Parallel-Forms Reliability and Minimal Detectable Change of the Four Telerehabilitation Version Mobility-Related Function Scales in Stroke Survivors

Zhi-Yuan Zhang; Lu Huang; Min Gao; Tian-Qi Zhang; Feng-Yue Zhang; Jiang Yi; Zhong-Liang Liu

doi:10.1016/j.apmr.2024.01.016

Parallel-Forms Reliability and Minimal Detectable Change of the Four Telerehabilitation Version Mobility-Related Function Scales in Stroke Survivors

Arch Phys Med Rehabil. 2024 Feb 1:S0003-9993(24)00059-5. doi: 10.1016/j.apmr.2024.01.016. Online ahead of print.

Authors

Zhi-Yuan Zhang¹, Lu Huang¹, Min Gao¹, Tian-Qi Zhang¹, Feng-Yue Zhang¹, Jiang Yi¹, Zhong-Liang Liu²

Affiliations

¹ Department of Rehabilitation Medicine, The Second Hospital of Jilin University, Chang Chun, China.
² Department of Rehabilitation Medicine, The Second Hospital of Jilin University, Chang Chun, China. Electronic address: zhongliang@jlu.edu.cn.

PMID: 38307318
DOI: 10.1016/j.apmr.2024.01.016

Abstract

Objective: To investigate the parallel-forms reliability, minimal detectable change with 95% confidence interval (MDC₉₅), and feasibility of the 4 telerehabilitation version mobility-related function scales: Fugl-Meyer Assessment-lower extremity subscale (Tele-FMA-LE), Berg Balance Scale (Tele-BBS), Tinetti Performance Oriented Mobility Assessment-Gait subscale (Tele-POMA-G), and Rivermead Mobility Index (Tele-RMI).

Design: Reliability and agreement study and cross-sectional study.

Setting: Medical center.

Participants: Stroke survivors' ability to independently walk 3 meters with assistive devices, age of ≥18 years for participants and their partners, stable physical condition, and absence of cognitive impairment (N=60).

Interventions: Not applicable.

Main outcomes measures: Parallel-forms reliability and MDC₉₅ of Tele-FMA-LE, Tele-BBS, Tele-POMA-G, and Tele-RMI.

Results: No significant differences (P>.05) were observed among the mean scores of the telerehabilitation version and face-to-face version mobility-related function scales. Intraclass correlation coefficients (ICCs) indicated good reliability for most scales, with Tele-FMA-LE, Tele-BBS, and Tele-RMI scores achieving values of 0.81, 0.78, and 0.84. Tele-POMA-G scores demonstrated moderate reliability (ICC=0.72). Weighted kappa (κw) showed good-to-excellent reliability for most individual items (κw>0.60). The MDCs of the Tele-FMA-LE, Tele-BBS, Tele-POMA-G, and Tele-RMI were 5.84, 8.10, 2.74, and 1.31, respectively. Bland-Altman analysis showed adequate agreement between tele-assessment and face-to-face assessment for all scales. The 5 dimensions affirm the robust feasibility of tele-assessment: assessment time, subjective fatigue perception, overall preference, participant satisfaction, and system usability.

Conclusions: The study demonstrates good parallel-forms reliability, MDC, and promising feasibility of the 4 telerehabilitation version mobility-related function scales (Tele-FMA-LE, Tele-BBS, Tele-POMA-G, and Tele-RMI) in survivors of stroke.

Keywords: Mobility limitation; Rehabilitation; Stroke; Telerehabilitation; Validation study.