What factors determine exercise adherence in individuals with mobility impairments?

Purpose: To determine 1) the factors that predicted exercise adherence among individuals with mobility impairments, 2) barriers to exercise adherence, and 3) facilitators to exercise adherence. Methods: A quasi-experimental, longitudinal, repeated measures study was conducted from 2005 to current among St. Louis residents, at least 18 years of age, with mobility impairments who use either a cane/crutch/walker, manual wheelchair, power wheelchair, and/or scooter. Participants completed a survey at baseline (T1), at the end of a free 12 week exercise program (T2), 4 months after the cessation of the exercise program (T3), and at one year from their baseline (T4). Results: Ninety finished T1, 31 completed T2, 10 individuals completed T3, and 2 completed T4. Of those that completed T3 and T4, 50% were female, ages range from 22-70, and 60% diagnosed with SCI. Findings show that goal achievement, exercise attendance, a decrease in secondary conditions, and an increase in home and community participation were all factors that predicted exercise adherence. Participation was measured using the PART/S survey. The most common barriers to exercise adherence included gym membership fees, transportation, and assistance during exercise. Suggested facilitators to exercise adherence were group work-outs, health newsletters, accessible equipment and gyms, and health seminars about varying wellness topics. Conclusions: The study showed that a multitude of factors predict exercise adherence. In order to increase exercise adherence the healthcare community needs to develop a comprehensive health and wellness program that eliminates barriers and enhances the facilitators. A detailed program plan is in progress.