Among the 25 included articles, 12 (48%) (reporting on 12 unique studies) used a cross-sectional study design† with the purpose of describing the relationship between physical activity, or physical activity and sleep, and another variable of interest using WPAMs (Table 1). Seven articles (28%) (6 unique studies and 1 study protocol) were randomized controlled trials (RCTs) with the purpose of assessing the effect of an intervention that was not a WPAM to improve physical activity,41 , 43 , 44 , 55 , 61 lifestyle factors,44 nutrition,64 or neurocognitive function55 , 58 among adults living with HIV (Table 1). The remaining articles included 2 case reports (8%),47 , 57 2 systematic reviews (8%),46 , 62 1 case-control study (4%),59 and 1 observational study (4%) (nested within an aforementioned RCT44 ) 49 (Table 1).
The total sample size of participants at baseline in the 20 studies involving primary data collection was 1421 adults ranging in age from 33 to 67 years (Table 2). Of the 1421 participants, 1212 (85%) were adults living with HIV, 49 (3%) were HIV negative, and HIV status was not reported in the remaining 160 participants (11%). Of the 20 studies, 19 (95%) reported on the sex and/or gender of participants (n = 1193), of which 665 (56%) were female or women, 452 (38%) were male or men, and 76 (6%) were unreported. Of the 20 studies, 13 (65%) reported on ethnicity of participants (n = 808), of which 466 (58%) were identified as African American, 161 (20%) as Hispanic, 118 (15%) as Caucasian, 21 (3%) reported another ethnicity that was not specified, and 42 participants (5%) did not respond to ethnocultural background questions.
Among the 25 articles that described 20 unique studies, a total of 23 different WPAMs were worn by adults living with HIV: 10 (43%) WPAMs were actigraphs used to describe physical activity,* 8 (35%) were accelerometers used to describe physical activity,41 , 45 , 47 , 51–53 , 56 , 59 and 5 (22%) were pedometers used to measure steps taken and distance walked44 , 49 , 55 , 63 , 64 (Table 3). Of the 23 WPAMs, 6 (26%) were worn on the hip,32 , 44 , 45 , 50 , 56 , 58 6 (26%) on the waist,48 , 55 , 61 , 63 4 (17%) on the nondominant wrist or wrist,47 , 54 , 57 , 60 1 (4%) on the upper arm,42 , 43 1 (4%) on the chest,51 and the location of 5 (22%) were not explicitly stated.41 , 52 , 53 , 59 , 64 Accelerometers and actigraphs were generally worn on the wrist, whereas pedometers were generally worn on the waist or the hip (Table 3). The duration of WPAM use ranged from 48 hours64 of consecutive monitoring to 12 months.44
Of the 23 WPAMs used in the 20 included studies, 20 WPAMs were used to describe outcomes of interest in the given study including physical activity41–45 , 47–61 , 64 , 65 or physical activity in combination with sleep (Table 3). WPAMs used to assess physical activity specifically measured time spent in moderate or vigorous physical activity, heart rate, energy expenditure, sedentary time, steps taken, and distance walked.† Three articles used WPAMs to assess sleep (in combination with physical activity), whereby WPAMs measured sleep duration, sleep-onset latency (length of time to fall asleep measured in minutes), sleep cycle mesor (stages of sleep), total wake time, sleep efficiency (ratio of total sleep time to time spent in bed), and sleep fragmentation index (measure of restlessness, and wake after sleep onset).42 , 47 , 57 Of the 20 included studies, 2 (8%) compared the use of a WPAM (n = 3 WPAMs) to a self-reported description of physical activity32 , 63 (Table 3).
