Promote Exercise Adherence Research Articles

Social support and college students' exercise adherence: Chain mediating effect test

This study explored the relationships between social support, cognitive reappraisal, emotional intelligence, and college students' exercise adherence. We investigated the mechanism underlying the relationship between social support and exercise adherence to provide a potential route through which to promote exercise adherence among college students. Using convenience sampling, we recruited 1,621 college students in Liaoning Province, China, who completed scales measuring social support, exercise adherence, cognitive reappraisal, and emotional intelligence. The results showed that (a) social support directly and positively influenced college students' exercise adherence, and (b) social support indirectly influenced college students' exercise adherence through the independent mediating effect of emotional intelligence and the chain mediating effect of cognitive reappraisal and emotional intelligence. This research deepens understanding of the influence of social support on exercise adherence in college students.

Developing a mobile exercise program for individuals with Spinal Cord Injury: Stakeholder perceptions of app features and implementation determinants

BackgroundIndividuals with Spinal Cord Injury (SCI) often experience physical deconditioning, leading to long-term health challenges. While regular exercise can offer substantial health benefits, adherence to exercise guidelines among individuals with SCI is hindered by barriers such as inaccessibility. Exercise programs using the mobile application (App) tailored to individual needs present a promising solution for promoting exercise adherence among individuals with SCI. ObjectiveThis study aimed to identify factors contributing to the successful implementation of an app-based home exercise program for individuals with SCI and gather user feedback on app preferences, functionality, and features. MethodsGuided by the Consolidated Framework for Implementation Research (CFIR), twenty-six clinicians completed an expert panel survey to rank factors influencing the implementation of an app-based intervention for increasing exercise adherence for individuals with SCI. CFIR-selected factors and app quality features obtained from the Mobile Application Rating Scale (MARS) framework were discussed in seven focus groups with 23 individuals with SCI, 6 caregivers, and 6 clinicians. ResultsThe expert survey identified adaptability, complexity, evidence strength/quality, relative advantage, knowledge/beliefs about the initiative, and execution as the key CFIR factors that affected the intervention's success. Major themes emerging from focus groups with individuals with SCI and caregivers included usability, instruction and guidelines, user-friendly interface, and clinician interaction. In contrast, clinicians mentioned themes such as the representation of the SCI population, time commitment, accessibility, and equipment. ConclusionsThe study highlights the significance of incorporating these determinants into future designs to develop app-based home exercise interventions for individuals with SCI.

Psychological Effects of Music in Exercise and Sports Performance

Purpose: The general purpose of this study was to examine the psychological effects of music in exercise and sports performance.
 Methodology: The study adopted a desktop research methodology. Desk research refers to secondary data or that which can be collected without fieldwork. Desk research is basically involved in collecting data from existing resources hence it is often considered a low cost technique as compared to field research, as the main cost is involved in executive’s time, telephone charges and directories. Thus, the study relied on already published studies, reports and statistics. This secondary data was easily accessed through the online journals and library.
 Findings: The findings reveal that there exists a contextual and methodological gap relating to technology and traditional arts in modern sporting events. Preliminary empirical review revealed that music significantly influences psychological states during physical activity. It found that music with faster tempos and motivational lyrics enhanced arousal, mood, and performance outcomes such as endurance and coordination. Additionally, personalized music interventions tailored to individual preferences maximized the performance-enhancing effects of music. The study emphasized the importance of considering both psychological and physiological responses to music in designing effective interventions for optimizing performance outcomes and promoting exercise adherence. Overall, the findings highlighted the intricate relationship between music and exercise performance and suggested potential avenues for future research in this area.
 Unique Contribution to Theory, Practice and Policy: Theory of Arousal Regulation, Self-Determination Theory (SDT) and Attentional Focus may be used to anchor future studies on psychological effects of music in exercise and sports performance. The study provided comprehensive recommendations that contributed to theory, practice, and policy in the field. Through theoretical development, the study refined existing frameworks such as the Theory of Arousal Regulation and Self-Determination Theory, deepening our understanding of how music influences psychological states in athletic contexts. Practical guidelines were established to integrate music into athlete preparation routines, emphasizing personalized playlists and warm-up protocols to optimize performance outcomes. Policy implications highlighted the need to institutionalize music-based interventions in sports programs, promoting athlete well-being and enjoyment. Furthermore, the study identified future research priorities, evaluation frameworks, and public health initiatives to advance the integration of music into exercise and sports settings, fostering physical activity participation and overall health.

