Disclosures: Richard Wu, BS: No financial relationships or conflicts of interest

Objective: In-person physical examinations remain difficult to replicate through current telehealth technology. The Microsoft Kinect-based Virtual Remote Tele-Physical Examination (VIRTEPEX) tele-rehabilitation system utilizes motion tracking and inverse dynamics to estimate body movement forces, thereby enabling remote evaluation of musculoskeletal strength. This study aims to validate VIRTEPEX as a telehealth supplement for facilitating asynchronous, remote assessment.

Design: In this cross-sectional pilot study, we conducted in-person, standard telehealth, and asynchronous VIRTEPEX evaluations of participants’ strength for 4 upper extremity movements: shoulder abduction, shoulder flexion, elbow flexion, and wrist extension. Telehealth and VIRTEPEX evaluations were then incorporated into a composite evaluation that aimed to represent how VIRTEPEX would be used to supplement a typical telehealth examination.

Setting: Participants completed in-person, synchronous telehealth, and asynchronous VIRTEPEX evaluations at a Veterans Affairs (VA) hospital’s outpatient physical medicine and rehabilitation clinic. Telehealth evaluators were at the VA hospital, and VIRTEPEX evaluators were at the VA hospital or a remote research lab.

Participants: The cohort included 12 participants with upper extremity pain/weakness. 10 had unilateral deficits and were evaluated for one side only. 2 had bilateral deficits and were separately evaluated for each side.

Interventions: N/A

Main Outcome Measures: Inter-rater agreement and kappa statistics were calculated for each upper extremity movement to compare the following: in-person and telehealth, in-person and VIRTEPEX, in-person and composite, and telehealth and VIRTEPEX evaluations.

Results: In-person and telehealth evaluations had greater overall agreement (85.71%) than the agreements between in-person and VIRTEPEX (62.50%), in-person and composite (75%), and telehealth and VIRTEPEX evaluations (62.50%). However, for shoulder flexion, agreements between in-person and VIRTEPEX (78.57%, κ=0.571), and in-person and composite evaluations (78.57%, κ=0.571), were greater than that for in-person and telehealth (71.43%, κ=0.429).

Conclusions: Although VIRTEPEX showed less alignment with in-person evaluation compared to telehealth, it maintained a moderate level of agreement overall and holds potential to enhance the current standard of virtual patient encounters.

Level of Evidence: Level III

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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/virtual-remote-tele-physical-examination-virtepex-system-user-validation/