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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\u2010aged and older adults. Thirty\u2010one participants underwent an evaluation of cortico\u2010motor plasticity using transcranial magnetic stimulation (TMS) to measure changes in motor\u2010evoked potentials following intermittent theta\u2010burst stimulation (iTBS). Health history, cardiorespiratory fitness, and exercise\u2010related behavioral factors were also assessed. The participants engaged in a 2\u2010month supervised aerobic exercise program, attending sessions three times a week for 60\u2009min each, totaling 24 sessions at a moderate\u2010to\u2010vigorous intensity. They were divided into Completers (<jats:italic>n<\/jats:italic>\u2009=\u200919), who attended all sessions, and Dropouts (<jats:italic>n<\/jats:italic>\u2009=\u200912), who withdrew early. Completers exhibited lower smoking rates, exercise barriers, and resting heart rates compared to Dropouts. For Completers, TMS\/iTBS cortico\u2010motor plasticity was associated with better exercise adherence (<jats:italic>r<\/jats:italic>\u2009=\u2009\u2212.53, <jats:italic>corrected p<\/jats:italic>\u2009=\u2009.019). Exploratory hypothesis\u2010generating regression analysis suggested that post\u2010iTBS changes (<jats:italic>\u03b2<\/jats:italic>\u2009=\u2009\u22127.78, <jats:italic>p<\/jats:italic>\u2009=\u2009.013) and self\u2010efficacy (<jats:italic>\u03b2<\/jats:italic>\u2009=\u2009\u2212.51, <jats:italic>p<\/jats:italic>\u2009=\u2009.019) may predict exercise adherence (<jats:italic>adjusted\u2010R<\/jats:italic><jats:sup>2<\/jats:sup>\u2009=\u2009.44). In conclusion, this study highlights the significance of TMS\/iTBS cortico\u2010motor plasticity, self\u2010efficacy, and cardiovascular health in exercise adherence. Given the well\u2010established cognitive benefits of exercise, addressing sedentary behavior and enhancing self\u2010efficacy are crucial for promoting adherence and optimizing brain health. Clinicians and researchers should prioritize assessing these variables to improve the effectiveness of exercise programs.<\/jats:p>","DOI":"10.1111\/psyp.14591","type":"journal-article","created":{"date-parts":[[2024,4,17]],"date-time":"2024-04-17T12:25:27Z","timestamp":1713356727000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Determinants of exercise adherence in sedentary middle\u2010aged and older adults"],"prefix":"10.1111","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0162-1039","authenticated-orcid":false,"given":"Danylo F.","family":"Cabral","sequence":"first","affiliation":[{"name":"Department of Physical Therapy University of Miami Miller School of Medicine  Coral Gables Florida USA"},{"name":"Berenson\u2010Allen Center for Noninvasive Brain Stimulation, Beth Israel Deaconess Medical Center Harvard Medical School  Boston Massachusetts USA"},{"name":"Department of Neurology Harvard Medical School  Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6041-2996","authenticated-orcid":false,"given":"Peter J.","family":"Fried","sequence":"additional","affiliation":[{"name":"Berenson\u2010Allen Center for Noninvasive Brain Stimulation, Beth Israel Deaconess Medical Center Harvard Medical School  Boston Massachusetts USA"},{"name":"Department of Neurology Harvard Medical School  Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6940-9849","authenticated-orcid":false,"given":"Marcelo","family":"Bigliassi","sequence":"additional","affiliation":[{"name":"Department of Teaching and Learning Florida International University  Miami Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8447-1026","authenticated-orcid":false,"given":"Lawrence P.","family":"Cahalin","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy University of Miami Miller School of Medicine  Coral Gables Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6510-0780","authenticated-orcid":false,"given":"Joyce","family":"Gomes\u2010Osman","sequence":"additional","affiliation":[{"name":"Department of Neurology University of Miami Miller School of Medicine  Miami Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,4,17]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1249\/MSS.0B013E31821ECE12"},{"key":"e_1_2_9_3_1","volume-title":"Social foundations of thought and action: A social cognitive theory","author":"Bandura 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