Role of Social Support and Technology Interventions in Exercise Adherence among Older Adults with Stroke: A Narrative Review

Stroke is a major cause of disability among older adults, and exercise is a critical component of poststroke rehabilitation. However, exercise adherence among stroke survivors is often low, leading to reduced quality of life and functional outcomes. This narrative review aims to explore the types and effectiveness of social support and technology interventions in promoting exercise adherence and improving health outcomes among older adults with stroke. The studies included in this review were relevant (original articles, systematic reviews, and meta-analyses) and reported on exercise adherence, social support, and technology within the context of older adults with stroke. The studies extracted for this narrative review were research articles published from 2010 till date. Electronic databases were searched to identify relevant studies. Our findings report that group-based exercise programs are more effective social support interventions for long-term exercise adherence than home-based individual programs for older adults. Technology, particularly remote monitoring devices and platforms, is also been effective in improving engagement and adherence to exercise programs, leading to better functional outcomes and enhanced quality of life for older adults with stroke. In conclusion, social support and technology are effective strategies for promoting exercise adherence in post-stroke older adults. However, further research is needed to identify how best to complement social support approaches with technology tools in clinical practice for optimal outcomes. Through these strategies healthcare professionals can improve functional outcomes and enhance the quality of life for stroke survivors.

The relationship between autonomy support from parents and exercise adherence among male Korean adolescents: the multiple mediating effects of resilience and coping style

The purpose of this study was to investigate the effect of parental autonomy support on adolescents’ exercise adherence and the combined mediating effects of psychological resilience and coping style. A total of 478 male adolescents were evaluated using the Parental Autonomy Support Scale (PASS), the Connor-Davidson Resilience Scale (CD-RISC), the Coping Inventory for Competitive Sport (CICS), and the Scale of Exercise Adherence (SEA). The combined mediating effects of resilience and coping style were validated through hierarchical regression and bootstrap analysis. The results showed that: (1) parental autonomy support had a significant positive effect on exercise adherence in adolescents; (2) resilience and coping style mediated the relationship between parental autonomy support and exercise adherence. Parental autonomy support can not only directly promote exercise adherence in adolescents, but also indirectly promote it through the combined mediating effects of resilience and coping style. The mediating effect model constructed in this study demonstrates the internal mechanism through which parental autonomous support can have a positive influence on exercise adherence. It provides valuable information that can be used to promote exercise adherence among male Korean adolescents.

Abstract 14466: Study Protocol: Heart Camp Connect - Promoting Adherence to Exercise in Adults With Heart Failure With Preserved Ejection Fraction

Background: Heart failure with preserved ejection fraction (HFpEF) remains a challenge in cardiovascular care. A chief complaint in adults with HFpEF is fatigue, and regular exercise training is the only treatment shown to routinely improve this symptom. Adherence to exercise recommendations is difficult. We significantly improved 12-month adherence to exercise in adults with persistent HF using an in-person coaching intervention. Secondary analysis of our HFpEF subgroup showed promising long-term exercise adherence. These findings support our recently funded trial to test an intervention delivered in-person vs. virtually to achieve long-term exercise adherence in adults with HFpEF. Aims: We will: 1) Evaluate effects of in-person vs. virtual coaching and enhanced usual care on 12- and 18-month exercise adherence, 2) Determine the optimal minutes of moderate-intensity exercise that yields clinically meaningful change in patient-reported outcomes, 3) Evaluate interventional mechanisms and interim clinical events as mediators of adherence behaviors, and (4) Examine the cost of intervention delivery. Approach: This multi-site, 3-group randomized controlled trial will recruit 300 adults with stable HFpEF to compare an in-person coaching intervention to a virtual coaching, and both to enhanced usual care (UC). After a run-in period, all participants receive a medical fitness center membership (in-person or virtual) for 18 months and are randomized following a 2-2-1 strategy to in-person coaching and exercise (n=120), virtual coaching and exercise (n=120) or UC virtual exercise only (n=60). The primary outcome is adherence to ≥120 minutes of exercise/week measured using a heart rate monitor at 12 months, with a sustainability endpoint at 18 months. Secondary outcomes include health status, physical function and activity, HFpEF symptoms, and inflammatory biomarkers. Data are collected at baseline, 6, 12, and 18 months. Conclusions: Our findings will guide selection of the most efficacious and cost-effective delivery approaches to promote exercise adherence. Identifying active interventional mechanisms and the dose of exercise needed to elicit a response will help to achieve a clinically meaningful change in patient-reported outcomes in HFpEF.

