The GALS assessment is a quick and simple musculoskeletal screening tool used in primary care settings to identify abnormalities and assess the general musculoskeletal health of a patient. GALS stands for Gait, Arms, Legs, and Spine.
1. Gait
- Observation: Assess the patient's walking pattern.
- Normal Findings: Steady and coordinated gait without limping or abnormalities.
- Abnormalities: Antalgic gait, steppage gait, or any observable asymmetry.
2. Arms
- Inspection and Palpation: Examine the upper limbs for deformities, swelling, or muscle wasting.
- Range of Motion:Check for limitations in shoulder, elbow, and wrist movements.
- Normal Findings: Symmetrical appearance and full range of motion in the upper limbs.
- Abnormalities : Joint deformities, muscle atrophy, or limited range of motion.
3. Legs
- Inspection and Palpation: Examine the lower limbs for deformities, swelling, or muscle wasting.
- Range of Motion: Check for limitations in hip, knee, and ankle movements.
- Normal Findings: Symmetrical appearance and full range of motion in the lower limbs.
- Abnormalities: Joint deformities, muscle atrophy, or limited range of motion.
4. Spine:
- Inspection: Observe the spine for any curvature or deformities.
- Range of Motion Assess forward flexion, extension, lateral flexion, and rotation of the spine.
- Normal Findings: Straight and aligned spine with normal range of motion.
- Abnormalities: Scoliosis, kyphosis, Lordosis or limited range of motion.
IN THIS SESSION, GAIT IS BEEN DISCUSSED IN DETAIL
GAIT
1. Normal Gait: A regular walk for healthy individuals involves factors like step length, width, speed, arm movement, heel-to-toe motion, and smooth weight transfer. These factors work together for a balanced walking pattern. Any deviations could suggest health issues which requires clinical assessment.
2. Antalgic Gait: Altered walking due to pain; for example, a patient limping after a recent ankle sprain.
3. Trendelenburg Gait: Swaying of the trunk caused by weak hip abductor muscles; seen in conditions like hip arthritis.
Clinical Case: A patient with hip osteoarthritis presenting with a noticeable sway to one side during walking.
4. Ataxic Gait: Unsteady walk due to poor coordination; observed in conditions affecting the cerebellum, such as cerebellar ataxia.
Clinical Case: A person with multiple sclerosis experiencing difficulty maintaining balance and coordination while walking.
5. Spastic Gait: Stiff, jerky movements due to increased muscle tone; seen in conditions like cerebral palsy. Clinical Case: A child with cerebral palsy demonstrating a stiff and exaggerated walking pattern.
6. Scissors Gait: Legs cross or hit each other during walking; common in conditions like cerebral palsy or spastic paraplegia.
Clinical Case: An individual with spastic paraplegia exhibiting a scissoring gait.
7. Parkinsonian Gait: Shuffling steps, reduced arm swing, and a forward-leaning posture; typical in Parkinson's disease.
Clinical Case: An elderly patient with Parkinson's disease demonstrating a shuffling walk and reduced arm movement.
8. High Stepping Gait: Lifting the foot higher than normal; seen in conditions affecting the dorsal columns of the spinal cord.
Clinical Case: A person with spinal cord injury showing a high-stepping gait due to reduced sensory feedback.
9. Cerebellar Gait: Uncoordinated and staggering walk; associated with cerebellar disorders like multiple sclerosis.
Clinical Case: A patient with cerebellar ataxia displaying a wide-based and unsteady gait.
10. Waddling Gait: A swaying motion resembling a duck's walk; seen in conditions causing hip muscle weakness, such as muscular dystrophy.
Clinical Case: A child with muscular dystrophy presenting with a waddling gait.
11. Myopathic Gait: Weakness and difficulty with certain movements due to muscle disorders; observed in patients with myasthenia gravis.
Clinical Case: A person with myasthenia gravis showing muscle weakness and a compromised gait.
12. Hemiplegic Gait: Walking pattern affected on one side due to paralysis or weakness; common after a stroke.
Clinical Case: A stroke survivor with weakness on one side displaying a hemiplegic gait.
13. Dystonic Gait: Dystonic gait refers to an abnormal walking pattern caused by dystonia, a neurological movement disorder. It's characterized by involuntary muscle contractions, leading to twisting or repetitive movements while walking.
14. Equine Gait: Walk resembling a horse's gait; often observed in neurological conditions like Friedreich's ataxia.
Clinical Case: A patient with Friedreich's ataxia exhibiting a high-stepping and uncoordinated equine gait.
15. Scissor-wheel Gait: Combination of scissor and circumduction movements; seen in certain neuromuscular conditions like cerebral palsy.
Clinical Case: A child with cerebral palsy displaying a scissor-wheel gait pattern.
16. Festinating Gait: Small, rapid steps with increasing speed; common in Parkinson's disease.
Clinical Case: A person with Parkinson's disease showing festination characterized by progressively faster and shorter steps.
17. Apraxic Gait: Difficulty initiating or coordinating movements during walking; seen in conditions affecting motor planning, such as apraxia.
Clinical Case: A patient with apraxia struggling with initiating and coordinating steps while walking.
18. Footdrop Gait: Difficulty lifting the front part of the foot; causing a dragging or slapping gait; observed in conditions like peripheral neuropathy.
Clinical Case: A person with peripheral neuropathy displaying a footdrop gait with difficulty in dorsiflexing the foot.
19. Steppage Gait: High-stepping walk due to weakness or paralysis of the muscles that lift the foot; seen in conditions like foot drop.
Clinical Case: A patient with foot drop demonstrating a steppage gait characterized by exaggerated lifting of the foot.
20. Toe-Walking Gait: Walking on the toes without the heel touching the ground; common in children but may persist in conditions like cerebral palsy.
Clinical Case: A child with cerebral palsy exhibiting a persistent toe-walking gait.
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