Determinants of exercise adherence in sedentary middle‐aged and older adults
Regular exercise positively impacts neurocognitive health, particularly in aging individuals. However, low adherence, particularly among older adults, hinders the adoption of exercise routines. While brain plasticity mechanisms largely support the cognitive benefits of exercise, the link between phy...
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| Published in | Psychophysiology Vol. 61; no. 9; pp. e14591 - n/a |
|---|---|
| Main Authors | , , , , |
| Format | Journal Article |
| Language | English |
| Published |
United States
Blackwell Publishing Ltd
01.09.2024
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| Subjects | |
| Online Access | Get full text |
| ISSN | 0048-5772 1469-8986 1469-8986 1540-5958 |
| DOI | 10.1111/psyp.14591 |
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| Abstract | Regular exercise positively impacts neurocognitive health, particularly in aging individuals. However, low adherence, particularly among older adults, hinders the adoption of exercise routines. While brain plasticity mechanisms largely support the cognitive benefits of exercise, the link between physiological and behavioral factors influencing exercise adherence remains unclear. This study aimed to explore this association in sedentary middle‐aged and older adults. Thirty‐one participants underwent an evaluation of cortico‐motor plasticity using transcranial magnetic stimulation (TMS) to measure changes in motor‐evoked potentials following intermittent theta‐burst stimulation (iTBS). Health history, cardiorespiratory fitness, and exercise‐related behavioral factors were also assessed. The participants engaged in a 2‐month supervised aerobic exercise program, attending sessions three times a week for 60 min each, totaling 24 sessions at a moderate‐to‐vigorous intensity. They were divided into Completers (n = 19), who attended all sessions, and Dropouts (n = 12), who withdrew early. Completers exhibited lower smoking rates, exercise barriers, and resting heart rates compared to Dropouts. For Completers, TMS/iTBS cortico‐motor plasticity was associated with better exercise adherence (r = −.53, corrected p = .019). Exploratory hypothesis‐generating regression analysis suggested that post‐iTBS changes (β = −7.78, p = .013) and self‐efficacy (β = −.51, p = .019) may predict exercise adherence (adjusted‐R2 = .44). In conclusion, this study highlights the significance of TMS/iTBS cortico‐motor plasticity, self‐efficacy, and cardiovascular health in exercise adherence. Given the well‐established cognitive benefits of exercise, addressing sedentary behavior and enhancing self‐efficacy are crucial for promoting adherence and optimizing brain health. Clinicians and researchers should prioritize assessing these variables to improve the effectiveness of exercise programs.
Adherence to exercise and its cognitive brain health benefits relies on the mechanism of neuroplasticity, which may be altered by sedentariness and lack of self‐efficacy in middle‐aged and older adults. This study provides a better understanding of the link between physiological TMS/iTBS cortico‐motor plasticity and exercise‐related behavioral measures, which may advance current evidence and allow therapists and researchers to optimize and tailor exercise interventions for cognitive brain health. |
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| AbstractList | Regular exercise positively impacts neurocognitive health, particularly in aging individuals. However, low adherence, particularly among older adults, hinders the adoption of exercise routines. While brain plasticity mechanisms largely support the cognitive benefits of exercise, the link between physiological and behavioral factors influencing exercise adherence remains unclear. This study aimed to explore this association in sedentary middle‐aged and older adults. Thirty‐one participants underwent an evaluation of cortico‐motor plasticity using transcranial magnetic stimulation (TMS) to measure changes in motor‐evoked potentials following intermittent theta‐burst stimulation (iTBS). Health history, cardiorespiratory fitness, and exercise‐related behavioral factors were also assessed. The participants engaged in a 2‐month supervised aerobic exercise program, attending sessions three times a week for 60 min each, totaling 24 sessions at a moderate‐to‐vigorous intensity. They were divided into Completers (
n
= 19), who attended all sessions, and Dropouts (
n
= 12), who withdrew early. Completers exhibited lower smoking rates, exercise barriers, and resting heart rates compared to Dropouts. For Completers, TMS/iTBS cortico‐motor plasticity was associated with better exercise adherence (
r
= −.53,
corrected p
= .019). Exploratory hypothesis‐generating regression analysis suggested that post‐iTBS changes (
β
= −7.78,
p
= .013) and self‐efficacy (
β
= −.51,
p
= .019) may predict exercise adherence (
adjusted‐R
2
= .44). In conclusion, this study highlights the significance of TMS/iTBS cortico‐motor plasticity, self‐efficacy, and cardiovascular health in exercise adherence. Given the well‐established cognitive benefits of exercise, addressing sedentary behavior and enhancing self‐efficacy are crucial for promoting adherence and optimizing brain health. Clinicians and researchers should prioritize assessing these variables to improve the effectiveness of exercise programs.
