Table 2

Individual features of the GALS exam which were examined (6)


• Symmetry & smoothness of movement

• Stride length & mechanics

• Ability to turn normally & quickly

ARMS (Hands)

• Wrist/finger swelling/deformity

• Squeeze across 2nd to 5th metacarpals for tenderness (indicates synovitis)

• Turn hands over, inspect muscle wasting & forearm pronation/supination

ARMS (Grip Strength)

• Power grip (tight fist)

• Precision grip (oppose each finger to thumb)

ARMS (Elbows)

• Full extension

ARMS (Shoulders)

• Abduction & external rotation of shoulders

LEGS (Feet)

• Squeeze across metatarsals for tenderness (indicates synovitis)

• Calluses

LEGS (Knees)

• Knee swelling/deformity, effusion

• Quadriceps muscle bulk

• Crepitus during passive knee flexion

LEGS (Hips)

• Check internal rotation of hips

SPINE (Inspection from behind)

• Shoulders & iliac crest height symmetry

• Scoliosis

• Paraspinal, shoulder, buttocks, thighs & calves muscles normal

• Popliteal or hind foot swelling or deformity

SPINE (Inspection from front)

• Quadriceps normal in bulk & symmetry

• Swelling or at Varus or valgus deformity at knee

• Forefoot of midfoot deformity, action normal

• Ear against shoulder on either side to check lateral cervical spine flexion

• Hands behind head with elbows back (check rotator cuff muscles, acromioclavicular, sternoclavicular & elbow joints)

SPINE (Inspection from side)

• Normal thoracic & lumbar lordosis

• Normal cervical kyphosis

• Normal flexion (lumbosacral rhythm from lumbar lordosis to kyphosis) while touching toes

SPINE (Trigger point tenderness)

• Supraspinatus muscle tenderness (exaggerated response)

Beattie et al. BMC Musculoskeletal Disorders 2008 9:115   doi:10.1186/1471-2474-9-115

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