Background: In terms of motivation and long-term adherence, low-resistance exercise might be more suitable for older adults than high-resistance exercise. However, more data are needed to support this claim. Objective: The objective was to investigate the effect of low- and high-resistance exercise protocols on long-term adherence and motivation. Methods: This study was designed as an exploratory 24-week follow-up of a randomized 12-week resistance training intervention in older adults. Participants were free to decide whether or not they continued resistance training at their own expense following the intervention. Fifty-six older adults were randomly assigned to HIGH [2 × 10-15 repetitions at 80% of one repetition maximum (1RM)], LOW (1 × 80-100 repetitions at 20% of 1RM), or LOW+ (1 × 60 repetitions at 20% of 1RM + 1 × 10-20 repetitions at 40% 1RM). Motivation, self-efficacy and the perceived barriers for continuing resistance exercise were measured after cessation of each supervised intervention and at follow-up, while long-term adherence was probed retrospectively at follow-up. Results: Participants reported high levels of self-determined motivation before, during, and after the supervised intervention, with no differences between groups (p > 0.05). Nevertheless, only few participants continued strength training after the intervention: 17% in HIGH, 21% in LOW+, and 11% in LOW (p > 0.05). The most commonly reported barriers for continuing resistance exercise were perceived lack of time (46%), being more interested in other physical activities (40%), seasonal reasons (40%), and financial cost (28%). Conclusion: The results suggest no difference in long-term adherence after the end of a supervised exercise intervention at high or low external resistances. Long-term adherence was limited despite high levels of self-determined motivation during the interventions. These findings highlight the importance of further research on developing strategies to overcome barriers of older adults to adhere to resistance exercise without supervision.

Keywords:
Sarcopenia, Elderly people, Resistance exercise, Training load, Motivation, Exercise barriers
1.
Abellan van Kan G: Epidemiology and consequences of sarcopenia. J Nutr Health Aging 2009;13:708-712.
2.
Marcell TJ: Sarcopenia: causes, consequences, and preventions. J Gerontol A Biol Sci Med Sci 2003;58:M911-M916.
3.
American College of Sports Medicine: ACSM's Guidelines for Exercise Testing and Prescription, ed 9. Philadelphia, Lippincott Williams & Wilkins, 2013.
4.
Taaffe DR, Pruitt L, Pyka G, Guido D, Marcus R: Comparative effects of high- and low-intensity resistance training on thigh muscle strength, fiber area, and tissue composition in elderly women. Clin Physiol 1996;16:381-392.
5.
Van Roie E, Delecluse C, Coudyzer W, Boonen S, Bautmans I: Strength training at high versus low external resistance in older adults: effects on muscle volume, muscle strength, and force-velocity characteristics. Exp Gerontol 2013;48:1351-1361.
6.
Deci EL, Ryan RM: Intrinsic Motivation and Self-Determination in Human Behavior. New York, Plenum, 1985.
7.
Ryan RM, Deci EL: Self-determination theory and the facilitation of intrinsic motivation, social development, and well-being. Am Psychol 2000;55:68-78.
8.
Seghers J, Van Hoecke AS, Schotte A, Opdenacker J, Boen F: The added value of a brief self-efficacy coaching on the effectiveness of a 12-week physical activity program. J Phys Act Health 2014;11:18-29.
9.
Bandura A: Self-Efficacy: The Exercise of Control. New York, Worth Publishers, 1997.
10.
Barbeau A, Sweet SN, Fortier MS: A path-analytic model of self-determination theory in a physical activity context. J Appl Biobehav Res 2009;14:103-118.
11.
Chatzisarantis NL, Hagger MS: Effects of an intervention based on self-determination theory on self-reported leisure-time physical activity participation. Psychol Health 2009;24:29-48.
12.
Wilson PM, Rodgers WM, Blanchard CM, Gessel J: The relationship between psychological needs, self-determined motivation, exercise attitudes, and physical fitness. J Appl Soc Psychol 2003;33:2373-2392.
13.
Sniehotta FF, Scholz U, Schwarzer R: Bridging the intention-behaviour gap: planning, self-efficacy, and action control in the adoption and maintenance of physical exercise. Psychol Health 2005;20:143-160.
14.
McAuley E, Jerome GJ, Elavsky S, Marquez DX, Ramsey SN: Predicting long-term maintenance of physical activity in older adults. Prev Med 2003;37:110-118.
15.
