Each patient wore 6 activity monitors simultaneously which were selected as a result of a systematic review of the literature. These were two uniaxial activity monitors [Kenz Lifecorder (Kenz), Actiwatch (Actiwatch)], three triaxial activity monitors [RT3, Actigraph GT3X (Actigraph), DynaPort MiniMod (MiniMod)] and one multisensor activity monitor combining a triaxial accelerometer with different sensors [SenseWear Armband (SenseWear)]. More details about software, type, body location and outputs of these monitors can be found in Table 1 .
Patients also wore a portable metabolic system (Jaeger Oxycon Mobile), an oxygen saturation finger probe and a Polar T31 (Polar) coded transmitter belt for heart rate monitoring. The portable metabolic system was attached to the upper chest with a harness and due to its low weight (950 g), caused minimal discomfort. A face mask with a dead space of <30 mL (Hans Rudolph Inc, Kansas City MO/USA) was used. Location of attachment for the Oxycon Mobile together with the six activity monitors is shown inFigure 1 . A two-point gas calibration was completed prior to each test. Oxygen consumption (VO2), carbon dioxide production (VCO2), heart rate, respiratory rate and tidal volume were measured continuously. Breath-by-breath measurements were averaged over one-minute intervals. After the experiment, stored data were downloaded from the portable metabolic device to a personal computer. VO2 values were divided by participants’ body weight and converted to Metabolic Equivalents of Task (METs) [24] . Energy expenditure estimates from the portable metabolic system (METs) were used as a criterion measure for energy expenditure and were compared with the following activity monitor outputs: Kenz - arbitrary units (AU); Actiwatch - activity counts (AC); Actigraph and RT3 - vector magnitude units (VMU); MiniMod and SenseWear - METs.
Patients were instructed to perform a strict schedule of activities lasting 59 minutes (Table 2 ) which were chosen to be representative of everyday tasks (such as walking, stair climbing and sweeping the floor) that are reported as problematic by COPD patients [25] (link). Time was kept with both a stopwatch and a laptop computer clock so that activities were completed in whole minutes.
Patients also wore a portable metabolic system (Jaeger Oxycon Mobile), an oxygen saturation finger probe and a Polar T31 (Polar) coded transmitter belt for heart rate monitoring. The portable metabolic system was attached to the upper chest with a harness and due to its low weight (950 g), caused minimal discomfort. A face mask with a dead space of <30 mL (Hans Rudolph Inc, Kansas City MO/USA) was used. Location of attachment for the Oxycon Mobile together with the six activity monitors is shown in
Patients were instructed to perform a strict schedule of activities lasting 59 minutes (
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