Modified Goal Attainment Scale outcomes for ambulatory children: with and without orthopedic surgery

The purpose of this study was to determine if mobility goals were met when set and rated by the family using a modified Goal Attainment Scale following lower extremity orthopedic surgery or on follow-up without surgery.

Parents were asked to establish the top three goals for their child's mobility during a visit to the Motion Analysis Laboratory. Three groups of subjects were established: (1) 25 children with CP who had surgery, (2) 13 children with CP who did not have surgery and (3) 13 children without CP who had surgery. Goals were rated at the follow-up visit to the Motion Analysis Laboratory a mean of 12.4 months after initial visit using a non-criterion reference scale. The PODCI, Gait Deviation Index and Gillette FAQ were additional standardized tools used to measure outcomes. Data were reviewed retrospectively.

Both groups that had surgery on average met their goals. The group that did not have surgery did not, on average, meet their goals (overall, no change). Significant improvements were noted in both surgery groups on the PODCI and Gait Deviation Index while no changes were found for the group without surgery.

Generally, goals are met following orthopedic surgery when set and rated by the family using a modified Goal Attainment Scale in the Motion Analysis Laboratory. However, goals are not universally met which presents an opportunity to improve the goal setting and evaluation process. Goals identified in this study are specific and unique to the family and agree with other standardized outcome tools.