Hwang Rita, Mandrusiak Allison, Morris Norman R, Peters Robyn, Korczyk Dariusz, Russell Trevor
1 Department of Physiotherapy, Princess Alexandra Hospital, Metro South Health, Queensland, Australia.
2 Physiotherapy, School of Health and Rehabilitation Sciences, The University of Queensland, Queensland, Australia.
J Telemed Telecare. 2017 Feb;23(2):225-232. doi: 10.1177/1357633X16634258. Epub 2016 Jul 9.
Introduction This study aimed to determine the validity and reliability of video-based telerehabilitation assessments in patients with heart failure. Methods Seventeen consecutive participants (mean age 69 years, SD 12 years and 88% males) undertook assessments of three functional tests via both telerehabilitation and face-to-face approaches, on the same day. The assessment order was randomised and conducted by independent assessors. Outcome measures included functional tests: timed up and go (time), six-minute walk (distance), grip strength (kilograms); system usability scale to rate participant experience with telerehabilitation assessment; and number of technical issues encountered. Validity and inter- and intra-rater reliability of telerehabilitation assessments were examined using limits of agreement, intra-class correlation coefficients (ICC), and paired t-tests. Results The limits of agreement for telerehabilitation assessments were within the clinically acceptable limits for timed up and go and grip strength. Telerehabilitation assessments for all functional tests were strongly associated with face-to-face assessments, with ICCs of between 0.85 and 0.96. Inter- and intra-rater reliability of telerehabilitation assessments for all functional tests were excellent (all ICC > 0.95). The mean (SD) system usability scale score was 85 (15)/100. Some incidences of Internet drop-outs, video freezing and auditory fading occurred. Discussion The use of telehealth for the assessment of functional exercise capacity appears to be valid and reliable in patients with heart failure.
引言 本研究旨在确定基于视频的远程康复评估在心力衰竭患者中的有效性和可靠性。方法 17名连续入选的参与者（平均年龄69岁，标准差12岁，男性占88%）在同一天通过远程康复和面对面两种方式进行了三项功能测试的评估。评估顺序是随机的，由独立评估者进行。结果指标包括功能测试：计时起立行走（时间）、六分钟步行（距离）、握力（千克）；系统可用性量表用于评估参与者对远程康复评估的体验；以及遇到的技术问题数量。使用一致性界限、组内相关系数（ICC）和配对t检验来检验远程康复评估的有效性以及评估者间和评估者内的可靠性。结果 远程康复评估的一致性界限在计时起立行走和握力的临床可接受范围内。所有功能测试的远程康复评估与面对面评估密切相关，ICC在0.85至0.96之间。所有功能测试的远程康复评估的评估者间和评估者内可靠性都非常好（所有ICC＞0.95）。系统可用性量表的平均（标准差）得分是85（15）/100。出现了一些网络掉线、视频冻结和声音衰减的情况。讨论 在心力衰竭患者中，使用远程医疗评估功能运动能力似乎是有效且可靠的。
