cipants

Forty persons participated in this study. Inclusion criteria to participate were being at least eighteen years old, having a physical disability and/or chronic disease and being post-rehabilitation. Exclusion criteria to participate were being completely wheelchair dependent and/or having a mental impairment. Patients were recruited from several sources. Most were recruited from local patient activity groups, patient associations and sport clubs for disabled people in Groningen, Friesland and Drenthe. Others were recruited because of close friendly bonds with the researchers. All patients signed an informed consent and were told that withdrawing from this study was possible at all times without having to declare reason(s). Measurement started at the end of autumn 2015 and continued until the spring of 2016. No large weather fluctuations were present. All the study procedures were approved by the ethics committee of the University Medical Centre Groningen.

Study procedure

When a patient indicated to be interested in participating, one or more members of the research team visited the patient at their home for a first visit. During the first visit the patient read an information letter and signed an informed consent. The patients also filled-in a form with personal information. Bodyweight and height were measured by the researchers. Patients were provided with detailed instructions on how to use the Actiheart and how to fill in the questionnaires.

Subsequently, the researchers attached the Actiheart directly below the chest as shown in Figure 1. The Actiheart was attached using two ECG electrodes. One electrode was adhered at V1 or V2 (fourth intercostal) and the second one was placed approximately 10 centimetres away on the left side. The electrodes used were 45MM Stud Adaptor ECG’s (Covidien™, Medtronic™). Patients were instructed to remove the Actiheart wh