The MoXFo initiative – adherence: Exercise adherence, compliance and sustainability among people with multiple sclerosis: An overview and roadmap for research

We know very little about exercise adherence, compliance and sustainability in multiple sclerosis (MS), yet adherence is seemingly important for yielding immediate and sustained health benefits. This paper is focused on exercise adherence, compliance and sustainability in the context of informing research and practice involving MS. This focus is critical for clarifying terminology for future research and providing a roadmap guiding clinical research and practice. Our objective was accomplished through a narrative summary of the literature by a panel of experts on exercise adherence from the Moving Exercise Research in Multiple Sclerosis Forward (MoXFo) initiative and a concluding summary of the state of the literature and future research directions. The panel of experts identified three overall themes (Background and Importance; Understanding and Promoting Exercise Adherence, Compliance and Sustainability and Challenges to Exercise Adherence, Compliance and Sustainability) that represented a categorization of nine subthemes. These overall themes and subthemes formed the basis of our recommendations regarding future research broadly involving exercise adherence in MS. Overall, there is limited evidence on rates and determinants of exercise adherence and compliance in MS, and little is known about techniques and interventions for immediate and long-term exercise behaviour change.

Chemotherapy-related symptoms and exercise adherence in older patients with myeloid neoplasms.

Exercise may ameliorate treatment-related symptoms, but older adults have lower exercise adherence compared to their younger counterparts due to treatment-related symptoms. We recruited older patients with myeloid neoplasms receiving chemotherapy to a pilot study of a mobile health exercise intervention. Participants entered their steps and resistance data into the app daily, and symptom data twice a week, over an 8-12week period. In this proof-of-concept analysis, we used a linear mixed-effects model to assess the association of symptoms from the previous week with exercise adherence in the current week among older adults with myeloid neoplasms. Mean age was 74.3 (SD = 5.0) years (N = 7). At baseline, patients on average walked 2564 daily steps (SD = 1816), which increased to 2967 (SD = 3448) post-intervention. Patients on average performed 3.5 (SD = 2.6) days of resistance training weekly, with mean duration of 21.5min (SD = 11.6) and rated perceived exertion of 3.68 (SD = 1.78) on a 0-10 scale. Lower average steps in the current week was associated with greater interference with daily activities from pain (β = - 203.13, p = 0.05), memory (β = - 492.29, p = 0.09), numbness (β = - 353.57, p = 0.07), and sadness (β = - 403.03, p = 0.09) in the previous week. Similarly, lower average resistance minutes in the current week were associated with greater pain, sadness, and anxiety in the previous week. We found that greater pain, sadness, and anxiety were associated with lower exercise adherence. Symptom monitoring and management in older adults with myeloid neoplasms receiving chemotherapy can promote exercise adherence and in turn improve symptoms. ClinicalTrials.gov Identifier: NCT04035499. Registered 7/29/2019.

Development of a complex exercise rehabilitation intervention for people with pulmonary hypertension: the supervised pulmonary hypertension exercise rehabilitation (SPHERe) trial

BackgroundPeople with pulmonary hypertension (PH) are not routinely referred for exercise rehabilitation despite the potential for reducing breathlessness and improving quality of life. We describe the development of a supervised...

English

The interruption of regular physical exercise among Chinese college students is a key cause of the lack of motivation to exercise. Therefore, on the basis of self-efficacy theory, this study analysed the interrelationships between the perception of transformational leadership in physical education (PE) by teachers, physical self-efficacy, and exercise adherence among Chinese college students. A questionnaire survey was conducted using a convenience sample of 448 students from five universities in Hebei Province, China. They perceived transformational leadership by PE teachers to significantly positively influence exercise adherence. In addition, physical self-efficacy partially mediated the relationship between college students’ perceptions of transformational leadership by PE teachers and exercise adherence. These findings suggest that university administrators could encourage PE teachers to make greater use of transformational leadership and improve education and guidance regarding physical self-efficacy for college students to promote exercise adherence.   Key words: Transformational leadership, physical self-efficacy, exercise adherence, college students.

