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Abstract

This study explores reliability, validity, and feasibility of conducting clinical assessments of balance and walking ability for people post-stroke via videoconferencing. Twenty-eight people with chronic stroke who completed the in-person Six-minute Walk Test and Community Balance and Mobility Scale were recruited. Five clinical measures were modified as virtual assessments: Five-times Sit-to-Stand (5-times STS), Functional Reach Test (FRT), tandem stance (TS), Timed Up and Go test (TUG), and Thirty-seconds Sit-to-Stand (30-sec STS). Sessions were conducted over video-conferencing platform. Test-retest reliability was examined by Intra-class correlations (ICC) and the standard error of measurement (SEM) to evaluate the reliability and agreement between two testing days. The magnitude of associations among in-person and virtual assessments were used to examine convergent validity using Spearman rank correlation. Feasibility was evaluated by task completion rate, adverse events, and experienced technical difficulties. Twenty-one participants (52% female) participated both in-person and virtual assessments. There were no adverse events. Challenges of Internet connection or navigating the platform were experienced by 38% participants. The TUG, 30-sec STS, 5-times STS had good-to-excellent test-retest reliability (ICCs=0.97, 0.90, and 0.77 respectively). FRT and TS had moderate test-retest reliability (ICCs=0.54 and 0.50). The TUG, 5-times STS, and 30-sec STS had moderate-to-excellent relationships with in-person assessment (ρ= -0.55 to -0.85, P<0.001). FRT and TS showed no significant relationships with in-person assessments. The good-to-excellent test-retest reliability of remotely conducting 5-times STS, TUG, and 30-sec STS for people with stroke, together with strong convergent validity of the measures compared to in-person 6MWT is promising. Measurement of walking and balance function in ambulatory people post-stroke over video-conferencing is feasible; however, technical challenges were experienced.