Goal attainment scaling as a measure of treatment success after physiotherapy for chronic low back pain.
OBJECTIVE
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 2-6 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 >or=50); 55%, according to global outcome (therapy helped/helped a lot); 39%, according to the RM score change (score decrease >or=30%); and 44%, according to the pain score change (score decrease >or=30%).


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.
Mannion
Anne F
AF
Department of Research and Development, Spine Center Division, Schulthess Klinik, Lengghalde 2, 8008 Zürich, Switzerland. anne.mannion@kws.ch
Caporaso
Filomena
F
Pulkovski
Natascha
N
Sprott
Haiko
H
D000203:Activities of Daily Living / Q000523:psychology; D000328:Adult; D002908:Chronic Disease / Q000534:rehabilitation; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000534:rehabilitation / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D026741:Physical Therapy Modalities; D011788:Quality of Life / Q000523:psychology; D012720:Severity of Illness Index; D013223:Statistics as Topic; D011795:Surveys and Questionnaires; D016896:Treatment Outcome