Application of smart-approach, evaluation of goals in the patients rehabilitation

Authors:

Gerasimova Galina Vasilyevna, medical doctor, head of the Center for Physical Therapy and Medical Rehabilitation of the Albrecht Federal Scientific Centre of Rehabilitation of the Disabled of the Ministry of Labour and Social Protection of the Russian Federation, 50 Bestuzhevskaya Street, 195067 St. Petersburg, Russian Federation; e-mail: gera_gv@mail.ru

Strukova Natalia Viktorovna, deputy head of the Center for Physical Therapy and Medical Rehabilitation of the Albrecht Federal Scientific Centre of Rehabilitation of the Disabled of the Ministry of Labour and Social Protection of the Russian Federation, 50 Bestuzhevskaya Street, 195067 St. Petersburg, Russian Federation; e-mail: zavfto152@mail.ru

Kurdybaylo Sergey Fedorovich, Grand PhD in Medical sciences, senior researcher at the Institute of Prosthetics and Orthotics of the Albrecht Federal Scientific Centre of Rehabilitation of the Disabled of the Ministry of Labour and Social Protection of the Russian Federation, 50 Bestuzhevskaya Street, 195067 St. Petersburg, Russian Federation.

Komarova Alexandra Vladimirovna, physical therapy doctor, Center for Physical Therapy and Medical Rehabilitation of the Albrecht Federal Scientific Centre of Rehabilitation of the Disabled of the Ministry of Labour and Social Protection of the Russian Federation, 50 Bestuzhevskaya Street, 195067 St. Petersburg, Russian Federation.

Annotation:

Introduction. The medical rehabilitation system is closely with other aspects of rehabilitation aimed at restoring a person as a person, restoring and compensating for impaired cognitive functions, resuming work in a volume sufficient to achieve economic independence. To facilitate the time-consuming and often complex process of expressing the needs and priorities of the patient and family in the form of clear and measurable goals, it was proposed to use the SMART goals framework (Specific, Measurable, Achievable, Relevant, Time-bound).

Aim. The aim of our study was to retrospectively assess the possibilities of achieving the goals of medical rehabilitation of patients with various pathologies received restorative treatment at the Center for Physical Therapy and Medical Rehabilitation of the Albrecht Federal Scientific Centre of Rehabilitation of the Disabled of the Ministry of Labour and Social Protection of the Russian Federation in the period from 2018 to 2020.

Materials and methods. 8284 patients were rehabilitated at the Center for Physical Therapy and Medical Rehabilitation of the Albrecht Federal Scientific Centre of Rehabilitation of the Disabled in the period from 2018 to 2020, including 4537 children with pathologies of the nervous system and musculoskeletal system (cerebral palsy, n = 2617), congenital and acquired pathology of the musculoskeletal system (n = 1920), age — 2-17 years (average age — 8 years), males (n = 1852), females (n = 2685); 3747 adults with pathology of the nervous system and musculoskeletal system (cerebrovascular accident consequences, n = 1087), spinal injury consequences (n = 678); congenital and acquired pathology of the musculoskeletal system (n = 1982), patients age — 19-80 years (average age — 47 years), males (n = 1501), females (n = 2246).
Ashworth scale, DASH were used to assess the degree of spasticity and the effect of treatment in cerebral palsy. The DASH, Abilhand Kids, Rankin scale were used for the treatment. Rehabilitation goals were set in accordance with the International Classification of Functioning, Disability and Health.
The Goal Attainment Scale (GAS) was used to evaluate the achievement of rehabilitation goals.

Results. SMART-indicators were determined: specific — 158 goals; measurable — at 120 targets (75 %) the scale was rated as having well-defined steps for one single dimension; achievable — 128/158 goals (80 %); topical — individual selection for each patient; limited in time (Time-bound) — 8-12 weeks.

Discussion. The success of setting goals and scaling them up depends on the formulation of goals. The method we used is a useful tool for standardizing the recording of rehabilitation goals. This saves time and makes it easier to build goals that are specific enough to be measured.

Summary. The specialists of the Center for Physical Therapy and Medical Rehabilitation of the Albrecht Federal Scientific Centre of Rehabilitation of the Disabled found that the rehabilitation of patients using the SMARTapproach is an effective and optimal method that allows you to quickly assess the rehabilitation potential and help the patient to achieve his earlier goals.

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