Adaptation and Content Validation of the Adherence to Treatment of Neurological Physiotherapy Questionnaire (AdT-NeuroPhysio) in Spanish People with Stroke

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Background: Adherence to rehabilitation programmes is often poor after stroke, which limits functional recovery. Although adherence to rehabilitation programmes is frequently inadequate following a stroke and limits functional recovery, there is a need for more measures based on patient-reported information to assess this adherence. Purpose: This study aimed to adapt and validate the content of the Adherence to Treatment of Neurological Physiotherapy (AdT-NeuroPhysio) questionnaire for Spanish persons with subacute stroke. Patients and methods: After initial item adaptation by authors, a two-round Delphi study with 165 national stroke rehabilitation experts assessed relevance, comprehensibility, and content validity. Content Validity Indices (I-CVI, S-CVI), probability of chance agreement (Pc), and internal consistency (Cronbach's α) were calculated. Open-ended questions were proposed to gather author's extended opinion on items. Cognitive testing with 12 participants evaluated comprehensibility and feasibility. Results: After the two rounds, the AdT-NeuroPhysio demonstrated excellent content validity (I-CVI range: 0.80-0.98; S-CVI=0.90), negligible chance agreement, and good internal consistency (α=0.819). The compliance subscale showed high consistency (α=0.804), while the beliefs subscale was acceptable (α=0.685). Two open-ended sections on environmental barriers/facilitators were added. In the pilot study, participants found the questionnaire highly comprehensible (S-CVI=1), feasible, and easy to complete (mean time: ~3 minutes). Conclusion: The AdT-NeuroPhysio is a content-validated, comprehensible and feasible assessment for evaluating therapeutic adherence from the patient's perspective in Spanish subacute stroke populations. Further psychometric studies in larger samples are needed.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.