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PubMed1995

Relationship between physical performance and self-perceived physical function.

OBJECTIVE: The objective of this study was to compare two methods of measuring physical function in subjects with a broad range of abilities and to evaluate the effects of cognitive, social, educational, and age factors on the relationship between the two methods. DESIGN: Multiple regression analysis was used to compare self-perceived (dependent variables) with performance measures (independent variables). Covariates included age, gender, Mini-Mental State Exam score, education, living status, and depression score. SETTING: Five community-dwelling and two nursing home sites. PARTICIPANTS: 417 community-dwelling subjects and 200 nursing home residents aged 62-98 years. MEASUREMENTS: Self-perceived physical function was assessed with the physical dimension summary score of the Sickness Impact Profile, which comprises three subscales: ambulation, mobility, and body care and movement. Physical performance was evaluated by self-selected gait speed, chair-stand time, maximal grip strength, and a balance score. RESULTS: Nursing home residents and community-dwellers were significantly different (P < .0001) in all variables except age and gender. Self-perceived and performance-based measures were moderately correlated, with a range from r = -.194 to r = -.625 (P < .05). Gait speed was the strongest independent predictor of self-perceived physical function in both groups. Symptoms of depression were also an independent predictor of self-perceived function in nursing home residents; subjects who had such symptoms report more self-perceived dysfunction than would be predicted based on performance tests. CONCLUSIONS: Self-selected gait speed is a global indicator of self-perceived physical function over a broad range of abilities. External determinants (depressive symptoms, cognitive function, marital status, etc.) affect self-perceived function in both groups, but gait speed is the greatest single predictor of self-perceived function. In nursing home residents depressive symptomatology is related to self-perceived.

Activities of Daily Living↗

PubMed2004

Antioxidants and physical performance in elderly persons: the Invecchiare in Chianti (InCHIANTI) study.

BACKGROUND: Muscle strength and physical performance in old age might be related to the oxidative damage caused by free radicals. OBJECTIVE: The objective was to assess the correlation of plasma concentrations and daily dietary intakes of antioxidants with skeletal muscle strength and physical performance in elderly persons. DESIGN: This study is part of the Invecchiare in Chianti (InCHIANTI) study, which was conducted in 986 Italians aged > or = 65 y. Physical performance was assessed on the basis of walking speed, ability to rise from a chair, and standing balance. Knee extension strength was assessed with a hand-held dynamometer. The European Prospective Investigation into Cancer and Nutrition (EPIC) questionnaire was used to evaluate the daily dietary intakes of vitamin C, vitamin E, beta-carotene, and retinol. Plasma alpha- and gamma-tocopherol concentrations were measured. Adjusted linear regression analyses were used to calculate regression coefficients per SD increase in plasma concentrations and daily dietary intakes. RESULTS: In adjusted analyses, plasma alpha-tocopherol was significantly correlated with knee extension (beta = 0.566, P = 0.003) and the summary physical performance score (beta = 0.044, P = 0.008). Plasma gamma-tocopherol was associated only with knee extension strength (beta = 0.327, P = 0.04). Of the daily dietary intake measures, vitamin C and beta-carotene were significantly correlated with knee extension strength, and vitamin C was significantly associated with physical performance (beta = 0.029, P = 0.04). CONCLUSIONS: Plasma antioxidant concentrations correlate positively with physical performance and strength. Higher dietary intakes of most antioxidants, especially vitamin C, appear to be associated with higher skeletal muscular strength in elderly persons.

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PubMed1995

The structure underlying physical performance measures for older adults in the community.

A 6-item physical performance test assessing hand strength/speed, mobility, and balance was administered to 678 elderly people from a Japanese community (age 65-89). A second-order covariance structure model applied to the data revealed that three factors in observed variables (Hand Power, Walking, and Balance) had loadings more than 0.8 on a single higher-order factor, Basic Motor Ability (BMA). The BMA score, or "Physical Performance Age (PPA)", of the individual was calculated on the basis of this model as a unidimensional summary score of physical performances. The PPA predicted the self-reported levels of competence and physical activity with greater accuracy than age alone. The PPA also differentiated those at the high end of the functional spectrum, and thereby not identifiable by use of ordinary self-reported functional measures. The results suggest that a short physical performance battery assessing physical functioning is useful in community-based studies of aging.

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PubMed2002

Physical function in patients with cancer: psychometric characteristics and clinical usefulness of a physical performance test battery.

