Health behaviour change theories: contributions to an ICF-based behavioural exercise therapy for individuals with chronic diseases

Abstract

The current paper highlights the usefulness of theory-based integrative research in the field of exercise therapy, offers explicit methods and contents for physical therapists to promote PA behaviour, and introduces the ICF-based conceptual idea of a BET. Implications for Rehabilitation Irrespective of the clients' indication, therapeutic exercise programmes should incorporate effective, theory-based approaches to promote physical activity. Central determinants of physical activity behaviour are a number of personal factors: individuals' attitudes, skills, emotions, beliefs and knowledge. Clinicians implementing exercise therapy should set it within a wider theoretical framework including the personal factors that influence physical activity. To increase exercise-adherence and promote long-term physical activity behaviour change, the concept of a behavioural exercise therapy (BET) offers a theory-based approach to systematically address relevant personal factors with a combination of adequate contents of exercise with exercise-related techniques of behaviour change.

The importance of a multi-disciplinary perspective and patient activation programmes in MS management

“…Behavioural exercise therapy for chronic disease, for example, MS, with regard to the International Classification of Functioning, Disability and Health (ICF) model of Functioning and Disability (grey boxes and grey arrows). 61 The black and the dotted black arrows depict supposed mechanisms of action of behavioural exercise therapy. The dotted black arrows represent the biomedical mechanism of action: exercise enhances body functions and structures and consequently reduces activity limitations and participation restrictions.…”

“…60 This implies that personal factors such as individuals' attitudes, skills, emotions, beliefs and knowledge are key determinants for someone's physical activity. 61 Such a paradigm shift towards physical activity for health should also be encouraged in patients with MS. 60 Based on this idea, Geidl et al 61 developed a theorybased model of behavioural exercise therapy to increase exercise adherence and promote long-term physical activity behavioural change in individuals with chronic diseases ( Figure 6). To implement this in clinical practice, it is not sufficient to have an appointment with the neurologist and the MS nurse every 6 months.…”

Effective components of exercise and physical activity-related behaviour-change interventions for chronic non-communicable diseases in Africa: protocol for a systematic mixed studies review with meta-analysis

“…10 A significant component of behaviour change interventions may be non-pharmacological,11 12 with exercises to increase physical activity being of utmost importance 13. Evidence-based clinical practice guidelines for the treatment of NCDs recommend exercise training to promote physical activity 14–18.…”

“…Evidence-based clinical practice guidelines for the treatment of NCDs recommend exercise training to promote physical activity 14–18. This is known to improve physiological functioning, cognitive, emotional, social and psychosocial functioning as well as to alter health beliefs and increase acceptance of chronic disease 13. Furthermore, systematic reviews and meta-analysis of randomised controlled trials (RCTs) suggest that exercises promoting physical activity may be effective in reducing disability and improving chronic pain 19–24…”

“…Therefore, developing potentially effective exercise and physical activity-related behaviour-change interventions for chronic non-communicable conditions in Africa requires an understanding of the components that may increase patients’ adherence to these interventions and make them effective in this context. This is especially relevant, as exercise programmes that promote adherence to behaviour change may be underpinned by theories that may be informed by contextual factors irrespective of the chronic condition 13. This systematic review aims to determine the effective components of exercise and physical activity-related behaviour-change interventions for chronic NCDs in Africa, by combining quantitative and qualitative research evidence.…”