Darcy Ummels

General discussion | 143 7 research study are reported in chapter six. Next, chapter seven presents an overview of the main findings of each phase, followed by general methodological considerations. Finally, the lessons learned and the study’s implications for research, practice and education are given. Main findings The main findings are described within the three phases of the project. Phase One: Validity and feasibility of commercially available activity trackers in (older) adults with a chronic disease In chapter two, nine commercially available activity trackers were validated with a standardised free ‐ living protocol in which (older) adults with a chronic disease performed activities of daily living. The step count from the activity tracker was compared with video recordings, which is the gold standard. 1 The correlation between the number of steps counted by the activity trackers and the gold standard was low. All of the activity trackers showed significant systematic differences from the gold standard and both over ‐ and underestimated step count, depending on the number of steps taken. The Fitbit One appeared to be the most valid activity tracker on a group level. On an individual level, the Fitbit One also showed large over ‐ and underestimations of step count. A possible explanation for the low validity of these activity trackers is the generally low walking speed during activities of daily living, since studies showed that low walking speed reduces the validity of activity trackers. 2–5 Next, in chapter three the feasibility of commercially available activity trackers during physiotherapy treatment in (older) adults with a chronic disease was assessed. Patients experienced the use of activity trackers as positive and motivational in terms of increasing their physical activity levels. However, they mentioned several barriers that compromised the feasibility and would have liked more guidance from their physiotherapists. The three most mentioned barriers for (older) adults with a chronic disease were as follows: the complexity of the activity tracker, ‘pre ‐ set’ goals that were too high (e.g. 10.000 steps) and a lack of instructions. Furthermore, patients indicated that neither they nor their physiotherapists integrated the activity tracker into their physiotherapy sessions. Based on the results of this study, a framework was developed to examine the feasibility of activity trackers and other eHealth tools (found in the appendix to chapter three).