Chronic diseases are the leading cause of mortality and disability worldwide. Exercise therapy has been found effective for mortality, disability and well-being in many chronic conditions. Burden of treatment may reduce patient compliance and treatment efficacy. We aimed to develop and validate a self-reporting questionnaire assessing the burden of exercise therapy for patients with chronic conditions.

We conducted semi-structured interviews with patients to develop items of the questionnaire. The dimensional structure of the questionnaire was assessed by principal component analysis. Construct validity of the instrument was assessed by exploring convergent validity with the Treatment Burden Questionnaire (TBQ) and divergent validity with pain, self-efficacy, treatment satisfaction and health state. Reliability was assessed with the Cronbach alpha coefficient, a test–retest method using the intraclass correlation coefficient (ICC) and Bland-Altman plotting.

A preliminary list of items was developed from semi-structured interviews with 28 patients and reviewed by two expert physicians. Items obtained were reduced. Then, a sample of 163 patients was used to measure the psychometrics of the Exercise Therapy Burden Questionnaire (ETBQ), consisting of 10 items. Principal component analysis extracted one dimension. The Cronbach alpha was 0.86 [0.82–0.89]. Test–retest reliability (n=24 patients) was good, with ICC 0.93 [0.85–0.97], and Bland–Altman analysis did not reveal a systematic trend. The ETBQ showed expected convergent validity with the TBQ (r_s=0.52) and expected divergent validity with pain (r_s=0.37), self-efficacy (r_s=−0.34), treatment satisfaction (r_s=−0.49) and perceived health state (r_s=−0.28).

The ETBQ is the first questionnaire assessing exercise therapy burden in patients with chronic conditions. Its psychometric properties are promising.