ACSM CPT Chapter 8: Adherence to Exercise: Helping Your Client Stay Active
ACSM CPT Chapter 8: Adherence to Exercise: Helping Your Client Stay Active

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Chapter Objectives:

  • Find the factors contributing to clients’ adherence to exercise and apply the right behavior change strategy to promote exercise adherence.
  • Know and use the models of behavior change for health to support and facilitate exercise adherence and use the right strategies for building self-efficacy, motivation, and self-worth about exercise.
  • Find barriers to exercise that will assist clients in developing strategies for overcoming barriers and avoiding relapse.
  • Develop the skills needed to encourage clients to self-regulate for exercise and collaborate effectively with clients to set behavior goals.
  • See clients’ need for social support and teach them how to access additional support.
  • Find and use new strategies that clients may use to adhere to exercises, like technology, active transportation, and community programs.

Self-Efficacy, Motivation, and Self-Worth in Relationship to Exercise Adherence

Self-Efficacy and Exercise Adherence

Self-efficacy is one of the most consistent exercise adherence predictors in adults. This is defined as someone’s confidence in their ability to complete specific behaviors successfully. Trainers need to know that self-efficacy will affect the task completion ability and the ability to overcome barriers and achieve goals.

Motivation and Exercise Adherence

There are different types of motivation; some forms will cause better adherence than others. 

When extrinsically motivated, they will participate for strictly external outcomes like weight or appearance.

 Intrinsically motivated clients will participate for internal outcomes like enjoying the activity, feeling accomplished after workouts, and being challenged.

People are almost always more extrinsically motivated than intrinsically. This is because the main starting reason for exercise is often for appearances.

Self-Worth and Exercise Adherence

Self-worth is usually used interchangeably with self-esteem and is considered to be people’s satisfaction with themselves. Increases in self-worth lead to increases in exercise, and vice versa.

When you help your client to build self-worth, it will not only help for starting exercise but also for adherence over the long term.

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These strategies for building self-worth are vital to client success and must be well understood and utilized in the sessions.

Strategies for Increasing Exercise Adherence 

To improve adherence, we implement overcoming barriers to exercise, self-regulate exercise, and access social support.

Overcoming Barriers

Barriers are specific to every client and they show the person’s perceived obstacles to exercise. Trainers should ensure that clients know the benefits and possible barriers to exercise. 

Benefits of Exercise

People who perceive the pros outweigh the cons of exercise are always more likely to continue exercising. When clients adopt exercise, they should start by teaching them about exercise’s physiological and psychological benefits.

For example, many clients have the initial exercise goal of losing weight, but they may develop a love and understanding of the more complex results of the exercise.

Barrier Identification

Barriers that clients have will depend on their age, gender, weight, fitness level, and history. 

The barriers people have might be social, personal, or even environmental. Some examples may be the lack of time, motivation, confidence, or support from family.

Personal Barriers

These are individual barriers that can be behavioral or internal. These barriers include not having time, knowledge, motivation, an injury, and extrinsic motivations. 

If a client fears injury or is recovering from illness, the trainer can do things like to remind the client of their credentials or slow down the program to ensure further safety. This is one example of overcoming a personal barrier.

Trainers can provide challenging but attainable goals to help the client overcome some barriers.

Motivation is the most important role of the trainer, and assuring the client that they can succeed and overcome something will increase the client’s self-efficacy and potentially motivate them to overcome barriers.

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Giving anecdotal evidence of other experiences from the client can act to reassure the client and overcome barriers.

Social Barriers

These barriers come up due to the social network that the individual is in. It is about the significant individuals and their impact on their lives. 

Trainers can help by teaching home based exercises and how they can engage families in activities to alleviate barriers relating to caregiving.

Environmental Barriers

These are usually outside of the control of the client. These include things such as bad weather, lack of shower facilities, and safety concerns with travel or the area.

Trainers may assist with these by giving alternate routes to the gym or suggesting small changes of other kinds.

Exercise Self-Regulation

Planning Exercise

Planning is important for exercise as it helps clients get into a habit, and this habit of exercising regularly will increase self-efficacy and adherence. 

Trainers may teach people how to manage their time, develop backup plans for unavoidable conflicts, plan workouts before gym time, make action cues for controlling outside stimuli, and identify many ways to be active.

Avoiding Relapse

A lapse is a brief period of two or more weeks without exercising. Relapse is when it occurs again.

Most adults will encounter this problem at some point when exercising regularly. It will negatively affect both self-efficacy and self-worth. 

For trainers to assist clients and avoid relapsing, they must discuss these situations before them occurring.

Goal Setting

As discussed in the last chapter, goal setting is a great way to overcome barriers and add to adherence to exercise. The SMART goal philosophy s the ideal way for us to set effective goals and attain what we want with them.

When clients are allowed to decide on their goals related to exercise, they will increase their autonomy related to exercise and their competence in setting goals.

Self-Monitoring

This is monitoring your own behaviors, actions, and feelings with exercise. Doing so may help clients adhere to and say on track for their goals. These devices we use daily for exercise may also motivate people who like to set those goals and always reach for more.

Social Support

Social support is the exchange of aid between people within their social network. High levels of this will lead to higher self-efficacy and will then turn to more exercise participation. It can be separated into emotional, tangible, informational, and appraisal.

Social Support Needs

People must know the types of social support they should have before going out and trying to get it. Someone may need support from their spouse or friend who comes to the gym with them. 

Creating a Supportive Environment

Trainers should give clients an environment that supports fulfilling their needs relating to autonomy, relatedness to others, and competence. These will all increase adherence to exercise.

Accessing Social Support

Clients may hire trainers due to their lack of social support. They may also get a trainer for emotional or informational support needs. 

We should teach clients how to access social support in their networks and communities and online will help develop self-efficacy and adherence to exercise.

Innovative Strategies to Increase Adherence

Using the Internet to Promote Exercise Adherence

The internet can support behavior change strategies like overcoming barriers, setting goals, and social support. Trainers can also use it as a way to provide things for their clients. Trainers may provide things like interactive tools, website information, and client interaction through video.

Using the Physical Environment to Promote Exercise

Active Commuting

This strategy may help clients meet physical activity recommendations and positively impact their health. 

This may not be feasible for some, but if it is, it has a lot of great benefits.

Exercising Outdoors

Trainers may use this for their clients to increase the enjoyability of exercise. It may also improve the mental state of their clients and encourage people to exercise on their own in this way.

ACSM CPT Chapter 8: Adherence to Exercise: Helping Your Client Stay Active 1
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Tyler Read

Tyler Read, BSc, CPT. Tyler holds a B.S. in Kinesiology from Sonoma State University and is a certified personal trainer (CPT) with NASM (National Academy of sports medicine), and has over 15 years of experience working as a personal trainer. He is a published author of running start, and a frequent contributing author on Healthline and Eat this, not that.

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