Exercise adherence: integrating theory, evidence and behaviour change techniques

Introduction

Physiotherapeutic rehabilitation commonly includes exercise. For general health and fitness, and for most long-term conditions, accumulating and maintaining exercise benefit requires adherence. However, medium to longer-term exercise adherence is typically poor. People know what to do and do not do it (knowledge–behaviour gap), initial uptake in supervised settings does not translate into daily self-managed routine, and people stop and do not restart [1]. Adherence requires behaviour change. Physiotherapists can support behaviour change to enhance exercise adherence by: (1) applying relevant health behaviour theory; (2) understanding the patient's experience; and (3) using appropriate behaviour change techniques. Pelvic floor muscle exercise (PFME), widely used in the self-management of stress urinary incontinence, served to illustrate each point.