Mixed-methods study finds equivalent remote NSAA scores in 18 people with Duchenne muscular dystrophy

A non-interventional, mixed-methods study of 18 people with Duchenne muscular dystrophy reported comparable North Star Ambulatory Assessment (NSAA) scores from live telehealth, caregiver-captured asynchronous at-home video and recorded telehealth assessments. Participants had a mean age of 8.7 years and completed assessments at baseline, three months and six months, according to the study abstract.

Researchers used a video platform compliant with 21 Code of Federal Regulations Part 11 to compare live telehealth with asynchronous at-home videos and to compare live with recorded telehealth scoring. NSAA-certified physical therapists double-scored the assessments. The clinical trial number was listed as not applicable.

Mean NSAA scores were 25.8 for telehealth and 25.1 for asynchronous assessment, a difference of 0.82 points. This difference met the study’s two one-sided tests for equivalence within margins of plus or minus three standard errors of the mean, with p less than 0.001. Live and recorded telehealth scores differed by 0.23 points and were also reported as equivalent, with p less than 0.001. Inter-rater mean absolute differences were 1.87 points overall, comprising 1.61 points for telehealth and 2.15 points for asynchronous video; the abstract states that these values were below the study’s minimum clinically important difference threshold.

Based on the available abstract, the authors characterized remote NSAA administration and scoring as feasible, reliable and clinically comparable across the methods evaluated, supporting decentralized follow-up and data collection in Duchenne muscular dystrophy. The findings are bounded by the sample of 18 participants and the limited information available in the abstract, which does not describe recruitment, attrition, clinical characteristics beyond mean age, or the basis and magnitude of the clinically important difference threshold. Consequently, the abstract alone does not establish the precision or generalizability of the results across broader patient populations.

Subject of Research: Remote administration and scoring of the North Star Ambulatory Assessment in Duchenne muscular dystrophy

Article Title: Use of telehealth and at-home video for remote administration of the North Star Ambulatory Assessment (NSAA): a comparative methods study

Article References: Kane, A. S., Foreman, N., Lazzaro, E. C., Lastra, J. D., Gothier, J. D., Posner, N., & Jones, C. (2026). Use of telehealth and at-home video for remote administration of the North Star Ambulatory Assessment (NSAA): a comparative methods study. BMC Health Services Research. https://doi.org/10.1186/s12913-026-15496-w

Image Credits: AI Generated

DOI: 10.1186/s12913-026-15496-w

Keywords: Duchenne muscular dystrophy, North Star Ambulatory Assessment, telehealth, at-home video, remote assessment, physical therapy, equivalence testing, clinical comparability, at-home, video, remote, administration