Measurement Properties of Spanish Versions of Two Exercise Self-Efficacy Scales in People with Multiple Sclerosis

@article{santoyomedina2026measurement,
  title = {{Measurement Properties of Spanish Versions of Two Exercise Self-Efficacy Scales in People with Multiple Sclerosis}},
  author = {Santoyo-Medina C and Janer M and Lidón-Moyano C and Meza-Murillo ER and Galán I and Montalban X and Bagur-Calafat C and Sastre-Garriga J and Amor-Barbosa M},
  journal = {Patient Preference and Adherence},
  year = {2026},
  month = nov,
  url = {https://www.dovepress.com/measurement-properties-of-spanish-versions-of-two-exercise-self-effica-peer-reviewed-fulltext-article-PPA},
  note = {CC BY},
}

TY  - JOUR
TI  - Measurement Properties of Spanish Versions of Two Exercise Self-Efficacy Scales in People with Multiple Sclerosis
AU  - Santoyo-Medina C
AU  - Janer M
AU  - Lidón-Moyano C
AU  - Meza-Murillo ER
AU  - Galán I
AU  - Montalban X
AU  - Bagur-Calafat C
AU  - Sastre-Garriga J
AU  - Amor-Barbosa M
PY  - 2026
DA  - 2026/11/08
JO  - Patient Preference and Adherence
UR  - https://www.dovepress.com/measurement-properties-of-spanish-versions-of-two-exercise-self-effica-peer-reviewed-fulltext-article-PPA
AB  - Carme Santoyo-Medina,1,2 Montserrat Janer,1 Cristina Lidón-Moyano,2 Edwin Roger Meza-Murillo,1 Ingrid Galán,1 Xavier Montalban,1 Caritat Bagur-Calafat,2 Jaume Sastre-Garriga,1 Marta Amor-Barbosa2 1Neurology-Neuroimmunology Department & Neurorehabilitation Unit, Multiple Sclerosis Centre of Catalonia, Vall D’Hebron University Hospital, Barcelona, Spain; 2Department of Physiotherapy, Faculty of Medicine and Health Sciences, Universitat Internacional De Catalunya, Sant Cugat del Vallès, SpainCorrespondence: Carme Santoyo-Medina, Department of Physiotherapy, Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Spain, Email [email protected]; Caritat Bagur-Calafat, Department of Physiotherapy, Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Spain, Email [email protected]: Regular physical activity (PA) is recommended for people with multiple sclerosis (PwMS), yet long-term exercise adherence remains suboptimal. Exercise self-efficacy is a key patient-reported determinant of exercise initiation and maintenance, making its assessment relevant for both clinical practice and research. Although the Exercise Self-Efficacy Scale (EXSE; McAuley et al 1993) and the Exercise Self-Efficacy (ESE; Neupert et al 2009) have been previously used, validated Spanish versions are not available. This study aimed to translate, culturally adapt, and evaluate the measurement properties of the Spanish versions of the EXSE-McAuley (EXSE-Sp) and ESE-Neupert (ESE-Sp) in Spanish PwMS.Methods: The EXSE-McAuley and ESE-Neupert were translated and cross-culturally adapted into Spanish according to Beaton’s guidelines. Ninety-three Spanish PwMS completed both questionnaires twice, with a 7– 10-day interval between assessments at the end of their rehabilitation program. Structural validity, internal consistency, test–retest reliability, measurement error, and construct validity were evaluated following the COSMIN framework.Results: Both instruments demonstrated a unidimensional structure with adequate structural validity. Internal consistency was excellent for the EXSE-Sp (Cronbach’s α = 0.977) and good for the ESE-Sp (α = 0.896). Test–retest reliability was excellent (ICC = 0.992 and 0.969, respectively), with low measurement error (SEM = 2.83 and 1.20 points; Smallest Detectable Change [SDC] = 7.86 and 3.33 points, respectively). Construct validity was supported by the expected moderate positive correlation between the two scales (r = 0.56, p < 0.001), indicating that they assess related yet complementary aspects of exercise self-efficacy.Conclusion: The EXSE-Sp and ESE-Sp demonstrate good measurement properties and are suitable for assessing exercise self-efficacy in Spanish PwMS. These patient-reported measures may support clinical assessment, patient-centred rehabilitation planning, and evaluation of interventions targeting long-term PA participation.Graphical Abstract: Infographic titled, Patient Preference and Adherence and, Measurement properties of Spanish versions of two exercise self-efficacy scales in people with multiple sclerosis. Background. Regular physical activity improves health and quality of life in people with multiple sclerosis (PwMS), but long-term exercise adherence is often low. Exercise self-efficacy, the confidence to be active despite challenges, is a key factor influencing exercise initiation and maintenance. Two questionnaires have been used to measure exercise self-efficacy, but Spanish versions were not available. Aim. To translate, culturally adapt and evaluate the measurement properties of: EXSE, Exercise Self-Efficacy Scale by McAuley. ESE, Exercise Self-Efficacy by Neupert. in Spanish-speaking people with multiple sclerosis. Methods. Participants: 93 PwMS completed both questionnaires twice (test-retest) after a rehabilitation period. Translation and cross-cultural adaptation: Following Beaton’s guidelines. Test-Retest Interval: 7 to 10 days. Participants maintained their usual exercise routine. Measurement Properties Evaluated: Internal consistency. Test-retest reliability. Measurement error. Construct validity (structural, convergent and known-groups). Results. Internal consistency. Excellent consistency for EXSE-Sp and good consistency for ESE-Sp. EXSE-Sp Cronbach’s alpha 0.977. ESE-Sp Cronbach’s alpha 0.896. Minor floor effect and moderate ceiling effect for EXSE-Sp. No relevant floor or ceiling effects for ESE-Sp. Test-retest reliability. Excellent reliability for both scales. EXSE-Sp ICC (95 percent CI) 0.992 (0.987 to 0.995). ESE-Sp ICC (95 percent CI) 0.969 (0.954 to 0.980). Bland-Altman plots showed good agreement with no systematic bias. Measurement error. Low measurement error for both scales. SEM: EXSE-Sp 2.83; ESE-Sp 1.20. SDC: EXSE-Sp 7.86; ESE-Sp 3.33. Changes above the SDC are likely to represent true change beyond error. Structural validity. Both scales showed a unidimensional structure. EXSE-Sp 86.7 percent. ESE-Sp 55.5 percent. Good sampling adequacy (KMO 0.890 and 0.885; p less than 0.001). Construct validity. Convergent validity: Moderate correlation between scales (Spearman’s rho 0.56, p less than 0.001). Known-groups validity: No significant differences in scores across disability levels (EDSS groups). EXSE-Sp: p equals 0.253. ESE-Sp: p equals 0.637. Conclusion. The Spanish versions of the EXSE and ESE demonstrate strong measurement properties and are reliable tools to assess exercise self-efficacy in Spanish-speaking people with multiple sclerosis. These instruments can help identify individuals who may need additional support to stay active. They support personalized rehabilitation and the evaluation of exercise-based interventions. Their use may contribute to improving long-term physical activity participation and exercise adherence among people with multiple sclerosis. Clinical and research implications. Easy-to-use, patient-reported tools in…
SN  - 1177-889X
ER  -