Validity and reliability of remote administration of the one-leg stand, timed up and go and 30-second sit-to-stand via video call in patients with lumbar spinal stenosis awaiting decompression surgery.

BACKGROUND

Lumbar spinal stenosis commonly affects walking ability and balance in older adults. Physical capacity tests provide valuable objective measures beyond patient-reported outcomes, but time and travel barriers hinder access to in-person testing. Remote video-based testing could improve accessibility, although evidence of its validity and reliability in this patient group remains limited. This study aimed to evaluate the validity and reliability of three commonly used tests administered remotely via video calls, compared with in-person assessments in a clinical setting.

METHODS

Thirty-four patients scheduled for decompression surgery were enrolled from a Swedish spine clinic, of whom 28 completed at least one test session. Participants performed the one-leg stand, timed up and go, and 30-second sit-to-stand tests. Two consecutive trials of the full test battery were performed in two settings: remotely via video call from patients' homes and in person at the clinic. Participants were randomised to the order of test settings. Remote sessions were recorded and independently rated. Criterion validity (comparison between remote and in-person assessments) and intra- and inter-rater reliability were assessed using intraclass correlation coefficients, with values ≥ 0.70 considered sufficient for both criterion validity and reliability. Bland-Altman limits of agreement, standard error of measurement, and smallest detectable change were also calculated.

RESULTS

Intraclass correlation coefficients for criterion validity ranged from 0.83 to 0.88. Intra-rater reliability ranged from 0.95 to 0.97 in person and 0.80 to 0.98 remotely. Inter-rater reliability was 0.98 for all three tests. For the one-leg stand, confidence intervals were wider and measurement errors were greater than for the other tests. The median interval between sessions was three days. No adverse events occurred during testing.

CONCLUSIONS

Remote video-based assessments of the one-leg stand, timed up and go, and 30-second sit-to-stand tests demonstrated sufficient criterion validity and intra- and inter-rater reliability in patients with lumbar spinal stenosis awaiting decompression surgery. However, the one-leg stand showed greater measurement variability and should be interpreted with caution. Taken together, these findings suggest that remote assessment of these tests may serve as a valid and reliable complement to in-person evaluation. Larger studies are needed to assess measurement error and responsiveness.