Factor analysis of the Gait Outcomes Assessment List's goal questions: A new method to measure goal prioritization in ambulatory individuals with cerebral palsy

Meghan E. Munger, Nathan D. Shippee, Timothy J. Beebe, Tom F. Novacheck, Beth A. Virnig

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Aim: To evaluate the factor structure of the 49 goal prioritization questions of the Gait Outcome Assessment List (GOAL). Method: This was a retrospective review of 622 consecutive individuals diagnosed with cerebral palsy (median = 11 years 2 months, SD = 6 years 0 months, 370 male), who underwent a routine clinical gait analysis at a specialty center and completed the validated GOAL. To assess dimensionality, we performed exploratory and confirmatory factor analyses on the goal ratings of its 49 gait-related items. For internal consistency, we calculated Cronbach's alpha. We created standardized goal scores for each factor and determined floor and ceiling effects according to the Gross Motor Function Classification System (GMFCS). Results: Factor analyses suggested that the GOAL's 49 goal prioritization items represented eight factors, one more than the original GOAL validation because pain and fatigue were separated into distinct factors. Cronbach alphas were acceptably high (≥0.80) across factors except for use of braces and mobility aids (α = 0.68). Goal importance varied across domains and GMFCS levels. Interpretation: The GOAL can be expanded as a tool to better understand goal priorities in ambulatory individuals with cerebral palsy. These scores can be used to guide clinical conversations and provide more focus than previously available when faced with 49 individual goals. Scores can also be aggregated across relevant populations for larger-scale studies. What this paper adds: The goal items of the Gait Outcomes Assessment List (GOAL) can be reduced into eight goal domains. Pain and fatigue represent distinct goal domains. The level of goal importance varies across GOAL domains and Gross Motor Function Classification System levels.

Original languageEnglish (US)
Pages (from-to)70-81
Number of pages12
JournalDevelopmental Medicine and Child Neurology
Volume66
Issue number1
DOIs
StatePublished - Jan 2024

Bibliographical note

Publisher Copyright:
© 2023 The Authors. Developmental Medicine & Child Neurology published by John Wiley & Sons Ltd on behalf of Mac Keith Press.

PubMed: MeSH publication types

  • Journal Article

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