Social-Cognitive Factors of Long-Term Physical Exercise 7 Years After Orthopedic Treatment

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Objective: Although it has been confirmed that physical exercise improves orthopedic conditions, many individuals fail to maintain a regular exercise regimen after being discharged from medical rehabilitation. The present study examines the role of intention, social support, self-determination, planning, and self-efficacy in facilitating strength and endurance training. Design: In a 7-year observational study, intention, received social support and self-determination were assessed at baseline, self-efficacy and planning at 6-month follow-up, and physical exercise at 1-year, 3-year, and 7-year follow-up. Study participants were recruited from an orthopedic rehabilitation center, N = 641 participated in the survey at baseline, n = 495 at 6-month follow-up, n = 373 at 1-year follow-up, n = 330 at 3-year follow-up, and n = 191at 7-year follow-up. Path analyses were applied to investigate whether personal and social resources contribute to long-term physical activity. Results: Self-determination and planning mediated the link from intention and from social support to physical exercise at 1-, 3- and 7-year follow-ups. Self-efficacy facilitated planning and bridged the intention-behavior relationship in the domain of strength training after 1 year. An inverse direct relationship between social support and strength training was also found for all follow-ups. Conclusions: Findings indicate that intention, received social support and self-determination act as crucial resources in the long-term management of exercise. Planning can bridge the intention-behavior gap on a long-term basis. Behavior change interventions should replenish personal and social resources to empower individuals to maintain a healthy lifestyle

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