title: Tele-Assessment of the Berg Balance Scale: Effects of Transmission Characteristics.
abstract: To compare Berg Balance Scale (BBS) rating using videos with differing transmission characteristics with direct in-person rating.
  
  
  
  Repeated-measures study for the assessment of the BBS in 8 configurations: in person, high-definition video with slow motion review, standard-definition videos with varying bandwidths and frame rates (768 kilobytes per second [kbps] videos at 8, 15, and 30 frames per second [fps], 30 fps videos at 128, 384, and 768 kbps).
  
  
  
  Medical center.
  
  
  
  Patients with limitations (N=45) in ≥1 of 3 specific aspects of motor function: fine motor coordination, gross motor coordination, and gait and balance.
  
  
  
  Not applicable.
  
  
  
  Ability to rate the BBS in person and using videos with differing bandwidths and frame rates in frontal and lateral views.
  
  
  
  Compared with in-person rating (7%), 18% (P=.29) of high-definition videos and 37% (P=.03) of standard-definition videos could not be rated. Interrater reliability for the high-definition videos was .96 (95% confidence interval, .94-.97). Rating failure proportions increased from 20% in videos with the highest bandwidth to 60% (P<.001) in videos with the lowest bandwidth, with no significant differences in proportions across frame rate categories. Both frontal and lateral views were critical for successful rating using videos, with 60% to 70% (P<.001) of videos unable to be rated on a single view.
  
  
  
  Although there is some loss of information when using videos to rate the BBS compared to in-person ratings, it is feasible to reliably rate the BBS remotely in standard clinical spaces. However, optimal video rating requires frontal and lateral views for each assessment, high-definition video with high bandwidth, and the ability to carry out slow motion review.
authors.affiliation: Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore. Electronic address: kavita_v@nuhs.edu.sg.
authors.forename: Kavita
authors.initials: K
authors.lastname: Venkataraman
authors.affiliation: Center on Aging, Duke University Medical Center, Durham, NC.
authors.forename: Michelle
authors.initials: M
authors.lastname: Morgan
authors.affiliation: Physical Medicine and Rehabilitation Service, Durham Veterans Administration Medical Center, Durham, NC.
authors.forename: Kristopher A
authors.initials: KA
authors.lastname: Amis
authors.affiliation: Center on Aging, Duke University Medical Center, Durham, NC.
authors.forename: Lawrence R
authors.initials: LR
authors.lastname: Landerman
authors.affiliation: Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore.
authors.forename: Gerald C
authors.initials: GC
authors.lastname: Koh
authors.affiliation: Speech and Audiology, Department of Surgery, Duke University Medical Center, Durham, NC.
authors.forename: Kevin
authors.initials: K
authors.lastname: Caves
authors.affiliation: Physical Medicine and Rehabilitation Service, Durham Veterans Administration Medical Center, Durham, NC; Division of Geriatrics, Department of Medicine, Duke University Medical Center, Durham, NC.
authors.forename: Helen
authors.initials: H
authors.lastname: Hoenig
mesh_terms: D004185:Disability Evaluation; D006233:Persons with Disabilities / Q000534:rehabilitation*; D005260:Female; D006801:Humans; D020407:Internet; D008297:Male; D008875:Middle Aged; D004856:Postural Balance / Q000502:physiology*; D015203:Reproducibility of Results; D000069350:Telerehabilitation / Q000706:statistics & numerical data*; D014481:United States; D014728:Veterans; D014741:Video Recording
keywords: Postural balance; Rehabilitation; Telerehabilitation