Darcy Ummels

English summary | 163 S Alta HR. In a cross ‐ sectional validation study, twenty older adults performed an activity protocol based on activities of daily living. Their performance was video recorded and analysed for step count and dynamic, standing, and sedentary time. Validity was assessed by percentage error (PE), absolute percentage error (APE), Bland ‐ Altman plots, and correlation coefficients. For step count, MOX MissActivity had a mean APE of 9.3% and a correlation coefficient of 0.88. The mean APE values of dynamic, standing and, sedentary time were 15.9%, 19.9%, and 9.6%, respectively. The correlation coefficients were 0.55, 0.91, and 0.92, respectively. The MOX Annegran , the activPAL, and the Fitbit Alta HR showed higher errors and lower correlations for all outcome variables. This study showed that the optimised algorithm parameter settings can more validly estimate step count and physical behaviour during activities of daily living of older adults with our without chronic diseases wearing an activity tracker in their trouser pocket, than reference applications can. In Chapter Six, the MISS Activity was embedded in daily clinical practice to aid the clinical reasoning of healthcare professionals, to facilitate the engagement of patients in their treatment, and to enhance knowledge about the implementation process in clinical practice. The study was performed in a specialised rehabilitation centre for people with chronic somatic symptom disorders specific to spinal pain, and both healthcare professionals (psychosomatic therapists) and patients participated. An action research design was used so that psychosomatic therapists and patients could experience, reflect on, and learn about how and when they can use activity trackers. This process used as a departure point a draft manual, which the therapist adapted during the iterations to their specific context. Data collection was performed with audio recordings of conversations about the activity trackers during therapy, reflection sessions with the therapists with support from the research team, and semi ‐ structured individual interviews with the patients. Analyses were performed by directed content analyses based on the coding framework of Chapter Three. In total, three therapists and eleven patients participated. Twenty ‐ eight conversations during therapy about the measurement of physical activity, eleven semi ‐ structured interviews, and four reflection sessions were recorded within three iteration sessions. Throughout the iterations, therapists continued to develop the manual in which their theoretical framework and clinical reasoning were integrated. To achieve adequate reflection and depth during the reflection sessions, therapists needed a considerable amount of guidance from the research team. They also required sufficient time and sufficient patients to build up a knowledge base upon which to act. The therapists formulated exclusion criteria for patients as well as a flowchart clarifying when the activity tracker should be used, how to define goals, and how to discuss the (data of) the activity tracker. Not only did this action