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Agreement Between Video-Based and In-Person Assessment in Patients with Knee Pain-A Prospective Repeated-Measures
Stefanos Karanasios1, Athanasios Koutsouradis1, Christina Mavrogiannopoulou1
1Laboratory of Advanced Physiotherapy (LadPhys), Physiotherapy Department, School of Health and Care Sciences, University of West Attica, 122 43 Egaleo, Greece.
Journal of Clinical Medicine
|May 13, 2026
Summary
Video physiotherapy assessments show high agreement and reliability compared to in-person exams for knee pain patients. This telehealth approach is feasible for triage and management in specific clinical settings.
Area of Science:
- Physiotherapy
- Digital Health
- Musculoskeletal Assessment
Background:
- Telehealth adoption has increased, driven by digital health advancements.
- Limited evidence exists comparing video-based musculoskeletal assessments with traditional in-person examinations.
- This study addresses the need for evidence on video-based physiotherapy for knee pain.
Purpose of the Study:
- To evaluate the concurrent validity of video-based physiotherapy assessment against face-to-face assessment in patients with knee pain.
- To determine the interrater reliability of video-based physiotherapy assessments.
- To compare diagnostic accuracy across various knee pain categories using both assessment methods.
Main Methods:
- Forty-five patients with knee pain underwent randomized, consecutive in-person and video-based assessments.
- Experienced musculoskeletal physiotherapists conducted assessments, categorizing diagnoses into seven groups.
- Primary outcomes included intermethod agreement (Cohen's kappa) and interrater reliability.
Main Results:
- Identical diagnoses were achieved in 43 out of 45 cases between in-person and video assessments (Cohen's κ = 0.92).
- Video telehealth demonstrated high accuracy (90-100%) across all diagnostic categories.
- Interrater agreement among video-based assessors was high (93.3%, κ = 0.89).
Conclusions:
- Video-based physiotherapy assessment exhibits high concurrent agreement and excellent interrater reliability with face-to-face evaluations for knee pain.
- While demonstrating feasibility and agreement, results suggest potential for triage and management in select settings.
- Further research with larger, diverse populations and independent reference standards is recommended to establish diagnostic equivalence.