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Updated: Jan 24, 2026
Computerized Adaptive Testing System of Functional Assessment of Stroke
Published on: January 7, 2019
Tele-Assessment Compared With In-person Assessment in Stroke Individuals: A Systematic Review and Meta-analysis
María-José Estebanez-Pérez1, Pablo Pastora-Estebanez2, María-Jesús Vinolo-Gil3
1Unit of Excellence of the Melilla University Campus (UECUMEL), Department of Physiotherapy, Faculty of Health Sciences, University of Granada, Spain.
Objective:
To evaluate the scientific evidence on the diagnostic accuracy, reliability, and feasibility of synchronous physiotherapy tele-assessment via videoconferencing compared with in-person evaluation in individual's post-stroke.
Data Sources:
A systematic search was performed in 5 electronic databases (MEDLINE, Scopus, Web of Science, CINAHL, and Physiotherapy Evidence Database).
Study Selection:
Studies were eligible if they compared synchronous tele-assessment with in-person physiotherapy evaluation in adult stroke patients, reporting outcomes on diagnostic accuracy, interrater reliability, or feasibility. Seven studies met the inclusion criteria for the systematic review; 6 studies (n=270 stroke patients) provided sufficient data to be included in the meta-analysis.
Data Extraction:
Two independent reviewers extracted data on study characteristics, outcomes, and assessment tools. Methodological quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 tool and Quality Appraisal Tool for Studies of Diagnostic Reliability. Discrepancies were resolved through consensus by the research team.
Data Synthesis:
A random-effects meta-analysis was conducted. Tele-assessment showed strong agreement with in-person evaluation for balance outcomes (Hedges' g=0.03; 95% CI, -0.26 to 0.32; I²=0%). Sensorimotor outcomes demonstrated high heterogeneity (g=-0.02; 95% CI, -0.56 to 0.51; I²=94.2%). Functional capacity showed a small, nonsignificant effect in favor of tele-assessment (g=0.21; 95% CI, -0.76 to 1.18; I²=98.8%).
Conclusions:
Synchronous tele-assessment via videoconferencing appears to be a valid, reliable, and feasible alternative to in-person physiotherapy evaluation in stroke patients, particularly for balance assessment. These findings support the integration of tele-assessment protocols into rehabilitation services, especially when face-to-face access is limited. Further studies are needed to standardize protocols and validate their effectiveness across a broader range of functional outcomes.
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