Clinical Utility of Remote Teleassessment of Motor Performance in Individuals With Neurologic Disabilities: A COSMIN Systematic Review

Objective: To investigate the feasibility and measurement properties of measurement tools for remote evaluation of motor performance in people with neurologic conditions requiring only synchronous or asynchronous video conferencing without sensors or other complex technological tools. Data Sources: A systematic search was conducted in PubMed, Embase, the Cumulative Index for Nursing and Allied Health Literature (CINHAL), and ScienceDirect. The search strategy included keywords related to any neurologic population, telerehabilitation, and motor performance outcome measure; papers in Italian or English language on adults were included, without time restrictions. Study Selection: We included studies reporting data of at least one measurement property between reliability, validity, feasibility, or acceptability of measurement tools for remote motor assessment in neurologic disorders. We excluded studies that used wearable technologies, smartphones, or mobile applications. After duplicate removal, 2530 records were screened. Of the 461 remaining papers, 26 met the inclusion criteria and were included in the systematic review. Data Extraction: Two independent reviewers extracted data from the included records, evaluated the risk of bias of the studies using the Consensus-based Standards for the selection of health Measurement Instruments tool, and applied the criteria for good measurement properties and clinical utility. Discordance was solved through discussion with a third reviewer. Data Synthesis: Twenty-nine measurement tools were identified, and a narrative synthesis was conducted because of the heterogeneity of the included studies. The Fugl-Meyer Assessment for the Lower and Upper Extremity and the Tinetti Performance-Oriented Mobility Assessment Balance were suggested for the remote evaluation of people with stroke, whereas the Five Times Sit-to-Stand Test, the Nine-Hole Peg Test, and the Timed 25-Foot Walk Test were suggested for people with multiple sclerosis. Conclusions: Several measurement tools have been identified for remote evaluation of motor performance in people with neurologic disorders, but few of them can be suggested for clinical and scientific purposes. A higher methodological quality of studies would support the use of these tools in clinical practice.