The GALS locomotor screen and disability.

Abstract

Examination of the locomotor system is frequently neglected. Therefore, the GALS locomotor screen (Gait, Arms, Legs, Spine) has been proposed by Doherty et al as a practical method of identifying functionally important problems. This study was designed to test whether this screen reflects functional impairment, as measured by accepted health status measures. Two observers performed the GALS screen in a total of 83 patients with a variety of musculoskeletal conditions. The examination components of GALS were rated by a simple 0 to 3 scale. Physical ability was further assessed by Health Activity Questionnaire (HAQ), Barthel index and Steinbrocker's ARA classification. For the total patient group, Spearman correlations between GALS and the three functional indices were good (r = 0.62 to 0.71, p < 0.001). Correlations were equally good for rheumatoid arthritis patients alone (r = 0.65 to 0.70, p < 0.001), but less good although still significant for the other miscellaneous rheumatic conditions (r = 0.31 to 0.46, p < 0.05). Observed proportional agreement between the two observers for the individual scores was > 70%, with a kappa statistic k = 0.49 to 0.74. The GALS screen is a reliable and valid measure of functional ability, compared with standard accepted indices in a variety of musculoskeletal diseases. This supports the proposal for its use as a screening test by general practitioners and medical students.