da Costa Aline Barbosa, Freire Bruno, da Silva Tayara Gaspar, Michaelsen Stella Maris
Department of Physical Therapy, Motor Control Laboratory (LADECOM), Centre of Healthy and Sport Sciences, University of Santa Catarina State, Florianópolis, Santa Catarina, Brazil.
J Neurol Phys Ther. 2025 Apr 1;49(2):65-73. doi: 10.1097/NPT.0000000000000506. Epub 2024 Dec 27.
Telerehabilitation represents an alternative for individuals who have difficulty accessing services to receive care. Therefore, telerehabilitation measures must be studied for their reliability and validity. This study evaluated the validity and reliability of the videoconference-based Berg Balance Scale assessment in stroke survivors.
Thirty-one stroke survivors were assessed. Rater A conducted in-person and remote assessments via videoconferencing at 2 different times (test-retest), and rater B conducted an assessment using the second recording made remotely. The validity and agreement between the in-person and remote assessments were analyzed using the Pearson's correlation coefficient and the Bland-Altman plots limits of agreement (LoA), respectively. Test-retest and inter-rater reliability were analyzed using the intraclass correlation coefficient (ICC) with a 95% confidence interval (95% CI), and individual item reliability was assessed by weighted Kappa. The standard error of measurement and minimal detectable change were computed. Cronbach's alpha was used for the analysis of internal consistency, and the ceiling effect was investigated.
In-person and remote assessments showed a strong positive correlation ( r = 0.96) and less than a 1-point difference between the 2 assessments. Both the test-retest (ICC = 0.96; 95% CI, 0.93-0.98) and inter-rater (ICC = 0.93; 95% CI, 0.87-0.97) reliability were excellent. The standard error of measurement and minimal detectable change were 1.8 and 5.1 points, respectively. Results showed adequate internal consistency and no ceiling effect.
The Tele-Berg demonstrated validity, excellent test-retest and inter-rater reliability, low measurement error, adequate internal consistency, and lack of ceiling effect. These findings suggest that the Tele-Berg is comparable to in-person Berg Balance Scale in stroke survivors.
Video abstract available for more insights from the authors (see Supplemental Digital Content, available at: http://links.lww.com/JNPT/A509 ).
远程康复为那些难以获得服务进行治疗的个体提供了一种替代方案。因此，必须对远程康复措施的可靠性和有效性进行研究。本研究评估了基于视频会议的伯格平衡量表评估在中风幸存者中的有效性和可靠性。
对31名中风幸存者进行评估。评估者A在两个不同时间（重测）通过视频会议进行面对面和远程评估，评估者B使用第二次远程录制进行评估。分别使用Pearson相关系数和Bland-Altman图一致性界限（LoA）分析面对面评估和远程评估之间的有效性和一致性。使用组内相关系数（ICC）及95%置信区间（95%CI）分析重测信度和评分者间信度，通过加权Kappa评估单个项目的信度。计算测量标准误和最小可检测变化。使用Cronbach's α分析内部一致性，并研究天花板效应。
面对面评估和远程评估显示出强正相关（r = 0.96），且两次评估之间差异小于1分。重测信度（ICC = 0.96；95%CI，0.93 - 0.98）和评分者间信度（ICC = 0.93；95%CI，0.87 - 0.97）均极佳。测量标准误和最小可检测变化分别为1.8分和5.1分。结果显示内部一致性良好且无天花板效应。
远程伯格平衡量表显示出有效性、出色的重测信度和评分者间信度、低测量误差、良好的内部一致性以及无天花板效应。这些发现表明，在中风幸存者中，远程伯格平衡量表与面对面的伯格平衡量表相当。
可获取视频摘要以获取作者更多见解（见补充数字内容，网址：http://links.lww.com/JNPT/A509 ）。
