Goal attainment scaling in the rehabilitation of patients with lower-extremity amputations: A pilot study

Objective: To assess the interrater reliability, construct validity, and responsiveness of Goal Attainment Scaling (GAS) among patients who have had lower-extremity amputations. Design: Pilot study comparing GAS with 2 functional measures with established reliability, validity, and responsiveness values. Setting: Regional amputee program in southwestern Ontario. Participants: Ten patients (6 women, 4 mend mean age +/- standard deviation, 72.3 +/- 10.7y) with unilateral lower-extremity amputations who were consecutively admitted to a regional amputee program. The ratio of transtibial to transfemoral amputations was 6:4. Interventions: Not applicable. Main Outcome Measures: Subjects were assessed by using GAS, the Barthel Index, and the Locomotor Capabilities Index (LCI) of the Prosthetic Profile of the Amputee. Results: The interrater reliability of GAS was r=.67, and 63% of goals developed were identified independently by both investigators. The construct validity between GAS and the Barthel Index and the LCI was r=.44 and r=.35, respective y. GAS was more responsive than both the Barthel Index and the LCI, as indicated by the calculation of effect sizes and relative efficiencies. Conclusion: This pilot study suggests that GAS is a promising outcome measure for the rehabilitation of patients with lower-extremity amputations.