Can the Nine Hole Peg Test be administered via telehealth? A pilot feasibility study with stroke survivors
Katie Weston3, Liana Cahill3, Natasha Lannin4,5, Nicola Fearn1, Narelle Cox4,6, Lauren Christie1,2 1St Vincent’s Health Network Sydney, Darlinghurst, NSW, Australia2Australian Catholic University, North Sydney, NSW, Australia3Australian Catholic University, Melbourne, Victoria, Australia4Monash University, Melbourne, Victoria, Australia5Alfred Health, Melbourne, Victoria, Australia6Institute for Breathing and Sleep, Heidelberg, Victoria, Australia
Abstract
Background: The COVID-19 pandemic rapidly increased the need to minimise face-to-face health care services and the use of telehealth rapidly expanded. Despite implementation of many new telehealth services, there has been limited research on the effectiveness of completing standardised stroke upper limb assessments remotely.
Objectives: To establish the feasibility and acceptability of administering the Nine Hole Peg Test (NHPT) online to stroke survivors.
Methods: A randomised, prospective pilot feasibility study was undertaken. Stroke survivors were recruited from metropolitan hospital and community settings. Participants completed the NHPT in-person and online, randomised to either online administration first or second. Participant surveys explored participant comfort, ease of clinician interaction and clarity of instructions. Telehealth experience was rated using the System Usability Scale (SUS). Analysis involved descriptive and inferential statistics and thematic analysis.
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=-1.00, 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 remote and in-person administrations.
Conclusion: Results suggest the NHPT is feasible and acceptable to administer via telehealth, supporting remote administration with stroke survivors in geographically isolated locations.
Biography
Dr Lauren Christie is an occupational therapist clinician-researcher and the Senior Implementation Science Research Fellow-Allied Health at St Vincent’s Health Network Sydney where she leads the Allied Health Research Unit. Her program of research focuses on using implementation science methods to improve the delivery of evidence based interventions across the continuum of stroke recovery.