Acceptability and practicality of musculoskeletal examination in acute general pediatric assessment

Area of Science:

• Pediatric Musculoskeletal Health
• Clinical Assessment Tools
• Rheumatology

Background:

• Musculoskeletal (MSK) conditions are common in children.
• Early identification of MSK issues is crucial for timely intervention.
• Standardized screening tools can aid in routine pediatric assessments.

Purpose of the Study:

• To evaluate the practicality and acceptability of the pediatric Gait, Arms, Legs and Spine (pGALS) screening examination.
• To assess the feasibility of integrating pGALS into acute pediatric assessments.
• To determine patient and parent perceptions of the pGALS examination.

Main Methods:

• pGALS was added to routine examinations for consecutive school-aged children in an acute pediatric assessment unit.
• Practicality was assessed by time taken and completion rate.
• Acceptability was measured by patient and parent-reported time taken and discomfort.

Main Results:

• The pGALS examination was completed in 96% of 50 children, with a median time of 3 minutes.
• Acceptability was high, with 98% of children and 94% of parents finding the time appropriate.
• Most children (72%) reported little or no discomfort.
• Abnormal MSK findings were noted in 34% of children, with 12% having non-MSK related findings.

Conclusions:

• The pGALS screening is a practical and acceptable addition to acute pediatric assessments, even when performed by non-specialists.
• Abnormal findings during pGALS are common but require interpretation within the broader clinical context.
• pGALS can be a valuable tool for identifying potential pediatric musculoskeletal issues during acute care.