R. Eslami, C. Chalmers, C. Guidarelli, S. Stoyles, K. Winters-Stone FACSM

Oregon Health & Science University, Portland, OR

PURPOSE: Physical performance tests are valid and reliable measures of physical functioning in cancer survivors, but their measurement properties are based on in-person (IP) assessment. The reliability and validity of remote teleconference (RT) technology to collect these same measures has yet to be established. During two ongoing exercise clinical trials for breast and prostate cancer survivors, we used IP and RT testing to determine the reliability and validity of RT tests. METHODS: IP and RT physical performance tests included 3-meter (m) timed up and go (TUG) and short physical performance battery (sPPB), which includes the 4-m usual walk test (4mWT), and 5-time repeated chair sit to stand (5XSTS) measurements. Intra- and inter-rater reliability was evaluated by having participants complete two different RT testing visits with the same (intra) or different (inter) assessors. Validity of RT testing was evaluated by having participants complete IP testing at OHSU and then complete RT testing within 1 week of the IP testing. Intraclass correlation coefficients (ICC) were used for comparing intra- and inter-rater reliability— two-way mixed for intra-rater and one-way random models for inter-rater. Validity, determined by agreement between IP and RT tests was assessed using two-way mixed ICC models. RESULTS: The RT 5XSTS and 4mWT showed excellent (ICC = 0.92, 95% CI 0.84-0.96) and good (ICC = 0.87, 95% CI 0.71-0.94) intra-rater reliability, respectively, but somewhat lower inter-rater reliability (5XSTS: ICC = 0.65, 95% CI 0.34-0.83 and 4mWT: ICC = 0.62, 95% CI 0.30-0.81). RT 5XSTS had moderate agreement (ICC = 0.72, 95% CI 0.62-0.80) and 4mWT had poor agreement (ICC = 0.48, 95% CI -0.07-0.76) with IP tests. RT assessment of the TUG test had excellent intra-rater reliability (0.98, 95% CI 0.93-0.99), inter-rater reliability (ICC = 0.96, 95% CI 0.90-0.99), and good agreement with IP tests (ICC = 0.88, 95% CI 0.74-0.94). CONCLUSION: RT physical performance tests can be a reliable method for measuring physical functioning in cancer survivors, especially when using the same assessor over time. Validity of RT tests varies across measures, with TUG best replicating IP performance. Integration of RT for physical performance testing can broaden enrollment of hard to reach populations who may be at risk for functional decline.

Supported by the National Institutes of Health R01CA222605 and R01CA218093.

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