Consider using technologies such as wide-angle webcams (and robotic movement tracking devices where available) – these can improve field of view and aid remote movement assessments (see our paper on technologies to support assessment of movement in video consultations).

Berg Balance Scale) but with the family member close by. If it is safe then I have completed a more formal balance assessment (e.g. For example, if the patient is unsteady I complete a more functional assessment with a family member (if possible). The first session is about getting to know the patient and then decide what level of assessment to perform. Keep it simpler than a face-to-face assessment, capturing key elements of general mobility rather than looking at detailed and higher level activities – functional assessments and global movements will be easier.

reflexes, sensory/motor testing, specific strength testing and special tests. Some tests may need to be done face-to-face – e.g.

Objective testing is more difficult over the phone or video.

Ask them to point with one finger to the worst affected location and where the pain radiates.

When asking the patient to describe sources of pain, encourage them to be specific.

fatigue, weakness, continence, speech and swallowing). Consider using a prompt sheet with reminders to ask about different symptoms where visual cues are lacking (e.g.

Ask lots of probing questions and encourage the patient to describe clearly where demonstration is not possible.

Use copying movements when demonstrating a movement or exercise (make sure your hands/arms/the relevant body part can be seen in the camera).

This means that where any doubt or difficulties occur during the assessment of physical impairment I’m confident that despite this, the safest outcome for the patient happens. When I have done this, I would say that my outcomes following remote objective screening do not change. Listening to patients and undertaking thorough subjective examinations can give many insights into our expected outcomes.

Valid assessment tool