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

Abstract

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.