The diagnostic reliability of Internet-based observational kinematic gait analysis

We investigated the accuracy and reliability of observational kinematic gait assessments performed via a low-bandwidth Internet link (118 kbit/s) and a higher-speed Internet link (128 kbit/s). Twenty-four subjects were randomized to either bandwidth group. Gait was assessed with the Gait Assessment Rating Scale (GARS) in the traditional manner, which is from video-recordings, and with repeated measurements via the online method. Online assessment was found to provide as accurate a measure of gait performance as the traditional assessment (limits of agreement<1 GARS point; intraclass correlation coefficient, ICC=0.96) regardless of the speed of the Internet connection. The online assessment also demonstrated high intra-rater (ICC=0.96) and inter-rater (ICC=0.92) reliability. Low-bandwidth telerehabilitation applications appear to be feasible via the Internet.