results. Approximately one-fifth of the individualized goals were not covered by items of the RM. Of the
121 individualized goals, 41 (34%) were achieved at the expected level, 42 (35%) were exceeded and 38 (31%) were not reached. GAS scores correlated with change scores for pain (r = 0.61, P<0.0001) and RM (r = 0.49, P = 0.006). Sixty-five per cent of the patients had a successful outcome according to GAS(i.e. a score 550); 55%, according to global outcome (therapy helped/helped a lot); 39%, according to the RM score change (score decrease 530%); and 44%, according to the pain score change (score decrease
530%).

Conclusions. GAS demonstrates the achievement of important goals undetected by fixed-item measures and is a valid and sensitive outcome measure for assessing the success of rehabilitation in patients with cLBP.

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7 citations in Web of Science®
8 citations in Scopus®
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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Rheumatology Clinic and Institute of Physical Medicine
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:2010
Deposited On:09 Jul 2010 15:19
Last Modified:05 Apr 2016 14:09
Publisher:Oxford University Press
ISSN:1462-0324
Publisher DOI:10.1093/rheumatology/keq160
PubMed ID:20511346
Permanent URL: http://doi.org/10.5167/uzh-34348

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