Skip to main content
Top
Published in: Rheumatology International 4/2016

01-04-2016 | Original Article - Validation Studies

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

Authors: Luis Antonio Moreno-Torres, Adolfo Gabriel Hernández-Garduño, Carmen Araceli Arellano-Valdés, Aarón Salinas-Rodríguez, Nadina Rubio-Perez, Ingris Peláez-Ballestas

Published in: Rheumatology International | Issue 4/2016

Login to get access

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.
Appendix
Available only for authorised users
Literature
1.
go back to reference Eccleston C, Clinch J (2007) Adolescent chronic pain and disability: a review of the current evidence in assessment and treatment. Paediatr Child Health 12:117–120PubMedPubMedCentral Eccleston C, Clinch J (2007) Adolescent chronic pain and disability: a review of the current evidence in assessment and treatment. Paediatr Child Health 12:117–120PubMedPubMedCentral
2.
go back to reference Myers A, McDonagh JE, Gupta K, Hull R, Barker D, Kay LJ, Foster HE (2004) More ‘cries from the joints: assessment of the musculoskeletal system is poorly documented in routine paediatric clerking. Rheumatology (Oxford) 43:1045–1049CrossRef Myers A, McDonagh JE, Gupta K, Hull R, Barker D, Kay LJ, Foster HE (2004) More ‘cries from the joints: assessment of the musculoskeletal system is poorly documented in routine paediatric clerking. Rheumatology (Oxford) 43:1045–1049CrossRef
3.
go back to reference Perquin CW, Hazebroek-Kampschreur AA, Hunfeld JA et al (2000) Pain in children and adolescents: a common experience. Pain 87:51–58CrossRefPubMed Perquin CW, Hazebroek-Kampschreur AA, Hunfeld JA et al (2000) Pain in children and adolescents: a common experience. Pain 87:51–58CrossRefPubMed
4.
go back to reference Abernethy K, Jandial S, Hill L, Salazar Sánchez E, Foster H (2014) Acceptability and practicality of a Spanish translation of paediatric Gait Arms Legs and Spine (pGALS) in Peruvian children. Pediatr Rheumatol J 12:48. doi:10.1186/1546-0096-12-48 CrossRef Abernethy K, Jandial S, Hill L, Salazar Sánchez E, Foster H (2014) Acceptability and practicality of a Spanish translation of paediatric Gait Arms Legs and Spine (pGALS) in Peruvian children. Pediatr Rheumatol J 12:48. doi:10.​1186/​1546-0096-12-48 CrossRef
5.
go back to reference Foster H, Kay L (2003) Examination skills in the assessment of the musculoskeletal system in children and adolescents. Curr Paediatr 13:341–344CrossRef Foster H, Kay L (2003) Examination skills in the assessment of the musculoskeletal system in children and adolescents. Curr Paediatr 13:341–344CrossRef
6.
go back to reference Foster H, Jandial S (2008) pGALS a screening examination of the musculoskeletal system in school-aged children. Collect Rep Rheum Dis 5:1–8 Foster H, Jandial S (2008) pGALS a screening examination of the musculoskeletal system in school-aged children. Collect Rep Rheum Dis 5:1–8
7.
go back to reference Len CA, Terreri MT, Puccini RF, Wechsler R, Silva EK, Oliveira LM et al (2006) Development of a tool for early referral of children and adolescents with signs and symptoms suggestive of chronic arthropathy to pediatric rheumatology centers. Arthritis Rheum 55(3):373–377CrossRefPubMed Len CA, Terreri MT, Puccini RF, Wechsler R, Silva EK, Oliveira LM et al (2006) Development of a tool for early referral of children and adolescents with signs and symptoms suggestive of chronic arthropathy to pediatric rheumatology centers. Arthritis Rheum 55(3):373–377CrossRefPubMed
8.
go back to reference Clinch J (2009) Recognizing and managing chronic musculoskeletal pain in childhood. Paediatr Child Health 19(8):381–387CrossRef Clinch J (2009) Recognizing and managing chronic musculoskeletal pain in childhood. Paediatr Child Health 19(8):381–387CrossRef
10.
go back to reference Foster HE, Kay LJ, Friswell M, Coady D, Myers A (2006) Musculoskeletal screening examination (pGALS) for school-age children based on the adult GALS screen. Arthritis Rheum 55(5):709–716CrossRefPubMed Foster HE, Kay LJ, Friswell M, Coady D, Myers A (2006) Musculoskeletal screening examination (pGALS) for school-age children based on the adult GALS screen. Arthritis Rheum 55(5):709–716CrossRefPubMed
11.
