title: Feasibility of a shorter Goal Attainment Scaling method for a pediatric spasticity clinic - The 3-milestones GAS.
abstract: BACKGROUND
  Goal Attainment Scaling (GAS) is a method for writing personalized evaluation scales to quantify progress toward defined goals. It is useful in rehabilitation but is hampered by the experience required to adequately "predict" the possible outcomes relating to a particular goal before treatment and the time needed to describe all 5 levels of the scale. Here we aimed to investigate the feasibility of using GAS in a clinical setting of a pediatric spasticity clinic with a shorter method, the "3-milestones" GAS (goal setting with 3 levels and goal rating with the classical 5 levels). Secondary aims were to (1) analyze the types of goals children's therapists set for botulinum toxin treatment and (2) compare the score distribution (and therefore the ability to predict outcome) by goal type.
  
  
  METHODS
  Therapists were trained in GAS writing and prepared GAS scales in the regional spasticity-management clinic they attended with their patients and families. The study included all GAS scales written during a 2-year period. GAS score distribution across the 5 GAS levels was examined to assess whether the therapist could reliably predict outcome and whether the 3-milestones GAS yielded similar distributions as the original GAS method.
  
  
  RESULTS
  In total, 541 GAS scales were written and showed the expected score distribution. Most scales (55%) referred to movement quality goals and fewer (29%) to family goals and activity domains.
  
  
  CONCLUSIONS
  The 3-milestones GAS method was feasible within the time constraints of the spasticity clinic and could be used by local therapists in cooperation with the hospital team.
authors.affiliation: Institut Universitaire de Réadaptation Clemenceau-Strasbourg, 45, boulevard Clemenceau, 67082 Strasbourg, France; CNRS, Inserm, Laboratoire d'Imagerie Biomédicale (LIB), Sorbonne Universités, UPMC Université Paris 06, 75013 Paris, France; Service de Chirurgie Orthopédique Infantile, Hôpital de Hautepierre, CHU de Strasbourg, avenue Molière, 67098 Strasbourg cedex, France. Electronic address: agatakrasny@yahoo.com.
authors.forename: A
authors.initials: A
authors.lastname: Krasny-Pacini
authors.affiliation: Service de MPR et Pédiatrie, Centre Hospitalier du Luxembourg, Luxembourg, Luxembourg; Service de Chirurgie Orthopédique Infantile, Hôpital de Hautepierre, CHU de Strasbourg, avenue Molière, 67098 Strasbourg cedex, France.
authors.forename: F
authors.initials: F
authors.lastname: Pauly
authors.affiliation: Institut Universitaire de Réadaptation Clemenceau-Strasbourg, 45, boulevard Clemenceau, 67082 Strasbourg, France; Service de Chirurgie Orthopédique Infantile, Hôpital de Hautepierre, CHU de Strasbourg, avenue Molière, 67098 Strasbourg cedex, France.
authors.forename: J
authors.initials: J
authors.lastname: Hiebel
authors.affiliation: Service de Chirurgie Orthopédique Infantile, Hôpital de Hautepierre, CHU de Strasbourg, avenue Molière, 67098 Strasbourg cedex, France.
authors.forename: S
authors.initials: S
authors.lastname: Godon
authors.affiliation: Institut Universitaire de Réadaptation Clemenceau-Strasbourg, 45, boulevard Clemenceau, 67082 Strasbourg, France; EA 3072 "Mitochondrie, Stress Oxydant et Protection Musculaire", Fédération de Médecine Translationnelle de Strasbourg (FMTS), Strasbourg University, 67000 Strasbourg, France.
authors.forename: M-E
authors.initials: ME
authors.lastname: Isner-Horobeti
authors.affiliation: CNRS, Inserm, Laboratoire d'Imagerie Biomédicale (LIB), Sorbonne Universités, UPMC Université Paris 06, 75013 Paris, France; Service de Rééducation des Pathologies Neurologiques Acquises de l'Enfant, Hôpitaux de Saint-Maurice, 94410 Saint-Maurice, France.
authors.forename: M
authors.initials: M
authors.lastname: Chevignard
mesh_terms: D001905:Botulinum Toxins / Q000008:administration & dosage; D002648:Child; D005240:Feasibility Studies; D005260:Female; D006040:Goals; D006801:Humans; D008297:Male; D009128:Muscle Spasticity / Q000188:drug therapy / Q000209:etiology / Q000534:rehabilitation*; D009498:Neurotoxins / Q000008:administration & dosage; D017063:Outcome Assessment, Health Care / Q000379:methods*; D012046:Rehabilitation / Q000592:standards
chemical_list: D009498:Neurotoxins; D001905:Botulinum Toxins
keywords: Botulinum toxin; Children; Family; Goal Attainment Scaling; Goal setting