Interdisciplinary spasticity management clinic outcomes using the Goal Attainment Scale: A retrospective chart review.
2017 May 16
Hanlan, A.; Mills, P.; Lipson, R.; Finlayson, H.
J Rehabil Med
Adult; Female; Humans; Male; Middle Aged; Muscle Spasticity; Retrospective Studies; Treatment Outcome
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.