Interdisciplinary spasticity management clinic outcomes using the Goal Attainment Scale: A retrospective chart review.

Journal of rehabilitation medicine : official journal of the UEMS European Board of Physical and Rehabilitation Medicine

PubMedID: 28480944

Hanlan A, Mills P, Lipson R, Finlayson H. Interdisciplinary spasticity management clinic outcomes using the Goal Attainment Scale: A retrospective chart review. J Rehabil Med. 2017;49(5):423-430.
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.