go back to reference Duarte C, Ruperto N, Goycochea MV, Maldonado R, Beristain R, De Inocencio J, Burgos-Vargas R (2001) The Mexican version of the childhood health assessment questionnaire (CHAQ) and the child health questionnaire (CHQ). Clin Exp Rheumatol 19(4):106–110 Duarte C, Ruperto N, Goycochea MV, Maldonado R, Beristain R, De Inocencio J, Burgos-Vargas R (2001) The Mexican version of the childhood health assessment questionnaire (CHAQ) and the child health questionnaire (CHQ). Clin Exp Rheumatol 19(4):106–110
12.
go back to reference Hernández B, Gortmaker SL, Laird NM, Colditz GA, Parra-Cabrera S, Peterson KE (2000) Validity and reproducibility of a questionnaire on physical activity and non-activity for school children in Mexico City. Salud Publica Mex 42:315–323CrossRefPubMed Hernández B, Gortmaker SL, Laird NM, Colditz GA, Parra-Cabrera S, Peterson KE (2000) Validity and reproducibility of a questionnaire on physical activity and non-activity for school children in Mexico City. Salud Publica Mex 42:315–323CrossRefPubMed
13.
go back to reference Singh G, Atherya BH, Fries JF, Goldsmith DP (1994) Measurement of health status in children with juvenile rheumatoid arthritis. Arthritis Rheum 37(12):1761–1769CrossRefPubMed Singh G, Atherya BH, Fries JF, Goldsmith DP (1994) Measurement of health status in children with juvenile rheumatoid arthritis. Arthritis Rheum 37(12):1761–1769CrossRefPubMed
14.
go back to reference Ainsworth BE, Haskell WL, Herrmann SD, Meckes N, Bassett DR Jr, Tudor-Locke C, Greer JL, Vezina J, Whitt-Glover MC, Leon AS (2011) Compendium of physical activities: a second update of codes and MET values. Med Sci Sports Exerc 43(8):1575–1581CrossRefPubMed Ainsworth BE, Haskell WL, Herrmann SD, Meckes N, Bassett DR Jr, Tudor-Locke C, Greer JL, Vezina J, Whitt-Glover MC, Leon AS (2011) Compendium of physical activities: a second update of codes and MET values. Med Sci Sports Exerc 43(8):1575–1581CrossRefPubMed
15.
go back to reference Booysen F, van der Berg S, Burger R, von Maltitz M, du Rand G (2008) Using an asset index to assess trends in poverty in seven sub-Saharan African countries. World Dev 36(6):1113–1130CrossRef Booysen F, van der Berg S, Burger R, von Maltitz M, du Rand G (2008) Using an asset index to assess trends in poverty in seven sub-Saharan African countries. World Dev 36(6):1113–1130CrossRef
16.
go back to reference Moser C (2008) Assets and livelihoods: a framework for asset-based social policy. In: Moser C, Anis D (eds) Assets, livelihoods, and social policy. The World Bank, WashingtonCrossRef Moser C (2008) Assets and livelihoods: a framework for asset-based social policy. In: Moser C, Anis D (eds) Assets, livelihoods, and social policy. The World Bank, WashingtonCrossRef
17.
go back to reference Olaiz-Fernández G, Rivera-Dommarco J, Shamah-Levy T, Rojas R, Villalpando-Hernández S, Hernández-Avila M, Sepúlveda-Amor J (2006) Encuesta Nacional de Salud y Nutrición 2006. Instituto Nacional de Salud Pública, Cuernavaca Olaiz-Fernández G, Rivera-Dommarco J, Shamah-Levy T, Rojas R, Villalpando-Hernández S, Hernández-Avila M, Sepúlveda-Amor J (2006) Encuesta Nacional de Salud y Nutrición 2006. Instituto Nacional de Salud Pública, Cuernavaca
18.
go back to reference Guillemin F, Bombardier C, Beaton D (1993) Cross-cultural adaptation of health-related quality of life measures: literature review and proposed guidelines. J Clin Epidemiol 46(12):1417–1432CrossRefPubMed Guillemin F, Bombardier C, Beaton D (1993) Cross-cultural adaptation of health-related quality of life measures: literature review and proposed guidelines. J Clin Epidemiol 46(12):1417–1432CrossRefPubMed
19.
go back to reference Beaton D, Bombardier C, Guillemin F, Ferraz M (2000) Guidelines for the process of cross-cultural adaptation of self-report measures. Spine 25(24):3186–3191CrossRefPubMed Beaton D, Bombardier C, Guillemin F, Ferraz M (2000) Guidelines for the process of cross-cultural adaptation of self-report measures. Spine 25(24):3186–3191CrossRefPubMed
21.
go back to reference Acquadro C, Conway K, Hareendran A, Aaronson N (2008) Literature review of methods to translate health-related quality of life questionnaires for use in multinational clinical trials. Value Health 11(3):509–521CrossRefPubMed Acquadro C, Conway K, Hareendran A, Aaronson N (2008) Literature review of methods to translate health-related quality of life questionnaires for use in multinational clinical trials. Value Health 11(3):509–521CrossRefPubMed
22.
