Michael Mantell by Michael Mantell

personal trainer adherence clientSince fewer than two in 10 Americans get the recommended levels of exercise, and more than 25% of U.S. adults do not devote any time to physical activity, there was likely a sudden rush of new members and former recommitted clients at your gym at this new year. Many of these new gym-goers are probably also leaping into levels of exercise intensity that may have a negative impact on adherence.

To best understand this yearly pilgrimage beyond common “pop” media explanations, it is important to understand exercise “dose-response” and the “dual-mode” theory of exercise. The ACE IFT™ model embraces this understanding and assists trainers and clients in assuring adherence.

Ekkekakis and Acevedo in their 2006 text, “Psychobiology of Physical Activity,” suggest that the negative relationship between the intensity of exercise and adherence — critical at all times, but perhaps more important at this time of the year — may be related to emotion or more technically in psychological terms, affect, that exercise brings.

Specifically, in many of your clients, these authors say that more intense exercise or a “higher dose” may result in a more unpleasant affect.

Unless clients feel good about training and exercise, they are not likely to continue, given the general expectation that people choose what makes them feel good and drop out of activities that leave them feeling bad.

Science Behind the Exercise and Emotion Relationship

Now this may get a bit technical and theoretical, but advanced training coaches will likely increase adherence — and ensure they’re still training clients by Valentine’s Day — if they understand this material. Here’s the breakdown:

Emotional responses to exercise results from the interchange between a) those internal cognitions about the meaning of exercise, self-efficacy, attributions of the social context of exercise, and considerations of personal goals for exercise, and b) interoceptive cues stimulated by exercise-induced physiological changes.

Interoceptive cues relate to the sensory nerve cells innervating the viscera, their sensory end organs, or the information they convey to the spinal cord and the brain.

As exercise “dose” or intensity increase, these two factors — cognitions and interoceptive cues — will shift in importance. Cognitive factors will be more dominant at lower levels of exercise and interoceptive cues will be more dominant as exercise intensity increases to an individual’s maximal capacity.

Research has demonstrated that clients moving from aerobic metabolism to anaerobic supplementation (“gas exchange” or “lactate threshold”) is critical to understanding negative affect during exercise.

This model suggests that for clients exercising below the level of aerobic-anaerobic transition, there is homogenous pleasure with low- to moderate-level of cognitive influence. As clients reach the level of aerobic-anaerobic transition in exercise, there may be pleasure or displeasure with strong influences of cognitive factors. With clients exercising above the level of aerobic-anaerobic transition, there is homogenous displeasure with strong influences from interoceptive factors.

Applying This “Dual-Mode” Theory of Exercise to Ensure Adherence

First, it’s important to understand that the belief that exercise generally makes people feel better does not apply in all circumstances, given the relationship between exercise intensity and affective response. 

Those clients who experience positive affect are more likely to do so during and after low-intensity and self-paced exercise, and during recovery from vigorous exercise. When exercise is associated with muscular, skeletal or cardiorespiratory symptoms, positive affect declines — and so will adherence.

Additionally, the effectiveness of cognitive strategies that many trainers use to help clients cope with unpleasant affects of exercise will be more effective at intensities below or near the aerobic-anaerobic transition.

Using techniques of cognitive re-framing or increasing self-efficacy self-talk when exercise intensity exceeds the level of aerobic-anaerobic transition may well be ineffective and may lead to more frustration, negative affect, and reduced intrinsic motivation — leading to reduced adherence.

Using the ACE IFT model helps ensure that clients will not rush to an intensity level that will lead to negative affect or physiological symptoms.

The skill of connecting, communicating and collaborating with clients to help them understand the importance of moving through functional movement & resistance training, and cardiorespiratory phases appropriately, will make the ultimate difference in whether fitness professionals develop long-term clients or short-term resolution breakers.