This study investigated the psychometric properties of a battery of physical performance tests, characterized physical function in patients with cancer referred for rehabilitation, and provided normative standards against which to compare disease progression and/or future treatment effectiveness. A total of 109 patients with cancer (55 women and 54 men) and 105 control subjects (66 women and 39 men) participated. Subjects completed self-report questionnaires regarding pain, physical function, and fatigue, and also performed nine physical performance tests: the time taken to complete various tasks (picking up coins, tying a belt, reaching up, putting on a sock, standing from sitting, a 50-foot fast walk, a 50-foot walk at preferred speed), the distance walked in 6 minutes, and the distance reached forward while standing were measured. Inter-tester and test-retest reliability was good to excellent for all tests (ICC(11) 0.69 to 0.99). Known group analyses controlling for age were significant (P < 0.001) for all physical performance tests. Control subjects significantly and systematically outperformed those with cancer by a factor of two or three. Examination of the correlation matrices showed relatively low correlations between performance and external measures (r = 0.01 to 0.45). In contrast, correlations among performance measures were generally in the range of r = 0.25 to 0.85. Correlations between self-report of function and performance of functional tests were moderate, suggesting that the two methods of measuring function are complementary and both should be used for assessment and as outcome measures.

Adult↗

PubMed2004

Inflammatory markers and physical performance in older persons: the InCHIANTI study.

BACKGROUND: Some studies have proposed chronic inflammation as an underlying biological mechanism responsible for physical function decline in elderly people. The aim of this study is to evaluate the relationship between several inflammatory markers and physical performance in an older population. METHODS: This study is part of the "Invecchiare in Chianti" (InCHIANTI) study, a prospective population-based study of older people, aimed at identifying risk factors for late-life disability. The study sample consisted of 1020 participants aged 65 years and older living in the Chianti area of Italy. Physical performance was assessed using walking speed, the chair-stand test, and the standing balance test. Hand-grip strength was assessed using a hand-held dynamometer. Serum levels of C-reactive protein (CRP), interleukin (IL)-6, tumor necrosis factor-alpha (TNF-alpha), IL-10, IL-1beta, IL-6sR, and IL-1RA were determined. Linear regression analyses were used to assess the multivariate relationship of inflammatory marker levels with physical performance, scored as a continuous variable from 0 to 3, and hand-grip strength after adjustment for demographics, chronic conditions, medication use, and other biological variables. RESULTS: CRP, IL-6, and IL1RA were significantly correlated with physical performance (r=-0.162, r=-0.251, and r=-0.127, respectively). Significant correlations with hand-grip strength were found for CRP and IL-6 (r=-0.081 and r=-0.089, respectively). After adjustment for covariates, high levels of IL-6 and IL-1RA continued to be strongly associated with worse physical performance (p<.001 and p=0.004, respectively). High levels of CRP (p<.001) and IL-6 (p<.001) were associated with low hand-grip strength. Mean adjusted physical performance scores ranged from 2.21 in the CRP<0.59 mg/dl group to 2.07 in the CRP>0.60 mg/dl group (p for trend=.004), and from 2.25 in the lowest IL-6 quartile to 2.08 in the highest IL-6 quartile (p for trend<.001). This trend was also reflected in mean adjusted hand-grip strength, with a range from 28.8 kg for the CRP<0.59 mg/dl group to 26.0 kg for the CRP>0.60 mg/dl group (p for trend=.001), and from 27.4 kg for the lowest IL-6 quartile to 25.1 kg for the highest IL-6 quartile (p for trend=.001). CONCLUSIONS: Inflammation, measured as high levels of IL-6, CRP, and IL-1RA, is significantly associated with poor physical performance and muscle strength in older persons. These data also support the biological face validity of physical performance measures. The assessment of inflammatory markers may represent a useful screening test and perhaps a potential target of intervention.

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PubMed1991

Age, activity, and physical performance: an evaluation of performance models.

Two performance models relating age, physical activity, and physical performance were evaluated on 5 age cohorts involving more than 6,000 persons ranging in age from 20 to 69 years. Significant age and activity main effects, without 1 Age X Activity interaction, were obtained on 5 fitness measures and 2 activity indexes. These results are inconsistent with predictions from the moderation model, but they fit predictions from a recently formulated tonic and overpractice model of physical performance.

Activities of Daily Living↗

PubMed1997

Identifying hospitalized older patients at varying risk for physical performance decline: a new approach.

