GALS screening examination

Question 1

What three questions must you ask before a GALS examination

Answer 1

Do you have any pain or stiffness anywhere?
Are you able to walk up and down the stairs without difficulty?
Can you dress yourself completely without difficulty?

Question 2

What features of a gait would you assess in a GALS exam?

Answer 2

Symmetry
Smoothness
Normal heel strike
Normal step height

Question 3

What would you look for on the back of the patient for a general inspection in a GALS exam

Answer 3

Shoulder/glute/calf muscle symmetry
Spinal alignment
Iliac crest alignment
Popliteal swelling
Hindfoot abnormality

Question 4

What would an S-shaped spine indicate in a GALS exam

Answer 4

Scoliosis

Question 5

What would a popliteal swelling indicate in a GALS exam

Answer 5

Bakers cyst

Question 6

What would a pelvic tilt indicate in a GALS exam

Answer 6

Hip abductor weakness

Question 7

What would you look for on the side of the patient for a general inspection in a GALS exam

Answer 7

Normal lumbar/cervical curvature
Normal thoracic kyphosis
Knee flexion/hyperextension

Question 8

What would you look for on the front of the patient for a general inspection in a GALS exam

Answer 8

Shoulder/quadriceps muscle bulk
Elbow extension
Knee swelling
Foot arches

Question 9

What movements would you attempt with a patients spine in GALS exam

Answer 9

Lateral flexion of c spine (ears to shoulder)
Flexion of c spine (chin to chest)
Extension of c spine (head back)
Rotation of c spine (look over shoulders)

Flexion of l-spine (touch toes)

Question 10

What movements would you attempt with a patients arms and hands in GALS exam

Answer 10

Shoulder abduction, rotation and elbow flexion (hands behind head)
Pronation/supination of hands (turn over hands)
Power grip (squeeze my fingers)
Fine pincer (touch your fingers to your thumb in turn)

Question 11

What features would you look for on a patients hands in a GALS examination

Answer 11

Swelling
Deformity
Muscle wasting

Question 12

What would you feel a patients hands for in a GALS exam

Answer 12

squeeze MCP joints for tenderness

Question 13

What would you feel a patients hips, knees and feet for in a GALS exam

Answer 13

patellar tap

Squeeze MTP joints for tenderness

Question 14

What movements would you attempt with a patients hip and knee in a GALS exam

Answer 14

Active hip and knee flexion (bring knee up towards chin)

Passive hip rotation

Question 15

What features would you look for in a patients foot in a GALS exam

Answer 15

Swelling
Deformity
Callus formation

Question 16

To conclude examination for GALS exam

Answer 16

Perform more detailed examination on areas of concern

Question 17

Features and causes of antalgic gait

Answer 17

Limping

Pathology of hip/ankle/knee

Question 18

Features and causes of Trendelenburg gait

Answer 18

Waddling gait

Hip abductor weakness (polio, muscular dystrophy, nerve lesion, root lesion)
NOF fracture
slipped upper femoral epiphysis

Question 19

Features and causes of Parkinsonian gait

Answer 19

Hesitation
Shuffling
Festination
Retropulsion

Parkinsons
Atherosclerotic pseudoparkinsonism

Question 20

Features and causes of sensory ataxic gait

Answer 20

Broad based, looking at feet

Sensory peripheral neuropathy
Dorsal column loss (MS)

Question 21

Features and causes of cerebellar gait

Answer 21

Broad based
High stepping
Looking carefully ahead

Cerebellar lesion

Question 22

Features and causes of a hemiplegic gait

Answer 22

Foot plantarflexed and knee extended
Leg abducted and swung in lateral arc

UMN lesion (stroke, tumour, MS)

Question 23

Features and causes of a high stepping gait

Answer 23

Foot drop

Common peroneal nerve palsy
Sciatic nerve palsy
MND
Peripheral motor neuropathy