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

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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.

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References

  1. Eccleston C, Clinch J (2007) Adolescent chronic pain and disability: a review of the current evidence in assessment and treatment. Paediatr Child Health 12:117–120

    PubMed  PubMed Central  Google Scholar 

  2. 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) 43:1045–1049

    Article  CAS  Google Scholar 

  3. Perquin CW, Hazebroek-Kampschreur AA, Hunfeld JA et al (2000) Pain in children and adolescents: a common experience. Pain 87:51–58

    Article  CAS  PubMed  Google Scholar 

  4. 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

    Article  Google Scholar 

  5. Foster H, Kay L (2003) Examination skills in the assessment of the musculoskeletal system in children and adolescents. Curr Paediatr 13:341–344

    Article  Google Scholar 

  6. Foster H, Jandial S (2008) pGALS a screening examination of the musculoskeletal system in school-aged children. Collect Rep Rheum Dis 5:1–8

    Google Scholar 

  7. 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):373–377

    Article  PubMed  Google Scholar 

  8. Clinch J (2009) Recognizing and managing chronic musculoskeletal pain in childhood. Paediatr Child Health 19(8):381–387

    Article  Google Scholar 

  9. Doherty M, Dacre J, Dieppe P, Snaith M (1992) The GALS locomotor screen. Ann Rheum Dis 51:1165–1169

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. 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):709–716

    Article  CAS  PubMed  Google Scholar 

  11. 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

    Google Scholar 

  12. 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 42:315–323

    Article  PubMed  Google Scholar 

  13. Singh G, Atherya BH, Fries JF, Goldsmith DP (1994) Measurement of health status in children with juvenile rheumatoid arthritis. Arthritis Rheum 37(12):1761–1769

    Article  CAS  PubMed  Google Scholar 

  14. 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):1575–1581

    Article  PubMed  Google Scholar 

  15. 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):1113–1130

    Article  Google Scholar 

  16. 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, Washington

    Chapter  Google Scholar 

  17. 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

    Google Scholar 

  18. 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):1417–1432

    Article  CAS  PubMed  Google Scholar 

  19. Beaton D, Bombardier C, Guillemin F, Ferraz M (2000) Guidelines for the process of cross-cultural adaptation of self-report measures. Spine 25(24):3186–3191

    Article  CAS  PubMed  Google Scholar 

  20. Paediatric Gait Arms Spine (pGALS) Video demonstration. http://www.arthritisresearchuk.org/health-professionals-and-students/video-resourses/pgals.aspx

  21. 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):509–521

    Article  PubMed  Google Scholar 

  22. Van de Vijver F, Tanzer NK (2004) Bias and equivalence in cross-cultural assessment: an overview. Eur Rev Appl Psychol 54:119–135

    Article  Google Scholar 

  23. 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

    Google Scholar 

  24. 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):196–202

    Article  PubMed  Google Scholar 

  25. 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):668–671

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  26. Goff I, Bateman B, Myers A, Foster H (2010) Acceptability and practicality of musculoskeletal examination in acute general pediatric assessment. J Pediatr 156(4):657–662

    Article  PubMed  Google Scholar 

  27. 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):647–653

    Article  PubMed  Google Scholar 

  28. 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):P152

    Article  Google Scholar 

  29. 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):587–590

    Article  Google Scholar 

  30. 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):267–271

    Article  PubMed  Google Scholar 

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Correspondence to Ingris Peláez-Ballestas.

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Moreno-Torres, L.A., Hernández-Garduño, A.G., Arellano-Valdés, C.A. et al. Cross-cultural validation of the paediatric Gait, Arms, Legs, Spine (pGALS) tool for the screening of musculoskeletal disorders in Mexican children. Rheumatol Int 36, 495–503 (2016). https://doi.org/10.1007/s00296-015-3386-y

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