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Lookup NU author(s): Vicky Mercer, Professor Michela GuglieriORCiD, Professor Jeremy Parr, Emerita Professor Helen Foster, Dr Sharmila JandialORCiD
This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).
© 2024 The Author(s). Objectives: Healthcare professionals (HCPs) need to identify potentially serious musculoskeletal (MSK) presentations in children and refer them to specialists appropriately. Our aim was to develop 'pGALSplus' (paediatric gait, arms, legs and spine plus) to support clinical assessment, aid decision-making and assess feasibility and acceptability in exemplar MSK pathologies. Methods: We used a three-phase mixed methods approach: phase 1, preliminary stakeholder engagement and scoping review to propose pGALSplus; phase 2, iterative development of pGALSplus involving an expert working group; and phase 3, testing the feasibility of pGALSplus in exemplar MSK conditions [JIA, mucopolysaccharidoses (MPS), muscular dystrophy (MD), developmental coordination disorder (DCD) and healthy controls (HCs)]. The final pGALSplus was derived from analysis of phase 3 data and feedback from HCPs, families and expert consensus input from an international e-survey (n = 22) and virtual event (n = 13). Results: Feasibility was tested in 45 children (JIA, n = 10; MPS, n = 6; MD, n = 9; DCD, n = 10; HCs, n = 10). Overall the assessment was achievable in the target age range (2-10 years) and quick to complete [median 12 min (range 8-20)], with high acceptability from families. Expert feedback deemed pGALSplus to be very useful and of particular use to non-specialists in MSK paediatrics. The final pGALSplus comprises 26 clinical observations/skills with a colour-coding approach to aid decision-making and identification of more serious MSK presentations and additional resources to support its use in clinical practice. Conclusions: pGALSplus is a novel evidence- and consensus-based assessment building on pGALS, with high acceptability and feasibility. As community-based MSK assessment in children becomes more established, we propose that pGALSplus will facilitate and inform decision-making to promote access to specialist care.
Author(s): Mercer V, Smith N, Guglieri M, Jones SA, Parr JR, Foster HE, Jandial S
Publication type: Article
Publication status: Published
Journal: Rheumatology Advances in Practice
Year: 2024
Volume: 8
Issue: 3
Online publication date: 01/08/2024
Acceptance date: 15/07/2024
Date deposited: 27/08/2024
ISSN (electronic): 2514-1775
Publisher: Oxford University Press
URL: https://doi.org/10.1093/rap/rkae089
DOI: 10.1093/rap/rkae089
Data Access Statement: The data underlying this article are available in the article and in its online supplementary material.
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