Document Owner: Clinical Skills – LK/ST
Last Updated: April 2018
Clinical Examination Guide
GALS Examination
Introduction
The GALS (Gait, Arms, Legs, Spine) examination screens for common musculoskeletal and functional disability
• Introduce yourself, confirm patient ID
• Explain examination and need to expose their back and legs, gain consent, and ask patient to stand
• Ask
- “Do you have any pain or stiffness in your muscles, joints or back?”
- “Can you dress yourself completely without difficulty?”
- “Can you walk up and down stairs without difficulty?”
• Gel hands
General Inspection - standing
Front
Side
Behind
• Quadricep bulk and
symmetry
• Knee swelling, varus or
valgus
• Forefoot/midfoot
abnormalities
• Foot arches
• Normal cervical and lumbar
lordosis
• Normal thoracic kyphosis
• Full elbow extension
• Quadricep bulk and
symmetry
• Knee swelling, flexion /
hyperextension
• Forefoot / mid foot
abnormalities, normal foot
arches
• Shoulder muscle bulk /
symmetry
• Spinal alignment - no
scoliosis, symmetrical
paraspinal muscles
• Level iliac crests
• Gluteal muscle bulk /
symmetry
• Popliteal swellings
• Calf muscle bulk /
symmetry
• Hind foot / Achilles
abnormalities
Gait
Walking & Turning
With patient walking and turning, look for:
• symmetry, smoothness and normal stride length
• normal stance phase (heel strike, foot flat and toe off) and swing phase.
• ability to turn quickly
[Problems with walking may indicate lumbar spine and lower limb problems]
