Ann Rehabil Med.  2020 Jun;44(3):181-194. 10.5535/arm.19087.

Usefulness of Goal Attainment Scaling in Intensive Stroke Rehabilitation During the Subacute Stage

• Jung Y
• Sim J
• Park J
• Kim J
• Kim M

• KMID: 2504438
• DOI: http://doi.org/10.5535/arm.19087

Abstract

Objective
To investigate the usefulness of goal attainment scaling (GAS) in intensive stroke rehabilitation during the subacute stage.
Methods
Medical records of subacute post-stroke patients who had undergone intensive rehabilitation under hospitalization, before and after the application of GAS, were collected. GAS was conducted at the initial evaluation of each patient. Specific goals were suggested by physical and occupational therapists and were determined by the responsible physiatrist. A 5-point scale was used for the GAS score after 4 weeks of rehabilitation according to the preset criteria of each goal. To evaluate the influence of GAS in rehabilitation practice, functional improvements were compared between two patient groups before (n=121) and after (n=141) GAS. To assess progress in GAS practice, the standard GAS score was calculated, and the changes were observed over a 3-year period. The standard GAS score converged to 50 points when the goal was achieved. The therapists who used GAS also completed a survey regarding its usefulness.
Results
There were no statistical differences in the motor and cognitive outcomes of the patient groups before and after applying GAS scoring. Successive yearly changes in the standard GAS scores showed progressive convergence to 50 points, signaling that the patient’s goal-setting abilities improved. According to the survey, most therapists felt that GAS enhanced the quality of therapies (84.6%).
Conclusion
GAS improved goal-setting for the rehabilitation of subacute post-stroke patients and might have a positive effect on rehabilitation.

Keyword

Stroke; Rehabilitation; Physical therapy; Occupational therapy; Goals

Figure

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  Fig. 1. Changes in standard goal attainment scaling (GAS) scores by year. (A) Physical therapy (PT) and (B) occupational therapy (OT). The box-and-whiskers plots represent line is median value; box, upper and lower quartiles; whiskers, 5%–95% confidence. The median values are displayed above the box.

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  Fig. 2. Changes in standard goal attainment scaling (GAS) scores during 3 years classified by cognitive ability. (A) PT domain and (B) OT domain in the low condition group (MMSE <20). (C) PT domain and (D) OT domain in the high condition group (MMSE ≥20). The box-and-whiskers plots represent line is median value; box, upper and lower quartiles; whiskers, 5%–95% confidence. The median values are displayed above the box. MMSE, Mini-Mental State Examination.

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