The effect of physical therapy with goal attainment scaling on gait function in patients with subacute stroke

Correct goal setting for patients is one of the most important aspects of physical therapy.

The purpose of this study was to investigate the effect of physical therapy using goal attainment scaling (GAS) scores to assess the gait function in patients with subacute stroke and related factors.

This retrospective cohort study was conducted using the medical records of 129 patients with subacute stroke who had been treated with intensive rehabilitation intervention. This study was approved by the Institutional Review Board of Bundang Cha Hospital (2021-06-008). The functional ambulation category (FAC) was used to set goals with the involvement of patients and their caregivers after the initial assessment, and raw GAS scores were calculated according to whether the goals were achieved through assessment one month later based on the FAC score. The groups were then divided according to the raw GAS scores (-1, 0, 1, or 2), and the general characteristics and clinical assessment scores were statistically analysed.

From our results, there were differences in clinical assessment scores based on raw scores on the GAS ( $p<0.05$ ) and correlation between raw scores on the GAS and improvement scores on the clinical assessment items ( $p<0.05$ ). Moreover, when the gait function measured by FAC was used as a GAS in subacute stroke patients, the better the function of Rivermead mobility index ( $\beta =0.613$ , $p<0.05$ ) and Korean-mini-mental state examination ( $\beta =0.217$ , $p<0.05$ ) than the other clinical factors, the higher the goal attainment raw score.

Functions, including cognitive function, should be included when setting goals to improve the gait function and should be considered when developing the neurological physiotherapy programmes. This study helps physicians and physical therapists who first apply functional gait assessment as a GAS to set the initial goals and improves patient and caregiver motivations by applying GAS to patients with lower initial cognitive levels.