Validity and intra- and inter-rater reliability of the Tinetti performance-oriented mobility assessment balance subscale using different tele-assessment methods in patients with chronic stroke.

Introduction: Balance assessments are an important component of rehabilitation. Considering the increasing use of telemedicine to meet rehabilitation needs, it is important to examine the feasibility of such assessments. This study aimed to examine the reliability and validity of the Tinetti Performance-Oriented Mobility Assessment Balance Subscale (POMA-B) when applied via synchronous and asynchronous tele-assessment.

Methods: Twenty-five patients with chronic stroke were included in the study. The first physiotherapist assessed the patients on the first day in a face-to-face clinical setting. Synchronous or asynchronous tele-assessment was applied the next day. The assessments were performed in the same time zone, with an interval of one day. The synchronous tele-assessment was done online in real time by the first and second physiotherapists. A reference assessment video was sent to the patients for asynchronous tele-assessment. They were asked to make a video recording while performing the evaluation activities according to the reference video. Then the first and second physiotherapists assessed these video recordings separately. All the tests were repeated 10 days later to determine the intra-rater reliability of the tele-assessment methods.

Results: The intra-class correlation coefficients ranged from 0.96 to 0.98 for inter-rater reliability and from 0.97 to 0.98 for intra-rater reliability for both tele-assessment methods. Both asynchronous and asynchronous tele-assessment methods were medium correlated with the face-to-face versions.

Conclusions: We demonstrated the validity and reliability of the POMA-B in chronic stroke patients with different tele-assessment methods, typically using the internet and available devices.