School of Rehabilitation Sciences, McMaster University, Hamilton, Ontario, Canada.
Department of Kinesiology, McMaster University, Hamilton, Ontario, Canada.
Phys Ther. 2022 Aug 4;102(8). doi: 10.1093/ptj/pzac078.
For individuals who face barriers to care assessment, there is a need for remote administration or self-administration of physical performance measures that assess mobility to determine current functional status and to monitor and predict future changes in functional status. The primary purpose of this review is to evaluate the available measurement properties of scores for remotely or self-administered lower extremity mobility performance measures in adults. This review also outlines the test procedures and population suitability of these measures.
Data sources were Ovid MEDLINE, Ovid Embase, EBSCOhost CINAHL, Ovid AMED, and Cochrane CENTRAL-which were searched from inception to January 26, 2021-and the reference lists of relevant studies. Two individuals independently screened studies that assessed at least 1 prespecified measurement property of scores for a remote and/or self-administered lower extremity physical performance measure assessing mobility in an adult population. Two individuals independently extracted data on study characteristics, measurement properties, feasibility, and interpretability using piloted extraction forms. The COSMIN (COnsensus-based Standards for the selection of health Measurement INstruments) Risk of Bias tool was used to assess methodological quality. Data were qualitatively summarized, and results were compared against COSMIN's criteria for good measurement properties. Level of evidence was determined using COSMIN's modified GRADE approach.
Fourteen studies detailing 19 outcome measures were included. Many studies displayed "sufficient" measurement properties based on COSMIN's criteria; however, risk of bias for most of the included studies was rated adequate or doubtful.
Clinicians and researchers can consider the measurement properties of scores and feasibility of different approaches presented in this review when determining how to assess or monitor mobility in adult populations.
Assessing mobility via remote or self-administered physical performance measures in adult populations appears to be feasible using a variety of methods including simple tools (chair, stopwatch), videoconferencing, and smartphone applications. This strategy may be particularly valuable for self-management of chronic conditions and decreasing barriers to accessing care.
对于面临护理评估障碍的个体，需要远程管理或自我管理身体机能测量，以评估移动能力，从而确定当前的功能状态，并监测和预测未来功能状态的变化。本研究的主要目的是评估远程或自我管理的下肢移动能力性能测量的评分的现有测量性能。本综述还概述了这些措施的测试程序和人群适用性。
数据来源为 Ovid MEDLINE、Ovid Embase、EBSCOhost CINAHL、Ovid AMED 和 Cochrane CENTRAL，检索时间从建库至 2021 年 1 月 26 日，并查阅了相关研究的参考文献列表。两名研究人员独立筛选了至少评估 1 项远程和/或自我管理的下肢身体机能测量的评分的指定测量性能的研究。两名研究人员独立使用试点提取表格提取研究特征、测量性能、可行性和可解释性的数据。COSMIN（健康测量工具选择的共识标准）偏倚风险工具用于评估方法学质量。定性总结数据，并根据 COSMIN 的良好测量性能标准对结果进行比较。使用 COSMIN 改良的 GRADE 方法确定证据水平。
纳入了 14 项详细描述了 19 项结果指标的研究。根据 COSMIN 的标准，许多研究显示出“足够”的测量性能；然而，纳入研究的偏倚风险大多被评为适当或可疑。
当确定如何评估或监测成年人群的移动能力时，临床医生和研究人员可以考虑本综述中介绍的不同方法的评分和可行性。
通过远程或自我管理的身体机能测量来评估成年人群的移动能力，使用各种方法似乎是可行的，包括简单的工具（椅子、秒表）、视频会议和智能手机应用程序。这种策略对于慢性病的自我管理和减少获取护理的障碍可能特别有价值。
