Download PDF
Int J Sports Med 2003; 24(6): 459-464
DOI: 10.1055/s-2003-41177
Nutrition
© Georg Thieme Verlag Stuttgart · New York

Adherence and Attrition With Intermittent and Continuous Exercise in Overweight Women

D.  J.  Jacobsen1 , J.  E.  Donnelly1 , K.  Snyder-Heelan1 , K.  Livingston1
  • 1Energy Balance Laboratory, Robinson Center, University of Kansas, Lawrence, USA
Further Information

Publication History

Accepted after revision: January 23, 2003

Publication Date:
07 August 2003 (online)

Also available at
    Permissions and Reprints

Abstract

Few people are active to the levels recommended by Healthy People 2010. Intermittent exercise has been promoted as an exercise prescription which may enable more people to meet recommended guidelines. However, few data are available on intermittent exercise over the long-term. The purpose of the current study was to compare the effects of long-term (72 weeks) continuous (CON) and intermittent (INT) exercise on attrition and adherence in previously sedentary, moderately obese females. Participants were randomized to continuous walking at 60 to 75 % of maximum aerobic capacity, 3 days per week, 30 minutes per session, or intermittent exercise for two 15-minute sessions, 5 days per week. Adherence was calculated as the number of sessions completed compared to the number of sessions prescribed. At 12-week intervals, attrition was calculated as the number of participants in the study compared to the total number of participants originally enrolled. For the participants who completed the study, body weight decreased for CON from 80.17 ± 5.75 kg at baseline to 79.70 ± 5.40 at 16 months (p < 0.05). For INT, body weight did not change from baseline (85.85 ± 13.13 kg) to 16 months (85.05 ± 12.90 kg). By design, INT walked significantly (p < 0.05) further (819 ± 128 km) compared to CON (527 ± 46 km). Attrition was 58 % for both groups baseline to 72 weeks. However, attrition was greater for CON (38 %) compared to INT (16 %) in the first 24 weeks. Adherence was excellent for both groups (> 83 %) throughout the study. These results suggest that intermittent and continuous exercise both have considerable attrition rates within 72 weeks of exercise initiation; however, the pattern of attrition differs considerably. That is, it appears that intermittent exercise may reduce attrition in the first 24 weeks of an exercise program; however, attrition does not appear to be different than continuous exercise at 72 weeks.

Key words

Long-term - body weight - body composition - adherence - attrition - prescription