Of the 20 included studies, 2 reported on the comparison of a WPAM with a self-reported measure of physical activity.32 , 63 The first study compared a self-reported physical activity questionnaire, the International Physical Activity Questionnaire (IPAQ) Short Form, with 2 WPAMs. The Spearman correlation coefficients between the IPAQ minutes per week and pedometer steps per day revealed a correlation of 0.76.63 Participants had lower levels of physical activity as recorded by the accelerometer, and authors of this study concluded that a pedometer may help improve measuring physical activity among adults living with HIV who are capable of engaging in ambulatory acitivities.63
No included studies assessed the effectiveness of the WPAM as an intervention to change physical activity behavior. However, 2 articles reporting on the same study found that when using a WPAM, the WPAM could be used as an intervention to promote physical activity among adults living with HIV with risk factors for ischemic heart disease.44 , 49 Roos et al44 used the WPAM primarily as an outcome measure of physical activity by recording the number of steps taken among adults living with HIV. However, participants in this study reported that they also used the pedometer as a motivational tool to promote and increase their level of physical activity.44
Of the 25 articles included, authors of 11 articles (44%) mentioned that the WPAM used had been validated among either a healthy population or other chronic illness population such as people living with chronic pain, hypertension, and cancer.* None of the authors reported measurement properties of WPAMs specifically with adults living with HIV.
Of the 25 included articles, 2 were systematic literature reviews. The purpose of one review was to establish expected steps per day in a given day among populations living with chronic illnesses or disabilities, including people living with HIV.62 Sixty studies were included in this review, of which one study specifically included adults living with HIV.62 Tudor-Locke et al62 reported the median number of steps walked per day for each population, which included people living with heart diseases, chronic obstructive pulmonary disease, diabetes, breast cancer, neuromuscular diseases, arthritis, joint replacement, intellectual disabilities, and other special populations including adults living with HIV. The expected number of steps taken per day for each special population were provided with the use of a waist-mounted WPAM such as an accelerometer or and ankle-mounted WPAM such as a pedometer. Authors of the one included study specific to adults with HIV63 reported a mean of 7594 and 7495 steps walked per day as recorded by a pedometer for males and females living with HIV, respectively, and 7151 and 7886 mean steps per day as recorded by an accelerometer for males and females living with HIV, respectively.62
Authors of the other systematic literature review examined interventions in the literature used to promote exercise and nutrition among adults living with HIV and chronic disease.46 Botros et al46 included 22 publications pertaining to nutrition and lifestyle interventions and 10 publications pertaining to exercise among those with chronic disease and adults living with HIV. Interventions to increase physical activity identified by the authors from included publications were educational sessions, specialized equipment, and multicomponent physical activity and nutrition education with structure exercise classes.46 A pedometer-based publication was included where the goal of the pedometer was to increase motivation and time spent engaged in physical activity.46 , 66 Botros et al46 concluded that the aforementioned interventions may be used among adults living with HIV to promote exercise and nutrition that, in turn, improve adverse health outcomes such as cardiovascular, metabolic, and psychological consequences of HIV and treatments.46
This study is the first scoping review to characterize the literature pertaining to the use of WPAMs to measure or enhance physical activity among adults living with HIV. The majority of articles were published during the years 2011-2016, indicating that evidence of WPAM use is becoming increasingly prevalent in the literature. In summary, WPAMs were used primarily as an outcome measure to describe physical activity among adults living with HIV and to a lesser extent as a motivational intervention tool to enhance physical activity. The types of WPAMs used were accelerometers, actigraphs, and pedometers to measure the number of steps taken, distance walked, and active minutes engaged in physical activity. Gaps in the literature included a paucity of evidence assessing the measurement properties of WPAMs and the effectiveness of WPAMs in promoting physical activity among adults living with HIV.
Our results suggest a paucity of evidence documenting the role and effectiveness of WPAMs as an intervention or motivational tool to enhance physical activity among adults living with HIV. Authors of 2 systematic reviews suggested WPAMs may be used as a motivational intervention to increase physical activity among people who are overweight, obese, or living with type 2 diabetes.71 , 72 In this review, authors noticed in the discussion of one included study that participants suggested WPAMs motivated them to increase their physical activity levels.44 Future research should evaluate the effectiveness of WPAMs for enhancing outcomes of physical activity in this population.
