Table 1

study characteristics

AuthorPopulationAdherence interventionBehavioural theoryMeasure of adherenceControl or comparisonResultsConclusion
Boshuizen et al 48 Frail elderly
Mean age years (SD)
High guidance 80.0 (6.7), dropouts 80.8 (5.3)
Medium guidance 79.3 (7.0), dropouts 79.9 (5.9), control 77.2 (6.5), dropouts 75.2 (10.5)
Guidance and supervision
1) Two supervised sessions and one unsupervised a week
2) One supervised session and two unsupervised session a week
None givenPercentage of exercise sessions (supervised+unsupervised), taken from physical therapists records and self-report diaries.
At each location different physical therapists collected outcomes from those that lead the training
Asked to remain habitually activePercentage of exercise sessions undertaken
High guidance 79 (range 57–100)
Medium guidance 72 (range 20–93)
(No significant difference between groups)
No significant difference in the number of exercise sessions completed between the groups
Cheetham et al 52 Intermittent claudication
Mean age 67 years
Weekly exercise and motivation classNone givenSelf-reported compliance at 6 months—asked whether they walked <3 times, three times or >3 times a week
Data compiled by blinded personnel
Exercise advice: verbal and writtenAverage frequency of 30 min walks to near pain undertaken
Supervised exercise
<3 times 2
three times 8
>3 times 19
<3 times 9
three times 11
>3 times 9
A larger number of people in the exercise class group reported to be walking either three times a week or >3 times a week (P=0.012)
Duncan and Pozehl 47 Heart failure
Mean age 66.4 years
Individualised graphic feedback on exercise goals, participation and problem solvingSocial learning theoryExercise diaries—number of sessions completedExercise programme without adherence interventionExercise sessions completed
12 weeks
Control 59.3 (SD 11.1)
Intervention 62.3 (SD 6.4)
24 weeks
Control 41.2 (SD 9.7)
Intervention 59.6 (SD 10.6)*
*Significant difference (P<0.01)
The adherence intervention can increase exercise sessions completed after finishing a supervised exercise programme in patients with heart failure
Gallagher 49 Physical therapy patients with low back, hip or knee symptoms
Mean age years (SD)
69.3 (6.87)
Printed messages and magnets underpinned by socioemotional selectivity theory
1) Emotional and meaningful message
2) Factual and information message
Socioemotional selectivity theorySelf-reported adherence to their exercise programme (used to calculated adherence score)One message group compared with the otherAverage adherence score %
Emotional 60% (SD 34.4%)
Fact 55.3% (SD 34.0%)
(No significant difference between groups)
No significant difference found in participants’ adherence between the message groups
Gardner et al 50 Intermittent claudication
Mean age years (SD)
Control 65 (10)
Supervised ex 66 (12)
Home ex 65 (11)
Supervised vs unsupervised exercise
1) Home exercise (no supervision) for 12 weeks+step activity monitor
2) Supervised exercise for 12 weeks+step activity monitor
None givenTotal exercise sessions, using step activity monitor and exercise log bookEncouraged to walk more on their ownTotal exercise sessions completed %
Supervised group 84.8 (SD 20.9)
Home group 82.5 (SD 27.7)
(No significant difference between groups)
The relatively high adherence rate in home-based exercise was similar to that found with the supervised
exercise group
Ridgel et al 53 Parkinson’s disease and depression
Mean age years (SD) 70.2 (7.9)
Psychoeducation, peer education/support, group exercise (Enhanced EXerCisE thErapy (EXCEED) group)None givenNumber of exercise sessions attended, recorded by a research assistant. Those performing outcome measures were blinded to group assignmentSelf-guided psychoeducation and exercise (SGE). No group interactions or peer educationNumber of exercise sessions attended at 12 weeks
EXCEED=20.7 (SD 8.1)
