Musculoskeletal Screening Examination

The GALS (Gait-Arms-Legs-Spine) is a screening examination of the musculoskeletal system.

Screening Questions

• Do you have any pain or stiffness in your arms, legs, or back?
• Do you have any trouble getting up and down stairs or steps?
• Can you dress yourself completely without difficulty?

Examination

Gait

Look for symmetry, smoothness of movement, stride length, pelvic tilt, arm swing, heel strike, stance, toe-off, swing through, and turning. Note specific gait features such as Trendelenburg, antalgic, hemiplegic, Parkinsonian, etc.

Arms, Legs and Spine Inspection

• From behind
  • Spinal and pelvic alignment
  • Paraspinal, shoulder, and gluteal muscle bulk
  • Popliteal, foot, or hindfoot swelling.
• From the side
  • Spinal curvature
  • Schobers test
• From the front
  • Shoulder, and quadriceps muscle bulk and symmetry
  • Knee swelling
• Mid or hindfoot deformity

Arm, Legs, Spine Palpation and Movement

• Skin roll over the trapezius
• Cervical spine movement
• Thoracic spine movement
• Lumbar spine movement
• Temporomandibular joint movement
• Sterno-clavicular, gleno-humeral, and acromio-clavicular joint movement
• Elbow extension

Wrist and finger deformity or restricted range of motion

• Inspection
• Pronation, and supination
• Grip strength
• Fine precision - finger to thumb opposition
• Metacarpal squeeze

Supine position

• Leg length discrepancy
• Knee movement
• Hip joint movement
• Foot inspection
• Metatarsal squeeze