School of Physiotherapy, Division of Health Sciences, University of Otago, Dunedin, New Zealand.
School of Physiotherapy, Division of Health Sciences, University of Otago, Dunedin, New Zealand; Department of Medicine, Otago Medical School, University of Otago, Dunedin, New Zealand.
Exp Gerontol. 2022 Jun 1;162:111747. doi: 10.1016/j.exger.2022.111747. Epub 2022 Feb 25.
The use of telehealth has increased since the COVID-19 pandemic; however, the lack of reliable and valid tools to measure balance and gait remotely makes assessing these outcomes difficult. Thus, we investigated whether balance and gait measures used in clinical practice are reliable and valid when assessed remotely through telehealth.
In this pilot study, we investigated 15 healthy older adults who performed validated tests: Timed Up and Go simple, dual cognitive and motor tasks; Berg Balance Scale; Functional Gait Assessment and Dynamic Gait Index. The tests were assessed on two dates: (i) face-to-face, (ii) and remotely, via videoconference between 7 and 14 days after the initial assessment. Participants also undertook the Physiological Profile Assessment (PPA) to assess their risk of falling. Reliability was measured using intraclass correlation (ICC) two-way mixed with absolute agreement to contrast the score of the assessments undertaken face-to-face and remotely in real-time and recorded. We also assessed inter-rater reliability. Criterion validity was measured using Pearson correlation between the tests that were undertaken remotely and PPA.
All tests showed good reliability between face-to-face and real-time telehealth (ICC = 0.79-0.87) and face-to-face and recorded telehealth (ICC = 0.78-0.88) assessments and good to excellent inter-rater reliability (ICC = 0.80-1.00). Correlation between the tests and PPA were significantly (p < 0.05) moderate for real-time (r = -0.68-0.64) and recorded (r = -0.69-0.71) telehealth assessments.
The good reliability between face-to-face and remote measurements together with moderate validity of these measures to assess fall risk suggest that health professionals could use these measures to evaluate the balance and gait of healthy older adults remotely.
自 COVID-19 大流行以来，远程医疗的使用有所增加；然而，缺乏可靠和有效的工具来远程测量平衡和步态，使得评估这些结果变得困难。因此，我们研究了在通过远程医疗进行远程评估时，临床实践中使用的平衡和步态测量是否可靠和有效。
在这项初步研究中，我们调查了 15 名健康的老年人，他们进行了经过验证的测试：计时起立行走简单、双重认知和运动任务；伯格平衡量表；功能性步态评估和动态步态指数。这些测试在两天进行评估：（i）面对面，（ii）以及在初始评估后 7 至 14 天通过视频会议远程进行。参与者还接受了生理概况评估（PPA）以评估他们跌倒的风险。使用双向混合的组内相关系数（ICC）和绝对一致性来衡量面对面和实时记录的评估得分，以衡量可靠性。我们还评估了评分者间可靠性。效标效度通过远程进行的测试与 PPA 之间的 Pearson 相关性进行衡量。
所有测试在面对面和实时远程医疗（ICC=0.79-0.87）以及面对面和记录远程医疗（ICC=0.78-0.88）评估之间均表现出良好的可靠性，并且评分者间可靠性良好至极好（ICC=0.80-1.00）。远程医疗实时（r=-0.68-0.64）和记录（r=-0.69-0.71）评估中，测试与 PPA 之间的相关性均具有显著意义（p<0.05）。
面对面和远程测量之间的良好可靠性以及这些测量评估跌倒风险的中等有效性表明，医疗保健专业人员可以远程使用这些测量来评估健康老年人的平衡和步态。
