Clinical 7: GALS - Gait analysis and spine examination Flashcards
What is the purpose of the GALS exam?
To act as a screening exam for significiant problems with the locomotor system
What are some screening questions to accompany the GALS examination?
Do you have any pain or stiffness in your muscles, joint or back?
Can you dress yoursel completely without difficulty?
Can you walk up and down staris without any difficulty?
How do we assess the patients gait?
Ask to take a few steps turn quickly and walk back
What should be examined in the observation of the back in the GAIT exam?
Muscle bulk - trapezius, shoulder girdle, gluteal muscle bulk
Straight spine - should also palpate spinous process, sacroiliac joints and paraspinal muscles.
Iliac crest - level
Swelling in popliteal fossa
Hindfoot - no obvious abnormality
What should be examined from the side of the patient?
Normcal cervical lordosis
Thoracid kyphosis
Lumbar lordosis
Ask to bend forward and touch toes - place finger of lumbar spine to assess spinal movement
What should be assessed from the front of the patient?
Ask to stand in anatomical position - check cubital fossa and elbow definition
Ask to flex neck to all range of movements - assess cervical pain stability
Ask to open jaw wide and move side to side - TMJ joint pain can indicate RAMs
Ask to reach arms as far down thes side as possible
What features of the arms/hands should be assessed in a GALS exam?
Hands behind head - elbow flexion and gluteahumeral movement
Ask to extend arms fully
Assess supination and pronation
Assess hands for changes on dorsal and palmar surface with fingers stretched out.
Fist, grip strength test, opposition metacarpal pharangeal squueze,
What in the legs should be assessed in a GALS exam?
Passive -Knee flexion, Hip flexion, Internal rotation in the hip
Patella tap
Sweep test
Feet - inspect for abnormalities calluses formation and metatarsal squeeze.
What is important to remember when recording the GALS examination?
Write GALS NAD - indicates a completely normal GAIT examinations.
Any abnormal findings should be recorded and the appropriate regional joint examinations undertaken.
to complete - review any clinical imaging, neurovascular review of upper and lower limbs.
What is the spine should be examined in the GALS exam?
From standing inspect the spine from multiple angles
Assess lateral flexion of cervial spine by asking patient to bring their ears towrda shoulder in turn
Assess flexino of the lumbar spine - place fingers on bottom of lumbar spine and ensure they move with the patient bending
