Virtual or Video-pGALS (V-pGALS)
V-pGALS aims to facilitate assessment in the context of remote / telehealth clinics.
V-pGALS includes amended / additional manoeuvres to pGALS derived from components of pREMS Hip and Spine.
The Table below lists V-pGALS components: * denotes the amends / additions to pGALS. 'TP' refers to a Telepresenter who may be a parent, carer or a health care professional.
The V-pGALS Table is available as a pdf download (checklist).
There is a pdf download V-pGALS to demonstrate the manoeuvres (graphic).
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QUESTIONS |
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Any pain (joint/muscle/back) scale 0-10* |
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Any morning stiffness / Gelling [in minutes]* |
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Difficulty with dressing or undressing? |
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Difficulty walking or going up or downstairs? |
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GAIT |
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Standing posture: swelling, alignment, rash, deformity, wasting, posture, feet |
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Walk & turn, walk on heels, walk on tiptoe: ability, foot posture, limp |
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ARMS |
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Observation: nails, skin, muscles, deformity |
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Hold hands out straight: elbow, wrist, finger extension |
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Make a fist (*‘cat claw’/‘monkey paw’): supination, full flexion fingers |
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Pinch index finger & thumb: small finger joints, key grip strength |
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Touch individual fingers to thumb: small finger joints, dexterity, |
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TP to squeeze MCP joints*: tenderness grade (0-10) |
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Hands palm to palm / back to back: wrist flexion/extension |
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Reach arms up, head back: elbow, wrist, neck extension |
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Hands behind neck: shoulder abduction, external rotation |
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LEGS |
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Observation: nails, skin / soles, muscles, posture, alignment, leg length, flat feet |
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TP feels knee: at rest & on moving. Check for warmth, swelling, crepitus. If swollen ask TP if swelling feels soft (grape like) or hard (stone)? |
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TP assess movement of hips: leg roll* or prone lying*(‘X’/‘W’ leg position*) |
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TP assess range of movement knees: full extend and heel to buttock |
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Squat*: active knee flexion, restriction at ankle |
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Balance on tip toes* |
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1-leg stand*: balance, Trendelenberg |
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Sit cross legged & stand up*: fluency, balance, power |
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SPINE |
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Observation: skin, muscles, posture, normal lordosis, deformity |
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Touch ear to shoulder: cervical spine lateral flexion |
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Open mouth (1-3 fingers) & move jaw side-to-side* |
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Bend forward and touch toes |
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TP to assess sacroiliac joint tenderness [grade 0-10]* |
