GALS

Question 1

What is the purpose of a GALS screen?

Answer 1

To rapidly and efficiently screen for MSK issues that require further assessment.

Question 2

How is the GALS assessment generally introduced?

Answer 2

• Wash hands.
• PPE
• Introduce self.
• Ask name and DOB.
• Explain the examination.
• Gain consent.

Question 3

What comes after the general introduction?

Answer 3

Specific questions.

Question 4

What are the specific questions that are asked at the start of a GALS screening test?

Answer 4

• Do you have any pain or stiffness anywhere?
• Are you able to completely dress and undress yourself without any difficulty?
• Are you able to climb up and down stairs without any difficulty?

Question 5

What comes after the initial questions in GALS screening?

Answer 5

Inspection.

Question 6

How should the patient be inspected?

Answer 6

From the front.
From the side.
From the back.

Question 7

What comes after inspection?

Answer 7

Gait assessment.

Question 8

How is the patient’s gait assessed? What is being looked for?

Answer 8

Ask the patient to walk a few steps in one direction and then back. Observe:
- Arm swing.
- Pelvic tilt.
- Stride length.
- Any obvious pain (ask the patient this too).

Question 9

What comes after assessment of gait?

Answer 9

Assessment of spine.

Question 10

How is the spine assessed?

Answer 10

• Place two fingers on the patients lumbar spine, and ask them to touch their toes. Fingers should move outwards as the patient bends forwards, and then back together as they straighten.
• Ask the patient to touch their shoulder with their ear on both sides.

Question 11

What coms after assessment of the spine?

Answer 11

Assessment of the upper limbs.

Question 12

How are the upper libs assessed in GALS?

Answer 12

• Ask the patient to put their hands behind their head and push their elbows backwards (shoulder assessment).
• Ask the patient to put their hands out in front of them palms down. Then ask them to turn their hands over. Both inspect the hands for swelling/deformity, muscle wasting, skin/nail changes etc. as well as assessing the range of pronation/supination.
• Ask the patient to fully straighten their arms (elbow extension).
• Perform an MCP squeeze, and ask if there is pain.
• Ask the patient to make a fist that covers the nails, then to touch each finger to the thumb on the same hand rapidly and repeatedly.
• Ask the patient to squeeze your fingers to assess grip strength.

Question 13

What comes after upper limb assessment?

Answer 13

Lower limb assessment.

Question 14

How are the lower limbs assessed?

Answer 14

Ask the patient to lie on the couch.

Knee:
- Ask the patient to fully flex then extend each knee. Feel for crepitus as they do so.

• Patellar tap. Use one hand to slide fluid down from mid-thigh to the patellar. Then, use three fingers on the other hand to push down firmly. Feel for any bounciness suggesting there is fluid in the joint.

Hip:
- Bend the leg to 90, and then hold at the knee. Move the leg at the ankle and assess internal and external rotation of the hip.

Feet:
- Inspect feet/soles of feet for swelling, deformities or callouses.

• Complete a MTP squeeze.

Question 15

What comes after lower limb assessment?

Answer 15

Conclusion.

Question 16

How is the GALS screen concluded?

Answer 16

• Thank the patient for their time.
• Request that they redress.
• Wash your hands.