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.
Department of Research and Development, Spine Center Division, Schulthess Klinik, Lengghalde 2, 8008 Zürich, Switzerland. anne.mannion@kws.ch
Anne F
AF
Mannion
Filomena
F
Caporaso
Natascha
N
Pulkovski
Haiko
H
Sprott
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