title: A quality assurance study on the accuracy of measuring physical function under current conditions for use of clinical video telehealth.
abstract: OBJECTIVE
  To determine whether conditions for use of clinical video telehealth technology might affect the accuracy of measures of physical function.
  
  
  METHODS
  Repeated measures.
  
  
  METHODS
  Veterans Administration Medical Center.
  
  
  METHODS
  Three healthy adult volunteers for a sample size of n=30 independent trials for each of 3 physical function tasks.
  
  
  METHODS
  None.
  
  
  METHODS
  Three tasks capturing differing aspects of physical function: fine-motor coordination (number of finger taps in 30s), gross-motor coordination (number of gait deviations in 10ft [3.05m]), and clinical spatial relations (identifying the proper height for a cane randomly preset ±0-2in [5.1cm] from optimal), with performance simultaneously assessed in person and video recorded. Interrater reliability and criterion validity were determined for the measurement of these 3 tasks scored according to 5 methods: (1) in person (community standard), (2) slow motion review of the video recording (criterion standard), and (3-5) full speed review at 3 Internet bandwidths (64kps, 384kps, and 768kps).
  
  
  RESULTS
  Fine-motor coordination-Interrater reliability was variable (r=.43-.81) and criterion validity was poor at 64kps and 384kps, but both were acceptable at 768kps (reliability r=.74, validity β=.81). Gross-motor coordination-Interreliability was variable (range r=.53-.75) and criterion validity was poor at all bandwidths (β=.28-.47). Motionless spatial relations-Excellent reliability (r=.92-.97) and good criterion validity (β=.84-.89) at all the tested bandwidths.
  
  
  CONCLUSIONS
  Internet bandwidth had differing effects on measurement validity and reliability for the fine-motor task, the gross-motor task, and spatial relations, with results for some tasks at some transmission speeds well below acceptable quality standards and community standards.
authors: Rehabilitation Service, Durham Veterans Administration Medical Center, Durham, NC, USA. helen.hoenig@va.gov
authors: Helen
authors: H
authors: Hoenig
authors: Latoya
authors: L
authors: Tate
authors: Sarina
authors: S
authors: Dumbleton
authors: Christy
authors: C
authors: Montgomery
authors: Michelle
authors: M
authors: Morgan
authors: Lawrence R
authors: LR
authors: Landerman
authors: Kevin
authors: K
authors: Caves
mesh_terms: D005684:Gait; D006801:Humans; D020407:Internet / Q000592:standards; D009048:Motor Skills; D015588:Observer Variation; D009788:Occupational Therapy / Q000592:standards*; D026741:Physical Therapy Modalities / Q000592:standards*; D011785:Quality Assurance, Health Care; D013028:Space Perception; D017216:Telemedicine / Q000592:standards*; D014741:Video Recording; D049269:Videoconferencing