Physical Medicine and Rehabilitation Department, Clermont-Auvergne University, CHU Louise-Michel, Clermont-Ferrand University Hospital Center, route de Chateaugay, 63118 Cebazat, France.
Université Clermont Auvergne, CHU Clermont-Ferrand, CNRS, SIGMA Clermont, Institut Pascal, 63000 Clermont-Ferrand, France.
Ann Phys Rehabil Med. 2020 May;63(3):202-208. doi: 10.1016/j.rehab.2019.07.009. Epub 2019 Sep 18.
The physical activity (PA) level of individuals with knee osteoarthritis is lower than in the general population. International recommendations recommend a non-pharmacological intervention including a self-management education program, weight loss and an adapted exercise program. However, we have no scale assessing the perceived barriers to and facilitators of PA in this population.
We constructed and validated a self-administered questionnaire assessing perceived barriers to and facilitators of regular practice of PA in people with knee osteoarthritis.
Semi-structured interviews identified 24 barriers and facilitators. We developed a 24-item questionnaire, Evaluation of the Perception of Physical Activity (EPPA) that was completed by 548 individuals with knee osteoarthritis, to assess acceptability, construct validity, internal consistency and convergent validity. Participants also completed the Knee Osteoarthritis Fears and Beliefs Questionnaire (KOFBeQ), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and International Physical Activity Questionnaire (IPAQ). Reliability and sensitivity to change were evaluated in a second group of 168 people with knee osteoarthritis at a 3-week spa therapy resort.
Factorial analysis identified 17 items grouped into 4 subscales (Barriers, Facilitators, Motivation and Beliefs). The internal consistency was good for Barriers, Facilitators and Motivation subscales (Cronbach α>0.70) and intermediate for the Beliefs subscale (Cronbach α=0.64). The EPPA subscale scores were significantly correlated with KOFBeQ and WOMAC scores but not associated with IPAQ physical activity level. Reliability was good for all subscales, with intraclass correlation coefficients>0.60. A sensitivity to change was found for only the Beliefs subscale, with a moderate effect size.
The EPPA questionnaire has good psychometric properties and can help guide the management of knee osteoarthritis. It can be used in research for evaluating the perception of physical activity.
膝骨关节炎患者的身体活动（PA）水平低于一般人群。国际建议推荐一种非药物干预措施，包括自我管理教育计划、减肥和适应性锻炼计划。然而，我们没有评估该人群 PA 感知障碍和促进因素的量表。
我们构建和验证了一种自我管理问卷，用于评估膝骨关节炎患者定期进行 PA 的感知障碍和促进因素。
半结构化访谈确定了 24 个障碍和促进因素。我们开发了一个包含 24 个项目的问卷，即身体活动感知评估问卷（EPPA），该问卷由 548 名膝骨关节炎患者完成，以评估可接受性、结构有效性、内部一致性和收敛有效性。参与者还完成了膝关节骨关节炎恐惧和信念问卷（KOFBeQ）、西部安大略省和麦克马斯特大学骨关节炎指数（WOMAC）和国际体力活动问卷（IPAQ）。在第二个由 168 名膝骨关节炎患者组成的小组中，在 3 周的温泉治疗胜地评估了可靠性和对变化的敏感性。
因子分析确定了 17 个项目，分为 4 个分量表（障碍、促进因素、动机和信念）。障碍、促进因素和动机分量表的内部一致性良好（Cronbach α>0.70），信念分量表的内部一致性中等（Cronbach α=0.64）。EPPA 分量表得分与 KOFBeQ 和 WOMAC 评分显著相关，但与 IPAQ 身体活动水平无关。所有分量表的可靠性均良好，组内相关系数>0.60。仅发现信念分量表具有变化敏感性，具有中等效应大小。
EPPA 问卷具有良好的心理测量学特性，可帮助指导膝骨关节炎的管理。它可用于研究评估对身体活动的感知。
