Virtual assessment protocols for Timed-Up-and-Go, 5-repetition Chair Rise, and 1-minute Sit-to-Stand tests in community-dwelling older adults: Investigating feasibility, reliability, and validity

Abstract

ObjectiveTo 1) develop and evaluate virtual assessment protocols for the Timed-Up-and-Go (TUG) usual and fast-pace, Chair Rise-5 repetition, and the 1-minute Sit-to-Stand (1MSTS) tests, and 2) examine their feasibility, reliability, and validity. DesignThis was a prospective cohort study, where participants engaged in up to two virtual assessments and data was collected prospectively for one year. SettingAssessments took place in participants’ homes in the community. Toolkits were delivered that included the required equipment and internet-enabled tablet. ParticipantsParticipants included a random sample of adults ≥65 years old who could walk 10m without assistance from another person and communicate in English. Main outcome measuresFalls and healthcare utilization data were collected for one year after initial assessments. Descriptive data were used to examine feasibility; intra-class correlation and Pearson's/Spearman's correlation and AUCs were used to evaluate reliability and validity, respectively. ResultsSixty participants (mean age 76.6 ±5.6; 53% female) completed visit 1 and 52 completed visit 2. Technology issues were relatively common, yet no safety incidents occurred. All the virtual mobility tests demonstrated excellent test-retest (ICCs=0.86 to 0.95) and inter-rater (ICC=0.98 to 0.99) reliability. The tests had weak-to-moderate correlations with measures of physical function (r=-0.14 to -0.43) and physical activity (r=-0.19 to 0.32). Fifty-seven total falls were recorded by 28 participants (46%) over 1 year. The virtual mobility tests did not have adequate accuracy for predicting falls (AUCs = 0.53 to 0.59), specialist (AUCs=0.48-0.60), family doctor (AUCs=0.48-0.59), or rehabilitation professional visits (AUCs=0.65-0.67), or hospitalizations (AUCs=0.56-0.63). ConclusionResults support the feasibility and reliability of virtual administration of the TUG usual and fast-pace, Chair Rise, and 1MSTS. Clinicians and researchers can use the included manuals to conduct these tests virtually. Future research should examine the clinical utility of these tests for remote monitoring and mobility assessment.