《锻炼依从性评定量表》（EARS-Br）的巴西葡萄牙语版本在慢性下背痛患者中表现出了可接受的信度、效度和反应度。
The Brazilian Portuguese version of the Exercise Adherence Rating Scale (EARS-Br) showed acceptable reliability, validity and responsiveness in chronic low back pain.
机构信息
Post Graduate Program on Rehabilitation and Functional Performance, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.
Department of Health Sciences and Post Graduate Program on Rehabilitation and Functional Performance, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.
出版信息
BMC Musculoskelet Disord. 2020 May 12;21(1):294. doi: 10.1186/s12891-020-03308-z.
BACKGROUND
This study aimed to adapt the Exercise Adherence Rating Scale (EARS) into Brazilian Portuguese and evaluate its measurement properties, given as reliability, validity, and responsiveness in patients with non-specific Chronic Low Back Pain (CLBP).
METHODS
A total of 108 patients with a mean age of 46.62 years (SD = 9.98) and CLBP participated in this longitudinal study. Participants were oriented on undertaking the prescribed exercises in the first session, and adherence behavior was assessed after 1 week, and finally reassessed after 2 weeks (test-retest reliability). Three weeks after the first assessment, they were invited again to full fill the EARS (responsiveness). The intraclass correlation coefficient (ICC) and Cronbach's α were used to assess test-retest reliability and internal consistency, respectively. Spearman's correlation and confirmatory factor analysis (CFA) were used to assess construct validity, and the Receiver operating characteristic curve and area under the curve (AUC) were used to analyze responsiveness.
RESULTS
The one-factor EARS-Br (adherence behavior) structure with 6 items showed acceptable fit indexes (comparative fit index and goodness of fit index> 0.90 and root-mean-square error of approximation< 0.08). The EARS-Br scale showed acceptable internal consistency (α = 0.88) and excellent reliability (ICC = 0.91 [95% CI 0.86-0.94]). Mild to moderate correlations were observed between EARS-Br total score vs. disability, pain catastrophizing, depression/anxiety, fear-avoidance and pain intensity. A Minimally Important Change (MIC) of 5.5 in the EARS-Br total score was considered as a meaningful change in the adherence behavior (AUC = 0.82). Moderate accuracy (AUC = 0.89) was obtained for a 17/24 total EARS cutoff score after home exercise was prescribed. The sensitivity and specificity were also acceptable (greater than 80%).
CONCLUSION
Our results demonstrated acceptable EARS-Br reliability, validity, and responsiveness for patients with CLBP. A final score of 17/24 on EARS after the prescription of home-exercise could be used as a cut-off for an acceptable adherence behavior associated with improvement in patient outcomes.
背景
本研究旨在将《运动依从性评定量表》（EARS）改编为巴西葡萄牙语版本，并评估其在非特异性慢性下背痛（CLBP）患者中的测量特性，包括信度、效度和反应度。
方法
共有 108 名平均年龄为 46.62 岁（SD=9.98）的 CLBP 患者参与了这项纵向研究。在第一次评估后，参与者被指导在第一节课上进行规定的运动，1 周后评估依从性，2 周后再次评估（测试-重测信度）。第一次评估后 3 周，再次邀请他们填写 EARS（反应性）。采用组内相关系数（ICC）和克朗巴赫 α 评估测试-重测信度和内部一致性，Spearman 相关和验证性因子分析（CFA）评估结构效度，受试者工作特征曲线和曲线下面积（AUC）分析反应性。
结果
EARS-Br（依从行为）的 6 项单因素结构具有可接受的拟合指数（比较拟合指数和拟合优度指数>0.90，均方根误差近似值<0.08）。EARS-Br 量表具有可接受的内部一致性（α=0.88）和极好的信度（ICC=0.91[95%置信区间 0.86-0.94]）。EARS-Br 总分与残疾、疼痛灾难化、抑郁/焦虑、恐惧回避和疼痛强度之间存在轻度至中度相关性。EARS-Br 总分 5.5 被认为是依从行为的最小重要变化（MIC）（AUC=0.82）。在规定家庭运动后，EARS 总分为 17/24 时，具有中等准确性（AUC=0.89）。EARS 总分为 17/24 时的灵敏度和特异性也可接受（大于 80%）。
结论
本研究结果表明，EARS-Br 在 CLBP 患者中具有可接受的信度、效度和反应性。家庭运动后 EARS 得分为 17/24 可作为一个可接受的依从行为的截止值，与患者结局的改善相关。
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