Remote assessment of gait and balance of people with Parkinson’s disease – a reliability study

Abstract

Background: Due to COVID-19, the use of telehealth increased exponentially. However, despite this increase in the use of telehealth, clinicians lack reliable tools to assess the balance and gait of people with Parkinson’s disease (PD).

Aims: investigate the reliability of balance and gait assessments undertaken remotely via telehealth in people with PD.

Methods: 29 people with PD performed 14 tests of balance and gait twice: (i) face-to-face, and (ii) remotely, via videoconference (which was also recorded) between 7 and 14 days after. The tests included items from the Berg Balance Scale, Functional Gait Assessment, and the Timed-Up-And-Go. We compared face-to-face and live videoconference performance to obtain assessment reliability. One assessor rated the recording at least two weeks after the live videoconference to obtain intra-rater reliability. Another assessor rated the recording in order to obtain inter-rater reliability. Reliability was measured using either intraclass correlation (ICC) two-way mixed with absolute agreement (continuous measures) or Fleiss multi-rater Kappa test (ordinal measures).

Results: Most tests showed moderate to very good assessment reliability between face-to-face and live telehealth (ICC=0.505-1), between face-to-face and recorded telehealth (ICC=0.503-1) and for the inter-rater reliability between the recorded telehealth assessments (ICC=0.557-1). Reliability appeared to be higher in tests involving quantitative rather than qualitative measures of performance. A ceiling effect was noted in some tests where all participants completed tests with maximum scores in both face-to-face and remote assessments.

Conclusions: This study supports the feasibility of some remote assessments via telehealth for people with PD.