Validation of the Persian Version of the Exercise Adherence Rating Scale in Iranian Population: A Methodological Study

Background: Adherence to exercise is the degree to which an individual's behavior conforms to the agreed recommendations of healthcare providers. Objectives: This study was done to translate and validate the Exercise Adherence Rating Scale (EARS) in the Iranian population. Methods: A total of 160 patients with musculoskeletal pain participated in this methodological and cross-sectional study. At first, the English version of EARS was translated into the Persian language. The translation process was applied in a forward and backward fashion by four native Persian speakers based on international guidelines. Content validity [content validity ratio (CVR), content validity index (CVI)], construct validity [exploratory factor analysis (EFA)], test-retest reliability, and internal consistency of the Persian version of the EARS were assessed. Results: The results showed that the Persian version of EARS is contently valid (CVR: 0.6 - 1, CVI: 0.8 - 1). Principal axis factoring for construct validity showed that the EARS items loaded to one component (adherence behavior: variance = 67.76%, adherence/non-adherence reasons: variance = 61.88%). Test-retest reliability analysis showed good to excellent reproducibility (0.88 - 1). The internal consistency of the translated questionnaire was in good ranges (0.7 - 0.74). Conclusions: The translated version of EARS is a reliable and valid measure to assess exercise adherence. Our study results have implications for conducting comparative studies and clinical trials in the Iranian people who need home-based exercises.