Arabic Version of the EARS Questionnaire

Study Overview
=================
Brief Summary
-----------------
A study to translate and cross-culturally adapt the Exercise Adherence Rating Scale (EARS) into the Arabic language, and assess its psychometric properties.

Official Title
-----------------
Cross-cultural Adaptation and Psychometric Properties of the Arabic Version of the Exercise Adherence Rating Scale

Conditions
-----------------
Knee Osteoarthritis, Low Back Pain

Intervention / Treatment
-----------------
* Other: Standard treatment


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: Low back pain patients: aged 18 years or older, experienced non-specific CLBP of 3 months or longer, pain localized to the lumbar region. Knee OA patients: eligible participants must meet the knee OA diagnostic criteria according to the American College of Rheumatology (ACR). Exclusion Criteria: degenerative systemic diseases neurological symptoms lumbar stenosis spondylolisthesis history of spinal or knee surgeries pregnancy rheumatoid arthritis serious pathological conditions (inflammatory arthritis and malignancy) individuals who cannot read and understand documents written in the Arabic language.

Ages Eligible for Study
-----------------
Minimum Age: 20 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------

Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Knee Ostearthritis/ Low Bakc Pain<br>Patients referred for physical therapy rehabilitation | Other: Standard treatment<br>* Participants shall fill the EARS-Ar questionnaire three times within one month in addition to other questionnaires including the Roland Morris Disability Questionnaire (RMDQ) for low back pain (LBP) patients, and the Knee injury and Osteoarthritis Outcome Score (KOOS) for knee OA patients, in addition to the Fear-Avoidance Beliefs Questionnaire (FABQ), the Numeric Pain Rating Scale (NPRS), and the Global Rating of Change Scale (GRoC). The first time will be one week after enrolling in the study and receiving the prescribed home exercise program. the second time will be 3-6 days later to test the reliability of the EARS-Ar. After another week, participants will refill the EARS-Ar and the GRoC to test responsiveness.<br>|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Floor and ceiling effect | It will be considered present if more than 15% of the sample score the lowest or highest possible total score, respectively | 1 day | 
| Content Validity | Assessed using the Content Validity Index (CVI) with an acceptable value of at least 0.8. | 1 day | 
| Construct Validity | Assessed by calculating the Spearman's correlation coefficient (ρ) between the Exercise Adherence Rating Scale-Arabic version (EARS-Ar) score and the Fear Avoidance Belief Questionnaire (FABQ), the Numeric Pain Rating Scale (NPRS), the Roland-Morris Disability Questionnaire (RMDQ), and the Knee Injury and osteoarthritis Outcome Score (KOOS) measurement tools. The coefficient is classified as follows: ρ = 0.3-0.7 moderate correlation, and >0.7 strong correlation. | 1 day | 
| Internal Consistency | Assessed by calculating the Cronbach's alpha (α) and the corrected item-total correlation. A Cronbach's α value of ≥0.7, and a corrected item-total correlation, measured using the Pearson correlation coefficient, of ≥0.3 will be considered acceptable. | 3-7 days | 
| Test-retest Reliability | Assessed by calculating the intraclass correlation coefficient (ICC) between the EARS-Ar scores of the first two test sessions. An ICC value of >0.8 and 0.6-0.8 will be considered as excellent and good correlation, respectively. | 3-7 days | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Responsiveness | Participating patients will be categorized according to their reported Global Rating of Change (GRoC) scores (external anchor) to either improved (GRoC≥3) or stable group (GRoC<3 to >-3) and a between-group comparison will be performed using an unpaired t-test. | 3 weeks |