The 'GALS' locomotor screen.

Doherty, Michael; Dacre, J; Dieppe, P.; Snaith, M L

doi:10.1136/ard.51.10.1165

Cited by 131 publications

(60 citation statements)

References 5 publications

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“…While the use of comprehensive questionnaires such as the AIMS2 can be useful to assess interventions, it is time-consuming. In the clinical setting, a useful tool to screen for musculoskeletal problems is the GALS system (Gait, Arms, Legs, Spine), where validated questions and examination identify problem areas (25).…”

Section: Discussionmentioning

confidence: 99%

Impact of musculoskeletal disease on quality of life in long-standing acromegaly

Miller¹,

Doll²,

David³

et al. 2008

European Journal of Endocrinology

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Objective: To provide rheumatological assessment of patients with long-standing acromegaly and investigate the impact of musculoskeletal disease on quality of life. Design: Cross-sectional observational study. Methods: Fifty-eight patients diagnosed with acromegaly at least 5 years previously were interviewed and examined by a rheumatologist. Each patient completed the short form-36 (SF-36), arthritis impact measurement scales 2 (AIMS2) and acromegaly quality of life questionnaires (AcroQol). Results: Fifty-two out of 58 (90%) reported musculoskeletal pain, with 29 (50%) reporting neck pain. Hip osteoarthritis was present in 49 (84%) and knee osteoarthritis in 20 (34%). Half the patients (52%) reported sleep disturbance, but only 2 (3.5%) had fibromyalgia. Ten (17.2%) had previously undergone carpal tunnel decompression. Fifty-one (88%) patients had consulted their general practioner and 31 (54%) complementary therapists. SF-36, AIMS2 and AcroQol scores were lower in patients with musculoskeletal pain. Conclusions: This study of musculoskeletal problems in patients with acromegaly reports systematic rheumatological examination, use of medical services and quality of life scores. Musculoskeletal problems should be routinely addressed in acromegaly by both endocrinologist and rheumatologist and a multidisciplinary approach taken to management.European Journal of Endocrinology 158 587-593

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Section: Discussionmentioning

confidence: 99%

Impact of musculoskeletal disease on quality of life in long-standing acromegaly

Miller¹,

Doll²,

David³

et al. 2008

European Journal of Endocrinology

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“…Following the General Medical Council (UK) recommendations that musculoskeletal clinical conditions be emphasized in undergraduate teaching (26), musculoskeletal examination is taught in UK medical schools as part of core teaching (22), and many students are taught the Gait, Arms, Legs, and Spine (GALS) screening examination and are introduced to the basic elements of a more detailed regional examination (27). The GALS involves simple questions and procedures that permit rapid and effective assessment of the musculoskeletal system in adults (28,29), but it has not been tested in children.…”

Section: Introductionmentioning

confidence: 99%

Musculoskeletal screening examination (pGALS) for school‐age children based on the adult GALS screen

Foster

Kay

Friswell

et al. 2006

Arthritis & Rheumatism

129

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Objective. To develop and validate a musculoskeletal screening examination applicable to school-age children based on the adult Gait, Arms, Legs, Spine (GALS) screen.Methods. Adult GALS was tested in consecutive school-age children attending pediatric rheumatology clinics and was compared with an examination conducted, on the same day, by a pediatric rheumatologist who classified children as having abnormal or normal joints. Adult GALS was tested for validity compared with the pediatric rheumatologist's assessment and deficiencies in adult GALS were identified. Experts proposed amendments to adult GALS, achieving consensus by modified Delphi techniques. The resultant pediatric screening tool (pGALS) was tested (methodology identical to the testing of adult GALS) in an additional group of children.Results. Adult GALS was tested in 50 children (median age 11 years, range 4 -16), of whom 37 (74%) had juvenile idiopathic arthritis. Adult GALS missed important abnormalities in 18% of children, mostly at the ankle, foot, and temporomandibular joints. The pGALS was tested in 65 children (median age 13 years, range 5-17 years) and demonstrated excellent sensitivity (97-100%) and specificity (98 -100%) at all joints, with high acceptability scored by child and parent/guardian. The median time to perform pGALS was 2 minutes (range 1.5-3 minutes). Conclusion. The pGALS musculoskeletal screening tool has excellent validity, is quick to perform, and is acceptable to school-age children and parents/guardians. We propose that pGALS be incorporated into undergraduate and postgraduate medical training to improve pediatric musculoskeletal clinical skills and facilitate diagnosis and referral to specialists.

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“…First, the Competency Framework for Postgraduate General Paediatrics (www.rcpch.uk) includes for the first time pMSK core learning outcomes. Second, the introduction of adult MSK educational tools (9,10) in undergraduate teaching has improved clinical performance (11), and it is envisaged that a pMSK screening examination (12) will have a similar positive effect. Third, the successful introduction of "Student Selected Components" (www.GMC.org) may influence students to consider pediatric rheumatology as a career.…”

Section: To the Editorsmentioning

confidence: 99%

How do we improve pediatric rheumatology training? A UK perspective: Comment on the article by Mayer et al

Jandial

Foster

2007

Arthritis & Rheumatism

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size of our study (50 patients) could lead to spurious results in factor analysis. However, no consensus exists onthe minimum sample size needed to perform reliable factor analysis; recommendations from the literature are varied, even contradictory (2). A recent simulation study determined the minimum necessary sample size for 180 different population conditions that varied in number of variables, number of factors, number of variables per factor, and level of communalities (4). To make these determinations, 37,160,000 sample correlation matrices were generated. The minimum required sample size varied from 40 to 1,300 depending on the condition, and the authors concluded that "attempts to provide an absolute minimum necessary sample size are probably unrealistic."In our article, we also discussed the problem of the minimal sample size needed for factor analysis, and obviously a larger sample size leads to more reliable results. However, our conclusions, based on Spearman's correlation coefficient results, are more reliable because of the rather small confidence intervals (CIs) for these coefficients obtained with 50 patients. Therefore, the unexpected strength of the correlation (0.57; 95% CI 0.35-0.73) between the physical component score (PCS) and mental component score (MCS) in our sample suggests that the a priori stratification of the 8 subscales of the SF-36 might not be adapted in certain situations, and that the factorial structure of the scale may depend on the type of pathology. This hypothesis is supported by our recent study involving a sample of 2,540 patients with knee osteoarthritis and 1,593 with hip osteoarthritis, showing that the PCS and MCS a priori structure is not confirmed by factor analysis. The factorial structure of the 8 subscales obtained from patients with knee or hip osteoarthritis was similar, but it differed from that obtained from patients with SSc (4).It is widely accepted that in order to establish the construct validity of a scale, several studies with convergent results are needed (5). Therefore, comparing the factorial structure and the convergent and divergent validities of the SF-36 obtained in different samples of SSc patients might be an exciting challenge.

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The 'GALS' locomotor screen.

Abstract: The locomotor system is complex and difficult to examine. A selective clinical process to detect important locomotor abnormalities and functional disabiliity could prove valuable.

Cited by 131 publications

References 5 publications

Impact of musculoskeletal disease on quality of life in long-standing acromegaly

Impact of musculoskeletal disease on quality of life in long-standing acromegaly

Musculoskeletal screening examination (pGALS) for school‐age children based on the adult GALS screen

How do we improve pediatric rheumatology training? A UK perspective: Comment on the article by Mayer et al

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