TELE-ASSESSMENT COMPARED WITH IN-PERSON ASSESSMENT IN STROKE PATIENTS. A SYSTEMATIC REVIEW AND METANALYSIS.

Abstract

To evaluate the scientific evidence on the diagnostic accuracy, reliability, and feasibility of synchronous physiotherapy tele-assessment via videoconferencing compared to in-person evaluation in individual's post-stroke. A systematic search was performed in five electronic databases (MEDLINE, Scopus, Web of Science, CINAHL, and PEDro). 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; six studies (n = 270 stroke patients) provided sufficient data to be included in the meta-analysis. Two independent reviewers extracted data on study characteristics, outcomes, and assessment tools. Methodological quality was assessed using the QUADAS-2 and QAREL tools. Discrepancies were resolved through consensus by the research team. 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, 0.32]; I² = 0%). Sensorimotor outcomes demonstrated high heterogeneity (g = -0.02; 95% CI [-0.56, 0.51]; I² = 94.2%). Functional capacity showed a small, non-significant effect in favor of tele-assessment (g = 0.21; 95% CI [-0.76, 1.18]; I² = 98.8%). 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.