For benefits to be realized, it is important that patients
adhere to their exercise program. Multicomponent behavioral
adherence programs based on the model of stages
of change developed by Prochaska and DiClemente [47]
can greatly increase adherence to exercise. Clinicians
are encouraged to provide support, encouragement, and
accountability to patients when exercise is recommended
[29]. When patients have diffi culty adhering to an exercise
routine, a discussion of potential barriers to exercise can help problem-solve these issues and get them back
on track with their exercise program. Increased self-effi -
cacy is an important factor in this process and increases
the likelihood of maintaining an exercise program [48].
Marcus et al. [49] provided a review of contributors to the
adoption and maintenance of a physical activity.