Clinical Measures of Balance and Walking Ability in People with Stroke for Assessment via Videoconferencing

Abstract

Purpose: This study modified established clinical balance and walking measures and estimated the reliability, validity, and feasibility of using these measures to assess people post-stroke via videoconferencing. Method: Twenty-eight people with chronic stroke were recruited and completed the in-person balance and mobility tests. Five clinical measures were modified as virtual assessments over videoconferencing. Feasibility was evaluated by task completion rate, occurrence of adverse events, and technical difficulties. Test–retest reliability and agreement were examined by intra-class correlations and standard error of measurement between two testing days. Convergent validity was examined by the magnitude of associations between in-person and virtual assessments using Pearson or Spearman rank correlation. Results: Twenty-one participants (52% female) participated in both in-person and virtual assessments. No adverse events occurred. Technical challenges were experienced by eight participants. Test–retest reliability for timed up and go test, 30-seconds sit-to-stand, five-times sit-to-stand, functional reach test, and tandem stance resulted in intra-class coefficients of 0.97, 0.90, 0.77, 0.54, and 0.50 respectively. The standard error of measurement was low across all virtual assessments. The timed up and go test, five-times sit-to-stand, and 30-seconds sit-to-stand showed relationship with in-person assessments ( r = −0.55 to −0.81). Conclusion: Virtual assessment of walking and balance function in ambulatory people post-stroke is feasible; however, technical challenges were experienced. The test–retest reliability of virtual assessments of timed up and go test and sit-to-stand tasks for people with stroke, together with strong convergent validity of the measures compared to in-person assessments is promising.