Goal attainment scaling for patients with low back pain in rehabilitation: A systematic review

Haladay, Douglas E.; Swisher, Laura Lee; Hardwick, Dustin

doi:10.1002/hsr2.378

Cited by 10 publications

(8 citation statements)

References 69 publications

(153 reference statements)

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“…GAS may have therapeutic effects independent of intervention effects [21, 54]. For example, Herdman et al [21] found that clinically meaningful gains were found in both intervention and non-intervention groups using GAS in a memory and aging program.…”

Section: Discussionmentioning

confidence: 99%

Suitability of Goal Attainment Scaling in Older Adult Populations with Neurodegenerative Disease Experiencing Cognitive Impairment: A Systematic Review and Meta-Analysis

Fegter¹,

Santos²,

Rademaker³

et al. 2023

Gerontology

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Introduction: Identifying responsive outcome measures for assessing functional change related to cognition, communication, and quality of life for individuals with neurodegenerative disease is important for intervention design and clinical care. Goal Attainment Scaling (GAS) has been used as an outcome measure to formally develop and systematically measure incremental progress towards functional, patient-centered goals in clinical settings. Evidence suggests that GAS is reliable and feasible for use in older adult populations and in adult populations with cognitive impairment, but no review has assessed the suitability of GAS in older adults with neurodegenerative disease experiencing dementia or cognitive impairment, based on responsiveness. This study conducted a systematic review to evaluate the suitability of GAS as an outcome measure for older adult populations with neurodegenerative disease experiencing dementia or cognitive impairment, based on responsiveness. Methods: The review was registered with PROSPERO and performed by searching ten electronic scientific databases (PubMed, Medline OVID, CINAHL, Cochrane, Embase, Web of Science, PsychINFO, Scopus, OTSeeker, RehabDATA) and four registries (Clinicaltrials.gov, Grey Literature Report, Mednar, Open Grey). A summary measure of responsiveness (post-intervention minus pre-intervention mean GAS T-score) was compared across eligible studies using a random-effects meta-analysis. Risk of bias in included studies was assessed using the NIH Quality Assessment Tool for Before-After (Pre-Post) Studies with No Control Group. Results: 882 eligible articles were identified and screened by two independent reviewers. Ten studies met inclusion criteria for the final analysis. Of the ten included reports, 3 focus on all-cause dementia, 3 on Multiple Sclerosis, 1 on Parkinson’s Disease, 1 on Mild Cognitive Impairment, 1 on Alzheimer’s Disease, and 1 on Primary Progressive Aphasia. Responsiveness analyses showed pre- and post-intervention GAS goals were significantly different from zero (Z=7.48, p<0.001), with post-intervention GAS scores being higher than pre-intervention GAS scores. Three included studies showed a high risk of bias, 3 showed a moderate risk of bias, and 4 showed a low risk of bias. Overall risk of bias of included studies was rated as moderate. Discussion/Conclusion: GAS showed an improvement in goal attainment across different dementia patient populations and intervention types. The overall moderate risk of bias suggests that while bias is present across included studies (e.g., small sample size, unblinded assessors), the observed effect likely represents the true effect. This suggests that GAS is responsive to functional change and may be suitable for use in older adult populations with neurodegenerative disease experiencing dementia or cognitive impairment.

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Section: Discussionmentioning

confidence: 99%

Suitability of Goal Attainment Scaling in Older Adult Populations with Neurodegenerative Disease Experiencing Cognitive Impairment: A Systematic Review and Meta-Analysis

Fegter¹,

Santos²,

Rademaker³

et al. 2023

Gerontology

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“…An exception was “ViViRa bei Rückenschmerzen,” where the goal was performance enhancement. A systematic review by Haladay et al [ 32 ] shows that individual, patient-centered goals would be a useful addition to classic goals such as pain reduction. Apps should offer functions to formulate and track such goals.…”

Section: Discussionmentioning

confidence: 99%

Availability, Quality, and Evidence-Based Content of mHealth Apps for the Treatment of Nonspecific Low Back Pain in the German Language: Systematic Assessment