Adherence to exercise and its cognitive brain health benefits relies on the mechanism of neuroplasticity, which may be altered by sedentariness and lack of self‐efficacy in middle‐aged and older adults. This study provides a better understanding of the link between physiological TMS/iTBS cortico‐motor plasticity and exercise‐related behavioral measures, which may advance current evidence and allow therapists and researchers to optimize and tailor exercise interventions for cognitive brain health. Regular exercise is known to positively impact neurocognitive health, particularly in aging individuals. However, low adherence, particularly among older adults, hinders the adoption of exercise routines. While brain plasticity mechanisms largely support the cognitive benefits of exercise, the link between physiological and behavioral factors influencing exercise adherence remains unclear. This study aimed to explore this association in sedentary middle-aged and older adults. Thirty-one participants underwent an evaluation of cortico-motor plasticity using transcranial magnetic stimulation (TMS) to measure changes in motor-evoked potentials following intermittent theta-burst stimulation (iTBS). Health history, cardiorespiratory fitness, and exercise-related behavioral factors were also assessed. The participants engaged in a 2-month supervised aerobic exercise program, attending sessions three times a week for 60 minutes each, totaling 24 sessions at a moderate-to-vigorous intensity. They were divided into Completers ( n =19), who attended all sessions, and Dropouts ( n =12), who withdrew early. Completers exhibited lower smoking rates, exercise barriers, and resting heart rates compared to Dropouts. For Completers, TMS/iTBS cortico-motor plasticity was associated with better exercise adherence ( r = −0.53, corrected p = .019). Exploratory hypothesis-generating regression analysis suggested that post-iTBS changes ( β = −7.78, p = .013) and self-efficacy ( β = −.51, p= .019) may predict exercise adherence ( adjusted-R 2 = 0.44). In conclusion, this study highlights the significance of TMS/iTBS cortico-motor plasticity, self-efficacy, and cardiovascular health in exercise adherence. Given the well-established cognitive benefits of exercise, addressing sedentary behavior and enhancing self-efficacy are crucial for promoting adherence and optimizing brain health. Clinicians and researchers should prioritize assessing these variables to improve the effectiveness of exercise programs. Note . Numbers 1 through 5 refer to each result labeled in the artwork’s abstract figure. Following, we present the result highlights. 1 . “Completers” and “Dropouts” differed in neither baseline TMS/iTBS cortico-motor excitability nor cortico-motor plasticity mechanisms (red color boxes). Despite no between-group differences, only “Completers” demonstrated a significant potentiation post-TMS/iTBS, but it did not hold after correction (green color arrow). Both groups demonstrated a larger effect size. 2 . We demonstrated that the Dropout participants’ exercise barriers (e.g., lack of time, health, and budget) were significantly greater compared to the Completers group (green filled box). We also revealed that Dropout participants had significantly lower cardiorespiratory fitness, as demonstrated by lower RHR, exercise capacity, and estimated VO 2 peak compared to “Completers.” (green filled box) 3 . In the Completers group, exercise adherence, defined as the average length of intervention in days to complete the 24 prescribed exercise sessions, was 64.4 (9.2) days. The average number of rescheduled sessions for this group was 4.3 (7.3). 4 . The interval Post10–20 %Δ variable was the only selected TMS/iTBS cortico-motor plasticity predictor of exercise adherence and explained 22% of the variance (green-filled box). By including only exercise-related behavioral and fitness variables, exercise self-efficacy was the only predictor of exercise adherence in middle-aged and older adults and explained 21% of the variance. 5 . Adjusted models were fitted and revealed that both TMS/iTBS cortico-motor plasticity and exercise self-efficacy were the best predictors of exercise adherence and explained 44% of the variance (green-filled box). This result indicates that for every one-unit increase in TMS/iTBS cortico-motor plasticity mechanisms, the estimated mean length of intervention in days (exercise adherence) decreases by approximately eight days when controlling for self-efficacy. Models adjusting for age, gender, and cardiorespiratory fitness were fitted but did not improve the model. Regular exercise positively impacts neurocognitive health, particularly in aging individuals. However, low adherence, particularly among older adults, hinders the adoption