Comparison between in-person and remote assessment of four field tests for people with chronic lung diseases

ABSTRACT

Introduction: COVID-19 pandemic has driven an abrupt shift from centre-based pulmonary rehabilitation to home-based or telerehabilitation models in order to safely deliver this important treatment. However, functional capacity assessment is still carried out with in-person supervision. Aim(s) To compare remote and in-person assessment of four field tests for patients with chronic lung diseases. Method(s) People with chronic respiratory diseases underwent timed up and go test (TUG), 5-repetitions sit-to-stand test (5-repStS), 1-minute STS (1-minStS), and modified incremental step test (MIST). Tests were carried out at participants' home with in-person or remote (Skype or WhatsApp) assessment, in random order. During the remote assessment, the physiotherapist was at the pulmonary rehabilitation centre. The order of the tests was also randomized and was the same for in-person and remote supervision. Each test was performed twice and the test with best performance was used for comparison between remote and in-person supervision. A kit containing a finger pulse oximeter, tape measure, and a step was provided. Pair t -test expressed as mean difference (95% CI), intraclass correlation coefficient (ICC 21), and Bland-Altman method were used for analysis. Result(s) Forty-four participants (23 COPD, 18 bronchiectasis, three cystic fibrosis, FEV 1 47 +/- 19%, 56 +/- 15 years old) were assessed. There was no difference between in-person and remote supervision for all tests (TUG 0.04(-0.2-0.2) s, 5-repStS 0.3(-0.1-0.7) s, 1-minStS -0.9 (-1.9-0.1) repetitions, and MIST -3.1 (-9.9-3.7) steps). High reproducibility was observed by ICC (95% CI) (TUG 0.94 (0.89-0.97), 5-repStS 0.96 (0.92-0.98), 1-minStS 0.87 (0.77-0.93), and MIST 0.94 (0.88-0.96). Limits of agreement were narrow for TUG (-0.8-1.7), 5-repStS (-2.3-2.9), and 1-minStS (-7.4-5.5), but wide for MIST (-46-40). Conclusion(s) Remote assessment provides similar results to in-person assessment for four field tests commonly used in people with chronic lung diseases.