Ulrich,

Thies,

Schwarz

2023

JMIR Mhealth Uhealth

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Background Nonspecific low back pain (NSLBP) carries significant socioeconomic relevance and leads to substantial difficulties for those who are affected by it. The effectiveness of app-based treatments has been confirmed, and clinicians are recommended to use such interventions. As 88.8% of the German population uses smartphones, apps could support therapy. The available apps in mobile app stores are poorly regulated, and their quality can vary. Overviews of the availability and quality of mobile apps for Australia, Great Britain, and Spain have been compiled, but this has not yet been done for Germany. Objective We aimed to provide an overview of the availability and content-related quality of apps for the treatment of NSLBP in the German language. Methods A systematic search for apps on iOS and Android was conducted on July 6, 2022, in the Apple App Store and Google Play Store. The inclusion and exclusion criteria were defined before the search. Apps in the German language that were available in both stores were eligible. To check for evidence, the apps found were assessed using checklists based on the German national guideline for NSLBP and the British equivalent of the National Institute for Health and Care Excellence. The quality of the apps was measured using the Mobile Application Rating Scale. To control potential inaccuracies, a second reviewer resurveyed the outcomes for 30% (3/8) of the apps and checked the inclusion and exclusion criteria for these apps. The outcomes, measured using the assessment tools, are presented in tables with descriptive statistics. Furthermore, the characteristics of the included apps were summarized. Results In total, 8 apps were included for assessment. Features provided with different frequencies were exercise tracking of prefabricated or adaptable workout programs, educational aspects, artificial intelligence–based therapy or workout programs, and motion detection. All apps met some recommendations by the German national guideline and used forms of exercises as recommended by the National Institute for Health and Care Excellence guideline. The mean value of items rated as “Yes” was 5.75 (SD 2.71) out of 16. The best-rated app received an answer of “Yes” for 11 items. The mean Mobile Application Rating Scale quality score was 3.61 (SD 0.55). The highest mean score was obtained in “Section B–Functionality” (mean 3.81, SD 0.54). Conclusions Available apps in the German language meet guideline recommendations and are mostly of acceptable or good quality. Their use as a therapy supplement could help promote the implementation of home-based exercise protocols. A new assessment tool to obtain ratings on apps for the treatment of NSLBP, combining aspects of quality and evidence-based best practices, could be useful. Trial Registration Open Science Framework Registries sq435; https://osf.io/sq435

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“…GAS was first introduced by Kiresuk and Sherman in 1968 to evaluate outcomes in a mental health setting [ 7 ]. Since then, it has been successfully adapted for use in many other domains, including stroke rehabilitation [ 8 , 9 ], drug trials [ 2 ], back pain [ 10 ], rehabilitation [ 3 ], communication disorders [ 11 ], and in other older adults with dementia [ 1 ], and complex needs [ 12 ]. There is growing evidence that GAS is sensitive to change and can capture clinically meaningful changes that often are ignored or are not elicited by standardized tests [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

A systematic review of goal attainment scaling implementation practices by caregivers in randomized controlled trials

Cheema,

Dunn,

Chapman

et al. 2024

J Patient Rep Outcomes

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Background Goal attainment scaling (GAS), an established individualized, patient-centred outcome measure, is used to capture the patient’s voice. Although first introduced ~60 years ago, there are few published guidelines for implementing GAS, and almost none for its use when caregivers GAS is implemented with caregiver input. We conducted a systematic review of studies that implemented GAS with caregiver input; and examined variations in GAS implementation, analysis, and reporting. Methods Literature was retrieved from Medline, Embase, Cochrane, PsycInfo and CINAHL databases. We included randomized controlled trials (published between 1968 and November 2022) that used GAS as an outcome measure and involved caregiver input during goal setting. Results Of the 2610 studies imported for screening, 21 met the inclusion criteria. Most studies employed GAS as a primary outcome. The majority (76%) had children as study participants. The most common disorders represented were cerebral palsy, developmental disorders, and dementia/Alzheimer’s disease. The traditional five-point GAS scale, with levels from −2 to +2, was most often implemented, with −1 level typically being the baseline. However, most studies omitted essential GAS details from their reports including the number of goals set, number of attainment levels and whether any training was given to GAS facilitators. Conclusions GAS with caregiver input has been used in a limited number of randomized controlled trials, primarily in pediatric patients and adults with dementia. There is a variability in GAS implementation and many crucial details related to the specifics of GAS implementation are omitted from reports, which may limit reproducibility. Here we propose catalog that may be utilized when reporting research results pertaining to GAS with caregivers to enhance the application of this patient-centered outcome measure.

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Goal attainment scaling for patients with low back pain in rehabilitation: A systematic review

Cited by 10 publications

References 69 publications

Suitability of Goal Attainment Scaling in Older Adult Populations with Neurodegenerative Disease Experiencing Cognitive Impairment: A Systematic Review and Meta-Analysis

Suitability of Goal Attainment Scaling in Older Adult Populations with Neurodegenerative Disease Experiencing Cognitive Impairment: A Systematic Review and Meta-Analysis

Availability, Quality, and Evidence-Based Content of mHealth Apps for the Treatment of Nonspecific Low Back Pain in the German Language: Systematic Assessment

A systematic review of goal attainment scaling implementation practices by caregivers in randomized controlled trials

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