go back to reference Van de Vijver F, Tanzer NK (2004) Bias and equivalence in cross-cultural assessment: an overview. Eur Rev Appl Psychol 54:119–135CrossRef Van de Vijver F, Tanzer NK (2004) Bias and equivalence in cross-cultural assessment: an overview. Eur Rev Appl Psychol 54:119–135CrossRef
23.
go back to reference Beattie KA, Bobba R, Bayoumi I, Chan D, Schabort I, Boulos P, Kean W, Oberid J, McCallum R, Ioannidis G, Papaioannou A, Cividino A (2008) Validation of the GALS musculoskeletal screening exam for use in primary care a pilot study. BMC Musculoeskelet Disord 9(115):1–8 Beattie KA, Bobba R, Bayoumi I, Chan D, Schabort I, Boulos P, Kean W, Oberid J, McCallum R, Ioannidis G, Papaioannou A, Cividino A (2008) Validation of the GALS musculoskeletal screening exam for use in primary care a pilot study. BMC Musculoeskelet Disord 9(115):1–8
24.
go back to reference Beattie KA, Macintyre NJ, Pierobon J, Coombs J, Horobetz D, Petric A, Pimm M, Kean W, Larché MJ, Cividino A (2011) The sensitivity, specificity and reliability of GALS (gait, arms, legs and spine) examination when used by physiotherapists and physiotherapy students to detect rheumatoid arthritis. Physiotherapy 97(3):196–202CrossRefPubMed Beattie KA, Macintyre NJ, Pierobon J, Coombs J, Horobetz D, Petric A, Pimm M, Kean W, Larché MJ, Cividino A (2011) The sensitivity, specificity and reliability of GALS (gait, arms, legs and spine) examination when used by physiotherapists and physiotherapy students to detect rheumatoid arthritis. Physiotherapy 97(3):196–202CrossRefPubMed
25.
go back to reference Fox RA, Dacre JE, Clark Cl, Scotland AD (2000) Impact medical students of incorporating GALS screen teaching into the medical school curriculum. Ann Rheum Dis 59(9):668–671CrossRefPubMedPubMedCentral Fox RA, Dacre JE, Clark Cl, Scotland AD (2000) Impact medical students of incorporating GALS screen teaching into the medical school curriculum. Ann Rheum Dis 59(9):668–671CrossRefPubMedPubMedCentral
26.
go back to reference Goff I, Bateman B, Myers A, Foster H (2010) Acceptability and practicality of musculoskeletal examination in acute general pediatric assessment. J Pediatr 156(4):657–662CrossRefPubMed Goff I, Bateman B, Myers A, Foster H (2010) Acceptability and practicality of musculoskeletal examination in acute general pediatric assessment. J Pediatr 156(4):657–662CrossRefPubMed
27.
go back to reference Smith E, Molyneux E, Heikens GT, Foster H (2012) Acceptability and practicality of pGALS in screening for rheumatic disease in Malawian children. Clin Rheumatol 31(4):647–653CrossRefPubMed Smith E, Molyneux E, Heikens GT, Foster H (2012) Acceptability and practicality of pGALS in screening for rheumatic disease in Malawian children. Clin Rheumatol 31(4):647–653CrossRefPubMed
28.
go back to reference Rowan AL, Jandial S, Myers A, Bateman B, Friswell M, Foster HE (2008) pGALS performs well in the hands of a medical student. Pediatr Rheumatol 6(Suppl 1):P152CrossRef Rowan AL, Jandial S, Myers A, Bateman B, Friswell M, Foster HE (2008) pGALS performs well in the hands of a medical student. Pediatr Rheumatol 6(Suppl 1):P152CrossRef
29.
go back to reference Jandial S, Rapley T, Foster H (2009) Current teaching of paediatric musculoskeletal medicine within UK medical schools a need for change. Rheumatology (Oxford) 48(5):587–590CrossRef Jandial S, Rapley T, Foster H (2009) Current teaching of paediatric musculoskeletal medicine within UK medical schools a need for change. Rheumatology (Oxford) 48(5):587–590CrossRef
30.
go back to reference Jandial S, Myers A, Wise E, Foster HE (2009) Doctors likely to encounter children with musculoskeletal complaints have low confidence in their clinical skills. J Pediatr 154(2):267–271CrossRefPubMed Jandial S, Myers A, Wise E, Foster HE (2009) Doctors likely to encounter children with musculoskeletal complaints have low confidence in their clinical skills. J Pediatr 154(2):267–271CrossRefPubMed
Metadata
Title
Cross-cultural validation of the paediatric Gait, Arms, Legs, Spine (pGALS) tool for the screening of musculoskeletal disorders in Mexican children
Authors
Luis Antonio Moreno-Torres
Adolfo Gabriel Hernández-Garduño
Carmen Araceli Arellano-Valdés
Aarón Salinas-Rodríguez
Nadina Rubio-Perez
Ingris Peláez-Ballestas
Publication date
01-04-2016
Publisher
Springer Berlin Heidelberg
Published in
Rheumatology International / Issue 4/2016
Print ISSN: 0172-8172
Electronic ISSN: 1437-160X
DOI
https://doi.org/10.1007/s00296-015-3386-y

Other articles of this Issue 4/2016

Rheumatology International 4/2016 Go to the issue