Preprint · Nov 24, 2024
Remote physical function testing in older adults: a mixed methods study exploring test reliability, feasibility, and perceptions of participants and assessors. (Preprint)
By Fyfe JJ, Sousa F, Watson‐Mackie K et al.
BACKGROUND Impaired physical function is closely associated with adverse health outcomes in older adults. Low-cost, remote strategies for monitoring physical function could enable timely interventions to improve health and reduce the need for support services. OBJECTIVE This study aimed to evaluate the feasibility, reliability, and perceptions of remotely assessing physical function in older adults at home. METHODS Nineteen community-dwelling older adults (age 68 ± 5 years; 68% female) participated in three videoconferencing sessions with trained assessors from within their home, approximately one week apart. During each session, participants completed nine physical function tests [standing balance test battery, single-leg balance, four-square step test (FSST), gait speed (2.44 m and 4 m, both usual and fastest pace), five-times sit-to-stand (5-STS), 30-second STS (30-STS)]. Semi-structured interviews were conducted with participants and assessors to explore factors related to the feasibility and acceptability of testing. Test-retest reliability was assessed using intraclass correlation coefficients (ICCs) and Bland-Altman plots, and interview data were analysed thematically. RESULTS All participants successfully completed all physical function assessments on each of the three testing occasions with no adverse events. Test-retest reliability ranged from poor (ICC < 0.5; single-leg balance) to good (ICC 0.75–0.9; 5-STS, 30-STS, 2.44 m gait usual, 4 m gait fast, and FSST) but improved with repeated testing. Common barriers to testing from the perspectives of participants were setting up devices and physical demands associated with preparing their home for testing, while assessors saw participant understanding and receptiveness to testing as barriers. Both participants and assessors identified the availability of support people during testing as enablers. CONCLUSIONS Older adults can safely and feasibly perform a range of physical function tests remotely. Familiarisation improves test reliability and reducing technical and physical demands may improve implementation. Support from others at home is a key facilitator for successful remote testing.