Impact of adherence to exercise interventions on effectiveness in a randomized controlled trial in improving sleep in advanced lung cancer patients: A comparison between aerobic exercise and Tai Chi.

Adherence plays a vital role in the effectiveness of non-pharmacological interventions. The disappearance of interventions' effects at follow-up was caused by inadequate self-practice beyond intervention period. The purpose of this study is to examine the factors associated with adherence to aerobic exercise and Tai Chi and the impact of adherence on the short- and long-term effectiveness in improving sleep in patients with advanced lung cancer. This study analyzed data collected in a clinical trial that evaluated the effects of aerobic exercise and Tai Chi in patients with advanced lung cancer. Two types of exercises were maintained at the same intensity but with different dosage. A total of 99 patients with advanced lung cancer who were recruited between 2018 and 2020 were included. Data were collected using self-report questionnaires. Fifty participants were randomly assigned to aerobic exercise and 49 to Tai Chi intervention. Higher levels of satisfaction and lower levels of depression were significantly associated with higher attendance and compliance in both groups. Low fatigue levels contributed to higher attendance in Tai Chi. Both attendance and compliance were significantly associated with long-term sleep improvement. Higher levels of satisfaction and lower levels of depression were important characteristics of attendance and compliance with home-based practice in both groups, whereas lower levels of fatigue uniquely contributed to higher attendance in Tai Chi. Better exercise adherence improves long-term effectiveness of sleep in patients with advanced lung cancer. Adopting strategies is imperative to promote exercise adherence in patients with greater levels of depression and fatigue.

Adherence to exercise therapy among children and adolescents with Juvenile idiopathic arthritis: a scoping review

Purpose To identify parameters and measurement methods of exercise therapy adherence, as well as barriers and facilitators affecting adherence among children and adolescents with juvenile idiopathic arthritis (JIA). Methods Studies were eligible for inclusion if patients were 0–18 years of age, had JIA, and the focus of the research was on exercise therapy patterns, measurement/parameters of exercise adherence, and barriers/facilitators for exercise adherence. Two reviewers independently identified and categorized the barriers and facilitators to exercise therapy adherence using the International Classification of Functioning, Disability, and Health (ICF). Results Twenty articles were included in this review. Among patients with JIA, 29%–99% adhered to exercise therapy. The most commonly measured parameters of adherence were session completion and behavior component, with a self-report log serving as the most common means of assessment. Time pressure, symptoms related to JIA, lack of enjoyment, and insufficient motivation were the main barriers. Facilitators were commonly identified as adequate motivation, effective symptoms management, and social support. Conclusions Future interventions should consider the identified factors to promote exercise engagement in children and adolescents with JIA. Strategies for promoting exercise adherence in children and adolescents with JIA is needed.

Motivational Correlates, Satisfaction with Life, and Physical Activity in Older Adults: A Structural Equation Analysis.

Background: Motivation is a crucial factor in predicting health-related outcomes, and understanding the determinants of motivation can provide valuable insights into how to improve health behaviors and outcomes in older adults. In this study, we aimed to investigate the associations between intrinsic and extrinsic exercise motivation, basic psychological needs, satisfaction with life, and physical activity among the elderly population. Methods: The sample consisted of 268 older adults (59 male, 209 female) aged 65-90 years old (Mage = 68.11, SD = 6.95). All participants reported that they were exercising, on average, 1.65 days (SD = 0.51) per week. Factor analysis was conducted using a two-step approach. First, a confirmatory factor analysis and then a structural equation model considering all variables under analysis was performed. Results: the structural model displayed acceptable fit to the data: χ2/df = 3.093; CFI = 0.913; TLI = 0.908; SRMR = 0.071; RMSEA 0.079 [0.066, 0.092]. Significant direct effects were found as theoretically proposed, namely: (a) intrinsic motivation were positively and significantly associated with basic psychological need satisfaction (p < 0.001); (b) extrinsic motivation were negatively but not significantly associated with basic psychological needs (p < 0.001); and (c) basic psychological need satisfaction were positively and significantly associated with satisfaction with life (p < 0.001) and physical activity (p < 0.001). Conclusions: Intrinsic motivation and basic psychological needs play a crucial role in shaping exercise behavior and overall well-being. By understanding these motivation and needs, exercise and health professionals can work towards fulfilling them and achieving a greater sense of satisfaction in the life of the elderly and promote exercise adherence.

