Using a goal attainment scale in the evaluation of outcomes in patients with diplegic cerebral palsy

Area of Science:

• Pediatric Orthopedics
• Rehabilitation Medicine
• Biomedical Engineering

Background:

• Diplegic cerebral palsy significantly impacts children's gait and mobility.
• Evaluating intervention effectiveness requires patient-centered outcome measures.
• The Goal Attainment Scale (GAS) offers a personalized approach to assessing therapeutic success.

Purpose of the Study:

• To compare the effectiveness of surgical versus non-surgical interventions for improving gait in children with diplegic cerebral palsy using GAS.
• To assess the correlation between GAS outcomes and objective gait analysis metrics.
• To determine the relevance of GAS as a patient-reported outcome measure in this population.

Main Methods:

• A cohort of 45 children with diplegic cerebral palsy was divided into surgical (n=20) and non-surgical (n=25) intervention groups.
• Personalized goals were established pre-intervention and assessed post-intervention using a 5-point GAS questionnaire via telephone.
• GAS scores were standardized to T-scores; a subset of 16 children also underwent follow-up gait analysis.

Main Results:

• Both intervention groups achieved their personal goals, with the non-surgical group showing higher average goal attainment (mean T-score 56.3 vs. 47.1).
• The difference in GAS scores between the groups was statistically significant (p=0.010).
• No significant correlation was found between GAS scores and Gait Profile Scores in the subset analyzed.

Conclusions:

• Both surgical and non-surgical interventions are effective in helping children with diplegic cerebral palsy achieve their functional goals.
• GAS provides a valuable, patient-centered perspective on intervention outcomes, potentially complementing objective biomechanical measures.
• The findings support the use of GAS as a relevant outcome measure in pediatric gait rehabilitation.