OBJECTIVE: A classification tree analysis identifies patient groups at varying risk for decline in physical performance 1 year after hospitalization. DESIGN: Prospective cohort study. SETTING: Tertiary care VAMC. PARTICIPANTS: A total of 507 acutely ill hospitalized male veterans aged 65 years and older. MEASUREMENTS: Eighteen admission characteristics were considered as potential predictors: demographic data, medical diagnoses, functional status (e.g., ADL and IADL), geriatric conditions (e.g., incontinence, vision impairment, weight change), mental status, depression, and physical functioning (measured by self-report (MOS-PFR) and the Physical Performance and Mobility Examination (PPME)). Outcome measure was change in PPME status at 12-months post-admission. RESULTS: Patients with the greatest risk for decline had both high baseline physical performance (PPME > or = 9) and at least moderate self-report limitations on physical functioning (MOS-PFR < or = 36, mean = 30.8). Patients with the lowest risk of decline had impaired baseline physical performance (PPME < or = 8) but fewer self-report limitations on physical functioning (MOS-PFR > or = 31, mean = 37.4) and two or less geriatric conditions. CONCLUSIONS: The predictive role of self-report functioning suggests that perception of the impact of health on one's own physical functioning is associated with future performance. The number of geriatric conditions is also an important predictor of physical performance change. By identifying patient risk groups based on geriatric conditions, physical performance, and self-report physical functioning, future targeting strategies may improve physical performance outcomes for hospitalized older adults.

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PubMed2005

Adiposity of elderly women and its relationship with self-reported and observed physical performance.

BACKGROUND AND PURPOSE: There is a societal trend toward increasing obesity and a natural tendency for physical performance to decrease with age. Our purpose was to describe the adiposity of elderly women participating in a health screening and to determine the relationship between their adiposity and both observed and self-reported physical performance. METHODS: Subjects were 104 communitydwelling elderly women (74.9+/-7.5 years). Their adiposity was described using body mass index (BMI), waist circumference, and waist to hip ratio. Physical performance was characterized using timed sit-to-stand, unilateral standing, 25-foot walk and the Physical Functioning subscale of the SF-36. Habitual activity was summarized as the number of daily hours patients estimated they spent moving about on their feet. RESULTS: The majority of women had excessive adiposity. Greater adiposity was associated with worse physical performance. Both Pearson correlations and multiple regression revealed BMI to be significantly predictive of all physical performance measures. Age added to the explanation of walking time and unilateral stance time. Time moving about contributed to the explanation of self-reported physical functioning. CONCLUSIONS: Adiposity should be documented as part of the physical therapist examination of elderly women. It may be an appropriate target of intervention if physical performance is limited.

Adipose Tissue↗

PubMed2004

Using compensations to assess physical performance for ambulatory outpatients.

OBJECTIVE: To construct a physical performance scale for community-dwelling ambulatory outpatients that is linear, includes high functioning tasks, and uses common compensations to assess difficulty levels. DESIGN: Calibrated subject performances on 19 tasks were rated by an examiner, timed, and had compensations recorded. SETTING: Ambulatory outpatient physical therapy (PT) department of a tertiary care center. PARTICIPANTS: Convenience sample of 50 community-dwelling patients with difficulties in mobility referred for PT. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: The Community Ambulatory Physical Performance Scale (CAPPS) constructed by using Rasch analysis, the Lower Extremity Functional Scale (LEFS), and the six-minute walk test (6MWT). RESULTS: The CAPPS showed construct validity after removal of 3 items. Two additional items were removed for improved clinical utility. The person reliability was .89 and item reliability was .98. Subjects' performance on the CAPPS correlated with the 6MWT (r=.79; 95% confidence interval [CI], .65-.87) and with the LEFS (r=.62; 95% CI, .40-.78). CONCLUSIONS: The CAPPS showed good psychometric properties and has utility for assessments of higher-level physical functioning. This standardized approach to performance testing for ambulatory outpatients appears to be a promising method for articulating the compensations persons use to accomplish common tasks. Use of compensatory strategies to assess difficulties in physical performance may assist in delineating interventions directed toward improving task performance.

Activities of Daily Living↗

PubMed2003

Differences in physical performance between men and women with and without lymphoma.