A Pragmatic Pilot Randomized Controlled Trial of the OA Go Away Among Individuals with Osteoarthritis of the Hip or Knee.

Purpose: The main objective was to assess the feasibility of conducting a full randomized controlled trial (RCT) to test the effectiveness of the OA Go Away (OGA) behavioural intervention on adherence to prescribed exercise, level of physical activity, goal attainment, and health outcomes, and to determine the acceptability of the OGA. The OGA is an internal reinforcement tool designed to promote exercise adherence for people with hip or knee OA. Method: This 3-month pragmatic pilot RCT included 40 participants with hip or knee OA who were randomized into the treatment group who used the OGA for three months, or standard care. Results: This pilot RCT which included 37 participants (17 in the treatment group and 20 in the control group) showed that it would be feasible to complete a full RCT of the OGA behavioural intervention with adjustments to the format of the OGA (electronic), inclusion criteria, outcome measures and duration. The OGA was felt to be useful (75%) and motivational (82%) by participants. Conclusions: This pilot RCT justifies a formal RCT of the OGA and shows promising results concerning its acceptability, especially if available in an electronic format.

39 CAN BEHAVIOURAL CHANGE INTERVENTIONS IMPROVE SELF-EFFICACY AND EXERCISE ADHERENCE AMONG PEOPLE WITH PARKINSON’S? A SYSTEMATIC REVIEW

Abstract Background People with Parkinson’s (PwP) lead sedentary lifestyles compared to healthy peers. Personal influences including low self-efficacy and poor outcome expectation appear to predict exercise adherence more accurately than disease severity. The purpose of this review is to identify successful behavioural-change interventions that promote self-efficacy and exercise adherence among PwP. Methods Databases including EBSCO, Medline, CINAHL, Web of Science, PubMed, Embase, Scopus, Google Scholar and Cochrane Library were searched from inception to 2020. Interventional studies including a behavioural-change intervention were included. Title, abstract and full-text screening was conducted by two independent reviewers. The Cochrane Risk of Bias Tool and Robins-I were used to assess the Risk of Bias. Data was extracted by two independent reviewers. The outcomes of interest were self-efficacy, quality of life, physical function, and exercise adherence. A narrative synthesis was completed and mapped to the Theoretical Domains Framework, to produce practice-orientated outcomes. Results Seventeen studies (n=1319) were included. Risk of bias was generally moderate. A multicomponent behavioural-change intervention encompassing education, behavioural strategies and support groups appeared to improve quality of life, physical function, and exercise adherence in PwP. No intervention improved self-efficacy. Self-monitoring, goal setting, social supports, feedback, self-managements skills and action planning improved long-term adherence. Conclusion No intervention changed self-efficacy. However, it appears that a multicomponent intervention is essential to improve exercise adherence. Trials directly comparing different intervention types and adequate follow-up periods are limited, preventing a conclusive finding of the most effective behavioural-change intervention to promote exercise adherence among PwP.

MHealth Apps for Musculoskeletal Rehabilitation: Systematic Search in App Stores and Content Analysis.

