goal attainment scale
Recently Published Documents


TOTAL DOCUMENTS

39
(FIVE YEARS 21)

H-INDEX

6
(FIVE YEARS 1)

2022 ◽  
Author(s):  
Thiago Falcão Hora ◽  
Agostinho de Alencar Guerra ◽  
Gerson Otmar Kuhne ◽  
Vinícius de Sousa Alvarenga ◽  
Sabrina Fonseca Oliveira ◽  
...  

Abstract Purpose: Botulinum toxin (BTX) is a neurotoxin produced by the bacterium Clostridium botulinum, in recent decades, BTX has become an important adjunct treatment to neurological or rehabilitative strategies.We aimed to describe the clinical aspects of patients admitted to a rehabilitation hospital who were treated with BTX for spasticity and dystonia. Methods: This was a historical cohort; data was collected from the electronic charts of all outpatients treated with BTX between 2014 and 2016 in the spasticity and movement disorders service of a quaternary, open access, rehabilitation hospital. The inclusion criteria were limb spasticity due to traumatic brain injury (TBI), and stroke; limb tremor; cervical dystonia; and generalized limb dystonia from any cause in addition to pain that limits rehabilitation. We used relatively lower doses than those generally published in the literature. Therapeutic response was determined by the Goal attainment scale (GAS), pain (graded by visual analogue scale ), independence for daily living activities, target joint range of motion (pre- and post-application), and gait analysis (only for walkers patients). Results: A total of 63 patients were enrolled in this study with a mean follow-up of 2 years. There was significant improvement in joint restriction ) with 66.7% of patients reporting improvement in the GAS scale, best improvement occurred with ortheses and limb adjustments. Conclusions: Most patients have improved functionality on the GAS scale after treatment with BTX, which is used as an adjunct therapy in subjects already in rehabilitation programs. The main rehabilitation objectives with the GAS scale were achieved in most patients.


Toxins ◽  
2022 ◽  
Vol 14 (1) ◽  
pp. 43
Author(s):  
Christian Wong ◽  
Ian Westphall ◽  
Josephine Sandahl Michelsen

Sixty-seven percent of children with cerebral palsy (CCP) experience pain. Pain is closely interrelated to diminished quality of life. Despite this, pain is an overlooked and undertreated clinical problem. The objective of this study was to examine the analgesic effect of a single lower extremity intramuscular injection of Abobotulinum toxin A/Dysport in CCP. Twenty-five CCP with at least moderate pain (r-FLACC ≥ 4) during passive range of motion were included. Localized pain and pain in everyday living were measured by r-FLACC and the Paediatric Pain Profile (PPP), respectively. Functional improvements were evaluated by the goal attainment scale (SMART GAS). Quality of life was evaluated by either the CPCHILD or the CP-QOL. The subjects were evaluated at baseline before injection, then after 4, 12, and 28 weeks. Twenty-two subjects had a significant mean and maximum localized pain reduction (p < 0.001) at four weeks post-treatment in 96% (21/22). The reduction was maintained at 12 (19/19) and 28 weeks (12/15). Daily pain evaluated by the PPP was significantly reduced and functional SMART GAS goals were significantly achieved from 4 to 28 weeks. Quality of life improved significantly at four weeks (CPCHILD). Significant functional gains and localized and daily pain reduction were seen from 4 to 28 weeks.


Healthcare ◽  
2021 ◽  
Vol 9 (12) ◽  
pp. 1761
Author(s):  
Kayla Carissa Wong ◽  
Beron W. Z. Tan ◽  
Jasper W. K. Tong ◽  
Mei Yoke Chan

The aim of this study was to explore the benefits of music therapy (MT) for children with cancer over the course of their treatment in an acute paediatric hospital setting in Singapore. Twenty-five children undergoing cancer treatment received MT sessions as part of a multidisciplinary team rehabilitation intervention from March 2017 to January 2020. A total of 37 individualised goals were developed by the music therapist for each child. Goals were scored via the Goal Attainment Scale at 3-month intervals up to 1 year. Descriptive statistics and correlation analysis were used to evaluate the findings. The rate of goal achievement was 89.2% over 180 MT sessions (M = 7.20, SD = 6.45). Children diagnosed with brain tumours had the highest frequency of music sessions (M = 9.11, SD = 7.79). Most of the goals targeted the regulation of mood and morale through music. There was a positive correlation found between goals and sessions (rs = 0.56, p = 0.004). Age of the children was not correlated with the number of sessions received (rs= −0.19, p = 0.354). MT has been found to be an accessible and effective intervention in addressing functional and emotional goals for children across all ages who are undergoing cancer treatment.


