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Title: Mobility-Focused Physical Outcome Measures Over Telecommunication Technology (Zoom): Intra and Interrater Reliability Trial.
Austin Authors: Bird, Marie-Louise;Peel, Felix;Schmidt, Matt;Fini, Natalie A;Ramage, Emily;Sakakibara, Brodie M;Simpson, Dawn B;Mather, Carey;Cadilhac, Dominique A;Ahuja, Kiran D K;Bridgman, Heather;English, Coralie
Affiliation: The Florey Institute of Neuroscience and Mental Health
Department of Physical Therapy, University of British Columbia, Vancouver, BC, Canada..
School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, Australia..
School of Health Sciences, College of Health and Medicine, University of Tasmania, Hobart, Australia..
Physiotherapy Department, University of Melbourne, Melbourne, Australia..
School of Health Sciences, University of Newcastle, Callaghan, Australia..
School of Health Sciences and Priority Research Centre for Stroke and Brain Injury, University of Newcastle, Callaghan, Australia..
Heart and Stroke Research Program, Hunter Medical Research Institute, Newcastle, Australia..
Translational Public Health and Evaluation Division, Stroke and Ageing Research, Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Heidelberg, Australia..
Occupational Science and Occupational Therapy, University of British Columbia, Kelowna, BC, Canada..
Issue Date: 22-Aug-2022 2022
Publication information: JMIR Rehabilitation and Assistive Technologies 2022; 9(3): e38101
Abstract: Rehabilitation provided via telehealth offers an alternative to currently limited in-person health care. Effective rehabilitation depends on accurate and relevant assessments that reliably measure changes in function over time. The reliability of a suite of relevant assessments to measure the impact of rehabilitation on physical function is unknown. We aimed to measure the intrarater reliability of mobility-focused physical outcome measures delivered via Zoom (a commonly used telecommunication platform) and interrater reliability, comparing Zoom with in-person measures. In this reliability trial, healthy volunteers were recruited to complete 7 mobility-focused outcome measures in view of a laptop, under instructions from a remotely based researcher who undertook the remote evaluations. An in-person researcher (providing the benchmark scores) concurrently recorded their scores. Interrater and intrarater reliability were assessed for Grip Strength, Functional Reach Test, 5-Time Sit to Stand, 3- and 4-Meter Walks and Timed Up and Go, using intraclass correlation coefficients (ICC) and Bland-Altman plots. These tests were chosen because they cover a wide array of physical mobility, strength, and balance constructs; require little to no assistance from a clinician; can be performed in the limits of a home environment; and are likely to be feasible over a telehealth delivery mode. A total of 30 participants (mean age 36.2, SD 12.5 years; n=19, 63% male) completed all assessments. Interrater reliability was excellent for Grip Strength (ICC=0.99) and Functional Reach Test (ICC=0.99), good for 5-Time Sit to Stand (ICC=0.842) and 4-Meter Walk (ICC=0.76), moderate for Timed Up and Go (ICC=0.64), and poor for 3-Meter Walk (ICC=-0.46). Intrarater reliability, accessed by the remote researcher, was excellent for Grip Strength (ICC=0.91); good for Timed Up and Go, 3-Meter Walk, 4-Meter Walk, and Functional Reach (ICC=0.84-0.89); and moderate for 5-Time Sit to Stand (ICC=0.67). Although recorded simultaneously, the following time-based assessments were recorded as significantly longer via Zoom: 5-Time Sit to Stand (1.2 seconds), Timed Up and Go (1.0 seconds), and 3-Meter Walk (1.3 seconds). Untimed mobility-focused physical outcome measures have excellent interrater reliability between in-person and telehealth measurements. Timed outcome measures took approximately 1 second longer via Zoom, reducing the reliability of tests with a shorter duration. Small time differences favoring in-person attendance are of a similar magnitude to clinically important differences, indicating assessments undertaken using telecommunications technology (Zoom) cannot be compared directly with face-to-face delivery. This has implications for clinicians using blended (ie, some face-to-face and some via the internet) assessments. High intrarater reliability of mobility-focused physical outcome measures has been demonstrated in this study.
DOI: 10.2196/38101
Journal: JMIR Rehabilitation and Assistive Technologies
PubMed URL: 35994327
PubMed URL:
ISSN: 2369-2529
Type: Journal Article
Subjects: Zoom
mobile health
physical function
Appears in Collections:Journal articles

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