Remote Functional Assessment: Experiences Of People Living With Spinal Cord Injury

Research Objectives: To understand qualitative themes from interviews with people living with SCI following participation in both in-person and remote functional assessment.

Design: A qualitative research design was used, involving participants from a prior study validating three functional assessments for remote use: GRASSP, SCIM, and SCI-MovIN, administered once in-person and twice remotely to each participant (Grampurohit, 2022). The order in which the assessments were administered to each participant was randomized. Next, participants engaged in semi-structured interviews regarding their experiences. These interviews were recorded, transcribed verbatim, and coded using qualitative methodology, from which themes were identified.

Setting: Each assessment was administered once in-person at Thomas Jefferson University’s Center City Research Lab of the Department of Occupational Therapy and Center for Outcomes and Measurement, and twice remotely via Zoom with participants (and care partners if applicable) in their homes. The semi-structured interviews were administered via Zoom.

Participants: To recruit participants for the affiliated validation study, flyers and social media posts were distributed at various Thomas Jefferson University health centers and online. Information was also distributed through the Spinal Cord Injury Model System Database's newsletter.

This qualitative study included 25 adults with SCI, aged 18-80, who at least 9 months post-SCI. The level of injury and whether the injury was complete or incomplete varied across participants.

Interventions: Not applicable

Main Outcome Measures: Outcome measures were not emphasized due to the qualitative nature of this study. The expected outcome of this project was a list of themes describing experiences with in-person and remote functional testing.

Results: Qualitative analysis identified four major themes: (1.) Being able to avoid travel as well as participating in the context of one’s natural environment was valued. (2.) Assistance from care partners was crucial for those needing physical or setup help during remote assessments. (3.) Managing materials and camera angles can be challenging and warrants planning. (4.) Remote assessments were generally accepted, with some showing no strong preference for in-person versus remote. A list of recommendations to optimize remote functional assessment was generated from participant feedback.

Conclusions: The themes and recommendations identified in this study can guide stakeholders in clinical and research contexts when considering the benefits, challenges, and implementation of remote functional assessment for people with SCI. However, additional research is warranted to gather more information about the utility of remote functional assessment for people with SCI.

Author(s) Disclosures: The authors have no conflicts of interest to disclose.