“GALS” Screening Exam

STANDING

Inspect Gait	Symmetry, smooth movement, normal stride length, normal phases of gait.
Inspect from behind Spine Legs	Scoliosis, symmetrical paraspinal muscles, shoulder and gluteal muscles, level iliac crests. No popliteal swellings, normal knee alignment, no hindfoot swelling / deformity.
Inspect from the side Spine “Touch Toes”	Normal cervical and lumbar lordosis, mild thoracic kyphosis. Normal spine and hip flexion.
Inspect from the front Legs	Normal quadriceps mass/symmetry, normal knee alignment, no swelling, Normal ankle alignment, no swelling, normal forefoot, arch, toe alignment.

STANDING/SITTING

“Tilt head to shoulders”	Normal cervical lateral flexion.
“Arms behind head”	Normal shoulder movement.
“Arms straight”	Full elbow extension.
“Hands in front”	No wrist/finger swelling or deformity, able to extend fingers.
“Make a fist”	Normal power grip, flexion of MCPs, no swelling of troughs between MCPs.
“Fingers on thumb”	Normal fine precision pinch / dexterity.
“Turn hands over”	Normal supination/pronation, no erythema, swelling, muscle wasting in palms.
Gently squeeze across MCPs	Identify pain of synovitis

LYING DOWN

Palpate knees	No warmth, no effusions, normal muscle bulk.
Flex each hip and knee	Normal flexion of hips, knees, no flexion contractures, no crepitus, no pain.
Rotate each hip in flexion	Normal rotation of hips.
Gently squeeze across MTPs	Identify pain of synovitis.
Inspect soles of feet	No callosities to suggest abnormal weight bearing.

Reference: Doherty M, Dacre J, Dieppe P, et al. The ‘GALS’ locomotor screen. Ann Rheum Dis. 1992; 51(10): 1165-9. http://dx.doi.org/10.1136/ard.51.10.1165.Medline:1444632