How Patient Education Helps Patients With Chronic Musculoskeletal Disorders Stick to Home Exercise for Pain Relief.

The EARS-Ar survey will capture self-reported adherence levels to the prescribed home exercise program. The Exercise Adherence Rating Scale (EARS) is a six-item self-report measure that was developed to assess exercise adherence behavior. Each item is rated on a five-point Likert scale (0=completely agree to 4=completely disagree). Item scores are summed, and a higher total score denotes greater adherence (0-24). Three items (items 1, 4, and 6) with positive phrases are reversely scored. Its constructive validity and reliability have been established. The EArs was successfully cross-culturally adapted into Arabic following international guidelines. It has also demonstrated adequate accuracy and sensitivity to assess change in exercise adherence behavior. An EArs-Ar score of 12.5/24 could be used as a cutoff to indicate a patient's appropriate exercise adherence associated with improvement of symptoms.

The Numeric Pain Rating Scale (NPrs) is a horizontal 11-point scale (0-10), with 0 indicating no pain and 10 indicating the worst pain ever.

The Roland-Morris Disability Questionnaire (RMDQ) is a patient-reported outcome measure thatassesses LBP disability related to daily activities. It is comprised of 24 items, and patients check the item applicable to them on that specific day. Checked items are summed, and a total score is obtained (0-24). A higher score indicates greater disability. The RMDQ was cross-culturally translated to the Arabic language and showed good validity and reliability.

The Fear Avoidance Belief Questionnaire (FABQ) is a 16-item self-report questionnaire assessing the patient's beliefs about fear of movement related to physical activity and work (Waddell et al., 1993). The items are rated on a 7-point Likert scale (0=completely disagree to 4=completely agree). Higher total score (0-96) denotes strongly established fear avoidance beliefs. The questionnaire has two subscales; the work subscale (FABQw) with seven questions (maximum score of 42) and the physical activity subscale (FABQpa) with four questions (maximum score of 24). It was adapted and validated to Arabic language

The Knee Injury and OA Outcome Score (KOOS) is a self-report questionnaire used to subjectively assess five knee OA-relevant domains: Pain, Symptoms, Activities of Daily Living (Function), Sport and Recreation Function (Sport/Rec), and knee-related Quality of Life (QOL). It comprises 42 questions across the 5 subscales. A 5-point Likert scale (0-4) is used to answer 5 questions. Finally, A normalized score from 0 (extreme symptoms) to 100 (no symptoms) is calculated for each subscale. It was translated into Arabic and demonstrated good validity and reliability.

This outcome measure applies only to patients with knee OA.

The Quick DASH-Arabic questionnaire will be used to assess the functional limitations of the shoulder. This 11-item, paper-based survey uses a 5-point scale to measure the perceived difficulty in performing daily activities, with a higher score indicating greater impairment. The Quick DASH-Arabic is a reliable and validated self-reported questionnaire used to evaluate upper extremity musculoskeletal conditions. This outcome measure applies to patients with shoulder conditions.