Breaking Boundaries: Caregiver-Led Balance Assessments in the Era of Telemedicine

To determine the validity and reliability of caregiver led tele-assessment of BBS at home in people with neurological disorders.

In this cross-sectional study, 36 participants with neurological disorders, recently discharged from the hospital, were screened and selected based on specific inclusion criteria. After obtaining informed consent, Investigator 1 visited each participant’s home, administered the Berg Balance Scale (BBS) components, and recorded the scores. Caregivers were thoroughly instructed on how to administer the BBS for their patients, including guidance on video recording the process. Once caregivers completed the BBS assessments, they recorded and submitted the videos to the investigator.

The video recordings were subsequently scored by Investigator 2. The scores from both investigators (Investigator 1, who conducted the in-person assessments, and Investigator 2, who scored the caregiver-recorded videos) were compared for assessing the validity of caregiver-led tele-assessments of the BBS. Additionally, the BBS videos were evaluated by two independent raters to determine the inter-rater reliability of the tele-assessment process.

The participants had a mean age of 50.3 years (SD 13.5), comprising 19 males and 17 females. Of the 36 participants, 20 were able to ambulate independently, while 16 could walk only on level surfaces. The BBS total scores provided by Investigator 2, based on caregiver-recorded videos, demonstrated a moderate to high correlation with the scores of Investigator 1 (r = 0.71, p 0.001). The comparison between in-person and tele-assessment BBS scores showed excellent reliability (ICC = 0.952, 95% CI: 0.83 to 0.99) and near-perfect agreement.

Caregiver led tele-mode assessment of berg balance scale at home is valid and reliable. This approach has the potential to expand access to remote balance evaluations, offering a practical and effective solution for patients unable to attend in-person assessments.

Based on the demonstrated validity and reliability, tele-assessment of BBS could serve as a feasible alternative to in-person physical assessments. This remote approach minimizes the need for patient and caregiver travel, reducing associated costs and logistical challenges. Additionally, conducting BBS assessments at home may facilitate earlier identification of fall risks, promoting the timely implementation of fall prevention strategies.