Goal attainment scaling for patients with chronic low back pain receiving physical therapist care: a feasibility and reliability study

BACKGROUND: Low back pain is a widespread health concern in the United States. Traditional measures used for low back pain may lack meaningfulness to patients and be unable to capture patient's individual experience. This study aimed to examine the feasibility of a goal attainment scaling application for chronic low back pain patients (GAS-Back) and the nature of goals identified by patients with chronic low back pain (cLBP) receiving physical therapist (PT) care. METHODS: This feasibility study consists of a single-group, longitudinal, preliminary study with variation in baseline, intervention, and follow-up for each participant. It was conducted at the University of South Florida Health Physical Therapy Center (USF PT Center) in Tampa, FL. Convenience sampling was used to recruit potential participants. Thirty-three participants (n = 33) with cLBP, ranging from 21 to 64 years old, were enrolled in this study and completed GAS-Back in PT care. The primary outcomes of this study were GAS-Back training time (hours), GAS-Back implementation time (minutes and seconds), PT adherence (percent adherence to protocol), interrater reliability, and patient satisfaction and engagement. Secondary outcomes were the domain and subdomain for the nature of goals identified (percentages) according to the International Classification of Functioning, Disability and Health (ICF) categorization. RESULTS: GAS-Back clinician training time (7 h) and the average GAS-Back implementation time (9 min 9 s) were both considered to be efficient. Clinician adherence (89%) was considered feasible. High interrater reliability was observed for both GAS-Back goal comparison (95%) and GAS T-Score comparison (0.782). The majority of patient's (93%) noted "Very Good" or "Excellent" satisfaction and PTs (63%) observed mostly "Very Good" or "Excellent" patient engagement with GAS-Back. Participants set an average of 3 goals to which majority of participants (88%) identified at least one goal pertaining to activity limitations. CONCLUSION: This study demonstrates the feasibility and fidelity of using GAS-Back for patients with cLBP receiving PT care.