Musculoskeletal Screening Examination

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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

Arms, 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

External Links