Use of Goal Attainment Scaling in Brain Injury in a Rehabilitation Hospital1

Goal-Setting Method and Goal Attainment Measures in Physical Therapy for Stroke Patients: a Systematic Review

“…However, Stolee et al 54,55) demonstrated m o d e r a t e t o s t r o n g c o r r e l a t i o n s b e t w e e n standardized measures (BI and OARS Index of Instrumental Activities of Daily Living) and the GAS T-score in elderly patients, including stroke patients (r = 0.86, 0.60), which supports the construct validity. Furthermore, Joyce et al 52) demonstrated a strong correlation between the global clinical impression and GAS T-score in brain injury patients (r = 0.81), which confirms the convergent validity and higher inter-rater reliability 52) . Malec et al 53) published (1) the monitoring of patient progress, (2) the structuring of team conferences, and (3) ongoing rehabilitation planning and decision-making as useful parameters in the rehabilitation of brain injury patients.…”

“…In contrast, a moderate correlation was noted between the standardized measures, i.e., BI and FIM, and the GAS T-score in frail elderly people, which supports the construct validity of GAS. Good results were generally obtained with regard to the inter-rater reliability, regardless of the presence or absence of diseases 11,52,54,55,[58][59][60] . Reid et al 21) reported that the clinical utility of this technique had been observed in stroke patients, but no reports that verified either its validity or reliability were available.…”

“…Therefore, this may be considered to be an interview via free conversation, to set goals. The validity, reliability, and responsiveness of GAS has been evaluated not only in the mental health field but also in various fields such as those involving children with disabilities (e.g., cerebral palsy and mental and/or physical retardation), elderly patients, brain injury patients, dementia patients, and frail elderly people (Table 3, 4) 8, 11,17,18,[48][49][50][51][52][53][54][55][56][57][58][59][60][61] . In children with disabilities, no significant correlation was noted between the standardized measure, the Peabody Gross Motor Scale, and the GAS T-score 17,18) , which suggests that GAS determines aspects different from the Peabody Gross Motor Scale.…”

“…Furthermore, the inter-rater reliability 67,73) and the test-retest . 5-point scale (-2 -+2) 0=expected level of outcome +2=much more than the expected outcome level -2=much less than the expected outcome level Each goal weighted, and T-score calculated 8,46,47) Clients/patients of mental health programs 11,48) , young children with disabilities 8,17,18,49,50) , stroke or brain injuries 21,[51][52][53] , geriatric care 54,55) ,…”

“…The goals are set at a multiprofessional meeting 45) . Non significant correlations between PGMS and GAS change score (r=0.25, 0.33) 17,18) No correlation between COPM and GAS 49) Brain injuries Content analysis of goal areas (GAS goals were set in 17 of 18 goal areas in the rehabilitation of brain injury patients) supported content validity 52) NS Strong correlation between CGI and GAS change score (r=0.81) 52) Geriatric (include stroke) The agreement (82%) in identifying goal areas by two geriatricians, and content analysis of goal areas (GAS goals were set in 12 of 13 goal areas in the geriatric rehabilitation) supported content validity 54) . Content analysis of goal areas supported content validity (GAS goals were grouped into major categories, of which the most common were mobility, future care, ADL/IADL, bowel and bladder problems) 55) Strong correlation between BI and GAS change score (r=0.86) 54) Moderate correlation between BI, OARS-IADL and GAS change score (r=0.60, 0.48) 55) Alzheimer's disease or dementia NS Strong correlation between CGI (r=0.85), moderate correlation between ADAS-Cog (r=0.52), GDS (r=0.63) and GAS change score 56) Poor correlation between BI, HABAM, CIRS and GAS change score (r s =-0.22 ~ 0.17) 57) C o g n i t i v e rehabilitation NS NS Moderate correlation between MEDLS (r=0.52), RDRS (r=-0.47) and GAS change score 58) Frail elderly NS NS Moderate correlation between BI (r=0.59), FIM (r=0.45), the Physical Self-Maintenance Scale (r=-0.54) and GAS change score 59) Stroke NS NS NS Other NS Pain: Moderate to low correlation between walking (in 5 min) (r=0.47), ODQ (r=0.31) and GAS change score 61) Lower-extremity amputations: Non-significant correlations between BI, LCI, and GAS change score 60) Table 3.…”