Remote assessment of physical function in older people: feasibility, safety and agreement with in-person administration

Abstract

Background: Physical function is a key health indicator in older people. Interchangeable remote and in-person assessments could improve monitoring flexibility. Objective: To evaluate feasibility, safety and agreement between remote home and in-person laboratory physical function assessments in community-living older people. Methods: Thirty-seven people aged 60+ completed remote and in-person assessments of the five-times Sit-to-Stand (5STS), Timed Up-and-Go (TUG), standing balance test, 4 m Walk and Short Physical Performance Battery (SPPB) in counter-balanced order, two days apart. Feasibility was assessed as technological and environmental barriers, safety as adverse events, and agreement using intraclass correlation coefficients (ICCs) and smallest detectable differences (SDD), and based on kappa using clinical cutpoints (κ). Results: All participants completed the remote assessments without adverse events; 8% experienced minor connectivity issues. In-person performance was better for 5STS, TUG, 4 m Walk and standing balance; SPPB scores were comparable. Agreement was good for 5STS, TUG and standing balance (ICCs: 0.89 [95% confidence interval: 0.79–0.94], 0.85 [0.54–0.94], 0.77 [0.59–0.88], respectively)) and moderate for 4 m Walk and SPPB (ICCs: 0.64 [0.19–0.84] and 0.68 [0.46–0.82], respectively). SDD values for 5STS, TUG and SPPB fell within clinically acceptable ranges; categorical agreement was substantial (κ: 0.65, 0.77 and 0.65, respectively). Conclusions: Remote 5STS and TUG assessments showed good agreement, supporting their use with existing cut-points. Differences between settings in standing balance and walking speed (affecting SPPB) suggest caution in interpretation. Telehealth offers a feasible, safe option for monitoring physical function, though protocol refinements are needed for walking speed and standing balance.