Components Of An Exercise Consultation Assessing stage of exercise behaviour change

The consultation should begin by assessing the individual's stage of exercise behaviour change in order to select the most appropriate strategies to use in the consultation. Table 8.4 demonstrates how to assess an individual's stage of change moving from phase III to IV. Those who have recently completed a phase III exercise programme are likely to be either regularly physically active (i.e. in the action or maintenance stage) or doing some activity, but not enough to meet current physical activity guidelines (i.e. preparation stage).

Table 8.4. Assessing stage of exercise behaviour change (Adapted from Lowther, et al, 1999)

Stage of change Description

Precontemplation I am not regularly active and do not intend to be so in the next 6 months.

Contemplation I am not regularly active but am thinking about starting in the next 6 months.

Preparation I do some physical activity but not enough to meet the description of regular physical activity given above.

Action I am regularly active but only began in the last 6 months.

Maintenance I am regularly active and have been doing so for longer than

6 months.

• Assess stage of change

• Assess current physical activity status (e.g. using a questionnaire or diary)

• Discuss past and present activities to establish likes and dislikes

Decisional Balance Table

Pros Cons

1. Feel fitter 1. Lack of time

2. Improved well being 2. Don't like walking in bad weather

3. Increased confidence

Barriers to activity_

Barriers to remaining active_Strategies to overcome barriers

1. Less time now returned to work 1. Add some activities into daily routine

(e.g. walking part of journey to work)

2. Bad weather (e.g. rain, cold) 2. Do an indoor activity instead_

• Review physical activity recommendations

• Explore activity options

• Seek support for activity plan

Goal Setting

1 month

3 month

6 month

1. Brisk walk for 15


Increase brisk walk


Sponsored walk

mins 3 days/wk

to 25 mins 3 days/wk

2. Attend phase IV


Attend phase IV


Attend phase IV

programme 1 day/wk

programme 1 day/wk

programme 1 day/wk


Swimming once per


Swimming once per

week for 15 mins

week for 25 mins

Preventing relapse_

High-risk situations_Coping strategies_

1. Busy at work, not enough time to 1. Reschedule the swim session or go attend class or go swimming out walking instead

2. Bad weather, don't want to go 2. Do an indoor activity instead (e.g. out walking_swimming or exercise video)_

Figure 8.2. Example of an exercise consultation delivered to patients at the end of phase III.

Definition of regular physical activity:

• A minimum of 20 minutes of moderate intensity exercise on three days per week.


• Accumulated 30 minutes or more of moderate intensity physical activity on at least five days per week.

The aims of the consultation for individuals in action and maintenance are ensuring that they remain regularly physically active in phase IV and prevent relapse. Figure 8.2 shows an example of an exercise consultation at the transition from phase III to IV.

Individuals in preparation should be encouraged to become regularly physically active. Physical activity recommendations for phase IV participants are similar to the physical activity guidelines for healthy adults: individuals should be encouraged to accumulate at least 30 minutes of moderate intensity activity on most days of the week (Pate, et al., 1995) and engage in a minimum of three 20-minute sessions of moderate to vigorous intensity exercise per week (ACSM, 1990; 2001).

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