Revant Rehabilitation Centre Breda, The Netherlands.
Clin Rehabil. 2011 Dec;25(12):1128-39. doi: 10.1177/0269215511407220. Epub 2011 Jul 27.
To assess the responsiveness of Goal Attainment Scaling compared with the Pediatric Evaluation of Disability Inventory (PEDI) and the 66-item Gross Motor Function Measure (GMFM-66) in multidisciplinary rehabilitation practice.
Observational study. Pretest-posttest design.
SUBJECTS/PATIENTS: Twenty-three children with cerebral palsy, aged 2-13 years.
Goal Attainment Scaling, PEDI and GMFM-66 assessments were performed before and after six months of treatment. Physical, occupational and speech therapists constructed and scored 6-point Goal Attainment Scaling scales meeting predetermined criteria, describing the main functional goal per discipline. The contents of the three measures were compared using International Classification of Functioning, Disability and Health child and youth version (ICF-CY) codes. Spearman's rho correlations between Goal Attainment Scaling change scores per discipline and change scores obtained with the PEDI functional skills scales and GMFM-66 were calculated. Complete goal attainment was compared with significant change in terms of the standardized measures.
Twenty per cent of the Goal Attainment Scaling items were not covered by items of the PEDI or the GMFM-66. Inconclusive correlations were found between Goal Attainment Scaling and PEDI change scores (r 0.28-0.64). Even after exclusion of the non-corresponding items, correlations were moderate (r 0.57-0.73). Of 39/64 Goal Attainment Scaling scales scored as complete goal attainment, 16 individual PEDI scores did not show change on the corresponding scale. Low correlation was found between Goal Attainment Scaling change scores and GMFM-66 change scores.
Goal Attainment Scaling, PEDI and GMFM-66 were complementary in their ability to measure individual change over time in children with cerebral palsy. Using only the standardized instruments could have caused many individual rehabilitation goals actually attained being missed in the outcome evaluation.
评估目标达成量表（Goal Attainment Scaling，GAS）与小儿残疾评估量表（Pediatric Evaluation of Disability Inventory，PEDI）和 66 项粗大运动功能测量量表（66-item Gross Motor Function Measure，GMFM-66）在多学科康复实践中的反应度。
观察性研究。测试前后设计。
受试者/患者：23 名年龄为 2-13 岁的脑瘫儿童。
在治疗 6 个月前后，分别进行 GAS、PEDI 和 GMFM-66 评估。物理治疗师、职业治疗师和言语治疗师构建并评分了 6 分制的 GAS 量表，这些量表符合预定标准，描述了每个学科的主要功能目标。使用国际功能、残疾和健康分类儿童和青年版（International Classification of Functioning, Disability and Health child and youth version，ICF-CY）代码比较了这三个量表的内容。计算了每个学科的 GAS 量表变化评分与 PEDI 功能技能量表和 GMFM-66 变化评分之间的 Spearman's rho 相关。根据标准化测量值，将完全达成目标与显著变化进行了比较。
20%的 GAS 项目未被 PEDI 或 GMFM-66 项目涵盖。GAS 与 PEDI 变化评分之间的相关性不确定（r 0.28-0.64）。即使排除不相关的项目，相关性也是中等的（r 0.57-0.73）。在 64 个 GAS 量表中，有 39 个被评为完全达成目标，而在相应的 PEDI 量表中，有 16 个个体分数没有变化。GAS 量表变化评分与 GMFM-66 变化评分之间的相关性较低。
GAS、PEDI 和 GMFM-66 能够在脑瘫儿童随时间变化的个体变化测量方面互补。仅使用标准化工具可能会导致在结果评估中错过许多实际达成的个别康复目标。