Ekkekakis P, Parfitt G, Petruzzello SJ: The pleasure and displeasure people feel when they exercise at different intensities: decennial update and progress towards a tripartite rationale for exercise intensity prescription. Sports Med 2011;41:641-671.
16.
Mathews AE, Laditka SB, Laditka JN, Wilcox S, Corwin SJ, Liu R, Friedman DB, Hunter R, Tseng W, Logsdon RG: Older adults' perceived physical activity enablers and barriers: a multicultural perspective. J Aging Phys Act 2010;18:119-140.
17.
Baert V, Gorus E, Mets T, Geerts C, Bautmans I: Motivators and barriers for physical activity in the oldest old: a systematic review. Ageing Res Rev 2011;10:464-474.
18.
Robertson RJ, Goss FL, Rutkowski J, Lenz B, Dixon C, Timmer J, Frazee K, Dube J, Andreacci J: Concurrent validation of the OMNI perceived exertion scale for resistance exercise. Med Sci Sports Exerc 2003;35:333-341.
19.
Opdenacker J, Boen F, De Bourdeaudhuij I, Vanden Auweele Y: Explaining the psychological effects of a sustainable lifestyle physical activity intervention among rural women. Ment Health Phys Act 2008;1:74-81.
20.
Markland D, Tobin VJ: A modification to the behavioural regulation in exercise questionnaire to include an assessment of amotivation. J Sport Exerc Psychol 2004;26:191-196.
21.
Picorelli AMA, Pereira DS, Felicio DC, Dos Anjos DM, Pereira DA, Dias RC, Assis MG, Pereira LS: Adherence of older women with strength training and aerobic exercise. Clin Interv Aging 2014;9:323-331.
22.
Schutzer KA, Graves BS: Barriers and motivations to exercise in older adults. Prev Med 2004;39:1056-1061.
23.
Schuler PB, Roy JLP, Vinci D, Philipp SF, Cohen SJ: Barriers and motivations to exercise in older African American and European American women. Calif J Health Promot 2006;4:128-134.
24.
Cohen-Mansfield J, Marx MS, Guralnik JM: Motivators and barriers to exercise in an older community-dwelling population. J Aging Phys Act 2003;11:242-253.
25.
McLeroy KR, Bibeau D, Steckler A, Glanz K: An ecological perspective on health promotion programs. Health Educ Q 1988;15:351-377.
26.
World Health Organization: Global recommendations on physical activity for health. 2010. http://whqlibdoc.who.int/publications/2010/9789241599979_eng.pdf (accessed February 1, 2015).
27.
Kennis E, Verschueren SM, Bogaerts A, Coudyzer W, Boonen S, Delecluse C: Effects of fitness and vibration training on muscle quality: a 1-year postintervention follow-up in older men. Arch Phys Med Rehabil 2013;94:910-918.
28.
Motl RW, McAuley E, DiStefano C: Is social desirability associated with self-reported physical activity? Prev Med 2005;40:735-739.
29.
Trappe S, Williamson D, Godard M: Maintenance of whole muscle strength and size following resistance training in older men. J Gerontol A Biol Sci Med Sci 2002;57:B138-B143.
30.
Elsangedy HM, Krause MP, Krinski K, Alves RC, Hsin Nery CC, da Silva SG: Is the self-selected resistance exercise intensity by older women consistent with the American College of Sports Medicine guidelines to improve muscular fitness? J Strength Cond Res 2013;27:1877-1884.
31.
Focht BC: Perceived exertion and training load during self-selected and imposed-intensity resistance exercise in untrained women. J Strength Cond Res 2007;21:183-187.
32.
Baroni BM, Geremia JM, Rodrigues R, Borges MK, Jinha A, Herzog W, Vaz MA: Functional and morphological adaptations to aging in knee extensor muscles of physically active men. J Appl Biomech 2013;29:535-542.
33.
Frankel JE, Bean JF, Frontera WR: Exercise in the elderly: research and clinical practice. Clin Geriatr Med 2006;22:239-256.
34.
Kennis E, Verschueren SM, Bogaerts A, Van RE, Boonen S, Delecluse C: Long-term impact of strength training on muscle strength characteristics in older adults. Arch Phys Med Rehabil 2013;94:2054-2060.
35.
Visvanathan R, Chapman I: Preventing sarcopaenia in older people. Maturitas 2010;66:383-388.
36.
Kruger J, Carlson SA, Kohl HW III: Fitness facilities for adults: differences in perceived access and usage. Am J Prev Med 2007;32:500-505.
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2015
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