Validation of Physical Mobility Measures using Zoom

Abstract

Background: Telehealth is increasingly being used to solve health care access issues. Current commonly used mobility assessments, valid when performed in person, however, have not been validated when assessed using telehealth by a remote practitioner.
 
Aims: To investigate the validity of commonly used physical assessments when administered via Zoom for the purpose of telehealth.
 
Methods: Participants in a controlled environment were instructed to complete assessments in view of a laptop by a remote practitioner. Timed up and go (TUG), 5-time repeat Sit to Stand (STS-5), 3 and 4 meter walks (3MW, 4MW), Grip Strength (GST), Functional reach (FRT) and static balance tests (SBT) were assessed concurrently by the telehealth researcher connected via Zoom and a researcher in the controlled environment. Interrater reliability and Bland-Altman analysis were conducted.
 
Results: 30 healthy people (age 36.2±12.5 years) were recruited. The GST & FRT produced excellent reliability (ICC's: 0.99 and 0.99) The STS-5 & 4MW good reliability (ICC's: 0.84 and 0.76), the TUG  moderate reliability  (ICC: 0.64), the 3MW poor reliability (ICC: 0.-0.46). Interrater reliability and Bland-Altman could not be conducted for the SBT. Biases for longer times assessed over telehealth were observed for STS-5 (1.2s), TUG (0.98s), and 3MW (1.25s).  

Conclusions: Small consistent biases were observed in timed mobility assessments with increased times when assessed via telehealth. Other physical outcome measures demonstrated good to excellent reliability between in person and telehealth methods. This methodology may be useful in clinical populations. However, new normative data for reaction time dependent telehealth outcome measures are needed.