Measurement tools should be validated specifically for use with a given target population because instruments can produce differing outcomes between the observation and what the measurement tool is supposed to measure across different populations.74 Adults living with HIV are experiencing health challenges (or disability) as a consequence of HIV infection, side effects associated with long-standing antiretroviral use, and emerging concurrent health conditions aging with HIV infection.1 , 3 , 75 Some of the multimorbidity associated with HIV infection and long-term antiretroviral use may include peripheral neuropathy, HIV-associated myopathy (although relatively rare), and type 2 diabetes.3 Peripheral neuropathy specifically has a prevalence rate of approximately 30% to 70%76 and may present with numbness, paresthesia, and dysesthesia in the lower extremities, which, in turn, may lead to slower gait and gait impairments.3 Slower gait speed may lead to inaccurate measures of physical activity by WPAMs as measured by step counts, active minutes, and distance walked. For instance, some WPAMs were shown to be less accurate at slower walking speeds than faster walking speeds among people who have sustained a stroke.28 Hence, WPAMs may not provide accurate and reliable measurements of physical activity for adults living with HIV with gait impairments. Older adults living with HIV are more likely to have a greater number of concurrent health conditions including peripheral neuropathy and diabetes than younger adults living with HIV.77 In turn, older adults living with HIV may be more likely to experience the negative consequences associated with peripheral neuropathy, thus leading to gait impairments affecting WPAM use.3 , 77 Hence, it is important to consider the properties of WPAMs for their use in the context of HIV infection.
A paucity of evidence exists on the effectiveness of WPAMs as an intervention to increase physical activity among adults living with HIV. Authors of a systematic review suggested WPAMs can demonstrate ways to monitor health and evoke behavior changes to enhance physical activity among populations of all ages.78 Future research should focus on how WPAMs may play a role in promoting and adhering to physical activity among adults living with HIV. Second, none of the studies in our scoping review reported on the measurement properties of WPAMs specifically among adults living with HIV. Therefore, further research is needed to assess the validity and reliability of WPAMs in the context of HIV infection.
More than half of the participants (56%) in the included studies who reported on sex or gender self-identified as women or female living with HIV. On a global scale, approximately 35 million adults are currently living with HIV.79 Of those 35 million people, approximately 18.2 million are females (52%).79 Although it appears that the sex and gender breakdown reflects the global estimates of HIV, it is important to consider sex and gender difference among this population when using WPAMs. For instance, Kenyan women initiating antiretroviral therapy were approximately 10 times more likely to develop peripheral neuropathy than men within the first year of starting treatment.80 Sex and gender differences may exist when considering the ability, interest, and uptake of using WPAMs to measure physical activity. Hence, it is important to consider the measurement properties of WPAMs across a diverse sample of adults living with HIV to ensure external validity among the population.
Approximately half of the articles (52%) included in our scoping review were completed in high-income countries such as the United States.81 Adults living with HIV in developing countries may not have the resources to access WPAMs and thus may have resulted in fewer studies included in the review. Future research should explore the role of WPAMs in measuring and promoting physical activity among adults living with HIV living in high- as well as low- to middle-income contexts.
The authors thank Erica Lenton, Faculty Liaison and Instruction Librarian at the University of Toronto, for her help with the search strategy.
* References 41–43 , 45–48 , 52 , 54 , 55 , 60–62.
† References 32 , 42 , 45 , 48 , 50–54 , 56 , 60 , 63.
* References 42 , 43 , 45 , 47 , 48 , 50–52 , 56 , 60.
* References 32 , 48 , 50 , 54 , 55 , 57 , 58 , 60 , 61 63.
† References 31 , 41 , 43–45 , 48 , 50–53 , 55 , 56 , 58 , 61 , 63 , 65.
