Cross-cultural validation of the paediatric Gait, Arms, Legs, Spine (pGALS) tool for the screening of musculoskeletal disorders in Mexican children

Abstract

The aim of this study was to validate the paediatric Gait, Arms, Legs, Spine (pGALS) tool for Mexican Spanish to screen Mexican paediatric population for musculoskeletal (MSK) disorders. A cross-sectional study was performed in the Paediatric Hospital of the Mexican Social Security Institute in Guadalajara, Jalisco. The validation included children and adolescents aged 6-16 years, 87 patients with musculoskeletal disorders and 88 controls without musculoskeletal disorders. The cross-cultural validation followed the current published guidelines. The average pGALS administration time was 2.9 min (SD 0.54). The internal consistency score (Cronbach's α) was 0.90 (0.89 for inflammatory and 0.77 for non-inflammatory disorders) for MSK disorders, with a sensitivity of 97 % (95 % CI 92-99 %), a specificity of 93 % (95 % CI 86-97 %), a LR+ of 14.3, and a ROC curve of 0.95 (95 % CI 0.92-0.98 %). The inflammatory disorders group had a sensitivity of 97 % (95 % CI 86-99 %), a specificity of 93 % (95 % CI 86-97 %), a LR+ of 14.2, and a ROC curve of 0.95 % (95 % CI 0.91-0.99 %). The non-inflammatory disorders group had a sensitivity of 98 % (95 % CI 89-99 %), a specificity of 93 % (95 % CI 86-97 %), and a LR+ of 14.37, with a ROC curve of 0.95 % (95 % CI 0.92-0.98 %). pGALS is a valid screening tool, fast, easy to administer, and useful for detecting musculoskeletal disorders in Mexican children and adolescents.

Acceptability and Practicality of a Quick Musculoskeletal Examination into Sports Medicine Pre-Participation Evaluation

“…We acknowledge that our findings on pGALS were not validated by MSK ‘experts’ (e.g., physical medicine and rehabilitation doctors or orthopedic surgeons) but we regard our findings as useful to assess practicality and acceptability rather than the validity of pGALS itself. Indeed, the sensibility and specificity of this screening maneuver have already been proved to be high, with values ranging around 90% [ 25 , 26 ]: Foster and Jandial [ 27 ] reported a sensitivity of 97% and a specificity of 98% for pGALS, Moreno-Torres et al [ 25 ] showed that pGALS had a sensitivity of 97% and specificity of 93% in Mexican Spanish translation, Batu et al [ 26 ] had the sensitivity slightly lower (93.7%) and a specificity of 97.4% in Turkish children, and finally, Sukharomana et al [ 24 ] found a sensitivity and specificity of 74.14% and 100% in a Thai population.…”

“…Considering that pGALS has been validated worldwide [ 23 , 24 , 25 , 26 ] and has shown great sensibility and specificity as an MSK diagnostic tool [ 27 ], the aim of the present paper was to evaluate the acceptability and practicability of pGALS in the Italian sports medicine PPE.…”

Cross‐cultural adaptation and validation of the Gait, Arms, Legs, Spine locomotor screening test for detecting musculoskeletal disorders in Mexican adults

“…In spite of being published in 1992, the GALS 5 has been increasingly used in recent years, not only because of the surge in the number of MSK diseases, but also for being available and allowing for rapid implementation, as well as for offering sensitivity and specificity levels appropriate for screening purposes in routine clinical practice. The GALS test has been validated by different kinds of health staff and adapted for pediatric use by Foster et al 13 with one of the authors of this manuscript having participated in the cross‐cultural adaptation and validation of the pGALS in Mexican Spanish with positive results 16 …”

“…Unlike the pGALS, which has been translated into various languages including Mexican Spanish, 16 Peruvian Spanish 17 and Turkish, 18 the GALS had not been cross‐culturally adapted or validated until now, with our Mexican‐Spanish version thus representing a pioneering effort. Developed in accordance with standardized international guidelines, the present adaptation benefits other Spanish‐speaking populations with social and cultural characteristics similar to those of Mexico.…”

A Mixed Methods Evaluation of The Paediatric Musculoskeletal Matters (PMM) Online Portfolio

“…Paediatric Gait, Arms, Legs and Spine (pGALS) (21) is a simple MSK examination schedule useful in clinical practice (22)(23)(24)(25)(26)(27)(28) and is widely taught (29,30). The free pGALS app (launched in 2015) was developed with medical students at Newcastle University UK to inform format and content with exam revision notes and links to PMM website key pages (31,32).…”