BackgroundThe number of mobile health (mHealth) apps released for musculoskeletal (MSK) injury treatment and self-management with home exercise programs (HEPs) has risen rapidly in recent years as digital health interventions are explored and researched in more detail. As this number grows, it is becoming increasingly difficult for users to navigate the market and select the most appropriate app for their use case. It is also unclear what features the developers of these apps are harnessing to support patient self-management and how they fit into clinical care pathways.ObjectiveThe objective of this study was to scope the current market of mHealth apps for MSK rehabilitation and to report on their features, claims, evidence base, and functionalities.MethodsA cross-sectional study of apps for MSK rehabilitation was performed across the iTunes App Store and Google Play Store. Four search terms were used, namely, physiotherapy rehabilitation, physical therapy rehabilitation, rehabilitation exercise, and therapeutic exercise to identify apps, which were then cross-referenced against set selection criteria by 4 reviewers. Each reviewer, where possible, downloaded the app and accessed supplementary literature available on the product to assist in data extraction.ResultsA total of 1322 apps were identified. After applying the inclusion and exclusion criteria and removing duplicates, 144 apps were included in the study. Over half (n=81, 56.3%) of the included apps had been released within the past 3 years. Three quarters (n=107, 74.3%) of the apps made no reference to evidence supporting the design or efficacy of the app, with only 11.1% (n=16) providing direct citations to research. Most of the apps did utilize exercise pictures (n=138, 95.8%) or videos (n=97, 67.4%); however, comparatively few harnessed additional features to encourage engagement and support self-management, such as an adherence log (n=66, 45.8%), communication portal (n=32, 22.2%), patient-reported outcome capture (n=36, 25%), or direct feedback (n=57, 39.6%). Of note and concern, many of these apps prescribed generic exercises (n=93, 64.6%) in the absence of individualized input to the user, with few providing specific patient education (n=43, 34%) and safety advice or disclaimers (n=38, 26.4%).ConclusionsThe cohort of apps included in this study contained a large heterogeneity of features, so it is difficult for users to identify the most appropriate or effective app. Many apps are missing the opportunity to offer key features that could promote exercise adherence and encourage self-management in MSK rehabilitation. Furthermore, very few developers currently offering products on the market are providing evidence to support the design and efficacy of their technologies.

Personalised Outcomes Forecasts of Supervised Exercise Therapy in Intermittent Claudication: An Application of Neighbours Based Prediction Methods with Routinely Collected Clinical Data

Insights regarding individual patient prognosis may improve exercise therapy by informing patient expectations, promoting exercise adherence, and facilitating tailored care. Therefore, the aim was to develop and evaluate personalised outcomes forecasts for functional claudication distance over six months of supervised exercise therapy for patients with intermittent claudication. Data of 5 940 patients were eligible for analysis. Neighbours based predictions were generated via an adaptation of predictive mean matching. Data from the nearest 223 matches (a.k.a. neighbours) for an index patient were modelled via Generalised Additive Model for Location Scale and Shape (GAMLSS). The realised outcome measures were then evaluated against the GAMLSS model, and the average bias, coverage, and precision were calculated. Model calibration was analysed via within sample and of sample analyses. Neighbours based predictions demonstrated small average bias (- 0.04 standard deviations; ideal= 0) and accurate average coverage (48.7% of realised data within 50% prediction interval; ideal= 50%). Moreover, neighbours based predictions improved prediction precision by 24%, compared with estimates derived from the whole sample. Both within sample and of sample testing showed predictions to be well calibrated. Neighbours based prediction is a method for generating accurate personalised outcomes forecasts for patients with intermittent claudication undertaking supervised exercise therapy. Future work should examine the influence of personalised outcomes forecasts on clinical decisions and patient outcomes.

Comparison of fatigue and fatigability correlates in Korean breast cancer survivors and differences in associations with anxiety, depression, sleep disturbance, and endocrine symptoms: a randomized controlled trial

BackgroundFatigue is one of the most common and burdensome symptoms experienced by cancer patients. In interventions intended to reduce fatigue in such patients, fatigability, or perception of fatigue contextualized to activities of fixed intensity and duration, may also be measured. This study investigated the effects of a 15-month intervention on fatigue and fatigability in breast cancer survivors (BCS); explored the fatigue-fatigability relationship; and evaluated the impacts of fatigue and fatigability on anxiety, depression, sleep disturbance, and endocrine symptoms.MethodsA randomized controlled trial design was applied to an exercise program called BLESS (Better Life after cancer, Energy, Strength, and Support). The intervention included this 12-week exercise program and four follow-up contacts intended to promote exercise adherence over the following year. Participants were women aged 20 to 69 who had been diagnosed with stage I, II, or III breast cancer; had completed active treatment; and had moderate or higher fatigue. At the completion of the intervention, the survey responses of 40 BCS were evaluated using the chi-square test and multiple regression analysis. The Korean versions of the Revised Piper Fatigue Scale and Pittsburgh Fatigability Scale were used to measure fatigue and fatigability, respectively.ResultsThere was no significant difference in fatigue or fatigability between the experimental and control groups at intervention completion. However, the control group showed a stronger association than the experimental group between fatigue and physical fatigability. In the control group, fatigue and fatigability were significantly associated with anxiety, depression, sleep disturbance, and endocrine symptoms. In the experimental group, only the cognitive/mood fatigue score and depression were significantly associated. Only endocrine symptoms influenced mental fatigability (B = − 0.185, P < 0.05), and only depression influenced cognitive/mood fatigue (B = 1.469, P < 0.05).ConclusionsFatigue and fatigability showed different correlations with cancer-related symptoms after the exercise intervention. Future assessments of fatigability in intervention studies will allow measurement of the spectrum of patients’ abilities to overcome fatigue at various physical activity levels while capturing different aspects of cancer-related symptoms.Trial registrationThis study was retrospectively registered on Clinical Research Information Service (KCT0005763; date of registration: 31/12/2020).