* References 32 , 41 , 42 , 44 , 47 , 51 , 56 , 59–61 , 63.
1. Kendall CE, Wong J, Taljaard M, et al A cross-sectional, population-based study measuring comorbidity among people living with HIV
in Ontario. BMC Public Health. 2014;14(1):1.
2. Smit M, Brinkman K, Geerlings S, et al Future challenges for clinical care of an ageing population infected with HIV
: a modelling study. Lancet Infect Dis. 2015;15(7):810–818.
3. Robinson-Papp J, Tan IL, Simpson DM. Neuromuscular complications in HIV
: effects of aging. J Neurovirol. 2012;18(4):331–338.
4. Guaraldi G, Silva AR, Stentarelli C. Multimorbidity and functional status assessment. Curr Opin HIV
5. Guaraldi G, Orlando G, Zona S, et al Premature age-related comorbidities among HIV
-infected persons compared with the general population. Clin Infect Dis. 2011;53(11):1120–1126.
6. Justice AC. HIV
and aging: time for a new paradigm. Curr HIV
AIDS Rep. 2010;7(2):69–76.
7. Fortin M, Lapointe L, Hudon C, Vanasse A. Multimorbidity is common to family practice: is it commonly researched? Can Fam Physician. 2005;51(2):244–245.
8. Edmiston N, Passmore E, Smith DJ, Petoumenos K. Multimorbidity among people with HIV
in regional New South Wales, Australia. Sex Health. 2015;12(5):425–432.
9. Guaraldi G, Brothers TD, Zona S, et al A frailty index predicts survival and incident multimorbidity independent of markers of HIV
disease severity. AIDS. 2015;29(13):1633–1641.
10. Havlik RJ, Brennan M, Karpiak SE. Comorbidities and depression in older adults with HIV
. Sex Health. 2011;8(4):551–559.
11. Önen NF, Overton ET, Seyfried W, et al Aging and HIV
infection: a comparison between older HIV
-infected persons and the general population. HIV
Clin Trials. 2010;11(2):100–109.
12. Simonik A, Vader K, Ellis D, et al Are you ready? Exploring readiness to engage in exercise among people living with HIV
and multimorbidity in Toronto, Canada: a qualitative study. BMJ Open. 2016;6(3):e010029.
13. O'Brien KK, Bayoumi AM, Strike C, Young NL, Davis AM. Exploring disability from the perspective of adults living with HIV
/AIDS: development of a conceptual framework. Health Qual Life Outcomes. 2008;6(1):76.
14. O'Brien KK, Davis AM, Strike C, Young NL, Bayoumi AM. Putting episodic disability into context: a qualitative study exploring factors that influence disability experienced by adults living with HIV
/AIDS. J Int AIDS Soc. 2009;12(1):1.
15. Caspersen CJ, Powell KE, Christenson GM. Physical activity
, exercise, and physical fitness: definitions and distinctions for health-related research. Public Health Rep. 1985;100(2):126.
16. Physical Activity
Guidelines Advisory Committee. Physical Activity
Guidelines Advisory Committee Report, 2008. Washington, DC: US Department of Health and Human Services. 2008:A1–H14.
17. Tremblay MS, Warburton DE, Janssen I, et al New Canadian physical activity
guidelines. Appl Physiol Nutr Metab. 2011;36(1):36–46.
18. Canadian Society for Exercise Physiology. Canadian Physical Activity
Guidelines. Ottawa, ON, Canada: Canadian Society for Exercise Physiology Ottawa; 2011.
19. Frantz JM, Murenzi A. The physical activity
levels among people living with human immunodeficiency virus/acquired immunodeficiency syndrome receiving high active antiretroviral therapy in Rwanda. SAHARA-J. 2013;10(3/4):113–118.
20. Bize R, Johnson JA, Plotnikoff RC. Physical activity
level and health-related quality of life in the general adult population: a systematic review. Prev Med. 2007;45(6):401–415.
