Research Alert

Newswise — Patient adherence to an exercise program is a long-standing issue. What do you know about adherence? How can we, as nurses, influence adherence in older adults? Are there indicators that might predict adherence? Liu and Miyawaki describe the nationwide EnhanceFitness program (36,000+ participants) and identify the association of participants' function in three baseline physical function tests and adherence to the program. Read What Types of Physical Function Predict Program Adherence in Older Adults.



The aims of this study were to describe participants’ demographic characteristics by adherence levels and to examine the association between participants’ baseline physical function and their adherence to an evidence-based group exercise program.


A prospective exploratory study (N = 36,373).


Participants’ physical function was assessed using 30-second chair-stand, arm-curl, and 8-foot up-and-go tests. Adherence was calculated as the proportion of attended sessions over offered sessions.


Participants’ mean adherence was 52%. Older male, Asian/Pacific Islander race, and Washington State residents with fewer chronic conditions showed higher adherence. Multinomial logistic regression showed the baseline 30-second chair-stand, arm-curl, and 8-foot up-and-go tests significantly predict adherence levels after controlling for demographics.


Stronger upper- and lower-extremity strength and better walking balance and mobility are associated with higher adherence to exercise programs in older adults.

Clinical Relevance 

The results underscored the importance of offering classes at various physical function levels while considering participants’ individual needs.

Journal Link: Rehabilitation Nursing

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Rehabilitation Nursing