A GALS screen is an examination used by doctors and other healthcare professionals to detect locomotor abnormalities and functional disability relating to gait, arms, legs and the spine.
Arms, legs and spine From behind Inspect for: a straight spine (note any scoliosis), normal paraspinal muscle bulk, symmetrical shoulder and gluteal muscle bulk, symmetry of iliac crests, absence of popliteal swellings, absence of foot or hindfoot swellings.
Palpate: over mid supraspinatus and roll the skin over the trapezius to test for signs of hyperalgesia or fibromyalgia.
From the front Inspect for: normal and symmetrical shoulder and quadriceps muscle bulk, no knee swellings, no deformity of mid or hind feet.
Now ask the patient to do the following noting any painful, restricted or asymmetrical movements: Test rotation of the thoracic and lumbar spine.
Test lateral flexion of the thoracic and lumbar spine: "Stand up straight and then slide the palm of your right hand down your thigh towards your knee, bending your shoulder down to the side."
Now test for stiffness or pain flexing or extending the cervical spine: "bend your neck forwards to try to touch your chin against your chest."
"now make a fist with both hands around my fingers and squeeze tightly" test the grip for normal and symmetrical power.
Gait ● Observe the child walking ● “Walk on your tip-toes / walk on your heels” Arms ● “Put your hands out in front of you” ● “Turn your hands over and make a fist” ● “Pinch your index finger and thumb together” ● “Touch the tips of your fingers with your thumb” ● Squeeze the metacarpophalangeal joints ● “Put your hands together / put your hands back to back” ● “Reach up and touch the sky” ● “Look at the ceiling” ● “Put your hands behind your neck” Legs ● Feel for effusion at the knee ● “Bend and then straighten your knee” (Active movement of knees and examiner feels for crepitus) ● Passive flexion (90 degrees) with internal rotation of hip Spine ● “Open your mouth and put 3 of your (child’s own) fingers in your mouth” - to check for temporomandibular joint disease ● Lateral flexion of cervical spine – “Try and touch your shoulder with your ear” ● Observe the spine from behind ● “Can you bend and touch your toes?” Observe curve of the spine from side and behind Further reading and resources Free educational resources (DVD to order, web streamed demo and handouts) to demonstrate pGALS and an explanation of the manoeuvres (and how to interpret them) are available.