Goal setting, using goal attainment scaling, as a method to identify patient selected items for measuring arm...

Area of Science:

• Neurorehabilitation
• Clinical Measurement
• Upper Limb Function

Background:

• Stroke and brain injury frequently result in hemiparesis, affecting upper limb function.
• Rehabilitation goals focus on restoring active function, improving passive function, and facilitating limb care.
• Current outcome measures may not fully capture patient- and carer-centered goals for hemiparetic upper limb function.

Purpose of the Study:

• To identify functional goals for upper limb rehabilitation in patients with hemiparesis.
• To inform the development of a new patient-reported outcome measure (PROM) for active and passive upper limb function.
• To analyze goals set during spasticity intervention for physical therapy and botulinum toxin A.

Main Methods:

• Secondary analysis of a prospective observational cohort study.
• Functional goals set by patients, carers, and clinicians were categorized by two independent raters.
• Goals were assigned to categories and confirmed by a second reviewer.

Main Results:

• Five main goal categories were identified: passive function, active function, symptoms, cosmesis, and impairment.
• Two previously unidentified passive function items were discovered.
• The study involved 16 participants (15 stroke, 1 traumatic brain injury) with a mean age of 54.5 years.

Conclusions:

• Analysis of patient and carer goals provides essential items for a new upper limb function measure.
• This approach offers a valuable method for developing standardized measures with patient and carer involvement.
• The findings support the creation of the Arm Activity measure for hemiparetic upper limb function.