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Mobility focussed physical outcome measures over telecommunication technology (Zoom): intra and inter-rater reliability trial


Bird, ML and Peel, FM and Schmidt, M and Fini, NA and Ramage, E and Sakakibara, BM and Simpson, DB and Mather, C and Cadilhac, DA and Ahuja, KDK and Bridgman, H and English, C, Mobility focussed physical outcome measures over telecommunication technology (Zoom): intra and inter-rater reliability trial, JMIR rehabilitation and assistive technologies, 9, (3) Article 38101. ISSN 2369-2529 (2022) [Refereed Article]

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Copyright (2022) The Authors. This is an open-access article distributed under the terms of the Creative Commons Attribution License (

DOI: doi:10.2196/38101


Background: Rehabilitation provided via telehealth offers an alternative to currently limited in-person health care. Effective rehabilitation depends on accurate and relevant assessments that reliably measure changes in function over time. The reliability of a suite of relevant assessments to measure the impact of rehabilitation on physical function is unknown.

Objectives: We aimed to measure the intrarater reliability of mobility-focused physical outcome measures delivered via Zoom (a commonly used telecommunication platform) and interrater reliability, comparing Zoom with in-person measures.

Methods: In this reliability trial, healthy volunteers were recruited to complete 7 mobility-focused outcome measures in view of a laptop, under instructions from a remotely based researcher who undertook the remote evaluations. An in-person researcher (providing the benchmark scores) concurrently recorded their scores. Interrater and intrarater reliability were assessed for Grip Strength, Functional Reach Test, 5-Time Sit to Stand, 3- and 4-Meter Walks and Timed Up and Go, using intraclass correlation coefficients (ICC) and Bland-Altman plots. These tests were chosen because they cover a wide array of physical mobility, strength, and balance constructs; require little to no assistance from a clinician; can be performed in the limits of a home environment; and are likely to be feasible over a telehealth delivery mode.

Results:A total of 30 participants (mean age 36.2, SD 12.5 years; n=19, 63% male) completed all assessments. Interrater reliability was excellent for Grip Strength (ICC=0.99) and Functional Reach Test (ICC=0.99), good for 5-Time Sit to Stand (ICC=0.842) and 4-Meter Walk (ICC=0.76), moderate for Timed Up and Go (ICC=0.64), and poor for 3-Meter Walk (ICC=-0.46). Intrarater reliability, accessed by the remote researcher, was excellent for Grip Strength (ICC=0.91); good for Timed Up and Go, 3-Meter Walk, 4-Meter Walk, and Functional Reach (ICC=0.84-0.89); and moderate for 5-Time Sit to Stand (ICC=0.67). Although recorded simultaneously, the following time-based assessments were recorded as significantly longer via Zoom: 5-Time Sit to Stand (1.2 seconds), Timed Up and Go (1.0 seconds), and 3-Meter Walk (1.3 seconds).

Conclusions:Untimed mobility-focused physical outcome measures have excellent interrater reliability between in-person and telehealth measurements. Timed outcome measures took approximately 1 second longer via Zoom, reducing the reliability of tests with a shorter duration. Small time differences favoring in-person attendance are of a similar magnitude to clinically important differences, indicating assessments undertaken using telecommunications technology (Zoom) cannot be compared directly with face-to-face delivery. This has implications for clinicians using blended (ie, some face-to-face and some via the internet) assessments. High intrarater reliability of mobility-focused physical outcome measures has been demonstrated in this study.

Item Details

Item Type:Refereed Article
Keywords:telehealth, rehabilitation, assessment, balance, mobility
Research Division:Health Sciences
Research Group:Allied health and rehabilitation science
Research Field:Physiotherapy
Objective Division:Health
Objective Group:Evaluation of health and support services
Objective Field:Telehealth
UTAS Author:Bird, ML (Dr Marie-Louise Bird)
UTAS Author:Peel, FM (Mr Felix Peel)
UTAS Author:Schmidt, M (Mr Matthew Schmidt)
UTAS Author:Mather, C (Dr Carey Mather)
UTAS Author:Ahuja, KDK (Dr Kiran Ahuja)
UTAS Author:Bridgman, H (Dr Heather Bridgman)
ID Code:154564
Year Published:2022
Deposited By:Health Sciences
Deposited On:2022-12-12
Last Modified:2023-01-13

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