Technical feasibility of tele-assessments for rehabilitation

Background: Technical feasibility was evaluated for conducting standard motor assessment instruments in a remote setting. Remote assessment was compared to co-located assessment for five evaluation instruments. Developing teleassessment methods is important for delivering rehabilitation services to those whose access is limited by distance or the ability to travel to comprehensive rehabilitation clinics. The five clinical measures utilized were joint Range of Motion (ROM), Manual Muscle Test (MMT), Berg Sit-to-Stand, Berg Forward Reach and the Timed Up and Go (TUG). Methods: Co-located and remote rooms were in the same building, connected by broadband video and audio. Ten subjects without impairments participated, but were given simulated impairments to mimic the patient population commonly seen in rehabilitation clinics. One therapist performed all co-located testing while another performed all remote assessments. The two therapists were blinded to each others' test results. Measurements followed standard clinical methods. Data were analyzed using repeated measures ANOVA and paired t-tests. Results: No significant differences were found between co-located and remote assessments, but the power to detect small differences was low. Remote ROM tests using snapshots and a virtual goniometer were preferred. A digital dynamometer added no additional information to a visually-based remote MMT assessment. Conclusions: Remote application of several clinical test instruments was shown to be technically feasible and there are advantages to particular methods for conducting remote assessments. A clinical study with patients is needed to determine efficacy, reliability and validity of remote assessment.