OBJECTIVES: To describe and compare physical performance profiles in men and women with lymphoma with age- and gender-matched controls and to examine relationships among fatigue severity and physical performance in men and women with lymphoma. DESIGN: Case-control study. SETTING: Outpatient lymphoma service in a major cancer teaching hospital. PARTICIPANTS: Fifty-one patients with lymphoma (26 women, 25 men), age- and gender-matched to 51 subjects without lymphoma. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: A physical performance test battery consisting of a 50-ft (15-m) walk, a 6-minute walk, forward reach, repeated sit-to-stand, repeated reach-up, timed belt tie, sock test, and coin test. Patients also completed the Brief Fatigue Inventory (BFI). RESULTS: Multivariate analysis of variance was significant for main effects of group (F(8,89)=27.12, P<.05) and gender (F(8,89)=3.09, P<.05), and there was no significant interaction. Subsequent analyses found significant differences between groups and gender in the repeated reach-up task, forward reach, 50-ft walk, and distance walked in 6 minutes. Correlations among physical performance tasks and total BFI interference scores were moderate (r range,.27-.43; P<.05) for tasks involving upper extremity, and stronger (r range,.51 to -.73; P<.05) for tasks that involved whole-body movements. CONCLUSION: There is a leveling effect of lymphoma across gender on most tasks. The significant relations between physical performance tasks and fatigue are suggestive of the pervasive influence of fatigue on physical function.

Case-Control Studies↗

PubMed1997

Effects of aerobic exercise on the physical performance and incidence of treatment-related complications after high-dose chemotherapy.

Loss of physical performance is a universal problem of cancer patients undergoing chemotherapy. We postulated that this impairment can be partially prevented by aerobic exercise. In a randomized study, 33 cancer patients receiving high-dose chemotherapy followed by autologous peripheral blood stem cell transplantation (training group, T) performed an exercise program consisting of biking on an ergometer in the supine position after an interval-training pattern for 30 minutes daily during hospitalization. Patients in the control group (C, n = 37) did not train. Maximal physical performance was assessed with a treadmill test by admission and discharge. Physical performance of the two groups was not different on admission. The decrement in performance during hospitalization was 27% greater in the control group than in the training group (P = .05); this resulted in a significantly higher maximal physical performance at discharge in the trained patients (P = .04). Duration of neutropenia (P = .01) and thrombopenia (P = .06), severity of diarrhea (P = .04), severity of pain (P = .01), and duration of hospitalization (P = . 03) were reduced in the training group. We conclude that aerobic exercise can be safely carried out immediately after high-dose chemotherapy and can partially prevent loss of physical performance. Based on the potential significance of the observed outcomes, further studies are warranted to confirm our results.

Adult↗

PubMed1990

An objective measure of physical function of elderly outpatients. The Physical Performance Test.

Direct observation of physical function has the advantage of providing an objective, quantifiable measure of functional capabilities. We have developed the Physical Performance Test (PPT), which assesses multiple domains of physical function using observed performance of tasks that simulate activities of daily living of various degrees of difficulty. Two versions are presented: a nine-item scale that includes writing a sentence, simulated eating, turning 360 degrees, putting on and removing a jacket, lifting a book and putting it on a shelf, picking up a penny from the floor, a 50-foot walk test, and climbing stairs (scored as two items); and a seven-item scale that does not include stairs. The PPT can be completed in less than 10 minutes and requires only a few simple props. We then tested the validity of PPT using 183 subjects (mean age, 79 years) in six settings including four clinical practices (one of Parkinson's disease patients), a board-and-care home, and a senior citizens' apartment. The PPT was reliable (Cronbach's alpha = 0.87 and 0.79, interrater reliability = 0.99 and 0.93 for the nine-item and seven-item tests, respectively) and demonstrated concurrent validity with self-reported measures of physical function. Scores on the PPT for both scales were highly correlated (.50 to .80) with modified Rosow-Breslau, Instrumental and Basic Activities of Daily Living scales, and Tinetti gait score. Scores on the PPT were more moderately correlated with self-reported health status, cognitive status, and mental health (.24 to .47), and negatively with age (-.24 and -.18). Thus, the PPT also demonstrated construct validity. The PPT is a promising objective measurement of physical function, but its clinical and research value for screening, monitoring, and prediction will have to be determined.

Activities of Daily Living↗

PubMed1997

The role of change in physical performance in determining risk for dependence in activities of daily living among nondisabled community-living elderly persons.

