Huntington Kayla B, Suskauer Stacy J, Slomine Beth S, Svingos Adrian M
Brain Injury Clinical Research Center, Kennedy Krieger Institute, Baltimore, MD, USA.
Department of Physical Medicine and Rehabiltiation, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Child Neuropsychol. 2025 Mar 18:1-9. doi: 10.1080/09297049.2025.2480342.
Demand for telehealth services has increased in many settings as a means of reducing patient burden and increasing access to care. It is therefore critical to understand if clinical tools validated for in-person use are feasible to administer via telehealth and, if so, how results may vary from those obtained in-person. The Revised Physical and Neurological Examination of Subtle Signs (PANESS) is a validated assessment of pediatric neuromotor functioning that is sensitive to detecting motor dysfunction in youth. The Timed Motor section of the PANESS is an ideal candidate for telehealth administration given its strong inter-rater reliability when scored via video review. Here, we preliminarily examined the feasibility of administering the Timed Motor section of PANESS via videoconferencing and its equivalence with in-person administration. We administered the Timed Motor section of the PANESS in-person and via videoconferencing in 25 typically developing youth ages 10-18 (including = 11 who had clinically recovered from concussion). All were able to complete the assessment via videoconference. We observed moderate to excellent reliability of scores obtained in-person and via videoconference (intraclass correlations ranging from .743 to .971). Results suggest that the Timed Motor Section of the PANESS can be administered remotely in typically developing youth (including those with a history of concussion) and that the scores obtained are stable with in-person scores. Future work is needed to examine the feasibility and equivalence of telehealth-based PANESS administration in clinical settings and patient populations.
在许多情况下，对远程医疗服务的需求有所增加，以此作为减轻患者负担和增加医疗服务可及性的一种手段。因此，了解针对面对面使用而验证的临床工具通过远程医疗进行管理是否可行，如果可行，其结果与面对面获得的结果可能有何不同，至关重要。修订版细微体征体格与神经学检查（PANESS）是一项经过验证的儿科神经运动功能评估，对检测青少年的运动功能障碍很敏感。鉴于通过视频回顾评分时PANESS的定时运动部分具有很强的评分者间信度，它是远程医疗管理的理想选择。在此，我们初步研究了通过视频会议进行PANESS定时运动部分管理的可行性及其与面对面管理的等效性。我们对25名年龄在10至18岁的发育正常的青少年（包括11名已从脑震荡中临床康复的青少年）进行了PANESS定时运动部分的面对面和视频会议管理。所有人都能够通过视频会议完成评估。我们观察到面对面和通过视频会议获得的分数具有中度至高度的信度（组内相关系数范围为0.743至0.971）。结果表明，PANESS定时运动部分可以在发育正常的青少年（包括有脑震荡病史的青少年）中进行远程管理，并且获得的分数与面对面分数稳定。未来需要开展工作，以研究在临床环境和患者群体中基于远程医疗的PANESS管理的可行性和等效性。
