Validity and reliability of the assessment and diagnosis of musculoskeletal elbow disorders using telerehabilitation

J Telemed Telecare. 2012 Oct;18(7):413-8. doi: 10.1258/jtt.2012.120501. Epub 2012 Oct 19.


We examined the validity and reliability of a physiotherapy examination of the elbow, using telerehabilitation. The patho-anatomical diagnoses, systems diagnosis and physical examination findings of face-to-face physiotherapy examinations were compared with telerehabilitation examinations. Ten participants attended a single session, during which they were interviewed, a face-to-face physical examination was performed and a remote physical examination was conducted, guided by an examiner at a different location via a telerehabilitation system. Conventional face-to-face physiotherapy physical examination test results, diagnoses and systems diagnoses were compared to those produced by an examiner using the telerehabiliation system. There was substantial agreement for systems diagnosis (73%; P = 0.013) for validity and almost perfect agreement for intra-rater reliability (90%; P = 0.001). The inter-rater reliability had a weaker and non-significant agreement (64%; P = 0.11). Physical examination data demonstrated >68% agreement across all three datasets, between the examination methods. Performing a telerehabilitation physical examination to determine a musculoskeletal diagnosis of the elbow joint complex is both valid and reliable.

Publication types

  • Validation Study

MeSH terms

  • Adult
  • Elbow / abnormalities*
  • Female
  • Humans
  • Internet / statistics & numerical data
  • Male
  • Musculoskeletal Diseases / diagnosis*
  • Palpation / standards
  • Peripheral Nervous System
  • Physical Examination / methods*
  • Physical Therapy Modalities
  • Remote Consultation / methods*
  • Reproducibility of Results