Physiotherapists’ experiences and views of older peoples’ exercise adherence with respect to falls prevention in Singapore: a qualitative study

Purpose To seek physiotherapists’ perspectives on patient adherence to exercise prescription for falls prevention/risk reduction in the Singapore setting. Method Three focus groups with physiotherapists (n = 16) were conducted. An inductive thematic analysis was performed to identify main themes by four independent researchers. Results Three main themes emerged: “it’s about the patient,” “delivery of the programme,” and “carer/family support and facilitation.” Physiotherapists believed that adherence was all about the patients’ mindset and motivation, and they had to tailor interventions to optimise adherence to cater for patients as distinct characters, with different health/cultural beliefs and ability to prioritise time. Furthermore, physiotherapists reported better patient adherence when therapy goals referred to maintaining function rather than reducing falls. Families/carers can act as facilitators while providing practical and/emotional support further enhanced exercise adherence. Conclusions Awareness of the perspectives of physiotherapists in identifying and addressing patients' adherence to exercise may better equip researchers and healthcare providers in developing culturally relevant interventions that promote exercise adherence in Singapore. Certainly, adherence varies widely among patients receiving the same treatment. Analysis of predictive factors of non-adherence will assist to tailor intervention. Implications for rehabilitation Physiotherapists believe the use of individualised approaches that adapt to patients and their health beliefs are critical for exercise adherence in older people in Singapore to prevent falls and falls risk. Adherence to exercise is multi-factorial: physiotherapists need to include attention to education, building rapport and facilitating practical and emotional family/carer support. Non-adherence is not merely a patient problem but is influenced by both clinicians and the healthcare system in Singapore/Southeast Asia.

Facilitating Exercise Habit Formation among Cardiac Rehabilitation Patients: A Randomized Controlled Pilot Trial.

Background: The importance of promoting exercise adherence among individuals with acute coronary syndrome (ACS) is imperative. However, challenges in maintaining behavior among ACS patients are also well-documented. Emerging findings in the general population have supported the use of habit-formation techniques, which include incorporating routine consistency and cues, to be effective for facilitating exercise behavior. The effectiveness of habit formation approaches, however, has not been tested on participants with ACS. The purpose of this study was to test the effectiveness of facilitating physical activity habits among patients with ACS in a two-arm, parallel design, randomized controlled pilot trial. Methods: Participants (n = 13) were older adult patients (M age = 64.20, SD = 5.35) with ACS who were referred to a cardiac rehabilitation center. The experimental group attended monthly group meetings from months 1–3 and received phone call follow-ups from months 4–6. Conclusions: The experimental group showed an increase in weekly moderate-to-vigorous level physical activity, M = 228.20 mins (SD = 112.45), compared with the control group, M = 151.17 (SD = 112.22), d = 0.61. The experimental condition also showed greater use of routine consistency (experimental: M = 4.60 (SD = 0.548); control: M = 3.76 (SD = 1.62)) and cue usage (experimental: M = 3.60 (SD = 0.471); control: M= 2.60 (SD = 0.398)) over the control condition at the six-month mark. The study supports the effectiveness of habit-building techniques among patients with ACS, with effect sizes ranging from a medium to large magnitude. Findings from this pilot study support a full clinical trial with larger sample size.