Telemedicine in pediatric rheumatology: the video pediatric gait, arms, legs, and spine (v-pGALS)

Abstract

Background/aim: Video pediatric gait, arms, leg, and spine (v-pGALS) is a virtual application of pediatric gait, arms, leg, and spine (pGALS) examination performed by video. We aimed to verify the applicability, validity, and accuracy of the Turkish translation of the v-pGALS in a large pediatric patient cohort.Materials and methods: Children aged 4-18 years were included between May and June 2022. A hands-on physical examination and v-pGALS were performed. Demographics, active symptoms, physical examination findings, diagnosis, and v-pGALS findings were recorded. The acceptability of v-pGALS by the parent/patient was measured using a visual analog scale (VAS), in terms of additional distress and duration.Results: 102 patients (median age 12.41 years) were included. Juvenile idiopathic arthritis (JIA) was the most common diagnosis. The median duration of v-pGALS was 7 minutes. Abnormal v-pGALS was detected in 25 patients while the hands-on physical examination was abnormal in 27 patients. Scoliosis and pes planus were missed in v-pGALS. Both children and parents gave a median VAS score of 0 for additional discomfort and duration. That is, the duration of v-pGALS was acceptable for the majority of the patients/parents ≥98%, and ≥98% mentioned that it caused little/no discomfort. Video pGALS’s sensitivity and specificity were 92.6% and 100% for the detection of musculoskeletal (MSK) abnormalities, respectively.Conclusion: The v-pGALS is an applicable, accurate, and practical tool for evaluating MSK problems in children. The Turkish translation was also conveniently acceptable.