Agreement Between Face-to-Face and Tele-assessment of Upper Limb Disability in Lung cancer survivors during COVID-19 era

Abstract

Introduction: Upper limb disability can limit the quality of life of lung cancer survivors. The COVID-19 era has required a finding of alternatives to attend the monitoring of presented disturbances with the minor risk of spread. Tele-assessment offers new possibilities for clinical assessment demonstrating good reliability compared to traditional face-to-face assessment in a variety of patients. No previous study has been applied this type of assessment in lung cancer survivors. For this reason, the aim of this study was to evaluate the level of agreement between upper limb disability assessment using tele-assessment and the face-to-face method in lung cancer survivors.

Methods: A reliability study was conducted with 20 lung cancer survivors recruited from the Oncological Radiotherapy Service of the “Hospital PTS” (Granada). Patients attended a session for clinical face-to-face and real-time online tele-assessment. The main outcome measurements of the study included upper limb function (shirt task) and musculoskeletal disturbances (active range of movement and trigger points), and these outcomes were recorded by two independent researchers.

Results: The outcomes measures showed good agreement between both assessments. The active range of movement presented heterogeneous results, being excellent reliability (ρ > 0.75) in extension, internal rotation, homolateral adduction, and contralateral abduction, good (0,4 < ρ < 0,75) for flexion, homolateral abduction, contralateral adduction and contralateral external rotation, and poor (ρ< 0,4) for homolateral external rotation. The measure evaluating upper limb function and Trigger Points show the highest interrater reliability with confidence interval lower limits ≥ 0.99.

Discussion: The tele-assessment of upper limb function and musculoskeletal disorders of lung cancer survivors present a good interrater reliability compared to face-to-face assessment. It could be useful for monitoring the disability presented by cancer survivors whose access is difficulted by the residential situation, physical limitations or the risk of COVID-19 spread.