21. Webel AR, Perazzo J, Decker M, Horvat–Davey C, Sattar A, Voss J. Physical activity
is associated with reduced fatigue in adults living with HIV
/AIDS. J Adv Nurs. 2016;72(12):3104–3112.
22. Fazeli PL, Marquine MJ, Dufour C, et al Physical activity
is associated with better neurocognitive and everyday functioning among older adults with HIV
disease. AIDS Behav. 2015;19(8):1470–1477.
23. Clingerman EM. Participation in physical activity
by persons living with HIV
disease. J Assoc Nurses AIDS Care. 2003;14(5):59–70.
24. Schuelter-Trevisol FH, Wolff F, R Alencastro P, et al Physical activity
: do patients infected with HIV
practice? How much? A systematic review. Curr HIV
25. Hills AP, Mokhtar N, Byrne NM. Assessment of physical activity
and energy expenditure: an overview of objective measures. Front Nutr. 2014;1:5.
26. Strath SJ, Kaminsky LA, Ainsworth BE, et al Guide to the assessment of physical activity
: clinical and research applications: a scientific statement from the American Heart Association. Circulation. 2013;128(20):2259–2279.
27. Lee JM, Kim Y, Welk GJ. Validity of consumer-based physical activity
monitors. Med Sci Sports Exerc. 2014;46(9):1840–1848.
28. Klassen TD, Simpson LA, Lim SB, et al “Stepping up” activity poststroke: ankle-positioned accelerometer can accurately record steps during slow walking. Phys Ther. 2016;96(3):355–360.
29. Jehn M, Schmidt-Trucksäess A, Schuster T, et al Accelerometer-based quantification of 6-Minute Walk Test performance in patients with chronic heart failure: applicability in telemedicine. J Card Fail. 2009;15(4):334–340.
30. Kushida CA, Chang A, Gadkary C, Guilleminault C, Carrillo O, Dement WC. Comparison of actigraphic, polysomnographic, and subjective assessment of sleep parameters in sleep-disordered patients. Sleep Med. 2001;2(5):389–396.
31. Craig CL, Booth ML, Ainsworth BE, et al International Physical Activity
Questionnaire: 12-country reliability and validity. Med Sci Sports Exerc. 2003;195(9131/03):3508–1381.
32. Fillipas S, Cicuttini F, Holland AE, Cherry CL. The International Physical Activity
Questionnaire overestimates moderate and vigorous physical activity
-infected individuals compared with accelerometry. J Assoc Nurses AIDS Care. 2010;21(2):173–181.
33. Arksey H, O'Malley L. Scoping studies: towards a methodological framework. Int J Soc Res Methodol. 2005;8(1):19–32.
34. Peters M, Godfrey C, McInerney P, Soares C, Khalil H, Parker D. Methodology for JBI scoping reviews. In: Aromataris E, ed. The Joanna Briggs Institute Reviewers Manual. South Australia: The Joanna Briggs Institute; 2015:3–24.
35. Levac D, Colquhoun H, O'Brien KK. Scoping studies: advancing the methodology. Implement Sci. 2010;5(1):1–9.
36. Tricco AC, Lillie E, Zarin W, et al PRISMA Extension for Scoping Reviews (PRISMA-ScR): checklist and explanation. Ann Intern Med. 2018;169(7):467–473.
37. Reuters T. EndNote X7. Philadelphia, PA: Thomson Reuters; 2013.
38. Mavergames C. Covidence (Systematic Review Software). Melbourne, VIC, Australia: Covidence; 2013.
39. Ehrich K, Freeman GK, Richards SC, Robinson IC, Shepperd S. How to do a scoping exercise: continuity of care. Res Policy Plan. 2002;20(1):25–29.
40. Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Ann Intern Med. 2009;151(4):264–269.
41. Jaggers JR, Dudgeon W, Blair SN, et al A home-based exercise intervention to increase physical activity
among people living with HIV
: study design of a randomized clinical trial. BMC Public Health. 2013;13:502.
