Darcy Ummels

Using an activity tracker in daily clinical practice | 115 6 Introduction In the Netherlands in 2019, only 48% of the people with a chronic disease adhered to the physical activity recommendation. 1 Sufficient physical activity has several well ‐ known positive effects, such as prevention of premature mortality and primary and secondary prevention of chronic diseases. 2 A certain amount of physical activity is also needed to participate in daily life activities, such as household, work, and social activities. 3 Insight into a patient’s physical activity level is an important aspect of daily practice for healthcare professionals since it is used for diagnostic, prognostic, and evaluative purposes. 4 Outcomes of these measurements are a direct aid to the clinical reasoning of professionals and increase the engagement of patients in treatment. 5 Questionnaires are frequently used to measure physical activity levels. A review about the measurement properties of 76 physical activity questionnaires stated that only a few had sufficient validity and reliability and none of the questionnaires could be recommended above others. 6 Another review found that the reliability was acceptable for questionnaires (correlation ranging from 0.64–0.79) but the validity of questionnaires was moderate at best (correlation coefficient ranging from 0.25 to 0.41) mainly due to patients’ memory and the potential to induce social ‐ desirability bias. 7,8 A study showed that individuals experience difficulties estimating their physical activity; about half of the inactive participants in the study of Godino et al. overestimated their physical activity level and believed they were sufficiently active. 9 Next to low ‐ to ‐ moderate clinimetric properties, questionnaires and diaries also have low feasibility because they are time ‐ consuming to use for both patients and healthcare professionals. 7,8 Measuring physical activity with an activity tracker has advantages over the use of questionnaires or diaries. They can, for instance, objectively and continuously measure physical activity levels during daily life. Therefore, they provide insight and feedback into real ‐ life physical activity levels, which can guide both patients and healthcare professionals in establishing and changing routine activity behavior. In addition, several systematic reviews have shown that activity trackers are effective to increase physical activity levels 10 ‐ 14 if they are used in combination with an intervention or counseling. Numerous studies have been performed on the measurement qualities of activity trackers, such as validity and reliability, 15 ‐ 20 feasibility, 21 ‐ 28 and effectiveness. 10 ‐ 14,22 A systematic review showed that there is attention to the possible added value of activity trackers in healthcare. 29 These studies researched whether activity trackers were feasible in healthcare 30 or can predict certain events (e.g., hospitalization, length of stay in hospital). 31 ‐ 33 However, in these studies, the activity trackers were only used as an outcome measure and not used in daily routine care. The research teams performed the measurements, data analyses, and conclusions, and the results were not used in