Compliance/adherence in health-related exercise.

TLDR

Habitual exercise improves health, yet high dropout rates and a lack of systematic, theory-driven research limit its long‑term benefits. This review aims to synthesize evidence on exercise behavior models to guide future research and design behavioral prescriptions that enhance adherence. The models examined consider the exerciser, the exercise setting, and their interaction, underscoring the need for integrated strategies. Studies that focus only on screening, diagnosis, or intervention/control miss key predictive factors, underscoring the need for combined approaches.

Abstract

The well documented association between habitual exercise and health outcomes makes clear that adherence to therapeutic exercise programs is a fundamental issue for health psychology. Recidivism appears, however, to preclude much of the health potential which exercise can offer. High participant dropout rates are typically observed in clinical exercise settings; these generally approach or exceed 50% within six months of initial involvement. Despite the importance of this issue, investigations of the factors which influence long-term adherence to exercise programs have been essentially atheoretical and have not been pursued systematically. The present review attempts to organize available evidence around models of exercise behavior in the hope this will encourage new research. These models consider the exerciser, the exercise setting, and the person-setting interaction. Also illustrated are the predictive limitations of studies which have focused solely on screening and diagnosis or on intervention and control rather than on a strategy combining both approaches. The intended purpose of this review is to facilitate future study of behavioral prescriptions designed to promote exercise adherence. The timeliness of controlled research on exercise adherence is reinforced by the growing use of various interventions for the enhancement of exercise behavior in clinical settings and by similarities between adherence to health-related exercise and compliance with other types of medical prescriptions.