Remote Assessment of Functional Fitness Measures in Survivors of Cancer: A Reliability and Validity Study
Colleen Cuthbert, Madison P. Leia, Leanne Dickau, Vagner Deuel O. Tavares, Lais Renata A. Cezário Santos, Lin Yang, S. Nicole Culos-ReedBackground:
Virtual fitness assessments offer unique advantages to overcome the barriers many cancer survivors face in accessing in-person assessments. This study evaluated the reliability and concurrent validity of remotely administered functional fitness measures in cancer survivors.
Methods:
Remote assessments were conducted via Zoom videoconferencing software in participants’ homes. Assessments consisted of four functional fitness measures: right and left one-leg balance test (OLBT), sit-to-stand test (STS), chair sit-and-reach (CSAR), and 2-minute step test (2MST). Participants (n = 31) completed two remote assessments followed by one in-person assessment within a 2-week period. Intrarater reliability and concurrent validity were assessed using intraclass correlation coefficients (ICC) with 95% confidence intervals. Agreement of remote and in-person measures was assessed using the Bland–Altman 95% limits of agreement.
Results:
All ICCs met the threshold for good reliability: OLBT-R (ICC = 0.823, 0.66,0.91); OLBT-L (ICC = 0.874, 0.75,0.94); STS (ICC = 0.87, 0.75,0.94); CSAR (ICC = 0.90, 0.80,0.95); except the 2MST, which showed moderate reliability (ICC = 0.745, 0.53,0.87). ICCs for concurrent validity ranged from moderate for OLBT-R (ICC = 0.687, 0.44,0.83), good for STS (ICC = 0.87, 0.75,0.94), OLBT-L (ICC = 0.86, 0.72,0.92), and excellent for 2MST (ICC = 0.92, 0.84,0.96) and CSAR (ICC = 0.95, 0.90,0.97). However, some measures exhibited uncertainty, with wide confidence intervals and relatively large minimal detectable change values. Bland–Altman tests demonstrated underestimation between averaged means, with slight variability between limits of agreement.
Conclusion:
Remote assessment can be considered a reliable and valid alternative to in-person observations of functional fitness measures for cancer survivors.