Among community-living elderly persons, a single assessment of physical performance is a powerful predictor of dependence in activities of daily living (ADLs). The aim of this study was to determine whether an assessment of change in physical performance provides useful prognostic information beyond that available from a single assessment. Among a large representative cohort of elderly persons, we evaluated the 586 participants who were ADL independent at both the baseline and the one year interviews. For each of the three timed tests, participants who had a large decline in physical performance were significantly more likely to develop ADL dependence at three years than those who improved or showed no change. After adjusting for 1-year scores, however, change in physical performance was no longer associated with ADL dependence. However, among the 775 participants who were ADL independent at the baseline interview, change in physical performance was significantly associated with the onset of ADL dependence at one year, even after adjusting for baseline performance. When determining risk for ADL dependence, an assessment of change in physical performance over one year does not provide useful prognostic information beyond that available from a single assessment. Nevertheless, change in physical performance is independently associated with concurrent ADL dependence and may be useful in predicting future disability if measured over shorter intervals.

Activities of Daily Living↗

PubMed2002

The relationship between cognitive and physical performance: MacArthur Studies of Successful Aging.

BACKGROUND: The relationship between change in cognitive and physical performance has yet to be fully understood. Because aging decreases the ability to learn new information while preserving more established knowledge, this article examines whether the association between change in cognitive and physical performance depends on the nature of the physical task. METHODS: Data from the MacArthur Research Network on Successful Aging Community Study--a longitudinal three-site, cohort study of high-functioning, disability-free Americans aged 70 to 79 in 1988 (reinterviewed in 1991 and 1995)--are used for this investigation. We examine the association between change in cognitive performance and two categories of physical performance: novel/attentional demanding physical tasks (e.g., standing on a single leg) or routine physical tasks (e.g., walking at a normal pace). Change in physical performance (over 7 years) is regressed on change in cognitive performance (over the same period) controlling for baseline cognitive ability, demographic factors, health status, and behavioral characteristics. RESULTS: The findings suggest that declines in cognitive performance are associated with declines in both novel/attentional demanding and routine physical tasks. In addition to decline in cognition, gender, prevalent health conditions (e.g., cancer, high blood pressure, and the fracture of a hip), and smoking behavior are associated with decline in performance on some physical tasks. CONCLUSIONS: The findings suggest that the successful execution of physical tasks demands cognitive processes regardless of the nature of the task. Researchers using performance-based measures of physical functioning should pay particular attention to the cognitive capacities of their subjects and how these might influence their assessment.

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PubMedDate not supplied

Impaired physical performance and the assessment of dementia of the Alzheimer type.

CONTEXT: Impaired physical performance may confound the clinical assessment of dementia of the Alzheimer type (DAT). OBJECTIVES: Determine whether: (1) Physical Performance Test (PPT) scores are associated with the Clinical Dementia Rating (CDR), (2) PPT scores are correlated with clinical measures of health, and (3) impaired physical performance affects the clinical assessment of DAT. DESIGN: A retrospective and cross-sectional study. SETTING: An Alzheimer's Disease Research Center. PARTICIPANTS: Ninety-nine research volunteers aged 85 years and older were assessed from September 1997 through July 1999; 45 had DAT (CDR = 0.5-2), and 54 were nondemented controls. MEASUREMENTS: Clinical health history, daily functioning, physical and neurologic status, CDR, sum of boxes, and total PPT score were obtained during clinical evaluation. Independently assessed psychometric measures of verbal and nonverbal episodic and semantic memory, visuospatial abilities, and psychometric speed yielded to a factor score representing general cognitive function. Our outcome measure was the CDR (ie, the clinical dementia rating, where higher scores indicate greater dementia severity). RESULTS: The majority (88%) of subjects in this sample of demented and nondemented older adults had some degree of physical impairment as measured by the PPT. Correlational analyses identified clinically important relationships (/taub/ > 0.30, p < 0.05) between impaired PPT performance, higher CDR rating, and poor general health, including difficulty ambulating. The correlation between PPT performance and dementia severity (taub = -0.36) decreased after controlling for cognitive ability (taub = -0.19). The correlation between the cognitive factor score and dementia severity when PPT performance was controlled (taub = -0.60) was similar to the unadjusted correlation of the factor score with dementia severity (taub = -0.64). CONCLUSIONS: The presence of some degree of physical impairment was common in our sample, and PPT scores correlated with both physical and cognitive impairment. Nevertheless, Alzheimer Disease Research Center clinicians appear able to successfully distinguish between physical and cognitive causes of functional impairment and assign a CDR rating that accurately reflects DAT severity in individuals with impaired physical performance.

Activities of Daily Living↗

PubMed2000

Effect of commuter cycling on physical performance of male and female employees.

