Poster The Joint Annual Meeting of the Stroke Society of Australasia (SSA) and Smartstrokes 2023

Determining the acceptability and concurrent validity of administering the Nine Hole Peg Test via Telehealth (#140)

Katie Weston 1 , Liana S Cahill 1 , Natasha A Lannin 2 3 , Nicola Fearn 4 , Narelle Cox 5 6 , Lauren J Christie 1 4
  1. School of Allied Health, Faculty of Health Science, Australian Catholic University, Melbourne, VIC, Australia
  2. Alfred Health, Melbourne, VIC, Australia
  3. Department of Neuroscience, Central Clinical School, Monash University, Melbourne, VIC, Australia
  4. Allied Health Research Unit, St Vincent's Health Network , Sydney, VIC, Australia
  5. Respiratory Research at Alfred, Department of Immunology and Pathology, Monash Univerity, Melbourne, VIC, Australia
  6. Institute for Breathing and Sleep, Heidelberg, VIC, Australia

Background: 

The COVID-19 pandemic rapidly increased the need to minimise in-person health care services, and consequently the use of telehealth has expanded. Despite implementation of many new services being delivered via telehealth, there has been limited research on the feasibility and acceptability of completing standardised stroke upper limb assessments remotely.

Aims: 

To establish the feasibility, acceptability and reliability of administering the Nine Hole Peg Test (NHPT) remotely to stroke survivors.

Methods: 

A randomised, prospective pilot feasibility study was undertaken. Stroke survivor participants were recruited from metropolitan hospital and community settings. Participants completed the NHPT in-person and remotely, randomised to either remote administration first or second. Feasibility of remote administration was rated using the System Usability Scale (SUS).  Acceptability was measured through a satisfaction survey in which participants rated their comfort, ease of clinician interaction and clarity of instructions. Intra-rater and inter-rater reliability were evaluated by researchers scoring assessment video recordings blinded to initial scores. Descriptive and inferential statistics and inductive content analysis were used.

Results: 

Ten stroke survivors (mean age 54.8 years [SD ± 16.2]) completed both in-person and remote test administrations. Participants reported good usability with remote administration (mean SUS=77.25/100). There were no significant differences between in-person and remote administration for ease of clinician interaction (median difference=0, z=-1.41, p=0.32, r=0.22), clarity of instructions (median difference=0, z=-1.34, p=0.18, r=0.30) and participant comfort (median difference=0, z=-1.34, p=0.18, r=0.30). Some participants reported challenges with remote set-up, and barriers to completing the assessment remotely when alone. There was no difference in time taken to complete the NHPT between administration methods. Test-retest reliability was substantial (ICC=0.95).  Intra-rater and inter-rater reliability were excellent (ICC=0.99; ICC=0.99 respectively).

Conclusion:

The NHPT is feasible and acceptable to administer remotely. Findings could increase NHPT use with stroke survivors in geographically isolated locations and reduce in-person consultations.