of exercise routines. While brain plasticity mechanisms largely support the cognitive benefits of exercise, the link between physiological and behavioral factors influencing exercise adherence remains unclear. This study aimed to explore this association in sedentary middle‐aged and older adults. Thirty‐one participants underwent an evaluation of cortico‐motor plasticity using transcranial magnetic stimulation (TMS) to measure changes in motor‐evoked potentials following intermittent theta‐burst stimulation (iTBS). Health history, cardiorespiratory fitness, and exercise‐related behavioral factors were also assessed. The participants engaged in a 2‐month supervised aerobic exercise program, attending sessions three times a week for 60 min each, totaling 24 sessions at a moderate‐to‐vigorous intensity. They were divided into Completers (n = 19), who attended all sessions, and Dropouts (n = 12), who withdrew early. Completers exhibited lower smoking rates, exercise barriers, and resting heart rates compared to Dropouts. For Completers, TMS/iTBS cortico‐motor plasticity was associated with better exercise adherence (r = −.53, corrected p = .019). Exploratory hypothesis‐generating regression analysis suggested that post‐iTBS changes (β = −7.78, p = .013) and self‐efficacy (β = −.51, p = .019) may predict exercise adherence (adjusted‐R2 = .44). In conclusion, this study highlights the significance of TMS/iTBS cortico‐motor plasticity, self‐efficacy, and cardiovascular health in exercise adherence. Given the well‐established cognitive benefits of exercise, addressing sedentary behavior and enhancing self‐efficacy are crucial for promoting adherence and optimizing brain health. Clinicians and researchers should prioritize assessing these variables to improve the effectiveness of exercise programs. Adherence to exercise and its cognitive brain health benefits relies on the mechanism of neuroplasticity, which may be altered by sedentariness and lack of self‐efficacy in middle‐aged and older adults. This study provides a better understanding of the link between physiological TMS/iTBS cortico‐motor plasticity and exercise‐related behavioral measures, which may advance current evidence and allow therapists and researchers to optimize and tailor exercise interventions for cognitive brain health. Regular exercise positively impacts neurocognitive health, particularly in aging individuals. However, low adherence, particularly among older adults, hinders the adoption of exercise routines. While brain plasticity mechanisms largely support the cognitive benefits of exercise, the link between physiological and behavioral factors influencing exercise adherence remains unclear. This study aimed to explore this association in sedentary middle-aged and older adults. Thirty-one participants underwent an evaluation of cortico-motor plasticity using transcranial magnetic stimulation (TMS) to measure changes in motor-evoked potentials following intermittent theta-burst stimulation (iTBS). Health history, cardiorespiratory fitness, and exercise-related behavioral factors were also assessed. The participants engaged in a 2-month supervised aerobic exercise program, attending sessions three times a week for 60 min each, totaling 24 sessions at a moderate-to-vigorous intensity. They were divided into Completers (n = 19), who attended all sessions, and Dropouts (n = 12), who withdrew early. Completers exhibited lower smoking rates, exercise barriers, and resting heart rates compared to Dropouts. For Completers, TMS/iTBS cortico-motor plasticity was associated with better exercise adherence (r = -.53, corrected p = .019). Exploratory hypothesis-generating regression analysis suggested that post-iTBS changes (β = -7.78, p = .013) and self-efficacy (β = -.51, p = .019) may predict exercise adherence (adjusted-R = .44). In conclusion, this study highlights the significance of TMS/iTBS cortico-motor plasticity, self-efficacy, and cardiovascular health in exercise adherence. Given the well-established cognitive benefits of exercise, addressing sedentary behavior and enhancing self-efficacy are crucial for promoting adherence and optimizing brain health. Clinicians and researchers should prioritize assessing these variables to improve the effectiveness of exercise programs. Regular exercise positively impacts neurocognitive health, particularly in aging individuals. However, low adherence, particularly among older adults, hinders the adoption of exercise routines. While brain plasticity mechanisms largely support the cognitive benefits of exercise, the link between physiological and behavioral factors influencing exercise adherence remains unclear. This study aimed to explore this association in sedentary middle‐aged and older adults. Thirty‐one