School of Allied Health, University of Limerick, Limerick, Ireland.
Physical Activity for Health Centre, University of Limerick, Limerick, Ireland.
PLoS One. 2022 Sep 9;17(9):e0274349. doi: 10.1371/journal.pone.0274349. eCollection 2022.
Telehealth could enhance rehabilitation for people with chronic health conditions. This review examined the psychometric properties of performance-based measures of physical function administered via telehealth among people with chronic health conditions using the Consensus-Based Standards for the Selection of Health Measurement Instruments (COSMIN) approach.
This systematic review was registered with Prospero (Registration number: CRD42021262547). Four electronic databases were searched up to June 2022. Study quality was evaluated by two independent reviewers using the COSMIN risk of bias checklist. Measurement properties were rated by two independent reviewers in accordance with COSMIN guidance. Results were summarised according to the COSMIN approach and the modified GRADE approach was used to grade quality of the summarised evidence.
Five articles met the eligibility criteria. These included patients with Parkinson's Disease (n = 2), stroke (n = 1), cystic fibrosis (n = 1) and chronic heart failure (n = 1). Fifteen performance-based measures of physical function administered via videoconferencing were investigated, spanning measures of functional balance (n = 7), other measures of general functional capacity (n = 4), exercise capacity (n = 2), and functional strength (n = 2). Studies were conducted in Australia (n = 4) and the United States (n = 1). Reliability was reported for twelve measures, with all twelve demonstrating sufficient inter-rater and intra-rater reliability. Criterion validity for all fifteen measures was reported, with eight demonstrating sufficient validity and the remaining seven demonstrating indeterminate validity. No studies reported data on measurement error or responsiveness.
Several performance-based measures of physical function across the domains of exercise capacity, strength, balance and general functional capacity may have sufficient reliability and criterion validity when administered via telehealth. However, the evidence is of low-very low quality, reflecting the small number of studies conducted and the small sample sizes included in the studies. Future research is needed to explore the measurement error, responsiveness, interpretability and feasibility of these measures administered via telehealth.
远程医疗可以增强慢性病患者的康复效果。本研究采用共识基础的健康测量仪器选择标准（COSMIN）方法，评估了通过远程医疗进行的慢性疾病患者身体机能表现测量的心理测量特性。
本系统评价已在 PROSPERO（注册号：CRD42021262547）上注册。截至 2022 年 6 月，共检索了四个电子数据库。两位独立评审员使用 COSMIN 偏倚风险检查表评估研究质量。根据 COSMIN 指南，由两位独立评审员对测量特性进行了评估。结果根据 COSMIN 方法进行了总结，并使用改良 GRADE 方法对总结证据的质量进行了分级。
有五篇文章符合入选标准。这些文章包括帕金森病患者（n = 2）、中风患者（n = 1）、囊性纤维化患者（n = 1）和慢性心力衰竭患者（n = 1）。通过视频会议共研究了 15 种身体机能表现测量，涵盖了功能平衡测量（n = 7）、其他一般功能能力测量（n = 4）、运动能力测量（n = 2）和功能力量测量（n = 2）。研究在澳大利亚（n = 4）和美国（n = 1）进行。12 项测量的可靠性得到了报告，所有 12 项测量均具有足够的评分者间和评分者内可靠性。15 项测量的效标效度均得到了报告，其中 8 项测量具有足够的有效性，其余 7 项测量的有效性不确定。没有研究报告测量误差或反应性的数据。
在通过远程医疗进行的运动能力、力量、平衡和一般功能能力等领域的多项身体机能表现测量，可能具有足够的可靠性和效标效度。然而，证据质量为低-极低，反映了研究数量较少，且研究纳入的样本量较小。未来需要研究来探索这些通过远程医疗进行的测量的测量误差、反应性、可解释性和可行性。
