Lower limb orthopedic surgery in children and adolescents with cerebral palsy is well captured using individualized Goal Attainment Scale (GAS) and Canadian Occupational Performance Measure (COPM) goals.

Abstract

To investigate individualized goals set and goal attainment following lower limb orthopedic surgery for children and adolescents with cerebral palsy (CP). Retrospective chart review. Individualized goals set prior to orthopedic surgery using the Canadian Occupational Performance Measure (COPM) and/or Goal Attainment Scaling (GAS) with follow-up within 18 months post-surgery were analyzed. Goals were categorized into functional mobility, leisure, self-care and productivity. 44 children met the inclusion criteria, mean age 12.5 years (range 4.8-18.2yrs, SD 3.9), GMFCS I = 6, II = 19, III = 6, IV = 9, V = 4. In total 111 goals were analyzed, <i>n</i> = 79 COPM goals and <i>n</i> = 32 GAS goals. Clinically and statistically positive change was demonstrated in the COPM post-surgery, with mean changes of 3.74 (<0.0001) for performance and 4.26 (<i>p</i> < 0.0001) for satisfaction with performance. Of the 32 GAS goals set, 22 had an expected to much greater than expected outcome. COPM goals demonstrated clinically and statistically significant improvement in performance and satisfaction with performance for children of all GMFCS levels post-surgery. GAS goals were not universally met. This study highlights the importance of individualized goal setting and recommends further evaluation into non-achievement of goals and the relationship between goal outcomes and surgery type.