Measuring adherence to pulmonary rehabilitation 37 stage GOLD II-IV and having rehabilitation sessions for at least once a month, for at least one month. The exclusion criteria were home-based rehabilitation and insufficient mastery of the Dutch/Flemish language to complete the questionnaires. Physiotherapy practices were approached by email and social media for participation and patients were recruited by their attending physiotherapist. Patients who were willing to participate were contacted by the researcher per email for further information on their participation, and to obtain informed consent. For patients without an email address, this was done by their physiotherapist at their visit to the physiotherapy practice. Patients were also recruited via the COPD patient-organization in the Netherlands and Belgium who, in turn, invited their physiotherapist for participation. The study was approved by the Ethical Committee Psychology of the University of Groningen (PSY-1920-S-0504). Procedures Before the start of the study, all participating physiotherapists received an email about the implementation of the study. This information consisted of a manual on how to use and administer the RAdMAT-NL, the SIRAS and the Five Times Sit to Stand Test (FTSST). After signing informed consent and inclusion, patients completed an online (Qualtrics, online survey software) or paper form on their demographic characteristics; age (years), gender (male/female), level of education (lower/middle/high), smoking status (never/stopped/still smoking). If applicable, a paper form was sent by the researcher to the physiotherapy practice. After the researcher received the form back from the physiotherapist, the researcher entered these patients’ responses into Qualtrics to obtain a complete data file of all patients. About simultaneously, the physiotherapist provided information on the characteristics of the disease; GOLD classification as determined by the pulmonologist (II/III/IV), MRC score as determined by the patient (0/1/2/3/4/5), time since onset of COPD (years), duration of physiotherapeutic rehabilitation (0-3 months/3-6 months/6-12 months/1-5 years/> 5 years), and administered a baseline FTSST of the patient. The patients provided information about their homework exercises and their health at one month, two and three months after inclusion. After three months, the physiotherapist provided information and measurements on the patient's rehabilitation. Assessment instruments Five Times Sit to Stand Test (FTSST) Measuring exercise skills, e.g., lower extremity strength is a way to measure adherence [17]. If patients adhere to their rehabilitation program, their muscle strength will increase (or is at least stable) over time [17]. The FTSST is a test of lower limb function to assess the fastest time taken to stand five times from a chair
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