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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
