{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,17]],"date-time":"2026-01-17T04:00:45Z","timestamp":1768622445844,"version":"3.49.0"},"reference-count":27,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2024,8,1]],"date-time":"2024-08-01T00:00:00Z","timestamp":1722470400000},"content-version":"vor","delay-in-days":213,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100004339","name":"Sanofi","doi-asserted-by":"publisher","award":["GZ-2014-11255"],"award-info":[{"award-number":["GZ-2014-11255"]}],"id":[{"id":"10.13039\/100004339","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,6,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>Healthcare professionals (HCPs) need to identify potentially serious musculoskeletal (MSK) presentations in children and refer them to specialists appropriately. Our aim was to develop \u2018pGALSplus\u2019 (paediatric gait, arms, legs and spine plus) to support clinical assessment, aid decision-making and assess feasibility and acceptability in exemplar MSK pathologies.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>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\u2009=\u200922) and virtual event (n\u2009=\u200913).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Feasibility was tested in 45 children (JIA, n\u2009=\u200910; MPS, n\u2009=\u20096; MD, n\u2009=\u20099; DCD, n\u2009=\u200910; HCs, n\u2009=\u200910). Overall the assessment was achievable in the target age range (2\u201310\u2009years) and quick to complete [median 12\u2009min (range 8\u201320)], 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.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>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.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/rap\/rkae089","type":"journal-article","created":{"date-parts":[[2024,8,1]],"date-time":"2024-08-01T21:01:36Z","timestamp":1722546096000},"source":"Crossref","is-referenced-by-count":1,"title":["The development of pGALSplus: evaluating feasibility and acceptability of an assessment to facilitate the identification and triage of children with musculoskeletal presentations"],"prefix":"10.1093","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-0077-2541","authenticated-orcid":false,"given":"Vicky","family":"Mercer","sequence":"first","affiliation":[{"name":"Translational and Clinical Research Institute, Newcastle University , Newcastle upon Tyne, UK"},{"name":"Children\u2019s Physiotherapy, South Tyneside and Sunderland NHS Foundation Trust , South Shields, UK"},{"name":"Department of Sport, Exercise and Rehabilitation, Faculty of Health and Life Sciences, Northumbria University , Newcastle upon Tyne, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicola","family":"Smith","sequence":"additional","affiliation":[{"name":"Translational and Clinical Research Institute, Newcastle University , Newcastle upon Tyne, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michela","family":"Guglieri","sequence":"additional","affiliation":[{"name":"John Walton Muscular Dystrophy Research Centre, Newcastle University and Newcastle Hospitals NHS Foundation Trust , Newcastle upon Tyne, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simon A","family":"Jones","sequence":"additional","affiliation":[{"name":"Manchester Centre for Genomic Medicine, Saint Mary\u2019s Hospital , Manchester, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeremy R","family":"Parr","sequence":"additional","affiliation":[{"name":"Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK"},{"name":"Great North Children\u2019s Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust , Newcastle upon Tyne, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Helen E","family":"Foster","sequence":"additional","affiliation":[{"name":"Emerita Professor Paediatric Rheumatology, Population Health Sciences Institute, Newcastle University , Newcastle upon Tyne, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sharmila","family":"Jandial","sequence":"additional","affiliation":[{"name":"School of Medicine, Newcastle University , Newcastle upon Tyne, UK"},{"name":"Paediatric Rheumatology, Great North Children\u2019s Hospital , Newcastle upon Tyne, 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