Darcy Ummels

English summary | 161 S measurement tools are discussed. Thereafter, the potential use of activity trackers in healthcare is discussed, as is the aforementioned validity, and feasibility. Finally, the lack of knowledge regarding the meaningful use of activity trackers in healthcare is outlined. At the end of the first chapter, the objective, research questions, and outline of this thesis are described. Chapter Two describes the procedure and results of a validation study. This study aimed to investigate the validity of nine commercially available activity trackers for measuring step count during activities of daily living in people who have a chronic disease and are receiving physiotherapy. The selected activity trackers were the Accupedo (Corusen LLC), Activ8 (Remedy Distribution Ltd), Digi ‐ Walker CW ‐ 700 (Yamax), Fitbit Flex (Fitbit inc), Lumoback (Lumo Bodytech), Moves (ProtoGeo Oy), Fitbit One (Fitbit inc), UP24 (Jawbone), and Walking Style X (Omron Healthcare Europe BV). In total, 130 (older) adults with chronic diseases performed a standardised activity protocol, based on activities of daily living. The protocol was recorded on camera, and their step count was analysed through video observations (gold standard). The validity of the trackers’ step count was assessed by correlation coefficients, t ‐ tests, scatterplots, and Bland ‐ Altman plots. The correlations between the number of steps counted by the activity trackers and the gold standard were low (range: ‐ 0.02 to 0.33). For all activity trackers except the Fitbit One, a significant systematic difference with the gold standard was found for the step count. Plots showed a wide range in scores and an average underestimation was found for all activity trackers, except for the Activ8, for which an average overestimation was found. In conclusion, this study showed that the validity of nine commercially available activity trackers is low regarding their capacity to measure the step count of (older) adults who have chronic diseases, are receiving physiotherapy, and are engaged in activities of daily living. Chapter Three illustrates the experience with commercially available activity trackers within the physiotherapeutic treatment of (older) adults with chronic diseases. The qualitative study in question included twenty ‐ nine participants with a chronic disease. Each participant wore one of the following activity trackers: Accupedo (Corusen LLC), Activ8 (Remedy Distribution Ltd), Digi ‐ Walker CW ‐ 700 (Yamax), Fitbit Flex (Fitbit inc), Lumoback (Lumo Bodytech), Moves (ProtoGeo Oy), Fitbit One (Fitbit inc), UP24 (Jawbone), and Walking Style X (Omron Healthcare Europe BV) throughout the day for two to eight weeks. Data were collected using twenty ‐ three individual interviews as well as a focus group with six participants. A framework analysis with deductive and inductive content analyses was used to analyse the data. The framework analysis produced seven categories: purchase, instruction, characteristics, correct functioning, sharing data,