Darcy Ummels

Patients’ experiences with commercially available activity trackers embedded in physiotherapy treatment | 45 3 Introduction Activity trackers are increasing in popularity, with the top five brands combined selling 102.4 million activity trackers worldwide in 2016. 1 These activity trackers are primarily targeted at a healthy and athletic population, but they might have potential for other specific groups such as those in healthcare. In 2016 almost 9 million people in the Dutch population (52%) suffered from one or more chronic diseases, with neck ‐ and back pain, osteoarthritis and Diabetes Mellitus in the top three. 2 Over 90% of the inhabitants who are 70 years or older have one or more chronic diseases, the prevalence in inhabitants younger than 40 years is already 35%. 2 There is a positive relationship between physical activity and reduced premature death and the prevention of chronic diseases. 3 ‐ 5 For example, sufficient physical activity can reduce pain for people with osteoarthritis, can effectively control fasting and post ‐ walk blood sugar levels in patients with Diabetes Mellitus and can reduce the risk of emergency admission in patients with chronic lung diseases. 3 An adequate level of physical activity is one of the main points stressed in daily clinical practice, especially in physiotherapy, and recommended in evidence ‐ based professional guidelines. 6,7 Therefore, people with a chronic disease are a target group par excellence for additional support through monitoring and objectively measuring physical activity in daily life. Physiotherapists provide professional support with tailored advice on lifestyle changes 6 based on physical activity level and activity time distribution per day. They use questionnaires and diaries to measure the physical activity levels of their participants. However, questionnaires and diaries are time ‐ consuming, have limited reliability and validity and depend on the patient ’ s memory. 8,9 A promising alternative to overcome these limitations is activity trackers. They can provide an objective measurement of the person ’ s physical activity level, give insight into the distribution of physical activity levels during the day, and may motivate people to enhance their daily activity level. 10 The use of activity trackers in healthcare can aid in monitoring treatment results in the patient ’ s daily life, increasing self ‐ management, saving time and money, while addressing the actual setting where the lifestyle change should be achieved. A good quality measurement device is important for implementation purposes. Several publications can be found regarding the clinimetric properties, validity and reliability of activity trackers. 11 ‐ 14 Activity trackers have been shown to be valid during walking and running, however in daily living, activity trackers have a lower validity in people with a chronic disease. 11 ‐ 14 Another important property concerns feasibility, i.e., experiences with activity trackers in healthcare. In this context, feasibility is understood as an umbrella concept, including