2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 375-375
Author(s):  
Marie Boltz ◽  
Ashley Kuzmik ◽  
Barbara Resnick ◽  
Irene Best ◽  
Jacqueline Mogle

Abstract Family-centered Function-focused Care (Fam-FFC) works with family caregivers as care partners in the assessment, function-promoting goal setting, implementation, and evaluation of goal attainment during hospitalization and immediate post-acute period. ANCOVA technique examined the preliminary impact of Fam-FFC upon 30-day hospital readmissions and logistic regression tested the association of goal attainment, measured with the Goal Attainment Scale (GAS) with 30-day hospital readmissions. The majority of the patients were Black (50%), female (62%), had a mean age of 81.6 (SD=8.4), mean Barthel Index of 60.29 (SD=27.7), and mean MoCA of 10.67 (SD=7.0). Goals represented six main categories: mobility, cognition, self-care, toileting, sleep, and pain management. Patients in the intervention group had less 30-day hospitalizations (F= 4.6, p=.033) and goal attainment was significantly associated with less recidivism (B=.179, Wald= 2.8 (1), p= .045). FamFFC shows promise in reducing 30-day hospital readmissions; results support the contribution of family engagement and use of GAS


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Maggie McCue ◽  
Sara Sarkey ◽  
Anna Eramo ◽  
Clement François ◽  
Sagar V. Parikh

Abstract Background Major depressive disorder (MDD) is the leading cause of disability worldwide. Response to pharmacologic treatment is generally evaluated by traditional clinician- and patient-reported rating scales. Assessing therapeutic efficacy using the Goal Attainment Scale offers a complementary measure that focuses on recovery-oriented outcomes that patients consider valuable and vital to their well-being. This study aimed to examine outcomes using the Goal Attainment Scale adapted for depression (GAS-D). Methods A phase 4, single-arm, open-label, multicenter study enrolled patients with MDD who were switching antidepressant medication. Patients received vortioxetine 10–20 mg over 12 weeks. Three specific, measurable, attainable, relevant, and time-bound goals were collaboratively set by patients with their clinicians. One goal was determined by the patient’s self-defined objectives; 2 were related to predefined domain categories. Prespecified domains included psychological, motivational, emotional, physical/functional, and cognitive categories. The primary endpoint was the proportion of patients who achieved a GAS-D score ≥ 50 at week 12. Secondary and exploratory endpoints included changes from baseline in several clinical and patient-reported measures of depression and cognitive function. Safety and tolerability were also assessed. Results At week 12, of the 122 adults participating in the study, 57.8% achieved a GAS-D score ≥ 50. Depression severity, cognitive function, cognitive performance, well-being, employment, and quality of life also significantly improved. Treatment response and remission rates were 65 and 40%, respectively. Vortioxetine was well tolerated, with adverse events consistent with product labeling. Conclusions A majority of patients with MDD switching to vortioxetine achieved their treatment goals, including improvement in specific functional outcomes relating to physical and emotional goals, as assessed by the GAS-D and standard patient- and clinician-reported measures. When assayed for convergent validity in a separate analysis, changes in goal scores on the GAS-D were statistically significantly correlated with multiple commonly used clinical measures of depression assessed in this study. The GAS-D approach provides a new patient-centric paradigm for the collaborative development and assessment of progress toward meaningful treatment goals, contributing to a comprehensive evaluation of treatment outcomes in patients with MDD. Longer studies against a control intervention are justified. Trial registration ClinicalTrials.gov identifier: NCT02972632. Registered 21 November 2016.


