Lawrence P. Cahalin

Regular exercise positively impacts neurocognitive health, particularly in aging individuals. However, low adherence, particularly among older adults, hinders the adoption of exercise routines. While brain plasticity mechanisms largely support the cognitive benefits of exercise, the link between physiological and behavioral factors influencing exercise adherence remains unclear. This study aimed to explore this association in sedentary middle‐aged and older adults. Thirty‐one participants underwent an evaluation of cortico‐motor plasticity using transcranial magnetic stimulation (TMS) to measure changes in motor‐evoked potentials following intermittent theta‐burst stimulation (iTBS). Health history, cardiorespiratory fitness, and exercise‐related behavioral factors were also assessed. The participants engaged in a 2‐month supervised aerobic exercise program, attending sessions three times a week for 60 min each, totaling 24 sessions at a moderate‐to‐vigorous intensity. They were divided into Completers ( n = 19), who attended all sessions, and Dropouts ( n = 12), who withdrew early. Completers exhibited lower smoking rates, exercise barriers, and resting heart rates compared to Dropouts. For Completers, TMS/iTBS cortico‐motor plasticity was associated with better exercise adherence ( r = −.53, corrected p = .019). Exploratory hypothesis‐generating regression analysis suggested that post‐iTBS changes ( β = −7.78, p = .013) and self‐efficacy ( β = −.51, p = .019) may predict exercise adherence ( adjusted‐R 2 = .44). In conclusion, this study highlights the significance of TMS/iTBS cortico‐motor plasticity, self‐efficacy, and cardiovascular health in exercise adherence. Given the well‐established cognitive benefits of exercise, addressing sedentary behavior and enhancing self‐efficacy are crucial for promoting adherence and optimizing brain health. Clinicians and researchers should prioritize assessing these variables to improve the effectiveness of exercise programs.

Limited research has examined inspiratory muscle performance (IMP) and functional performance (FP) of patients after valve replacement surgery (VRS). The purpose of this study was to examine IMP as well as several measures of FP in patients post-VRS. The study results of 27 patients revealed that patients undergoing transcatheter VRS were significantly (p = 0.01) older than patients undergoing minimally invasive or median sternotomy VRS with the median sternotomy VRS group performing significantly (p < 0.05) better than the transcatheter VRS group in the 6-min walk test, 5x sit-to-stand test, and sustained maximal inspiratory pressure. The 6-min walk test and IMP measures in all groups were significantly (p < 0.001) lower than predicted values. Significant (p < 0.05) relationships were found between IMP and FP with greater IMP being associated with greater FP. Pre-operative and early post-operative rehabilitation may improve IMP and FP post-VRS.