References

  • 1 American Heart Association .Exercise testing and training of apparently healthy individuals: a handbook for physicians. The committee on exercise, American Heart Association #70-008-A, Dallas, TX: 1972
    Google Scholar
  • 2 Balon R, Arfken C L, Mufti R. Patients’ preferences about medication dosing regimens.  Psychiatric Services. 1998;  49 1095-1097
    PubMedGoogle Scholar
  • 3 Brownson R C, Jones D A, Pratt M, Blanton C, Heath G W. Measuring physical activity with the behavioral risk factor surveillance system.  Med Sci Sports Exerc. 2000;  32 1913-1918
    PubMedGoogle Scholar
  • 4 Brozek J, Grande F, Andersen J T, Keys A. Densiometric analysis of body composition: revision of some quantitative assumptions.  Ann N Y Acad of Scienc. 1963;  110 113-140
    CrossrefPubMedGoogle Scholar
  • 5 Cramer J A. Optimizing long-term patient compliance.  Neurology. 1995;  45 S25-S28
    PubMedGoogle Scholar
  • 6 Dishman R K, Sallis J F, Orenstein D R. The determinants of physical activity and exercise.  Pub Health Rep. 1985;  100 158-171
    PubMedGoogle Scholar
  • 7 Donnelly J E, Jacobsen D J, Heelan K S, Seip R, Smith S. The effects of 18 months of intermittent vs. continuous exercise on aerobic capacity, body weight and composition, and metabolic fitness in previously sedentary, moderately obese females.  Int J Obes. 2000;  24 566-572
    CrossrefPubMedGoogle Scholar
  • 8 Donnelly J E, Jacobsen D J, Jakicic J M, Whatley J, Gunderson S, Gillespie W J, Blackburn G L, Tran Z V. Estimation of peak oxygen consumption from a sub-maximal half mile walk in obese females.  Int J Obes. 1992;  16 585-589
    PubMedGoogle Scholar
  • 9 Donnelly J E, Jacobsen D J, Snyder K A, Seip R L. Effects of long-term, moderate intensity, intermittent exercise on weight loss and body composition.  Int J Obes. 2000;  25 566-572
    PubMedGoogle Scholar
  • 10 Farmer K C, Jacobs E W, Phillips C R. Long-term patient compliance with prescribed regimens of calcium channel blockers.  Clin Therapeutics: Int Peer Rev J Drug Ther. 1994;  16 316-326
    PubMedGoogle Scholar
  • 11 French S A, Jeffery R W, Murray D. Is dieting good for you? Prevalence, duration and associated weight and behavior changes for specific weight loss strategies over four years in US adults.  Int J Obes. 1999;  23 320-327
    CrossrefPubMedGoogle Scholar
  • 12 Grandits G A, Bartsch G E, Stamler J. Method issues in dietary data analyses in the Multiple Risk Factor Intervention Trial.  Am J Clin Nutr. 1997;  65 211-227
    PubMedGoogle Scholar
  • 13 Jakicic J M, Wing R R, Butler B A, Robertson R J. Prescribing exercise in multiple short bouts versus one continuous bout: Effects on adherence, cardiorespiratory fitness, and weight loss in overweight women.  Int J Obes. 1995;  19 893-901
    PubMedGoogle Scholar
  • 14 Jakicic J M, Winters C, Lang W, Wing R R. Effects of intermittent exercise and use of home exercise equipment on adherence, weight loss, and fitness in overweight women - A randomized trial.  JAMA. 1999;  282 1554-1560
    CrossrefPubMedGoogle Scholar
  • 15 King A C, Blair S N, Bild D E, Dishman R K, Dubbert P M, Marcus B H, Oldridge N B, Paffenbarger Jr R S, Powell K E, Yeager K K. Determinants of physical activity and interventions in adults.  Med Sci Sports Exerc. 1992;  24 221-236
    PubMedGoogle Scholar
  • 16 Martin S B, Morrow Jr. J, Jackson A W, Dunn A L. Variables related to meeting the CDC/ACSM physical activity guidelines.  Med Sci Sports Exerc. 2000;  32 2087-2092
    PubMedGoogle Scholar
  • 17 Murphy M H, Hardman A E. Training effects of short and long bouts of brisk walking in sedentary women.  Med Sci Sports Exerc. 1998;  30 152-157
    PubMedGoogle Scholar
  • 18 NIH Technical Assessment Conference . Panel Methods for voluntary weight loss and control.  Ann Int Med. 1992;  116 942-949
    PubMedGoogle Scholar
  • 19 Pate R R, Pratt M, Blair S N, Haskell W, Macera C A, Bouchard C, Buchner D, Ettinger W, Heath G W, King A C, Kriska A, Leon A S, Marcus B H, Morris J, Paffenbarger R S Jr, Patrick K, Pollock M L, Rippe J M, Sallis J, Wilmore J H. Physical activity and public health: A recommendation from the Centers for Disease Control and Prevention and the American College of Sports Medicine.  JAMA. 1995;  273 402-407
    Google Scholar
  • 20 Sallis J F, Haskell W L, Wood P D, Fortmann S P, Rogers T, Blair S N, Paffenbarger R S Jr. Physical activity assessment methodology in the five-city project.  Am J Epidemiol. 1985;  121 91-106
    CrossrefPubMedGoogle Scholar
  • 21 Snyder K A, Donnelly J E, Jacobsen D J, Hertner G, Jakicic J M. The effects of long-term, moderate intensity, intermittent exercise on aerobic capacity, body composition, blood lipids, insulin and glucose in overweight females.  Int J Obes. 1997;  21 1180-1189
    CrossrefPubMedGoogle Scholar
  • 22 Verbrugge L M, Gruber-Baldini A L, Fozard J L. Age differences and age changes in activities: Baltimore longitudinal study of aging.  J Gerontol. 1996;  51 30-41
    PubMedGoogle Scholar
  • 23 Withers R T, Smith D A, Tucker R C, Brinkman M, Clark D G. Energy metabolism in sedentary and active 49- to 70-yr-old women.  J Appl Physiol. 1998;  84 1333-1340
    PubMedGoogle Scholar

D. J. Jacobsen, Ph. D.

Energy Balance Laboratory

1301 Sunnyside Avenue · Robinson Center · University of Kansas · Lawrence, KS 66045 · USA ·

Phone: (+1) 785 8643371

Email: dennisj@ku.edu