2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Róisín Sinnott ◽  
Maria Rowlís

Purpose This paper aims to evaluate the impact of an eight-week gardening and woodwork group programme on individuals’ recovery goals in an adult community mental health setting. Design/methodology/approach Seven individuals participated in the research. The programme was designed and facilitated by two occupational therapists (the authors) and one horticulture and trade skills facilitator. The goal attainment scale was used as a quantitative outcome measure as it allowed individuals to collaboratively set occupation-focused recovery-oriented goals. Due to the small sample size, descriptive statistics were used to analyse this data. Qualitative feedback was gathered through participant feedback forms when the programme ended. Findings Quantitative findings indicate positive results for individuals’ progression towards their recovery goals, with six out of seven participants either achieving or exceeding their goals. One person who attended only one out of eight groups had “worse than expected” goal achievement. Originality/value While there is evidence for the use of gardening and woodwork group therapy in mental health settings, most studies have relied on symptom-focused questionnaires or qualitative results rather than quantifiable recovery-oriented measures (Cipriani et al., 2017; Kamioka et al., 2014; Parkinson et al., 2011). It is hoped that this paper begins to bridge that gap and also outlines how recovery principles, gardening and woodwork can be incorporated into occupational therapy group programmes. This is of particular merit during the COVID-19 pandemic, which has led to a greater need for group intervention in outdoor settings, where social distancing can be comfortably facilitated.


2021 ◽  
Vol 75 (5) ◽  
Author(s):  
Lauren Sponseller ◽  
Fern Silverman ◽  
Pamela Roberts

Importance: Occupational therapy practitioners can play a pivotal role in supporting breastfeeding mothers as they transition to and form new routines for this occupation. Objective: To explore whether occupational therapy programming can assist breastfeeding mothers in reaching their personal occupation-based wellness goals. Design: Mixed-methods design that involved development of an occupational profile and a goal attainment scale (GAS). After the intervention, participants rescored their GAS goals and completed a semistructured exit interview. Setting: Nonprofit lactation center located in the suburbs of a large mid-Atlantic U.S. city. Participants: Women recruited through convenience sampling who had been breastfeeding an infant for &lt;6 mo, who were not currently weaning, and who had met with a lactation consultant at least once since giving birth were eligible (N = 17). Intervention: Group occupational therapy that consisted of 10 weekly 1-hr sessions. Topics were based on occupational profiles, GAS scores, and lactation consultant input. Outcomes and Measures: Each participant created and scored three goals using the GAS before and after the intervention. Results: Data from 14 of the 17 participants were analyzed. The average postintervention GAS score was 56.50 (M = 50), indicating that most personal wellness goals were reached. Thematic analysis revealed that occupational therapy programming helped mothers persevere with breastfeeding, feel more confident as new parents, and value both themselves and their baby. Conclusions and Relevance: There is an increasing role for occupational therapy practitioners in helping new mothers reach their personal wellness goals in ways that support their ability to continue breastfeeding. What This Article Adds: Maternal wellness and breastfeeding represent an emerging area of practice in which occupational therapy practitioners can provide new mothers with physical, social, and psychological supports that help them maintain self-efficacy related to breastfeeding and other meaningful occupations. This study provides foundational evidence in support of this collaboration.


2021 ◽  
pp. 1-11
Author(s):  
Rozalina Dimitrova ◽  
Emily McCusker ◽  
Mark Gormley ◽  
Darcy Fehlings ◽  
Katharine E. Alter ◽  
...  

