DİZ OSTEOARTRİTLİ HASTALARDA PERFORMANS BAZLI TESTLERİN TELE-DEĞERLENDİRMESİNİN GÜVENİLİRLİĞİ

Abstract

Amaç: Diz osteoartriti (OA), engelliliğin başlıca nedenlerinden biri olup günlük aktiviteleri ve yaşam kalitesini önemli ölçüde etkilemektedir. Son yıllarda, özellikle yüz yüze sağlık hizmetlerine erişimde zorluk yaşayan hastalar için fiziksel performansın değerlendirilmesinde tele-değerlendirme yöntemleri giderek daha fazla önem kazanmıştır. Bu çalışma, tele-değerlendirme ortamında yaygın olarak kullanılan üç performans testinin -Zamanlı Kalk ve Yürü Testi (TUG), Tek Bacak Üzerinde Durma Testi (SLS) ve Otuz Saniyelik Sandalyeden Kalkma Testi (30SKT)- gözlemciler arası (inter-rater) ve gözlemci içi (intra-rater) güvenilirliğini değerlendirmeyi amaçladı. Yöntem: Kellgren ve Lawrence skalasına göre Evre 2-3 diz OA tanısı konmuş 60 katılımcı ile yöntemsel bir çalışma gerçekleştirildi. Katılımcılar TUG, SLS ve 30SKT testlerini iki farklı koşulda tamamladılar: klinik ortamda yüz yüze ve senkron (gerçek zamanlı video); asenkron (kayıtlı video) tele-değerlendirme yoluyla uzaktan. Güvenilirlik değerlendirmesi için Sınıf İçi Korelasyon Katsayısı (ICC), Bland-Altman grafikleri ve Standart Ölçüm Hatası (SEM) ile En Küçük Algılanabilir Değişim (SDC) gibi değişkenlik istatistikleri kullanıldı. Bulgular: Yüz yüze ve tele-değerlendirme arasındaki gözlemciler arası güvenilirlik, TUG (ICC=0.824), SLS (ICC=0.902) ve 30SKT (ICC=0.848) için iyi ile mükemmel arasında bulundu. Tele-değerlendirme içindeki gözlemci içi güvenilirlik ise TUG (ICC=0.949), SLS (ICC=0.814) ve 30SKT (ICC=0.926) için iyi ile mükemmel arasında değişti. Sonuç: Bulgular, TUG, SLS ve 30SKT testlerinin diz OA olan hastalar için tele-değerlendirme ortamında güvenilir araçlar olduğunu göstermektedir. Bu testler, ev temelli tele-sağlık programlarında fiziksel performansı izlemek ve rehabilitasyon müdahalelerine rehberlik etmek için etkili bir şekilde uygulanabilir. Bu testlerin uzaktan bakım modellerine entegrasyonu, hastaların rehabilitasyon protokollerine katılımını ve uyumunu artırabilir. Ayrıca, klinisyenlere tedavi sürecinin ilerleyişi hakkında bilinçli kararlar verebilmeleri için erişilebilir ve objektif ölçümler sunar.

Keywords

• Diz Osteoartriti
• Fonksiyonel Performans
• Tele-Tıp
• Sonuçların Tekrarlanabilirliği

RELIABILITY OF TELE-ASSESSMENT OF PERFORMANCE-BASED TESTS IN PATIENTS WITH KNEE OSTEOARTHRITIS

Abstract

Objective: Knee osteoarthritis (OA) is one of the primary causes of disability, significantly impacting daily activities and quality of life. In recent years, tele-assessment methods have gained importance as effective tools for assessing physical performance, particularly for patients who face challenges in accessing in-person healthcare services. This study aimed to assess the intra- and inter-rater reliability of three commonly used performance-based tests - Timed Up and Go Test (TUG), Single Leg Stance Test (SLS), and Thirty-Second Chair Stand Test (30CST) - when applied in tele-assessment settings. Method: A methodological study was conducted with 60 participants diagnosed with Grade 2-3 knee OA according to the Kellgren and Lawrence scale. Participants completed the TUG, SLS, and 30CST under two conditions: face-to-face in a clinical setting and remotely via tele-assessment (synchronized real-time video and asynchronized video recordings). Reliability was evaluated using Intraclass Correlation Coefficients (ICCs), Bland-Altman plots, and statistical measures of variability including Standard Error of Measurement (SEM) and Smallest Detectable Change (SDC). Results: The inter-rater reliability between face-to-face and tele-assessment was good-to-excellent for TUG (ICC=0.824), SLS (ICC=0.902), and 30CST (ICC=0.848). Intra-rater reliability for tele-assessment was also good-to-excellent for TUG (ICC=0.949), SLS (ICC=0.814), and 30CST (ICC=0.926). Conclusion: The findings indicate that TUG, SLS, and 30CST are reliable tools for tele-assessment in patients with knee OA. These tests can be effectively implemented in home-based telehealth programs to monitor physical performance and guide rehabilitation interventions. Their integration into remote care models may enhance patient engagement and adherence to rehabilitation protocols. Moreover, they provide clinicians with accessible and objective measures to make informed decisions regarding treatment progression.

Keywords

• Knee Osteoarthritis
• Functional Performance
• Telehealth
• Reproducibility of Results

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