Reliability of Tele-assessment of Functional Tests Used for Sarcopenia in People with Obesity: A Repeated Measures Observational Study

Abstract Sarcopenic obesity, the coexistence of obesity and sarcopenia, significantly impairs mobility, independence, and healthcare. Functional performance tests, including the Timed Up and Go Test (TUG), Five Times Sit-to-Stand Test (5xSTS), and 4-Meter Walk Test (4MWT), are essential for diagnosing and monitoring sarcopenia. This study aimed to evaluate the reliability of tele-assessment methods for functional performance tests compared to face-to-face evaluations in individuals with obesity. A repeated measures observational study was conducted with 82 participants diagnosed with obesity (BMI > 30 kg/m²). All participants completed TUG, 5xSTS, and 4MWT tests both in a clinical setting and at home via video-based tele-assessment. Inter-rater and intra-rater reliability were assessed using intraclass correlation coefficients (ICCs). Inter-rater reliability between face-to-face and tele-assessment formats was good for TUG (ICC = 0.826) and 5xSTS (ICC = 0.880), and moderate for 4MWT (ICC = 0.743). Intra-rater reliability across two tele-assessment sessions was excellent for TUG (ICC = 0.910) and 5xSTS (ICC = 0.902), and good for 4MWT (ICC = 0.858). Tele-assessment is a reliable alternative to face-to-face evaluation for functional performance testing in individuals with obesity. It provides an accessible way to assess mobility and strength, especially for those with limited access to in-person evaluations.