Abstract
A goal attainment scale (GAS) was used to evaluate outcomes of surgical and non-surgical interventions to improve gait in children with diplegic cerebral palsy (CP).
Personal goals were recorded pre-intervention from children and/or their carers attending the Edinburgh Gait Laboratory since 2012. Twenty children underwent orthopaedic surgery (Group 1) and 25 children underwent a non-orthopaedic intervention (Group 2). Patients were excluded if the intervention was <9 months before the study period. Post-operatively children and/or their carers were contacted by telephone to complete the mGAS questionnaire, rating the achievement of goals on a 5-point scale. The majority of goals related to structure and function and were similar between groups, with goals relating to stability and lower limb structure most frequently recorded. Attaining an improvement in pain was stated more frequently by Group 1 children. The GAS formula was used to transform the composite GAS into a standardised measure (T-score) for each patient. A t-test was used to determine if the change in T-score was significantly different from 0, i.e. no change. Both groups on average achieved their goals (mean change in T-score for Group 2 11.1, vs 21.1 for Group 1). The difference between these two means was significant (p = 0.012). Additionally 16 children had undergone a follow-up gait analysis, but the relationship between the change in Gait Profile Score and GAS, assessed by Pearson's correlation coefficient was statistically insignificant.
Both surgical and non-surgical interventions enabled children to achieve their goals, although Group 1 reported higher achievement. GAS reflect patients’ aspirations and may be as relevant as post-intervention kinematic or kinetic outcomes.
