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 the adherence of clients to their exercise and apply the right behavior change strategy in order to promote exercise adherence.
  • Know and use the models of behavior change for health in order for supporting and facilitating exercise adherence and use the right strategies for building self-efficacy, motivation, and self-worth in relation to exercise.
  • Find barriers for exercise that will assist clients to develop strategies for overcoming barriers and avoiding relapse.
  • Develop the skills needed for encouraging clients for self-regulation for exercise and collaborating effectively with clients in order to set behavior goals.
  • See the need for social support that clients have and teach them how to access additional support.
  • Find and use new strategies that clients may use to adhere to exercise, 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 own ability for successfully completing specific behaviors. It is important for trainers to know that self-efficacy will affect the task completion ability and the ability for overcoming barriers and achieving goals.

Motivation and Exercise Adherence

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

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

 Clients that are intrinsically motivated are going to 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 interchangeable with self-esteem and is considered to be satisfaction that people have with themselves. Increases in self-worth leads 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 need to be well understood and utilized in the sessions.

Strategies for Increasing Exercise Adherence 

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

Overcoming Barriers

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

Benefits of Exercise

People who perceive the pros outweighing the cons for exercise are always more likely to continue exercising. When clients are adopting exercise, they should start by teaching them about the physiological and psychological benefits from exercise.

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

Barrier Identification

Barriers that clients have will depend on their age, gender, weight, fitness level, and their 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 are the barriers that include things such as not having time, knowledge, motivation, having an injury, and extrinsic motivations. 

If a client has a fear of injury or is recovering from illness, the trainer can do things like reminding the client of their credentials or slowing down the program to ensure safety further. 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 motivate them to potentially overcome barriers.

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Giving anecdotal evidence of other experiences form 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 in reference to the significant individuals and the impact that they have on their life. 

Trainers can help by teaching home based exercises and how they can engage family in activity for the alleviation of 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 maybe able to 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 they can manage their time, develop backup plans for when unavoidable conflicts occur, plan workouts prior to 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 having exercised. 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. 

In order for trainers to assist clients and avoid relapsing, they must discuss these situations prior to them occurring.

Goal Setting

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

When clients are given the opportunity to decide on their goals that relate to exercise, they will increase the autonomy related to exercise and the competence they have in setting goals.

Self-Monitoring

This is monitoring your own behaviors, actions, and feeling that you have with exercise. Doing so may help clients adhere and say on track for their goals. These devices we use on a daily basis for exercise may also serve as motivators for people who like to set those types of goals and always reach for more.

Social Support

Social support is the exchanging 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

It is important that people know the types of social support that they should have before they go out and try to get it. Someone may need their support from their spouse or their friend that comes to the gym with them. 

Creating a Supportive Environment

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

Accessing Social Support

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

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

Innovative Strategies to Increase Adherence

Using the Internet to Promote Exercise Adherence

The internet can be used for supporting behavior change strategies like overcoming barriers, setting goals, and social support. It can also be used by trainers as ways to provide things for their clients. Trainers may provide things like interactive tools, information form websites, and client interaction through video.

Using the Physical Environment to Promote Exercise

Active Commuting

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

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 in order 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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