Reliability of Hip and Shoulder Measurements Assessed via Telehealth Versus a Standard In-Person Visit Modality.

Abstract

Introduction: Restricted in-person interaction throughout the pandemic coincided with increased reliance on telehealth for patient evaluation and treatment. However, few studies have investigated telehealth efficacy and accuracy compared with in-person musculoskeletal physical examination. Importantly, this virtual platform can be challenging for practitioners whose care relies on physical examination measurements. This study evaluated the validity and accuracy of measuring hip and shoulder strength and range of motion (ROM) via telehealth examination.

Methods: In this cross-sectional study, 45 participants without hip or shoulder pain underwent an in-person physical examination and a telehealth examination. Hip and shoulder ROM were measured from in-person and telehealth examinations, using Halo goniometers (Halo Medical Devices) and virtual goniometers, respectively. Hip and shoulder strength were also assessed. Measures obtained from in-person and telehealth examinations were compared, and percent agreements were calculated.

Results: The mean age of participants was 32.0 ± 7.2 years; 67% (n = 30) were female. Hip flexion strength, right hip abduction, and right shoulder strength had the strongest percent agreement (91.1%-100.0%) across in-person and telehealth modalities. Left hip abduction, left shoulder active abduction, shoulder internal ROM, and shoulder external ROM showed moderate-to-high agreement (26.7%-77.8%). Left (2.2%) and right hip (8.9%) external ROM showed poor agreement.

Discussion: Measurements with the greatest agreement between telehealth and in-person examinations included hip flexion, shoulder strength, hip abduction, and shoulder active abduction.

Conclusion: Certain strength and ROM tests can be accurately assessed via telehealth examination. Future research is needed to expand upon these findings and to develop a reliable, standardized protocol for the telehealth musculoskeletal physical examination.