Darcy Ummels

160 | Addendum English summary Physical activity is key to preventing chronic disease and enabling participation in activities of daily living. Healthcare professionals, such as physiotherapists, occupational therapists, psychosomatic therapists, and nurse practitioners, often measure the physical activity levels of their patients, including older adults and people with chronic diseases. Currently, healthcare professionals use questionnaires and diaries to gain insight into their patients’ physical activity levels. However, most questionnaires and diaries lack validity, reliability, and feasibility. A potential alternative method of measuring physical activity, both within and beyond the context of healthcare, is to use activity trackers, which are known to provide objective data and are feasible in use in a healthy population. However, there is a gap of evidence on both the validity and feasibility of activity trackers for those with slower walking speeds and activity levels, such as (older) adults with or without chronic diseases which are often seen in healthcare. Furthermore, no guidelines have been developed or studies performed to aid healthcare professionals in using activity trackers in their daily clinical practices. Therefore, the primary aim of this dissertation was to increase the knowledge about the meaningful* use of activity trackers in healthcare, particularly for (older) adults with chronic diseases and older adults with or without chronic diseases. To achieve this objective, this dissertation was divided into three phases. In phase one, the validity and feasibility of commercially available activity trackers were assessed in (older) adults with chronic diseases. In phase two, an existing activity tracker was (re)designed for older adults with or without chronic diseases by adjusting the tracker’s algorithm and upgrading its user interface. The ‘new’ activity tracker was called ‘The Measure It Super Simple (MISS)’ Activity. The feasibility of the MISS Activity was evaluated among older adults with or without a chronic disease. In phase three the MISS Activity was integrated into daily clinical practice. Chapter One begins by stressing the importance of physical activity and physical capacity to one’s possebilities to fully participate in daily life. The chapter then delineates how healthcare professionals can measure physical activity by using subjective measurement tools (questionnaires and diaries) or objective measurement tools (doubly labelled water or indirect calorimetry). Furthermore, the advantages and disadvantages of these * The word ‘meaningful’ refers to our intention that the use of an activity tracker should be personalised and incorporated into daily life and healthcare in a manner that the data support both the patient and healthcare professional. It should provide insight into the patient’s activity levels, aid decisions, and support the formulation of recommendations for changing the patient’s behavioural habits towards a healthier lifestyle.