Joffrey Drigny1, Charles Joussain2, Vincent Gremeaux3, Remy Morello4, Patrick H Van Truc5, Paul Stapley6, Emmanuel Touzé7, Alexis Ruet8. 1. Service de Médecine Physique et de Réadaptation, CHU de Caen, France. Electronic address: j.drigny@gmail.com. 2. Université de Versailles St-Quentin en Yvelines, INSERM UMR 1179, Montigny-le-Bretonneux, France. 3. Institute of Sport Sciences of University of Lausanne, Lausanne, Switzerland; Swiss Olympic Medical Center, Sport Medicine Unit, Lausanne University Hospital, Lausanne, Switzerland; CIC-P-INSERM 1432, Technological Platform, University Hospital Dijon, France. 4. Unité fonctionnelle de Biostatistique et Recherche Clinique (UBRC) CHU de Caen, France. 5. IMPR du Bois-de-Lébisey, allée des Boisselles, 14200 Hérouville Saint-Clair, France. 6. Neural Control of Movement Laboratory, School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW, Australia. 7. Université de Normandie UNICAEN, INSERM UMR-S U1237, Physiopathologie et imagerie des troubles neurologiques PhIND, Cyceron, Caen, France et Service de Neurologie, CHU de Caen, France. 8. Service de Médecine Physique et de Réadaptation, CHU de Caen, France; Université de Normandie UNICAEN, INSERM UMR-SU1077, Neuropsychologie et Imagerie de la Mémoire Humaine, Caen, France.
Abstract
OBJECTIVE: To develop and validate a self-reported questionnaire assessing the barriers to physical activity (PA) among stroke survivors. DESIGN: Psychometric study. SETTING: Ambulatory stroke care. PARTICIPANTS: A total of one hundred and forty-six (N=146) individuals were included in this study. In stage 1, community-living stroke survivors (n=37; 13 women) with low-moderate disability (modified Rankin Score 0-3, stroke >3mo) were included. In stage 2, participants (n=109; 40 women) with same characteristics were included. Nine professionals experienced in PA for poststroke patients formed an expert panel. INTERVENTIONS: In stage 1, semistructured interviews identified perceived barriers to PA, which were then selected by the expert panel and grouped on a Barriers to Physical Activity After Stroke (BAPAS) scale. In stage 2, stroke participants completed a personal information questionnaire and the BAPAS scale. MAIN OUTCOME MEASURES: An item selection process with factor analysis was carried out. The suitability of the data set was analyzed using the Kaiser-Meyer-Olkin coefficient, internal consistency was evaluated by Cronbach α, and concurrent validity was assessed with Spearman correlation coefficients between the BAPAS scale and the modified Rankin Scale. Test-retest repeatability was estimated using 2-way random effects intraclass correlation coefficient model 2,1 at 4-6 day follow-up (n=21). RESULTS: Factor analysis supported a 14-item BAPAS that explained 62% of total variance (Kaiser-Meyer-Olkin=0.82) and total score calculated higher than 70 (higher scores for higher barriers). Cronbach α was 0.86, Spearman correlation with the modified Rankin Scale was r=0.65 (P<.001), and test-retest intraclass correlation coefficient was 0.91 (95% CI, 0.79-0.97). The BAPAS scores were higher in patients with greater disabilities and in those with a longer time since the stroke event (P<.01). CONCLUSION: We developed and validated the BAPAS scale to assess barriers to PA in stroke survivors with low-moderate disability with promising psychometric properties.
OBJECTIVE: To develop and validate a self-reported questionnaire assessing the barriers to physical activity (PA) among stroke survivors. DESIGN: Psychometric study. SETTING: Ambulatory stroke care. PARTICIPANTS: A total of one hundred and forty-six (N=146) individuals were included in this study. In stage 1, community-living stroke survivors (n=37; 13 women) with low-moderate disability (modified Rankin Score 0-3, stroke >3mo) were included. In stage 2, participants (n=109; 40 women) with same characteristics were included. Nine professionals experienced in PA for poststroke patients formed an expert panel. INTERVENTIONS: In stage 1, semistructured interviews identified perceived barriers to PA, which were then selected by the expert panel and grouped on a Barriers to Physical Activity After Stroke (BAPAS) scale. In stage 2, strokeparticipants completed a personal information questionnaire and the BAPAS scale. MAIN OUTCOME MEASURES: An item selection process with factor analysis was carried out. The suitability of the data set was analyzed using the Kaiser-Meyer-Olkin coefficient, internal consistency was evaluated by Cronbach α, and concurrent validity was assessed with Spearman correlation coefficients between the BAPAS scale and the modified Rankin Scale. Test-retest repeatability was estimated using 2-way random effects intraclass correlation coefficient model 2,1 at 4-6 day follow-up (n=21). RESULTS: Factor analysis supported a 14-item BAPAS that explained 62% of total variance (Kaiser-Meyer-Olkin=0.82) and total score calculated higher than 70 (higher scores for higher barriers). Cronbach α was 0.86, Spearman correlation with the modified Rankin Scale was r=0.65 (P<.001), and test-retest intraclass correlation coefficient was 0.91 (95% CI, 0.79-0.97). The BAPAS scores were higher in patients with greater disabilities and in those with a longer time since the stroke event (P<.01). CONCLUSION: We developed and validated the BAPAS scale to assess barriers to PA in stroke survivors with low-moderate disability with promising psychometric properties.
Authors: Katie I Gallacher; Terry Quinn; Lisa Kidd; David Eton; Megan Dillon; Jennifer Elliot; Natalie Johnston; Patricia J Erwin; Frances Mair Journal: BMJ Open Date: 2019-09-18 Impact factor: 2.692