BACKGROUND: This is the first large study of onabotulinumtoxinA as treatment for pediatric upper limb spasticity. OBJECTIVE: Evaluate efficacy and safety of a single treatment with onabotulinumtoxinA plus occupational therapy (OT). METHODS: In this registrational phase 3, multinational study (NCT01603602), participants were randomized 1:1:1 to onabotulinumtoxinA 3 U/kg/OT, 6 U/kg/OT, or placebo/OT. Primary endpoint was average change from baseline at weeks 4 and 6 in Modified Ashworth Scale-Bohannon (MAS) score. Secondary endpoints included Modified Tardieu Scale (MTS), Clinical Global Impression of Change (CGI) and functional Goal Attainment Scale (GAS). RESULTS: 235 participants were randomized. At weeks 4 and 6, onabotulinumtoxinA groups had greater mean reductions in MAS (both –1.9; p <  0.001) versus placebo (–1.2). OnabotulinumtoxinA doses improved dynamic tone per MTS. Mean CGI at weeks 4 and 6 was unchanged in the overall population, but improved in a post hoc analysis of patients with a single affected UL muscle group (elbow or wrist). GAS score for passive goals was significantly higher for 6 U/kg versus placebo at week 12. Most AEs were mild/moderate in severity; overall incidence was similar between groups. CONCLUSIONS: OnabotulinumtoxinA (3 and 6 U/kg) was safe and effective in reducing upper limb spasticity in pediatric participants.


2021 ◽  
Vol 4 (3) ◽  

Background: Goal directed physiotherapy is a task oriented therapy based on neurodevelopmental principles used in rehabilitation process. The aim of this study is to compare the neurodevelopmental effects of early goal directed physiotherapy with a detailed goal directed home program in infants with risk. Methods: Forty at-risk infants (18 male, 22 female, median age 5.69 mo) were assigned to early goal directed physiotherapy and detailed goal directed home program group randomely. Both early goal directed physiotherapy and detailed goal directed home program continued for 12 weeks. The outcome measures were Hammersmith Infant Neurological Examination, Alberta Infant Motor Scale and Goal Attainment Scale. Results: Significant difference was found in Hammersmith Infant Neurological Examination in early goal directed physiotherapy group (p<0.05) whereas no difference was found in Alberta Infant Motor Scale and Goal Attainment Scale between the groups (p>0.05). In all test results the effect size of early goal directed physiotherapy was more than detailed goal directed home program. Conclusions: According to our results, though Hammersmith Infant Neurological Examination results are better in the early goal directed physiotherapy group, it can be concluded that if parents had good, attainable and eligible guidelines received from the physiotherapist, detailed goal directed home program is also a useful approach in rehabilitation programs of infants with risk.


2021 ◽  
Vol 28 (3) ◽  
pp. 1-11
Author(s):  
Ehab Georgy

Background/aims Stroke early supported discharge services were introduced to provide a comprehensive stroke specialist therapy input, while reducing cost of acute care. Early supported discharge services resulted in better health-related outcomes. A consensus has not yet been established regarding specific early supported discharge patient characteristics and clinical profile. The main aim of this study was to establish evidence to support the development of an early supported discharge patient profile (demographics and clinical) and eligibility criteria to enable early supported discharge services achieve their purposes of reducing post-stroke disability and institutionalisation rates. This article outlines the relationship between early supported discharge patients' clinical profiles and clinical outcomes, in terms of disability, goal attainment and institutionalisation rates. Methods A retrospective review of data was implemented to determine whether specific early supported discharge patients' clinical profiles and characteristics correlate with clinical outcomes. Data were collected for patients admitted to the Suffolk Stroke Early Supported Discharge Service between August and October 2016, comprising patients' demographics and clinical profiles, including stroke type, Barthel Index and Modified Rankin Scale. Performance data were collected at the end of the early supported discharge service including therapy frequency and intensity, as well as clinical outcomes including the Goal Attainment Scale. Results Data were collected for 53 patients. Data were analysed for all patients in three groups: goals not achieved; goals achieved; and goals achieved to a higher level), according to the Goal Attainment Scale. A Chi-square test showed no significant difference with regard to sex and stroke side (P=0.27). Analysis of variance revealed no significant difference in age. Conversely, results showed a significant association between goal attainment and the stroke subtype, severity and length of hospital stay. Conclusions Specific clinical characteristics and disease profiles correlate with functional outcomes and could influence goal attainment and functional status. A specific patient cohort seems to benefit the most from early supported discharge services in terms of optimised functional outcomes and recovery.


Sign in / Sign up

Export Citation Format

Share Document