Agreement Between Face-to-Face and Tele-assessment of Upper Limb Functioning in Patients with Parkinson Disease.

Background: Upper limb disturbances are prevalent in patients with Parkinson disease (PD) and can limit their participation in activities of daily living. Tele-assessment of upper limb motor symptoms using an Internet application may be an alternative for addressing the growing demand for monitoring of disease progression. Objective: To evaluate the level of agreement between face-to-face and tele-assessment of patients with PD.

Design: Reliability study. Setting: Parkinson's Disease Association. Participants: Twenty-one patients with PD from a local association participated in the study.

Methods: Patients attended a session for clinical face-to-face and real-time online tele-assessment. Main outcome measurements: Upper limb measures of function (assessed with the Manual Ability Measure 16), dexterity (evaluated using the coin rotation task), motor speed (assessed by the finger tapping test), tremor (evaluated with the Fahn-Tolosa-Marin Tremor Rating Scale), and range of motion (using the Kinovea software) were recorded by two independent researchers.

Results: All the outcome measures evaluated showed a good interrater, intraclass correlation coefficient (ρ > 0.75). In addition, most confidence intervals were narrow and excluded 0.8. The lowest reliability was obtained for elbow flexion of the most affected upper limb (ρ = 0.75; confidence interval 0.49-0.89) and the highest reliability for finger tapping tests (ρ = 1; 1, 1).

Conclusions: This study demonstrates high interrater reliability of upper limb tele-assessment in patients with PD compared to a face-to-face assessment. Level of evidence: III.