Patients with chronic fatigue syndrome appear to be less physically active compared with asymptomatic controls. There is no difference in variation of physical activity levels between patients with chronic fatigue syndrome and healthy control subjects, but the validity and reliability of some methods of measuring physical activity is questionable or unknown.

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Table of contents Chapter 1 General introduction Chapter 2 Daily physical activity of patients with the chronic fatigue syndrome: A systematic review Chapter 3 Deviations in daily physical activity patterns in patients with the chronic fatigue syndrome: A case control study Chapter 4 Ambulatory feedback at daily physical activities in treatment of the chronic fatigue syndrome Chapter 5 Ambulatory feedback at daily physical activities in treatment of chronic fatigue syndrome: A randomized controlled trial Chapter 6 Is there a difference in response to ambulatory activity feedback when different goal settings are used? A randomized controlled trial Chapter 7 General discussion Chapter 8 Summary Chapter 9 Samenvatting Chapter 10 Dankwoord Chapter 11 Over de Auteur Chapter 12 Progress Range

Mobile physical activity interventions can be improved by incorporating behavioural change theories. Relations between self-efficacy, stage of change, and physical activity are investigated, enabling development of feedback strategies that can be used to improve their effectiveness. A total of 325 healthy control participants and 82 patients wore an activity monitor. Participants completed a self-efficacy or stage of change questionnaire. Results show that higher self-efficacy is related to higher activity levels. Patients are less active than healthy controls and show a larger drop in physical activity over the day. Patients in the maintenance stage of change are more active than patients in lower stages of change, but show an equally large drop in level of physical activity. Findings suggest that coaching should at least be tailored to level of self-efficacy, stage of change, and physical activity pattern. Tailored coaching strategies are developed, which suggest that increasing self-efficacy of users is most important. Guidelines are provided.

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