Exploring the Interrelationships Between Physical Function,Functional Exercise Capacity,and Exercise Self-Efficacy in Persons Living with HIV

Abstract

While physical activity can mitigate the metabolic effects of HIV disease and HIV medications, many HIV-infected persons report low levels of physical activity.

Purpose:

To determine if there were differences between the subjective and objective assessments of physical activity while controlling for sociodemographic, anthropometric, and clinical characteristics.

Setting/sample:

A total of 810 participants across eight sites located in three countries.

Measures:

Subjective instruments were the two subscales of Self-efficacy for Exercise Behaviors Scale: Making Time for Exercise and Resisting Relapse and Patient-Reported Outcomes Measurement Information System, which measured physical function. The objective measure of functional exercise capacity was the 6-minute Walk Test.

Analysis:

Both univariate and multivariant analyses were used.

Results:

Physical function was significantly associated with Making Time for Exercise (β = 1.76, p = .039) but not with Resisting Relapse (β = 1.16, p = .168). Age (β = −1.88, p = .001), being employed (β = 16.19, p < .001) and race (βs = 13.84–31.98, p < .001), hip–waist ratio (β = −2.18, p < .001), and comorbidities (β = 7.31, p < .001) were significant predictors of physical functioning. The model predicting physical function accounted for a large amount of variance (adjusted R² = .938). The patterns of results predicting functional exercise capacity were similar. Making Time for Exercise self-efficacy scores significantly predicted functional exercise capacity (β = 0.14, p = .029), and Resisting Relapse scores again did not (β = −0.10, p = .120). Among the covariates, age (β = −0.16, p < .001), gender (β = −0.43, p < .001), education (β = 0.08, p = .026), and hip–waist ratio (β = 0.09, p = .034) were significant. This model did not account for much of the overall variance in the data (adjusted R² = .081). We found a modest significant relationship between physical function and functional exercise capacity (r = 0.27).

Conclusions:

Making Time for Exercise Self-efficacy was more significant than Resisting Relapse for both physical function and functional exercise capacity. Interventions to promote achievement of physical activity need to use multiple measurement strategies.