Department of Physiotherapy, Faculty of Health Sciences, University of Granada, Spain.
Oncological Radiotherapy Service of the "Hospital PTS", Clínico San Cecilio University Hospital, Spain.
J Telemed Telecare. 2024 May;30(4):668-674. doi: 10.1177/1357633X221079543. Epub 2022 Feb 25.
Upper limb disability can limit the quality of life of lung cancer survivors. The COVID-19 era has required a finding of alternatives to attend the monitoring of presented disturbances with the minor risk of spread. Tele-assessment offers new possibilities for clinical assessment demonstrating good reliability compared to traditional face-to-face assessment in a variety of patients. No previous study has applied this type of assessment in lung cancer survivors. For this reason, the aim of this study was to evaluate the level of agreement between upper limb disability assessment using tele-assessment and the face-to-face method in lung cancer survivors.
A reliability study was conducted with 20 lung cancer survivors recruited from the Oncological Radiotherapy Service of the "Hospital PTS" (Granada). Patients attended a session for clinical face-to-face and real-time online tele-assessment. The main outcome measurements of the study included upper limb function (shirt task) and musculoskeletal disturbances (active range of movement and trigger points), and these outcomes were recorded by two independent researchers.
The outcome measures showed good agreement between both assessments. The active range of movement presented heterogeneous results, being excellent reliability ( > 0.75) in extension, internal rotation, homolateral adduction, and contralateral abduction, good (0.4 < < 0.75) for flexion, homolateral abduction, contralateral adduction and contralateral external rotation, and poor ( < 0.4) for homolateral external rotation. The measure evaluating upper limb function and trigger points show the highest interrater reliability with confidence interval lower limits ≥0.99.
The tele-assessment of upper limb function and musculoskeletal disorders of lung cancer survivors present a good interrater reliability compared to face-to-face assessment. It could be useful for monitoring the disability presented by cancer survivors whose access is difficult by the residential situation, physical limitations or the risk of COVID-19 spread.
上肢残疾会限制肺癌幸存者的生活质量。在 COVID-19 时代，需要找到替代方法来监测出现的障碍，同时将传播风险降到最低。远程评估为临床评估提供了新的可能性，与各种患者的传统面对面评估相比，具有良好的可靠性。以前没有研究将这种评估类型应用于肺癌幸存者。因此，本研究的目的是评估使用远程评估和面对面方法评估肺癌幸存者上肢残疾的水平之间的一致性。
对“PTS 医院”（格拉纳达）肿瘤放射治疗科的 20 名肺癌幸存者进行了一项可靠性研究。患者参加了一次临床面对面和实时在线远程评估。该研究的主要结果测量包括上肢功能（衬衫任务）和肌肉骨骼障碍（主动运动范围和触发点），这些结果由两名独立的研究人员记录。
两种评估方法的结果测量具有良好的一致性。主动运动范围呈现出不同的结果，伸展、内旋、同侧内收和对侧外展具有极好的可靠性（>0.75），屈曲、同侧外展、对侧内收和对侧外旋具有良好的可靠性（0.4<0.75），同侧外旋的可靠性较差（<0.4）。评估上肢功能和触发点的测量结果具有最高的组内相关性，置信区间下限≥0.99。
与面对面评估相比，肺癌幸存者上肢功能和肌肉骨骼疾病的远程评估具有较好的组内相关性。对于那些由于居住情况、身体限制或 COVID-19 传播风险而难以接触的癌症幸存者来说，这种评估可能是有用的，可以监测他们的残疾情况。
