Introduction
Methods
Overview
Setting
The goal setting process
Participants
Data collection
SMART Variables | Description | Example |
---|---|---|
Specific goal description | Describe activity (free text) | Stand at work desk without sleeping sensation in legs |
Measurement | How much, time or distance and/or how often, for example, times per week? (free text) | 20 min. 5 times during an 8-hour shift |
Acceptance of discomfort | Degree of discomfort associated with achieving goals (0–10; 0 = None, 10 = Worst imaginable) | 8 |
Time frame | How many weeks are set to reach the goal? (weeks) | 8 weeks |
Variables | Description | Scale |
---|---|---|
Sex | Extracted from personal identification number | Female | Male |
Age | Extracted from personal identification number | 18–39 years | 40–59 years | 60 + years [46] |
Pain duration | How long has it been since the current pain began? | 0–2 weeks | 2–4 weeks | 4–12 weeks | 3–12 months | More than 1 year |
Previous episodes of LBP | Before this episode of LBP, how many episodes of LBP have you been treated for in the last 2 years? | No | 1 episode | 2–3 episodes | More than 3 episodes |
Back pain | Pain intensity within the last week in Numeric Rating Scale (NRS). | 0 = No pain to 10 = Worst imaginable |
Disability | Current activity limitation on Oswestry Disability Index (ODI). | 0–100; higher scores reflect more disability |
Data analysis
Linking of GLA:D Back SMART goals to ICF
ICF Component | Examples from GLA:D Back (original text shortened) | Main concept | Lowest ICF category |
---|---|---|---|
Body Function and Structure (B & S). Def.: The physiological functions of body systems with body structures referring to the anatomical parts of the body. | Sleep well. | To sleep with good quality | b1343 Quality of sleep Def.: Mental functions that produce the natural sleep leading to optimal physical and mental rest and relaxation. |
Activity and Participation (A & D). Def.: The complete range of domains denoting aspects of functioning from both an individual and a societal perspective. | Get out of a car. Engage in a football match. | Getting out of sitting position from car Engage in organized game. | d4103 Sitting Def.:Getting into and out of a seated position and changing body position from sitting down to any other position, such as standing up or lying down. d9201 Sports Def.: Engaging in competitive and informal or formally organized games or athletic events, performed alone or in a group, such as bowling, gymnastics or soccer. |
Contextual factors: Environmental factors and Personal factors (E & P). Def.: Making up the physical, social, and attitudinal environment in which people live and conduct their lives. | Avoid increasing consumption of medicine | Intake of products or substances for personal consumption | e1101 Drugs Def.: Any natural or human-made object or substance gathered, processed or manufactured for medicinal purposes, such as allopathic and naturopathic medication. |
Defining goals as adherent to the SMART Approach
Statistical analysis
Results
Study sample
Baseline characteristic | Denmark (n = 394) | Alberta (n = 131) |
---|---|---|
Sex, n (% female) | 266 (69%) | 73 (65%) |
Missing values, n | 9 | 19 |
Age, mean (std. deviation) | 58.3 (13.0) | 55.9 (14.0) |
Missing values, n | 7 | 19 |
Pain duration, n (%) | ||
0–4 weeks | 30 (8.0%) | 17 (15.3%) |
4–12 weeks | 41 (10.9%) | 9 (8.1%) |
3–12 months | 87 (23.1%) | 18 (16.2%) |
> 1 year | 218 (58.0%) | 67 (60.4%) |
Missing values, n | 18 | 20 |
Previous episodes, n (%) | ||
0–1 | 68 (17.8%) | 24 (21.4%) |
2–3 | 148 (39.0%) | 27 (24.11%) |
>3 | 164 (43.2%) | 61 (54.5%) |
Missing values, n | 14 | 19 |
Backpain baseline (NRS), median (25th − 75th) | 5 (4–7) | 5 (3–7) |
Missing values, n | 16 | 19 |
ODI sum baseline, median (25th − 75th) | 24 (16–34) | 13 (9–17) |
Missing values, n | 27 | 48 |
ICF categorised goals
SMART criteria
Association of type of goal with sex and age
Denmark (95% CI) | Alberta (95% CI) | Total sample (95% CI) | |||||||
---|---|---|---|---|---|---|---|---|---|
Goal description | < 40 N = 30 | 40–60 N = 159 | > 60 N = 198 | < 40 N = 15 | 40–60 N = 45 | > 60 N = 52 | < 40 N = 45 | 40–60 N = 204 | > 60 N = 250 |
Walking | 10% (3.3–22.3) | 15.7% (10.8–22.3) | 32.3% (26.2–39.2) | 0% (-) | 8.9% (3.3–21.6) | 25.0% (15.0–38.6) | 6.7% (2.2–18.8) | 14.2% (10.0–19.7) | 30.8% (25.4–36.8) |
Maintaining a body position | 46.7% (32.8–37.2) | 20.1% (14.6–27.1) | 15.7% (11.2–21.4) | 40% (19.0–65.5) | 26.7% (15.7–41.5) | 21.2% (12.0–34.5) | 44.4% (32.7–61.2) | 21.6% (16.5–27.8) | 16.8% (12.7–22.0) |
Moving around | 16.7% (7.1–34.4) | 14.5% (9.8–20.9) | 8.1% (5.0–12.8) | 6.7% (0.9–35.7) | 11.1% (4.7–24.2) | 10.7% (5.2–23.6) | 13.3% (6.1–26.7) | 13.7% (9.6–19.2) | 8.8% (5.9–13.0) |
Changing basic body position | 3.3% (0.5–20.3) | 10.7% (6.7–16.6) | 12.1% (8.3–17.5) | 13.3% (3.3–40.9) | 8.9% (3.3–21.6) | 5.8% (1.9–16.6) | 6.7% (2.2–18.8) | 10.3% (6.8–15.3) | 10.8 (7.5–15.3) |
Doing housework | 3.3% (0.5–20.3) | 6.3% (3.4–11.3) | 7.1% (4.2–11.6) | 6.7% (0.9–35.7) | 4.4% (1.1–16.3) | 5.8% (1.9–16.6) | 4.4% (1.1–16.2) | 5.9% (3.4–10.1) | 6.8% (4.3–10.7) |
Recreation and leisure | 6.7% (1.7–23.2) | 4.4% (2.1–9.0) | 3.4% (0.8–5.3) | 6.7% (0.9–35.7) | 15.6% (7.5–29.4) | 3.9% (1.0–14.3) | 6.7% (2.2–18.8) | 6.9% (4.1–11.3) | 2.4% (1.1–5.3) |
Caring for household object | 0% (-) | 3.8% (1.7–8.2) | 5.1% (2.7–9.2) | 13.3% (3.3–40.9) | 4.4% (1.1–16.3) | 9.6% (4.0–21.3) | 4.4% (1.1–16.2) | 3.9% (2.0–7.7) | 6% (3.6–9.7) |
Sensation of pain | 13.3% (5.1–30.7) | 9.4% (5.8–15.1) | 10.1% (6.6–15.2) | 6.7% (0.9–35.7) | 2.2% (0.3–14.4) | 3.9% (1.0–14.3) | 11.1% (4.7–24.1) | 7.8% (4.9–12.4) | 8.8% (5.9–13.0) |