participants underwent an evaluation of cortico‐motor plasticity using transcranial magnetic stimulation (TMS) to measure changes in motor‐evoked potentials following intermittent theta‐burst stimulation (iTBS). Health history, cardiorespiratory fitness, and exercise‐related behavioral factors were also assessed. The participants engaged in a 2‐month supervised aerobic exercise program, attending sessions three times a week for 60 min each, totaling 24 sessions at a moderate‐to‐vigorous intensity. They were divided into Completers (n = 19), who attended all sessions, and Dropouts (n = 12), who withdrew early. Completers exhibited lower smoking rates, exercise barriers, and resting heart rates compared to Dropouts. For Completers, TMS/iTBS cortico‐motor plasticity was associated with better exercise adherence (r = −.53, corrected p = .019). Exploratory hypothesis‐generating regression analysis suggested that post‐iTBS changes (β = −7.78, p = .013) and self‐efficacy (β = −.51, p = .019) may predict exercise adherence (adjusted‐R2 = .44). In conclusion, this study highlights the significance of TMS/iTBS cortico‐motor plasticity, self‐efficacy, and cardiovascular health in exercise adherence. Given the well‐established cognitive benefits of exercise, addressing sedentary behavior and enhancing self‐efficacy are crucial for promoting adherence and optimizing brain health. Clinicians and researchers should prioritize assessing these variables to improve the effectiveness of exercise programs. Regular exercise positively impacts neurocognitive health, particularly in aging individuals. However, low adherence, particularly among older adults, hinders the adoption of exercise routines. While brain plasticity mechanisms largely support the cognitive benefits of exercise, the link between physiological and behavioral factors influencing exercise adherence remains unclear. This study aimed to explore this association in sedentary middle-aged and older adults. Thirty-one participants underwent an evaluation of cortico-motor plasticity using transcranial magnetic stimulation (TMS) to measure changes in motor-evoked potentials following intermittent theta-burst stimulation (iTBS). Health history, cardiorespiratory fitness, and exercise-related behavioral factors were also assessed. The participants engaged in a 2-month supervised aerobic exercise program, attending sessions three times a week for 60 min each, totaling 24 sessions at a moderate-to-vigorous intensity. They were divided into Completers (n = 19), who attended all sessions, and Dropouts (n = 12), who withdrew early. Completers exhibited lower smoking rates, exercise barriers, and resting heart rates compared to Dropouts. For Completers, TMS/iTBS cortico-motor plasticity was associated with better exercise adherence (r = -.53, corrected p = .019). Exploratory hypothesis-generating regression analysis suggested that post-iTBS changes (β = -7.78, p = .013) and self-efficacy (β = -.51, p = .019) may predict exercise adherence (adjusted-R2 = .44). In conclusion, this study highlights the significance of TMS/iTBS cortico-motor plasticity, self-efficacy, and cardiovascular health in exercise adherence. Given the well-established cognitive benefits of exercise, addressing sedentary behavior and enhancing self-efficacy are crucial for promoting adherence and optimizing brain health. Clinicians and researchers should prioritize assessing these variables to improve the effectiveness of exercise programs.Regular exercise positively impacts neurocognitive health, particularly in aging individuals. However, low adherence, particularly among older adults, hinders the adoption of exercise routines. While brain plasticity mechanisms largely support the cognitive benefits of exercise, the link between physiological and behavioral factors influencing exercise adherence remains unclear. This study aimed to explore this association in sedentary middle-aged and older adults. Thirty-one participants underwent an evaluation of cortico-motor plasticity using transcranial magnetic stimulation (TMS) to measure changes in motor-evoked potentials following intermittent theta-burst stimulation (iTBS). Health history, cardiorespiratory fitness, and exercise-related behavioral factors were also assessed. The participants engaged in a 2-month supervised aerobic exercise program, attending sessions three times a week for 60 min each, totaling 24 sessions at a moderate-to-vigorous intensity. They were divided into Completers (n = 19), who attended all sessions, and Dropouts (n = 12), who withdrew early. Completers exhibited lower smoking rates, exercise barriers, and resting heart rates compared to Dropouts. For Completers, TMS/iTBS cortico-motor plasticity was associated with better exercise adherence (r = -.53, corrected p = .019). Exploratory hypothesis-generating regression analysis suggested that post-iTBS changes (β = -7.78, p = .013) and self-efficacy (β = -.51, p = .019) may predict exercise adherence (adjusted-R2 = .44). In conclusion, this study highlights the significance of TMS/iTBS cortico-motor plasticity, self-efficacy, and cardiovascular health in exercise adherence. Given the well-established cognitive benefits of exercise, addressing sedentary behavior and enhancing self-efficacy are crucial for promoting adherence and optimizing brain health. Clinicians and researchers should prioritize assessing these variables to improve the effectiveness of exercise programs. |