42. Wirth MD, Jaggers JR, Dudgeon WD, et al Association of markers of inflammation with sleep and physical activity
among people living with HIV
or AIDS. AIDS Behav. 2015;19(6):1098–1107.
43. Jaggers JR, Prasad VK, Dudgeon WD, et al Associations between physical activity
and sedentary time on components of metabolic syndrome among adults with HIV
. AIDS Care. 2014;26(11):1387–1392.
44. Roos R, Myezwa H, van Aswegen H, Musenge E. Effects of an education and home-based pedometer walking program on ischemic heart disease risk factors in people infected with HIV
: a randomized trial. J Acquir Immune Defic Syndr. 2014;67(3):268–276.
45. Webel AR, Jenkins T, Longenecker CT, Sattar A, Moore SM, Josephson R. Impaired fitness is common in adults living with HIV
, despite viral suppression, and correlates with markers of immune dysregulation. Circulation. 2015;132:A19576.
46. Botros D, Somarriba G, Neri D, Miller TL. Interventions to address chronic disease and HIV
: strategies to promote exercise and nutrition among HIV
-infected individuals. Curr HIV
AIDS Rep. 2012;9(4):351–363.
47. Sandoval R, Gilkerson R. Management of sleep quality and pain in an individual living with HIV
and Hepatitis C coinfection using an activity monitor. J Int Assoc Provid AIDS Care. 2015;14(6):476–481.
48. Ramírez-Marrero FA, Santana-Bagur JL, Joyner MJ, Rodríguez-Zayas J, Frontera W. Metabolic syndrome in relation to cardiorespiratory fitness, active and sedentary behavior in HIV
+ Hispanics with and without lipodystrophy: fitness and metabolic-syndrome in HIV
. Puerto Rico Health Sci J. 2014;33(4):163.
49. Roos R, Myezwa H, van Aswegen H. “Not easy at all but I am trying”: barriers and facilitators to physical activity
in a South African cohort of people living with HIV
participating in a home-based pedometer walking programme. AIDS Care. 2015;27(2):235–239.
50. Forde C, Loy A, O'Dea S, Mulcahy F, Gormley J, Daly C. Physical activity
is associated with metabolic health in men living with HIV
. AIDS Behav. 2018;22(6):1965–1971.
51. Olsen MF, Kæstel P, Tesfaye M, et al Physical activity
and capacity at initiation of antiretroviral treatment in HIV
patients in Ethiopia. Epidemiol Infect. 2015;143(5):1048–1058.
52. Rehm KE, Konkle-Parker D. Physical activity
levels and perceived benefits and barriers to physical activity
-infected women living in the deep south of the United States. AIDS Care. 2016;28(9):1205–1210.
53. Kruger HS, Havemann-Nel L, Ravyse C, Moss SJ, Tieland M. Physical activity
energy expenditure and sarcopenia in black South African Urban women. J Phys Act Health. 2016;13(3):296–302.
54. Sandkovsky U, Robertson KR, Meza JL, et al Pilot study of younger and older HIV
-infected adults using traditional and novel functional assessments. HIV
Clin Trials. 2013;14(4):165–174.
55. Henry BL, Moore DJ. Preliminary findings describing participant experience with iSTEP, an mHealth intervention to increase physical activity
and improve neurocognitive function in people living with HIV
. J Assoc Nurses AIDS Care. 2016;27(4):495–511.
56. Wadley AL, Mitchell D, Kamerman PR. Resilience does not explain the dissociation between chronic pain and physical activity
in South Africans living with HIV
. Peer J. 2016;4:e2464.
57. Rodríguez-Estrada E, Fernández-Sánchez M, Muñoz-Delgado J, Fresan-Orellana A, Reyes-Terán G. Sleep and rest activity measured by wrist actigraphy in an HIV
-infected patient with Steven-Johnson syndrome. Biol Rhythm Res. 2016;47(1):1–6.
