Interdisciplinary Spasticity Management Clinic Outcomes Using the Goal Attainment Scale: A Retrospective Chart Review

Publication Type
Journal Article
Year of Publication
2017
Authors
Hanlan, A; Mills, P; Lipson, R; Thompson, DJS; Finlayson, H
Secondary
J Rehabil Med
Volume
49
Start Page
423-430
Pagination
423-430
Date Published
05/2017
Keywords
GAS T-scores; International Classification of Functioning Disability and Health (ICF); patient-centred outcome measures; spasticity management clinic; spasticity management rehabilitation
Abstract

OBJECTIVE:

To generate practice-based evidence of outcomes in an interdisciplinary spasticity management clinic using practical application of the Goal Attainment Scale (GAS).

DESIGN:

Retrospective chart review.

PATIENTS:

A total of 225 adult patients who were referred for spasticity management at a tertiary rehabilitation hospital and returned for follow-up between 2010 and 2013.

METHODS:

GAS scores were determined for all patients. GAS T-scores were evaluated based on age; sex; diagnosis; International Classification of Functioning, Disability and Health (ICF) domain; body region affected; and site of botulinum neurotoxin injection.

RESULTS:

The distribution of GAS outcomes did not vary by age, sex or diagnosis. The overall GAS T-score for the clinic was 47.7, which is consistent with appropriate goal setting. GAS T-scores did not vary by diagnosis or ICF domain. Significant intervention effects were identified for botulinum neurotoxin, with improvements in GAS T-scores for treatment targeted to both upper and lower limb muscles, compared with no botulinum neurotoxin, across diagnoses and ICF domains.

CONCLUSION:

The GAS is a useful patient-centred outcome measure that can be practically applied in the clinical setting for a heterogeneous population with diverse goals. Botulinum neurotoxin treatment in this setting was associated with improved goal attainment relating to multiple ICF domains.