Concise report Goal attainment scaling as a measure of treatment success after physiotherapy for chronic low back pain

Objectives. In some chronic conditions, patient-specific tools with individualized items have proved to be more sensitive outcome instruments than fixed-item tools; their use has not yet been investigated in chronic low back pain (cLBP). Methods. Eleven males and 21 females [mean age 44.0 (12.3) years] with cLBP, undergoing a spine-stabilization physiotherapy programme, completed the Roland Morris (RM) Disability Scale and a 0–10 pain scale preand post-therapy. Post-therapy, goal attainment scaling (GAS) scores were calculated regarding achievement of 2–6 priority GAS goals established pre-therapy; global outcome of therapy was assessed on a 5-point Likert scale. Results. Approximately one-fifth of the individualized goals were not covered by items of the RM. Of the 121 individualized goals, 41 (34%) were achieved at the expected level, 42 (35%) were exceeded and 38 (31%) were not reached. GAS scores correlated with change scores for pain (r = 0.61, P< 0.0001) and RM (r = 0.49, P = 0.006). Sixty-five per cent of the patients had a successful outcome according to GAS (i.e. a score 550); 55%, according to global outcome (therapy helped/helped a lot); 39%, according to the RM score change (score decrease 530%); and 44%, according to the pain score change (score decrease 530%). Conclusions. GAS demonstrates the achievement of important goals undetected by fixed-item measures and is a valid and sensitive outcome measure for assessing the success of rehabilitation in patients with cLBP.