58. McDermott A, Zaporojan L, McNamara P, et al The effects of a 16-week aerobic exercise programme on cognitive function in people living with HIV
. AIDS Care. 2017;29(6):667–674.
59. Faurholt-Jepsen M, Faurholt-Jepsen D, Range N, et al The use of combined heart rate response and accelerometry to assess the level and predictors of physical activity
in tuberculosis patients in Tanzania. Epidemiol Infect. 2014;142(6):1334–1342.
60. Bopp CM, Phillips KD, Fulk LJ, Dudgeon WD, Sowell R, Hand GA. Physical activity
and immunity in HIV
-infected individuals. AIDS Care. 2004;16(3):387–393.
61. Jansen L. The effect of exercise on explanatory style in HIV
-infected men. Dissertation Abstracts International: Section B: The Sciences and Engineering. 2003;63(10-B):4906.
62. Tudor-Locke C, Washington TL, Hart TL. Expected values for steps/day in special populations. Prev Med. 2009;49(1):3–11.
63. Ramirez-Marrero FA, Rivera-Brown AM, Nazario CM, Rodriguez-Orengo JF, Smit E, Smith BA. Self-reported physical activity
in Hispanic adults living with HIV
: comparison with accelerometer and pedometer. J Assoc Nurses AIDS Care. 2008;19(4):283–294.
64. Karsegard VL, Raguso CA, Genton L, Hirschel B, Pichard C. L-Ornithine α-ketoglutarate in HIV
infection: effects on muscle, gastrointestinal, and immune functions. Nutrition. 2004;20(6):515–520.
65. Roos R, Myezwa H, van Aswegen H, Musenge E. The effect of physical activity
modification on ischaemic heart disease risk factors in people living with HIV
: randomised control trial. Physiotherapy. 2015;101:e1298–e1299.
66. Rotheram-Borus MJ, Swendeman D, Lee S-J, Li L, Amani B, Nartey M. Interventions for families affected by HIV
. Transl Behav Med. 2011;1(2):313–326.
67. Troosters T, Sciurba F, Battaglia S, et al Physical inactivity in patients with COPD, a controlled multi-center pilot-study. Respir Med. 2010;104(7):1005–1011.
68. English C, Healy GN, Coates A, Lewis L, Olds T, Bernhardt J. Sitting and activity time in people with stroke. Phys Ther. 2016;96(2):193–201.
69. Pinto BM, Frierson GM, Rabin C, Trunzo JJ, Marcus BH. Home-based physical activity
intervention for breast cancer patients. J Clin Oncol. 2005;23(15):3577–3587.
70. Tudor-Locke CE, Myers AM. Methodological considerations for researchers and practitioners using pedometers to measure physical (ambulatory) activity. Res Q Exerc Sport. 2001;72(1):1–12.
71. Baskerville R, Ricci–Cabello I, Roberts N, Farmer A. Impact of accelerometer and pedometer use on physical activity
and glycaemic control in people with type 2 diabetes: a systematic review and meta–analysis. Diabet Med. 2017;34(5):612–620.
72. de Vries HJ, Kooiman TJ, van Ittersum MW, van Brussel M, de Groot M. Do activity monitors
increase physical activity
in adults with overweight or obesity? A systematic review and meta–analysis. Obesity. 2016;24(10):2078–2091.
73. Johnson-Kozlow M, Sallis JF, Gilpin EA, Rock CL, Pierce JP. Comparative validation of the IPAQ and the 7-day PAR among women diagnosed with breast cancer. Int J Behav Nutr Phys Act. 2006;3(1):7.
74. Streiner DL, Norman GR. Health Measurement Scales: A Practical Guide to Their Development and Use. Oxford; New York: Oxford Medical Publications; 2003.
