Gait analysis is an important component of many rehabilitation programs. While it is best done in a formal in-person setting and with appropriate equipment, such setups are expensive and not readily available clinically.
With the increased provision of telerehabilitation services, performing gait analysis remotely may be achieved through wearable equipment, but this also has high demands in terms of resources and data synchronisation. Therefore, it is relevant to determine whether gait analysis can be performed using only typically available internet and video quality.
This study compared the overall bias, validity, and interrater reliability of gait analysis and cane height evaluation between in-person, slow-motion, and normal speed video at various frame rates and bandwidth speeds. A total of 42 subjects were eligible for both the gait and cane height analysis, respectively.
The Tinetti Performance-Oriented Mobility Assessment Gait scale (POMA-G) was used for gait evaluation; this is a 7-item scale requiring only a chair, a stopwatch, and an approximately 4.6-m (15 feet) walkway for administration. The images were recorded at different frame rates (8, 15, and 30 frames per second) and transmitted at different bandwidths (128, 384, and 768 kB per second).
The interrater reliability for the POMA-G was moderate to good across all tested connection settings (0.66-0.77). Both in-person (0.63) and normal speed video assessment (0.74) showed moderate validity.
Regarding cane height assessment, the same range of values were found for interrater reliability, except for lower bandwidths and frame rates, while the validity was good for both in-person (0.80) and normal speed video assessment (0.86).
The teleassessment of gait and cane height therefore seems to be a feasible tool using typically available internet and video quality.
> From: Venkataraman et al., Phys Ther 100 (2020) 708-717 (Epub ahead of print). All rights reserved to Oxford University Press. Click here for the online summary.
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Expert opinion
In this time of marked changes to healthcare provision, it is interesting to see that this is a service which may be provided remotely with acceptable quality using typically available resources.
This free full-text article shows how adaptable we must be to the circumstances in order to maintain quality care and patient satisfaction. An interesting read with implications that may reach far beyond the current paradigm of remote care and shape future practice patterns.
