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

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.