Translation, validation and reliability of the Exercise Adherence Rating Scale

Abstract

Background: Evidence for reliable and valid measurements to determine the adherence trough self-reported measurements is limited. Measuring adherence can help to determine whether changes in outcomes could be explained by the extent of adherence to the HBEPs. In the UK, a standardized questionnaire is developed to measure the adherence to home-based exercise programs (HBEPs). A valid and reliable tool to assess exercise adherence behavior is required in the Netherlands. Aim: To determine the test-retest reliability, the concurrent and construct validity of the translated Exercise Adherence Rating Scale (EARS) in a sample of Dutch adults with chronic low back pain (CLBP) who received a prescribed HBEP by a primary care physiotherapist. Methods: The EARS is translated from English to Dutch using a forward-backward procedure. Only adults of 18 years or older whom suffered from CLBP for a duration of more than three months were included in this study. Patients completed the EARS twice, the treating physiotherapist completed the Utrecht HBA Adherence Scale (UHAQ) once. The test-retest reliability was tested with the weighted kappa coefficient between the first and the second round of the EARS. The concurrent validity was determined using Spearman’s rho between the EARS and UHAQ. For construct validity, five hypotheses were formed and then tested with a correlation coefficient. Results: Thirty-eight participants with CLBP were included in the statistical analysis. The test-retest reliability was moderate (k = .58). The correlation between the EARS and the UHAQ was r = 0.04. The construct validity was only partly confirmed as three out of five hypotheses were in line with the expected correlation. Conclusion: The translated version of the EARS showed moderate test-retest reliability, low concurrent validity, and a partly confirmed construct validity in patients with CLBP. Clinical Relevance: The EARS is a reliable scale to measure the adherence to HBEPs. It can provide the treating physiotherapist an insight into the facilitators and barriers of patients to the HBEP adherence.