Reliability and Acceptability of Real-time Virtual Video Pediatric Gait, Arms, Legs and Spine (V-pGALS)
Condition: Musculoskeletal Abnormality; Pediatric
MeSH terms: Musculoskeletal Abnormalities
Study type: Interventional

Summary: 
      The use of telemedicine in musculoskeletal assessment has been historically low. The current
      COVID 19 global pandemic has forced a paradigm shift with many centers rapidly adopting
      virtual visits to conduct care resulting in rapid expansion of use of telemedicine amongst
      practices. Mayoclinic has published The Telemedicine Musculoskeletal Examination for adults.
      Paediatric Musculoskeletal Matters (PMM) has put video Pediatric Gait, Arms, Legs and Spine
      (V-pGALS) assessment sheet on their website. However, there is a lack of the acceptability
      and reliability of these tools. The aim of this study is to investigate acceptability and
      reliability of real-time virtual video Pediatric Gait, Arms, Legs and Spine (V-pGALS)
      assessment for musculoskeletal assessment of children for telemedicine visits.
    

Detailed description: 
      The use of telemedicine in musculoskeletal assessment has been historically low. The current
      COVID 19 global pandemic has forced a paradigm shift with many centers rapidly adopting
      virtual visits to conduct care resulting in rapid expansion of the use of telemedicine
      amongst practices. Mayoclinic has published The Telemedicine Musculoskeletal Examination for
      adults. 'Paediatric Musculoskeletal Matters' (PMM- www.pmmonline.org, is a free,
      evidence-based, and peer-reviewed open e-resource for pediatric musculoskeletal (MSK)
      medicine targeting non-MSK specialists. They have also published video Pediatric Gait, Arms,
      Legs and Spine (V-pGALS), an assessment sheet for telemedicine visits on their webpage.
      However, there is a lack of the acceptability and reliability of these tools. The aim of this
      study is to investigate acceptability and reliability of real-time virtual video Pediatric
      Gait, Arms, Legs and Spine (V-pGALS) assessment for musculoskeletal assessment of children
      for telemedicine visits. For this purpose, children at between the ages of 7-18 who admitted
      the Pediatric Rehabilitation outpatient clinic of Department of Physical Medicine and
      Rehabilitation of Marmara University School of Medicine will be recruited to the study. They
      will be evaluated via V-pGALS face to face on the day of admission and the physiatrist will
      record the diagnosis if there is. Within 24 hours the child will be reevaluated via V-pGALS
      by using Zoom application virtually. The acceptability of V-pGALS examination to the child
      and parents in terms of the duration and additional discomfort caused was evaluated using
      visual analog scale with smiley faces (0-10, 0 for full acceptability).
    

Intervention name(s): video Pediatric Gait, Arms, Legs and Spine (V-pGALS)
Intervention type(s): Diagnostic Test
Intervention description(s): The Video-pGALS includes maneuvers from pediatric regional examination of the musculoskeletal system (pREMS) and derived from the pediatric gait arms legs spine examination assessment which is a validated simple basic musculoskeletal (MSK) examination for children. V-pGALS offers a structured approach to a cursory overview MSK exam with a focus on range of movement and symmetry. Utilizing the parent or caregiver to feel the joint in question for obvious warmth/ swelling or to palpate for point of maximal tenderness can add important information.
Intervention model: Single Group Assignment
Intervention model description: Children between the ages of 7-18 who admit pediatric rehabilitation outpatient clinic
Masking: None (Open Label)
Primary purpose: Diagnostic
Keywords: telemedicine; pandemic; video Pediatric Gait, Arms, Legs and Spine (V-pGALS); pediatric examination; musculoskeletal examination; reliability; acceptability