Effects of a 6-month incentive-based exercise program on adherence and work capacity

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Abstract
ROBISON, J. I., M. A. ROGERS, J. J. CARLSON, B. E. MAVIS, T. STACHNIK, B. STOFFELMAYR, H. A. SPRAGUE, C. R. MCGREW, and W. D. VAN HUSS. Effects of a 6-month incentive-based exercise program on adherence and work capacity. Med. Sci. Sports Exerc., Vol. 24, No. 1, pp. 85–93, 1992. The purpose of the study was to evaluate the effect of behavioral management techniques on exercise adherence linked to improvements in work capacity and maximal oxygen consumption (V̇O2max). One hundred thirty-seven participants in six different worksites on a university campus (five experimental and one comparison site) completed 6 months of a minimally supervised, incentive-based endurance exercise program. All participants in the experimental group contracted to engage in at least four bouts of 30 min of verified aerobic exercise within a prescribed target heart rate range each week for the duration of the program. Forty dollars deposited at the beginning of the program served as a response cost that could be lost as a result of failure to fulfill the weekly contracts. Individuals in the comparison group participated in a similar 6-month program but without the contracts and response cost strategies. Weekly adherence for both groups was strictly defined as verified fulfillment of all four bouts of exercise. Adherence for the experimental group was 97% by this definition, and adherence for the comparison group was 19% (P< 0.01). V̇O2max increased 2.6% (P < 0.01), and treadmill test time increased 16% (P < 0.01) in the experimental group after the 6-month program, with no significant changes in the comparison group. Recovery heart rates at 2 and 4 min post-exercise were significantly lower at 6 months in the experimental group but not in the comparison group. These data provide evidence that adherence to a 6-month endurance exercise program can be improved significantly through the use of well conceived behavior management strategies. In addition, the increased adherence results in significant improvements in cardiovascular efficiency and work capacity.

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