Beyond pGALS: the need for a multifaceted musculoskeletal decision-making tool ('pGALSplus') in community-based
Vicky Mercer1,2,3, Nicola Smith1, Sharmila Jandial4,5
1Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK.
Insights
This study identifies additional musculoskeletal (MSK) assessments to enhance the pediatric gait, arms, legs, and spine (pGALS) assessment. These additions aim to improve clinical decision-making for children with various MSK conditions.
Area of Science:
- Pediatric Musculoskeletal Health
- Clinical Assessment Tools
Background:
- Musculoskeletal (MSK) conditions are prevalent in children, necessitating accurate identification for appropriate healthcare referral.
- The Paediatric Gait, Arms, Legs and Spine (pGALS) assessment is a key tool for evaluating joint abnormalities in children.
Purpose of the Study:
- To identify supplementary MSK assessments to augment the pGALS tool, creating an enhanced 'pGALSplus' assessment.
- To support clinical decision-making for children with a range of MSK conditions, including Juvenile Idiopathic Arthritis (JIA), mucopolysaccharidoses, muscular dystrophy, and developmental co-ordination disorder.
Main Methods:
- Conducted a literature review of 35 articles focusing on clinical assessments for exemplar pediatric MSK conditions.
- Included questionnaires, physical examinations, and functional tests used by healthcare professionals.
Main Results:
- Identified various clinical assessments and components thereof that could be integrated into the pGALSplus framework.
- Provided a rationale for the utility of these identified assessments within the enhanced pGALSplus context.
Conclusions:
- The identified assessments form a basis for developing and validating the pGALSplus tool.
- Further research is needed to establish the efficacy and clinical utility of the proposed pGALSplus assessment.
Abstract:
Musculoskeletal (MSK) problems in children are common, and health-care professionals must identify those requiring onward referral. Paediatric gait, arms, legs and spine (pGALS) is an MSK assessment to discern abnormal joints. We aimed to identify MSK assessments to add to pGALS (pGALSplus) to facilitate decision-making in the context of exemplar conditions representing a spectrum of MSK presentations, namely JIA, mucopolysaccharidoses, muscular dystrophy and developmental co-ordination disorder. A literature review identified 35 relevant articles that focused on clinical assessments [including questionnaire(s), physical examination and functional tests] used by health-care professionals in the context of the exemplar conditions. We provide a description of these assessments and the rationale regarding how they, or components of such tools, might be useful within pGALSplus. This process provides a foundation for further work to develop and validate pGALSplus.
