Accepted for/Published in: JMIR Research Protocols
Date Submitted: Oct 16, 2025
Date Accepted: Jun 29, 2026
Remote Assessment of Physical Function and Physical Activity in Adults with Autism Spectrum Disorder: Protocol for Feasibility, Validity, and Reliability
ABSTRACT
Background:
Adults with autism spectrum disorder (ASD) face elevated risks for chronic health conditions and reduced quality of life (QoL), often linked to physical inactivity, motor impairments, and limited access to healthcare services. While communication and social challenges are well-documented, persistent motor impairments such as deficits in coordination, balance, and gait remain underexplored in adulthood. These challenges may contribute to increased fall risk and reduced engagement in physical activity. Telehealth and wearable technologies offer promising solutions to expand access to physical therapy and enable remote monitoring of physical function (PF) and activity levels.
Objective:
This pilot study will evaluate the feasibility, reliability, and validity of remotely administered PF assessments in adults with ASD. Specific aims include: (1) adapting and testing remote assessments of functional mobility and balance tailored to the sensory and motor profiles of adults with ASD; (2) examining differences in PF, physical activity (PA), fall risk, and QoL across racial and ethnic groups; and (3) exploring whether sex and race/ethnicity moderate the relationship between PF/PA and QoL.
Methods:
A two-phase, cross-sectional, noninterventional study will be conducted using secure videoconferencing and wearable activity trackers. Phase 1 will involve remote administration of standardized PF assessments (e.g., Five Times Sit-to-Stand, 30-Second Sit-to-Stand, standing balance, single-leg stance), with video recordings used to evaluate inter- and intra-rater reliability. Phase 2 will include self-report surveys (PROMIS Physical Function, Global Health, Instrumental Support), Lower extremity Functional Scale, Fall Risk Screening Survey, Godin-Shephard Leisure-Time Physical Activity Questionnaire, and PA (steps/day) data collected via Fitbit Inspire devices. Participants will be recruited from the SPARK registry, with targeted outreach to ensure diverse representation.
Results:
A total of 155 adults with ASD (ages 18–59) were enrolled, with 66% female and 77% identifying as Black or Hispanic. Data analysis is underway, and findings will be disseminated through peer-reviewed publications and conference presentations.
Conclusions:
This study represents the first comprehensive evaluation of remote, performance-based PF assessments in adults with ASD. Results will inform standardized telehealth protocols and support future research linking objective functional measures to patient-reported outcomes, ultimately enhancing access to physical therapy services and promoting lifelong wellness in neurodiverse populations. Clinical Trial: NA
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