Videoconferencing for Physical Function Assessment in Patients with CKD

BACKGROUND: CKD is highly prevalent and commonly accompanied by declines in functional status, which are associated with adverse clinical outcomes. Physical function is a component of functional status and can be assessed using measures including handgrip strength, Timed Up & Go, and gait speed. However, these tests are underutilized in routine CKD care, in part due to logistical and resource constraints. Telemedicine-based approaches may help address these barriers, with videoconferencing platforms showing potential for assessing physical function in other chronic disease populations. METHODS: In this prospective, single-center study, adults with CKD completed simultaneous in-person and videoconference-based physical function assessments in a controlled research setting. Measures included handgrip strength with two dynamometers, Timed Up & Go, and 4-meter usual gait speed. Self-reported physical function was collected using validated questionnaires. Criterion validity, reliability, and construct validity of remote assessments were evaluated using intraclass correlation coefficients, Bland-Altman, and correlation coefficients. The System Usability Scale and qualitative inductive thematic analysis explored the usability of remote testing. RESULTS: Nineteen adults with CKD completed baseline assessments, and eighteen completed follow-up. Criterion validity of remote assessments was excellent for handgrip strength and TUG, and moderate for gait speed. Reliability was high for handgrip strength, excellent for TUG, and more moderate for gait speed. Remote measures correlated with self-reported physical function. The digital dynamometer showed high criterion validity with the Jamar dynamometer, with a modest systematic bias. Participants reported high usability of the remote assessments, with only minor challenges related to the videoconferencing format. CONCLUSIONS: Videoconference-based physical function assessments conducted in a controlled research environment demonstrated acceptable validity, reliability, and usability in adults with CKD. Larger, multicenter studies are needed to confirm these findings across diverse CKD populations and home-based settings, and to refine approaches for remote assessment of gait speed.