Continuous post-injury exercise intention was associated with a stepwise path of attitude → control beliefs → intention, with control beliefs showing the largest predictive effect size on intention (β = 0.824) and connecting internal values and social norms in a chained HBM-TPB mediation model.
Control beliefs regarding exercise rehabilitation showed the largest predictive effect size on continuous exercise intention in the model.
Perceived severity was negatively associated with attitude toward sustained exercise, consistent with fear-avoidance theory.
Perceived health benefits were associated with continuous exercise intention through a chained mediation pathway involving attitude and then control beliefs.
Subjective norm was associated with continuous exercise intention, fully mediated by control beliefs.
Perceived susceptibility and perceived barriers were indirectly related to lower control beliefs through a pathway that did not operate through attitude.
The integrated HBM-TPB structural equation model demonstrated acceptable fit for explaining post-injury exercise intention in university students.
The authors propose that interventions targeting post-injury exercise maintenance may benefit from emphasizing benefit empowerment over risk intimidation and reconstructing rehabilitation control through social support networks.
This research suggests that among university students who have experienced a sports injury, their intention to keep exercising after injury is most strongly predicted by how much control they feel they have over their own rehabilitation — what the researchers call 'control beliefs.' Using a survey of 421 injured university students and a statistical model that combined two psychological theories (the Health Belief Model and Theory of Planned Behavior), the study found that this sense of rehabilitation control had a much stronger link to exercise intention than any other factor measured, including attitudes toward exercise or social influences. Importantly, the belief that exercise offers health benefits was associated with exercise intention through a chain: it first improved attitudes toward sustained exercise, which then boosted rehabilitation control beliefs, which then predicted intention to keep exercising. The study also found that perceiving an injury as highly severe was actually associated with a more negative attitude toward continuing exercise — a pattern the researchers describe as consistent with 'fear-avoidance theory,' meaning that feeling seriously injured may cause people to avoid activity rather than maintain it. Social norms (what important people in one's life think about exercise) were also linked to exercise intention, but entirely through the pathway of control beliefs, suggesting that peer or social influence only matters insofar as it shapes a person's sense of control over their recovery. This research suggests that programs designed to help injured students stay active might be more effective if they focus on making the benefits of continued exercise clear and building people's confidence and sense of control over their rehabilitation, rather than emphasizing how dangerous or severe their injury is. The authors also suggest that involving social support networks — such as friends, coaches, or peers — could help rebuild that sense of control. However, they caution that since this was a cross-sectional study (a one-time survey), the findings show associations rather than causes, and these intervention ideas need to be tested in future experimental research before firm conclusions can be drawn.
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Upload Your LabsHu X, Chen P. (2026). Mechanism of continuous exercise intention after sport injury: a chained HBM-TPB mediation model.. Frontiers in public health. https://doi.org/10.3389/fpubh.2026.1894556