Thesis

Chapter 1 14 Objectives Based on the gap and challenges identified above, the aim of this thesis is threefold: 1. To develop and validate a measurement instrument to objectively measure exercise adherence in patients with COPD; 2. To develop a prediction model to predict the probability of adherence in patients with COPD already following pulmonary rehabilitation in primary care; and 3. To develop a protocol to investigate the effectiveness of more self-management and the predictive validity of the prediction model. Research questions 1. What is the reliability of a Dutch version of the RAdMAT in patients who are undertaking physiotherapeutic rehabilitation in a primary physiotherapy practice? 2. Wat is the structural and construct validity of a Dutch version of the RAdMAT in patients with chronic obstructive pulmonary disease? 3. What are prognostic factors of home-based exercise adherence in patients with chronic diseases? 4. Is adherence constant over time, or does it rather increase or decrease or fluctuate? 5. What factors predict exercise adherence in patients with COPD following pulmonary rehabilitation? 6. What interventions might possibly improve exercise adherence? 7. What is the effectiveness of more self-management in pulmonary rehabilitation? 8. What is the predictive validity of the PATCH tool used in primary physiotherapy practices? Thesis outline Chapter 2 describes the results of a cross-sectional study, performed to evaluate the inter-rater reliability of the Dutch version of the Rehabilitation Adherence Measure for Athletic Training (RAdMAT-NL). This study forms the basis of the development of a measurement instrument to assess exercise adherence in patients with chronic diseases. Chapter 3 explores the dimensionality and construct validity of the RAdMAT-NL in patients with chronic obstructive pulmonary disease (COPD), using a prospective cohort design. In addition, it examines if the RAdMAT-NL could be used as a single

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