The Arabic version of the Exercise Adherence Rating Scale: translation, cross-cultural adaptation and psychometric...

To culturally adapt the Arabic version of the Exercise Adherence Rating Scale (EARS) and evaluate its psychometric properties in chronic low back pain patients (CLBP).

This methodological study cross-culturally adapted EARS into Arabic (EARS-Ar) following recommended guidelines. Ninety-three CLBP outpatients were prescribed home-based exercises. Dimensionality of the EARS-Ar was assessed by Confirmatory Factor Analysis (CFA) and validity was assessed by comparing EARS-Ar with Fear-Avoidance Beliefs Questionnaire (FABQ), Numeric Pain Rating Scale (NPRS), and Roland Morris Disability Questionnaire (RMDQ). Internal consistency and test-retest reliability were evaluated. Responsiveness was examined using the receiver operating characteristic curve (AUC).

CFA confirmed dimensionality of the EARS-Ar. It had moderate negative correlations (rho= -0.42 to -0.62) with FABQ, NPRS, and RMDQ. EARS-Ar demonstrated excellent internal consistency (α = 0.97). Intraclass correlation coefficients were excellent (ICCs= 0.89-0.920) with acceptable corrected item correlations (rho= 0.56-0.77). Responsiveness of the EARs-Ar was good with significant moderate correlation (rho= 0.35) between the EARS-Ar change score and global rating of change (GRoC). A cutoff point of 12.5/24 was determined with moderate accuracy (AUC= 0.81, sensitivity= 81%, specificity= 41%).

EARS-Ar showed good reliability, validity, and responsiveness, which renders it a reliable tool for evaluating exercise adherence behavior of CLBP patients.