| Author | Cahalin, Lawrence P. Bigliassi, Marcelo Fried, Peter J. Gomes‐Osman, Joyce Cabral, Danylo F. |
| AuthorAffiliation | 4. Department of Teaching and Learning, Florida International University, Miami, FL, USA 2. Berenson-Allen Center for Noninvasive Brain Stimulation, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA 1. Department of Physical Therapy, University of Miami Miller School of Medicine, Coral Gables, FL, USA 5. Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, USA 3. Department of Neurology, Harvard Medical School, Boston, MA, USA |
| AuthorAffiliation_xml | – name: 1. Department of Physical Therapy, University of Miami Miller School of Medicine, Coral Gables, FL, USA – name: 2. Berenson-Allen Center for Noninvasive Brain Stimulation, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA – name: 3. Department of Neurology, Harvard Medical School, Boston, MA, USA – name: 4. Department of Teaching and Learning, Florida International University, Miami, FL, USA – name: 5. Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, USA |
| Author_xml | – sequence: 1 givenname: Danylo F. orcidid: 0000-0003-0162-1039 surname: Cabral fullname: Cabral, Danylo F. email: dferrei1@bidmc.harvard.edu organization: Harvard Medical School – sequence: 2 givenname: Peter J. orcidid: 0000-0001-6041-2996 surname: Fried fullname: Fried, Peter J. organization: Harvard Medical School – sequence: 3 givenname: Marcelo orcidid: 0000-0001-6940-9849 surname: Bigliassi fullname: Bigliassi, Marcelo organization: Florida International University – sequence: 4 givenname: Lawrence P. orcidid: 0000-0001-8447-1026 surname: Cahalin fullname: Cahalin, Lawrence P. organization: University of Miami Miller School of Medicine – sequence: 5 givenname: Joyce orcidid: 0000-0001-6510-0780 surname: Gomes‐Osman fullname: Gomes‐Osman, Joyce organization: University of Miami Miller School of Medicine |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/38629783$$D View this record in MEDLINE/PubMed |
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| Keywords | exercise transcranial magnetic stimulation aging adults brain health adherence neuroplasticity |
| Language | English |
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| Notes | Lawrence P. Cahalin and Joyce Gomes‐Osman contributed equally to this study and share the last authorship. ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 14 content type line 23 These authors have contributed equally to this work and share the last authorship. |
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| PublicationDate | September 2024 |
| PublicationDateYYYYMMDD | 2024-09-01 |
| PublicationDate_xml | – month: 09 year: 2024 text: September 2024 |
| PublicationDecade | 2020 |
| PublicationPlace | United States |
| PublicationPlace_xml | – name: United States – name: Oxford |
| PublicationTitle | Psychophysiology |
| PublicationTitleAlternate | Psychophysiology |
| PublicationYear | 2024 |
| Publisher | Blackwell Publishing Ltd |
| Publisher_xml | – name: Blackwell Publishing Ltd |
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| Snippet | Regular exercise positively impacts neurocognitive health, particularly in aging individuals. However, low adherence, particularly among older adults, hinders... Regular exercise is known to positively impact neurocognitive health, particularly in aging individuals. However, low adherence, particularly among older... |
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| SubjectTerms | adherence Aged aging adults Behavioral plasticity brain health Cardiorespiratory fitness Cardiorespiratory Fitness - physiology Cognition Evoked Potentials, Motor - physiology Exercise Exercise - physiology Female Humans Magnetic fields Male Middle Aged Motor Cortex - physiology Neuronal Plasticity - physiology Neuroplasticity Older people Patient Compliance Physical fitness Sedentary Behavior Transcranial Magnetic Stimulation |
| Title | Determinants of exercise adherence in sedentary middle‐aged and older adults |
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