Investigation of the validity and reliability of tele-assessment of upper extremity functions in individuals with stroke

Objective This study aimed to investigate the validity and reliability of assessment tools used to evaluate upper extremity function in individuals with stroke using a tele-assessment approach. Methods Twenty-four individuals with stroke (mean age: 61.13 ± 12.56 years), aged 18–75 years and classified as Brunnstrom stage ≥3 for upper extremity and hand function, were included. Upper extremity function was assessed using the Motor Activity Log-28 (MAL-28), Duruöz Hand Index (DHI), ABILHAND-Stroke Hand Function Questionnaire (ASQ), Nine-Hole Peg Test (NHPT), and Fugl-Meyer Upper Extremity Motor Assessment (FM-UE) using face-to-face and tele-assessment. Tele-assessment sessions were video-recorded and re-evaluated by the same physiotherapist after 3 weeks. Results The NHPT completion times for the non-affected hand were significantly longer during tele-assessment than during the face-to-face assessment ( p < 0.001). Agreement among face-to-face assessment, tele-assessment, and repeated tele-assessment was good for DHI dressing, NHPT non-affected hand, and FM-UE coordination and speed subscales (intra-class correlation coefficient (ICC) = 0.80–0.90), while all other measures showed excellent agreement (ICC > 0.90). Intra-rater reliability between tele-assessment and repeated tele-assessment was good for the FM-UE coordination and speed subscales (ICC = 0.834) and excellent for all remaining measures. The affected side (right/left) did not significantly influence tele-assessment outcomes ( p > 0.05). Conclusion The MAL-28, DHI, ASQ, NHPT, and FM-UE can be administered reliably via tele-assessment to evaluate upper extremity function in individuals with stroke. Tele-assessment represents a valid and reliable alternative for functional evaluations that can be conducted verbally and do not require physical guidance, particularly for individuals with limited access to healthcare services.