SGE=22.0 (SD 8.0)
Both groups attended a similar number of exercise sessions
Schneider et al 42 Older adults who engage in aerobic or strengthening exercise <3 or more days a week
Mean age years (SD)
71.8 (5.1)
Cognitive behavioural therapy (CBT)
1) CBT group
2) Attention-control education group
CBTTime spent exercising in the past month. Exercise behaviour was assessed by a research assistant blinded to group allocationControl group—no CBT, no education groupTime spent exercising
Strengthening exercises (h)
3 months to 6 months
CBT 1.0 (SD 0.8) 1.0 (0.7)
Education 1.1 (SD 0.8) 1.0 (0.7)
Control 1.3 (SD 1.3) 1.2 (1.3)
9 months 12 months
CBT 1.0 (1.2) 0.9 (1.0)
Education 1.2 (2.3) 1.2 (2.4)
Control 1.0 (1.0) 1.1 (1.1)
(No significant difference between groups)
No significant difference with time spent exercising between groups
Schoo et al 41 Osteoarthritis of the hip and/or knee
Mean age Years (SD)
Brochure 71.1 (6.83)
Audio 70.9 (7.23)
Video 69.2 (6.36)
Exercise programme instruction method:
1) Brochure+audio tape
2) Brochure+video tape
None givenHome exercise log sheetsBrochure-only groupHome exercise adherence (median)
1–4 weeks: Brochure 93%
Video 92%
Audio 89%
5–8 weeks: Brochure 89.5%
Video 81.5%
Audio 87%
(No significant differences)
Audio and video tapes given in addition to an exercise brochure, did not show an increase in adherence compared with the brochure only group
Steele et al 46 Chronic lung disease
Mean age 67 years
Weekly phone calls and one home visit over 3 months
Consisting of dealing with queries about exercise adherence, problem solving, exercise maintenance, recommendations about health problems, encouragement, evaluated home safety, assistance in establishing an individualised exercise routine. Receiving a digital pedometer and exercise handbook
None givenExercise diary—total minutes of exerciseContinued care from referring provider. Recommendation for continuation of the exercise programme.
Invited to attend the lung club group sessions.
Minutes of exercise
Control 14 (SD 14)
Intervention 21 (SD 19)*
Control 28 (SD 21)
Intervention 30 (SD 32)
20 weeks
Control 16 (SD 19)
Intervention 32 (SD 46)*
1 year
Control 22 (SD 25)
Intervention 33 (SD 36)
*Significant differences (P<0.05)
The adherence intervention gave limited improvement in the short term regarding self-reported maintenance of exercise after pulmonary rehabilitation in highly sedentary chronic lung disease patients. No long-term benefit was found
Wu et al 40 People at risk of falling
Mean age Years (SD)
Tele ex 76.1 (7.9)
Comm ex 74.1 (6.9)
Home ex 75.9 (6.3)
Method of delivering exercise programme:
1) Instructor lead video call at home
2) Instructor lead community-based group
None givenLog sheets
-Number of sessions
-Time exercising
Home exercise with a digital versatile disc (DVD)Total time exercising (h)
Tele 30 (SD 12)
Comm 31 (SD 12)
Home 17 (SD 17)
Attendance rate (%)
Tele 69 (SD 27)
Comm 72 (SD 27)
Home 38 (SD 46)
(Tele and comm significantly higher for time exercising and attendance rate (both P<0.01)
Compared with home exercise, tele ex (video conferencing) and comm ex (community class) were better for total time spent exercising and number of exercise sessions completed
Yates et al 51 Postcardiac rehabilitation
Mean age years (SD)
66.7 (9.4)
Booster sessions, structured education and counselling given
1) Over the phone
2) In clinic
Self-efficacy theoryConsidered adherent if they had performed exercise ≥3 times a weekUsual care—one telephone call at 4–6 weeksAdherence rate at 3 months
Control 50%
Clinic 70%
Phone 75%
Adherence rate at 6 months
Control 50%
Clinic 40%
Phone 63%
(No significant difference were found between groups)
Adherence to the recommended exercise programme was greater in the two treatment groups compared with usual care, but differences were not significant
  • *Significant (P<0.05) difference between control and intervention.