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Critical Reviews™ in Physical and Rehabilitation Medicine
SJR: 0.121 SNIP: 0.228 CiteScore™: 0.17

ISSN Druckformat: 0896-2960
ISSN Online: 2162-6553

Critical Reviews™ in Physical and Rehabilitation Medicine

DOI: 10.1615/CritRevPhysRehabilMed.v18.i2.10
pages 95-106

Research on Exercise Adherence: A Review of Primary Studies

Kazuhiro Izawa
Department of Rehabilitation Medicine, St. Marianna University School of Medicine Hospital, Kanagawa, Japan
Physical Therapy
Koichiro Oka
Faculty of Sport Sciences, Waseda University, Saitama, Japan
Satoshi Watanabe
Department of Respiratory Medicine and Infectious Diseases, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan


Physical activity and exercise are important to maintain both exercise capacity and the caloric expenditure associated with reduced mortality. Even though the health benefits of regular exercise and physical activity are well documented, most individuals are inadequately active or completely inactive. It has been recommended that research on exercise adherence be conducted according to behavioral science models. One of the most effective is the transtheoretical model of behavior change (TTM). The TTM has been used to explain both the stages and processes individuals go through when trying to adopt a positive behavior (eg, habitual exercise). The TTM suggests that individuals attempting to change behavior move through five stages of change. The model incorporates stages of change, processes of change, decisional balance, and self-efficacy. Many researchers have shown that self-efficacy is an important predictor of adoption and maintenance of exercise behavior. This article reviews the research literature that applies the TTM to investigations of exercise adherence. In addition, the influence of exercise adherence on exercise capacity, muscle strength, self-efficacy, stress, physical activity, and health-related quality of life in the general population and in patients is reviewed.