187 The second step was to provide the basis for developing an exercise adherence prediction model. For this aim, the following research questions were formulated: ‘What are prognostic factors of home-based exercise adherence in patients with chronic diseases?’ (chapter 4) and ‘Is adherence constant over time, or does it rather increase or decrease or fluctuate?’ (chapter 5). Ideally, a prediction model is developed based on a prespecified model to avoid as much selection bias as possible. The systematic review and the meta-analysis described in chapter 4 form the basis of the prespecified model. To determine the time period over which a prediction model can make predictions, chapter 5 describes how adherence behaves over time in this study cohort. The third step of this thesis was to develop an exercise adherence prediction model and to evaluate how this prediction model might be used in primary physiotherapy practices. For this aim, three research questions were formulated: ‘What factors predict exercise adherence in patients with COPD following pulmonary rehabilitation?’ (chapter 6), ‘What interventions might possibly improve exercise adherence?’ (chapter 7) and ‘How might an exercise adherence prediction model be applied in primary physiotherapy practices?’ (chapter 8). To develop the prediction model, chapter 6 adopted a probabilistic approach. To not only predict adherence, but also to better understand the relationship between determinants and adherence, chapter 7 describes the relationship between possible predictors and adherence as a complement to the prediction model of adherence described in chapter 6. Chapter 8 provides a protocol for a study that will evaluate the effectiveness of self-management within pulmonary rehabilitation on health outcomes in patients with COPD, the predictive validity of the prediction model, and the feasibility and acceptability of self-management and the prediction model by patients and physiotherapists. Chapter 2 This chapter describes de results of a cross-sectional study developed to determine the inter-rater reliability of the RAdMAT-NL. Participants of the study were 36 patients; 18 with musculoskeletal injuries and 18 with chronic diseases who were undertaking physiotherapeutic rehabilitation in a primary physiotherapy practice. The inter-rater reliability was evaluated using the intraclass correlation coefficient (ICC). The inter-rater reliability of the RAdMAT-NL was excellent: ICC = 0.98 for all the participants. The inter-rater reliability was also excellent for patients with musculoskeletal injuries (ICC = 0.98) and patients with chronic diseases (ICC = 0.99). Chapter 3 This chapter describes the results of a prospective study with the aim to examine the dimensionality (structural validity) and the construct validity of the RAdMAT-NL in patients with COPD. In this study participated 193 patients with COPD, who were
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