Tele-assessment of Mobility and Balance is Reliable and Safe for Individuals with Chronic Stroke – A Guideline for a Systematic Physical Evaluation

Despite the growing use of telehealth in stroke rehabilitation, it remains unclear whether online assessments (i.e., tele-assessment) can match the accuracy of in-person evaluations. Given the high prevalence of stroke and its significant impact on mobility, precise assessment is essential. This study evaluated the reliability and safety of a tele-assessment protocol for mobility and balance in individuals with chronic stroke, using the OMPEPE guideline. Twenty-five participants underwent in-person and synchronous tele-assessment (Timed Up and Go, Five Times Sit-to-Stand, and Functional Reach tests) within 24 to 48 hours. One month later, the same physiotherapist and a second investigator independently scored asynchronous video recordings. Results showed strong agreement between online and in-person assessments, with excellent intra- and inter-rater reliability (ICC > 0.90). Most participants had moderate to severe motor impairment. These findings suggest that tele-assessment is a reliable and safe approach when systematically planned, providing an effective solution for monitoring individuals with chronic stroke conditions when in-person healthcare is not feasible.