PURPOSE: The purpose of this study was to determine the effect of commuter cycling on physical performance. Eighty-seven male and 35 female employees volunteered to cycle regularly to their work. METHODS: Sixty-one participants went commuter cycling for 1 yr (cycling group); the others cycled only in the second half year (control group). A maximal exercise test on a cycle ergometer was carried out at the start of the study, after 6 months, and after 1 yr to measure maximal external power (Wmax) and maximal oxygen uptake (VO2max). RESULTS: After the first 6 months of commuter cycling, with a mean single trip distance of 8.5 km and a mean frequency of more than three times a week, a significant increase of 13% was found in the Wmax per kilogram body weight (Wmax x kg(-1)) in both sexes of the cycling group. The improvement in VO2max x kg(-1) was significant for the male participants (6%) but not for the female participants (-2%). At the end of the second half year, the control group also showed a mean gain in Wmax x kg(-1) of 13%. Their VO2max x kg(-1) declined in the first half year, but this was counteracted in the second half year. A dose-response relationship was found between two independent variables and the physical performance; the lower the physical performance at the start of the study and the higher the total amount of kilometers cycled, the higher the gain in Wmax. For subjects with a low initial fitness level, a single trip distance of only 3 km turned out to be enough to improve physical performance. CONCLUSION: Commuter cycling can yield much the same improvement in physical performance as specific training programs.

Adult↗

PubMed2000

A prospective study of the effect of fracture on measured physical performance: results from the MacArthur Study--MAC.

OBJECTIVE: To examine the impact of fractures on measured physical performance and to assess whether specific fractures have unique sequelae. SUBJECTS: 762 men and women, aged 70 to 79 at baseline, who were part of the MacArthur Study of Successful Aging. DESIGN: A longitudinal case-cohort: those with prevalent fractures at baseline were excluded; cases were persons with a medically diagnosed hip, arm, spine, or wrist fracture during the follow-up period (1988-1995). MEASURES: Eight physical performance tests: turning a circle, walking fast, chair stands, timed tap, tandem stand, grip strength, single leg stand, and balance (average of single leg and tandem stands) measured at baseline and follow-up. ANALYSIS: Two fracture groups were defined: (1) those with incident wrist fractures (n = 7) and (2) those with a fracture of the hip, arm, or spine (combined fractures group, n = 16). Change in physical performance was analyzed using crude, age-adjusted, and multiply-adjusted ANCOVA models. RESULTS: The combined fracture group demonstrated statistically significant (P < .05) declines seven of eight of the performance tests compared with individuals without fractures. In contrast, individuals with wrist fractures did not experience a statistically significant decline in any performance measure compared with the no fracture group. CONCLUSIONS: Relative to those without fractures, individuals with a hip, arm, or clinical spinal fracture show similar global declines in physical performance, whereas those with wrist fracture demonstrate no physical performance decrements.

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PubMedDate not supplied

The differential influence of pain and fatigue on physical performance and health status in ambulatory patients with human immunodeficiency virus.

OBJECTIVES: The purposes of this study were to: 1) characterize physical performance in individuals with human immunodeficiency virus; and 2) examine group differences by pain and fatigue on a multivariate profile of disease, physical, and psychologic symptoms. METHODS: One hundred outpatients, 78 men and 22 women (mean age 40.70 +/- 7.49 years) participated. Patients completed a battery of physical performance tests in which the time taken or the distance reached or walked was measured. Self-report questionnaires included measures of pain (0-10 numerical rating scale), fatigue (Brief Fatigue Inventory), and perceived health status (Medical Outcomes Survey-HIV scale). RESULTS: Physical performance was compromised in a task specific manner. Patients took twice as long as healthy individuals on a belt-tie and 4 times as long on a sit-to-stand task and in 6 minutes walked 75% of the distance covered by healthy individuals. Fifty percent of patients (n = 50) had pain at the time of testing (mean 6.3 +/- 2.4), and 98% had fatigue (mean 5.4 +/- 2.3). Multivariate analysis of variance showed pain had a greater influence on performance than fatigue. Pain, distance walked in 6 minutes, and unloaded forward reach accounted for 26% of the variability in quality of life (r = 0.51, P < or = 0.0001). DISCUSSION: Pain has a substantial impact on physical performance and quality of life among ambulatory human immunodeficiency virus patients. Fatigue also impacts physical performance. Compromised ability to perform certain physical tasks affects quality of life. Further investigation of the roles of these relevant variables should be investigated in path analyses.

Acquired Immunodeficiency Syndrome↗