The Sport Injury Rehabilitation Adherence Scale : a reliable scale for use in clinical physiotherapy

Objective: To evaluate, through two studies, the factor structure, inter-rater agreement, and test–retest and inter-rater reliability of the Sport Injury Rehabilitation Adherence Scale (SIRAS). Design: Repeated measures design in both Study 1 (video evaluation) and Study 2 (clinical evaluation). Setting: University department (Study 1) and outpatient physiotherapy department (Study 2). Participants: Sixty physiotherapists and physiotherapy students in Study 1 and 45 patients undergoing physiotherapy treatment for a musculoskeletal injury in Study 2. Intervention: In Study 1, participants rated the adherence of a simulated videotaped patient demonstrating high, moderate and low adherence during rehabilitation. In Study 2, two physiotherapists rated the adherence of patients at two consecutive rehabilitation sessions. Main outcome measure: The SIRAS. Results: In Study 1, principal components analysis confirmed a single factor for the SIRAS, and inter-rater agreement values ranged from 0.87 to 0.93. In Study 2, inter-rater and test–retest reliability coefficients ranged from 0.76 [95% confidence interval (CI) 0.54 to 0.83] to 0.89 (95% CI 0.79 to 0.95), and from 0.63 (95% CI 0.36–0.82) to 0.76 (95% CI 0.55–0.88), respectively. Conclusion: The SIRAS is a reliable measure with high inter-rater agreement when used to evaluate clinic-based adherence to physiotherapy rehabilitation for musculoskeletal injury.