75. Rusch M, Nixon S, Schilder A, Braitstein P, Chan K, Hogg RS. Impairments, activity limitations and participation restrictions: prevalence and associations among persons living with HIV
/AIDS in British Columbia. Health Qual Life Outcomes. 2004;2:46.
76. Evans SR, Ellis RJ, Chen H, et al Peripheral neuropathy in HIV
: prevalence and risk factors. AIDS. 2011;25(7):919.
77. Vance DE, Mugavero M, Willig J, Raper JL, Saag MS. Aging with HIV
: a cross-sectional study of comorbidity prevalence and clinical characteristics across decades of life. J Assoc Nurses AIDS Care. 2011;22(1):17–25.
78. Strath SJ, Rowley TW. Wearables for promoting physical activity
. Clin Chem. 2018;64(1):53–63.
79. Joint United Nations Programme on HIV
/AIDS (UNAIDS). UNAIDS Data 2017. Geneva, Switzerland: UNAIDS; 2017.
80. Mehta SA, Ahmed A, Laverty M, Holzman RS, Valentine F, Sivapalasingam S. Sex differences in the incidence of peripheral neuropathy among Kenyans initiating antiretroviral therapy. Clin Infect Dis. 2011;53(5):490–496.
81. World Health Organization. World Health Statistics 2018: Monitoring Health for the SDGs, Sustainable Development Goals. Geneva, Switzerland: World Health Organization; 2018.
82. Taibi DM, Price C, Voss J. A pilot study of sleep quality and rest-activity patterns in persons living with HIV
. J Assoc Nurses AIDS Care. 2013;24(5):411–421.
83. Lee KA, Gay C, Portillo CJ, et al Types of sleep problems in adults living with HIV
/AIDS. J Clin Sleep Med. 2012;8(1):67.
84. Reid S, Dwyer J. Insomnia in HIV
infection: a systematic review of prevalence, correlates, and management. Psychosom Med. 2005;67(2):260–269.
85. Guaraldi G. Validity of the ViovFit2 activity tracker in measuring steps in community dwelling HIV
-infected geriatric patients. Poster presented at: 19th International Workshop on Co-morbidities and Adverse Drug Reactions in HIV
; October 23-25. 2017; Milan, Italy; 2017.
86. Ramirez-Marrero FA, Amalbert-Birriel MA, Matos M, Santana-Bagur JL, Frontera W, Wojna V. Cardiorespiratory fitness response to high intensity interval training in HIV
plus Hispanic women with and without neurocognitive impairment. J Neuroimmune Pharmacol. 2018.
87. O'Brien KK, Bayoumi AM, Solomon P, et al Evaluating a community-based exercise intervention with adults living with HIV
: protocol for an interrupted time series study. BMJ Open. 2016;6(10):e013618.
88. Webel AR, Perazzo J, Longenecker CT, et al The influence of exercise on cardiovascular health in sedentary adults with human immunodeficiency virus. J Cardiovasc Nurs. 2018;33(3):239–247.
89. Webel AR, Moore SM, Longenecker CT, et al Randomized controlled trial of the system change intervention on behaviors related to cardiovascular risk in HIV
+ adults. J Acquir Immune Defic Syndr. 2018;78(1):23–33.
90. Safeek RH, Hall KS, Lobelo F, et al Low physical activity
among persons living with HIV
/AIDS is associated with poor physical function. AIDS Res Hum Retroviruses. 2018:34(11). doi:10.1089/aid.2017.0309.
91. Martinez E, Bloch M, Guaraldi G. MACAPMOMCFMMZSFIGBMCL, ed. Feasibility and Long-term Assessment of Physical and Behavioural Functioning Among Older Adults With HIV
. International Medical Press Ltd; 2017;13:S70.
92. Mabweazara SZ, Leach L, Ley C, Smith M. A six week contextualised physical activity
intervention for women living with HIV
and AIDS of low socioeconomic status: a pilot study. AIDS Care. 2018;30(suppl 2):61–65.