GALS

Question 1

What are the 3 screening questions for GALS?

Answer 1

• “Do you have any pain or stiffness in your muscles, joints or back?”
  “Do you have any difficulty getting yourself dressed without any help?”
  “Do you have any problem going up and down stairs?”

Question 2

Steps of GALs? (5)

Answer 2

- Gait 
(+general obs=anterior/medial/posterior)
- Arms
- Legs
- Spine

Question 3

What is observed in gait? (7)

Answer 3

• Normal heel strike/toe off/arm swing?
• Normal step height?
• Not broad based steps?
• Normal speed?
• Symmetrical?
• Smooth?
• Turn quickly?

Question 4

What should be generally observed in the patient anteriorly? (7)

Answer 4

• Quadriceps bulk and symmetry?
• Shoulder bulk and symmetry?
• Iliac crests equal level?
• Limbs aligned?
• Anatomical position: full elbow and knee extension?
• High/low foot profile?
• Forefoot abnormality?
• Knee swelling

Question 5

What should be generally observed in the patient medially? (6)

Answer 5

• Knee flexion/hyperextension?
• Bulk symmetry of muscle?
• Cervical lordosis?
• Thoracic kyphosis?
• Lumbar lordosis?
• Foot arches

Question 6

What should be generally observed in the patient posteriorly? (7)

Answer 6

• Baker’s cyst?
• Popliteal swelling/aneurysm?
• Glute bulk and symmetry?
• Calve bulk and symmetry?
• Shoulder bulk and symmetry?
• Straight spine alignment?
• Hindfoot abnormality?

Question 7

Steps in arm assessment? (9)

Answer 7

• Patient hands behind head
• Inspect for swelling + deformity of wrists and hands + muscle bulk
• Hands held out fingers stretched
• Turn hands over fingers stretched
• Make a fist=power grip
• Squeeze fingers=grip strength
• Finger to meet thumbs
• MCP squeeze, signs of discomfort
• Fine percision pinch tests

Question 8

What movements does the patient putting their hands behind their head assess? (3)

Answer 8

• Shoulder abduction
• External rotation
• Elbow flexion

Question 9

What should be looked for with the patient’s hands outstretched palms down? (2)

Answer 9

• Joint swelling

- Deformity

Question 10

What should be looked for with the patient’s hands outstretched palms up? (2)

Answer 10

• Muscle bulk

- Abnormality

Question 11

What is assessed when the patient makes a fist?

Answer 11

• Power grip
• Hand and wrist function
• Finger range of movement

Question 12

What is assessed when the patient squeezes your fingers?

Answer 12

Grip strength

Question 13

What is assessed when the patient brings each finger in turn to meet the thumb?

Answer 13

Fine precision pinch

Question 14

Position in leg assessment?

Answer 14

Lying on couch

Question 15

Steps in leg assessment? (6)

Answer 15

• Full knee flexion (Crepitus)
• Full knee extension (Crepitus)
• Internal hip rotation in flexion
• Patellar tap
• Foot inspection
• MTP squeeze

Question 16

How should internal hip rotation be assessed? (3)

Answer 16

• Hip and knee flexed to 90
• Hold knee and ankle
• Twist leg out

Question 17

What should the feet be inspected for? (3)

Answer 17

• Swelling
• Deformity
• Callsities on soles

Question 18

Steps in spine assessment? (5)

Answer 18

• Patient stands
• Inspect spine from behind and side
• Cervical lateral flexion
• Touch toes: lumbar spine flexion
• Temporomandibular joint (mouth opening)

Question 19

What should the spine from behind be inspected for?

Answer 19

Scoliosis

Question 20

What should the spine from the side be inspected for? (2)

Answer 20

• Abnormal lordosis

- Abnormal kyphosis

Question 21

How is neck lateral flexion assessed? (2)

Answer 21

• Tilt head to each side bringing ear to shoulder

- Don’t raise shoulders

Question 22

How is lumbar spine flexion assessed? (4)

Answer 22

• Touch toes
• Place 2-3 fingers on lumbar vertebrae
• Move apart on flexion
• Back together on extension

Question 23

Good phrases

Answer 23

“Normal phases of gait”

“Open that fist then squeeze my fingers”