Sticking with it? Factors associated with exercise adherence in people with alcohol use disorder

 Background: Emerging evidence suggests that exercise may be an efficacious treatment for alcohol use disorder  (AUD), but adherence is suboptimal. We examined factors associated with adherence to an exercise intervention  for non-treatment seeking adults with AUD.  Methods: This secondary analysis of a randomized controlled trial included 95 physically inactive adults aged  18–75 years with clinician-diagnosed AUD. Study participants were randomly assigned to 12-weeks fitness  centre-based, supervised aerobic exercise or yoga classes and asked to attend at least three times/week.  Adherence was assessed both objectively (based on use of a keycard at entry) and subjectively using an activity  calendar. The association between AUD and other predictor variables with adherence was assessed using logistic  and Poisson regression models.  Results: Just under half of participants (47/95, 49%) completed ≥ 12 supervised exercise sessions. When both  supervised classes and self-reported sessions were included, 32/95 (34%) participants completed ≤ 11 sessions,  28/95 (29%) did 12–23 sessions and 35/95 (37%) completed ≥ 24 sessions. In univariate logistic regression  analyses, lower education was associated with non-adherence (<12 sessions) (OR = 3.02, 95%CI = 1.19–7.61).  In models adjusted for demographic and clinical variables, moderate AUD (OR = 0.11, 95%CI = 0.02–0.49) and  severe AUD (OR = 0.12, 95%CI = 0.02–0.69) were associated with non-adherence, when compared to low  severity AUD. Higher body mass index (OR = 0.80, 95%CI = 0.68–0.93) was also associated with non-adherence.  Results were materially the same when objective and subjective adherence data were combined.  Conclusion: Adults with AUD can be supported to engage in yoga and aerobic exercise. Additional support may be  required for those with moderate or severe AUD, higher BMI, and lower education.