title: Health behaviour change theories: contributions to an ICF-based behavioural exercise therapy for individuals with chronic diseases.
abstract: OBJECTIVE
  The purpose of this perspective is (1) to incorporate recent psychological health behaviour change (HBC) theories into exercise therapeutic programmes, and (2) to introduce the International Classification of Functioning (ICF)-based concept of a behavioural exercise therapy (BET).
  
  
  METHODS
  Relevant personal modifiable factors of physical activity (PA) were identified based on three recent psychological HBC theories. Following the principles of intervention mapping, a matrix of proximal programme objectives specifies desirable parameter values for each personal factor. As a result of analysing reviews on behavioural techniques and intervention programmes of the German rehabilitation setting, we identified exercise-related techniques that impact the personal determinants. Finally, the techniques were integrated into an ICF-based BET concept.
  
  
  RESULTS
  Individuals' attitudes, skills, emotions, beliefs and knowledge are important personal factors of PA behaviour. BET systematically addresses these personal factors by a systematic combination of adequate exercise contents with related behavioural techniques. The presented 28 intervention techniques serve as a theory-driven "tool box" for designing complex BET programmes to promote PA.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Friedrich Alexander-University of Erlangen-Nürnberg, Institute of Sport Science and Sport, Division 'Exercise and Health' , Erlangen , Germany.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Geidl
authors.forename: Jana
authors.initials: J
authors.lastname: Semrau
authors.forename: Klaus
authors.initials: K
authors.lastname: Pfeifer
mesh_terms: D001294:Attitude to Health; D001521:Behavior Therapy / Q000379:methods*; D002908:Chronic Disease / Q000523:psychology / Q000534:rehabilitation; D005081:Exercise Therapy / Q000379:methods / Q000458:organization & administration / Q000523:psychology; D005858:Germany; D015438:Health Behavior; D006801:Humans; D009043:Motor Activity; D011580:Psychological Techniques; D011582:Psychological Theory; D012047:Rehabilitation Centers; D063586:Social Validity, Research
keywords: Chronic non-communicable disease; integrative approach; personal factors; physical activity; physical therapy; rehabilitation