Venkataraman K, Amis K, Landerman LR, Caves K, Koh GC, Hoenig H. Teleassessment of Gait and Gait Aids: Validity and Interrater Reliability.
Phys Ther 2020;
100:708-717. [PMID:
31984420 PMCID:
PMC7439231 DOI:
10.1093/ptj/pzaa005]
[Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 04/02/2019] [Accepted: 08/06/2019] [Indexed: 01/19/2023]
Abstract
BACKGROUND
Gait and mobility aid assessments are important components of rehabilitation. Given the increasing use of telehealth to meet rehabilitation needs, it is important to examine the feasibility of such assessments within the constraints of telerehabilitation.
OBJECTIVE
The objective of this study was to examine the reliability and validity of the Tinetti Performance-Oriented Mobility Assessment gait scale (POMA-G) and cane height assessment under various video and transmission settings to demonstrate the feasibility of teleassessment.
DESIGN
This repeated-measures study compared the test performances of in-person, slow motion (SM) review, and normal-speed (NS) video ratings at various fixed frame rates (8, 15, and 30 frames per second) and bandwidth (128, 384, and 768 kB/s) configurations.
METHODS
Overall bias, validity, and interrater reliability were assessed for in-person, SM video, and NS video ratings, with SM video rating as the gold standard, as well as for different frame rate and bandwidth configurations within NS videos.
RESULTS
There was moderate to good interrater reliability for the POMA-G (intraclass correlation coefficient [ICC] = 0.66-0.77 across all configurations) and moderate validity for in-person (β = 0.62; 95% confidence interval [CI] = 0.37-0.87) and NS video (β = 0.74; 95% CI = 0.67-0.80) ratings compared with the SM video rating. For cane height, interrater reliability was good (ICC = 0.66-0.77), although it was significantly lower at the lowest frame rate (8 frames per second) (ICC = 0.66; 95% CI = 0.54-0.76) and bandwidth (128 kB/s) (ICC = 0.69; 95% CI = 0.57-0.78) configurations. Validity for cane height was good for both in-person (β = 0.80; 95% CI = 0.62-0.98) and NS video (β = 0.86; 95% CI = 0.81-0.90) ratings compared with SM video rating.
LIMITATIONS
Some lower frame rate and bandwidth configurations may limit the reliability of remote cane height assessments.
CONCLUSIONS
Teleassessment for POMA-G and cane height using typically available internet and video quality is feasible, valid, and reliable.
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