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Background Goal setting is considered a key component of rehabilitation for adults with acquired disability, yet there is little consensus regarding the best strategies for undertaking goal setting and in which clinical contexts. It has also been unclear what effect, if any, goal setting has on health outcomes after rehabilitation. Objectives To assess the effects of goal setting and strategies to enhance the pursuit of goals (i.e. how goals and progress towards goals are communicated, used, or shared) on improving health outcomes in adults with acquired disability participating in rehabilitation. Search methods We searched CENTRAL, MEDLINE, EMBASE, four other databases and three trials registers to December 2013, together with reference checking, citation searching and contact with study authors to identify additional studies. We did not impose any language or date restrictions. Selection criteria Randomised controlled trials (RCTs), cluster-RCTs and quasi-RCTs evaluating the effects of goal setting or strategies to enhance goal pursuit in the context of adult rehabilitation for acquired disability. Data collection and analysis Two authors independently reviewed search results for inclusion. Grey literature searches were conducted and reviewed by a single author. Two authors independently extracted data and assessed risk of bias for included studies. We contacted study authors for additional information. 1 Goal setting and strategies to enhance goal pursuit for adults with acquired disability participating in rehabilitation (Review)

12 Abstract 13In spite of pain in the CRPS limb, clinical observations show patients pay little attention to, and fail to care for, their affected 14 limb as if it were not part of their body. Literature describes this phenomenon in terms of neurological neglect-like symptoms. This 15 qualitative study sought to explore the nature of this phenomenon with a view to providing insights into central mechanisms and the 16 relationship with pain. Twenty-seven participants who met the IASP CRPS classification were interviewed using qualitative methods 17 to explore feelings and perceptions about their affected body parts. These semi-structured interviews were analysed utilising princi-18 ples of grounded theory. Participants revealed bizarre perceptions about a part of their body and expressed a desperate desire to 19 amputate this part despite the prospect of further pain and functional loss. A mismatch was experienced between the sensation 20 of the limb and how it looked. Anatomical parts of the CRPS limb were erased in mental representations of the affected area. Pain 21 generated a raised consciousness of the limb yet there was a lack of awareness as to its position. These feelings were about the CRPS 22 limb only as the remaining unaffected body was felt to be normal. Findings suggest that there is a complex interaction between pain, 23 disturbances in body perception and central remapping. Clinically, findings support the use of treatments that target cortical areas, 24 which may reduce body perception disturbance and pain. We propose that body perception disturbance is a more appropriate term 25 than 'neglect-like' symptoms to describe this phenomenon. 26

Broadening thinking about RTW to take into consideration the complexities of its developmental nature holds promise for understanding and improving RTW, as it not only clarifies the importance of incremental milestones, but also facilitates intervention choice and evaluation.