Comparison of face-to-face, synchronous and asynchronous use of methods used for balance assessments in individuals with chronic stroke

The study was conducted to examine the reliability and validity of the synchronous and asynchronous application of Berg Balance Scale (BBS) and Tinetti Balance Test (TBT) in individuals with chronic stroke. Thirty-six chronic stroke individuals, 12 women and 24 men, aged between 30-77 years, were included in the study.All individuals were evaluated with 3 different methods: face-to-face, synchronous tele-assessment and asynchronous tele-assessment. Face-to-face evaluation was performed by the 1st evaluator in a clinical setting.In the face-to-face evaluation, evaluations of individuals' sociodemographic information, information about stroke disease, balance, functional and clinical status were made. Asynchronous and synchronous tele-assessments were performed by the 1st and 2nd evaluator. In asynchronous and synchronous tele-assessments, individuals were evaluated only with BBS and TBT. Reliability was investigated with internal consistency, intra-rater and inter-rater reliability.For rater reliability, both synchronous and asynchronous video recordings of 18 individuals were evaluated by 2 raters 10 days later. Validity was examined with concurrent validity and concurrent validity. Reliability was investigated with internal consistency, intra-rater and inter-rater reliability. Both synchronous and asynchronous video recordings of 18 individuals were evaluated by 2 raters 10 days later for rater reliability. Validity was examined with concurrent validity and concurrent validity. Motor Assessment Scale (MAS), Hospital Anxiety and Depression Scale (HADS), Brunnstrom lower and upper extremity recovery stages were used to examine the convergent validity. Concurrent validity was investigated by examining the relationship with BBS, TBT, mediolateral sway (MLS), anteroposterior sway (APS) and oscillation velocity. As a result of our study; For both tele-assessment methods, the internal consistency (Cronbach a=0.930 to 0.970), intra-rater reliability (ICC=0.970 to 0.990), and inter-rater reliability (ICC=0.970 to 0.990) of the BBS and TBT was found to be excellent. In the construct validity analysis, it was seen that the BBS had a two-factor structure for both tele-assessment methods. It was determined that TBT had a single factor structure.When the convergent validity of the synchronous and asynchronous tele-assessment of BBS and TBT is examined; It was determined that the MAS score had excellent positive correlations with the lower extremity Brunnstrom levels, and excellent correlations with the upper extremity Brunnstrom level and BBS and good correlations with the TBT (p<0,05). There was an insignificant negative correlation with HADS score. In the analyzes made for the concurrent validity of both tele-assessment methods; BBS and TBT were positively correlated with face-to-face BBS and TBT, and moderately negatively correlated with MLS, APS and oscillation velocity. As a result of our study; It was found that BBS and TBT were valid and reliable in synchronous and asynchronous tele-assessment methods.