Videoconferencing for Physical Function Assessment in Patients with CKD.

KEY POINTS: Videoconference-based physical function assessment in CKD showed high validity, reliability, and usability compared with in-person tests. Remote handgrip strength and timed up and go showed excellent agreement; gait speed showed moderate agreement, highlighting areas for refinement. Using common videoconferencing platforms and low-cost tools may reduce barriers to routine physical function assessment in CKD care.

BACKGROUND

CKD is highly prevalent and commonly accompanied by declines in functional status, which are associated with adverse clinical outcomes. Physical function is a component of functional status and can be assessed using measures including handgrip strength, timed up and go, and gait speed. However, these tests are underutilized in routine CKD care, in part because of logistical and resource constraints. Telemedicine-based approaches may help address these barriers, with videoconferencing platforms showing potential for assessing physical function in other chronic disease populations.

METHODS

In this prospective, single-center study, adults with CKD completed simultaneous in-person and videoconference-based physical function assessments in a controlled research setting. Measures included handgrip strength with two dynamometers, timed up and go, and 4-m usual gait speed. Self-reported physical function was collected using validated questionnaires. Criterion validity, reliability, and construct validity of remote assessments were evaluated using intraclass correlation coefficients, Bland-Altman, and correlation coefficients. The system usability scale and qualitative inductive thematic analysis explored the usability of remote testing.

RESULTS

Nineteen adults with CKD completed baseline assessments, and 18 completed follow-up. Criterion validity of remote assessments was excellent for handgrip strength and timed up and go and moderate for gait speed. Reliability was high for handgrip strength, excellent for timed up and go, and more moderate for gait speed. Remote measures correlated with self-reported physical function. The digital dynamometer showed high criterion validity with the Jamar dynamometer, with a modest systematic bias. Participants reported high usability of the remote assessments, with only minor challenges related to the videoconferencing format.

CONCLUSIONS

Videoconference-based physical function assessments conducted in a controlled research environment demonstrated acceptable validity, reliability, and usability in adults with CKD. Larger, multicenter studies are needed to confirm these findings across diverse CKD populations and home-based settings and to refine approaches for remote assessment of gait speed.