Sedentary Time Accumulated in Bouts is Positively Associated with Disease Severity in Fibromyalgia: The Al-Ándalus Project

Levels of sedentary behaviour in people with fibromyalgia: a systematic review and meta-analysis

PURPOSE

Sedentary behaviour is associated with pain, fatigue, and a more severe impact of the disease in fibromyalgia, independently of physical activity levels. Despite this knowledge, little attention has been attributed to estimate sedentary behaviour in this population. The aims of this meta-analysis were to: (a) establish the pooled mean time spent sedentary, (b) investigate moderators of sedentary levels, and (c) explore differences with age- and gender-matched general population controls in people with fibromyalgia (PwF).

METHODS

Two independent authors searched major databases until 1 December 2022. A random effects meta-analysis was performed. The methodological quality of included studies was assessed with the Quality Assessment Tool for Observational Cohort and Cross-sectional Studies.

RESULTS

Across 7 cross-sectional studies of fair methodological quality, there were 1500 patients with fibromyalgia (age range = 43-53 years). PwF spent 545.6 min/day (95% CI = 523.7-567.5, p < 0.001, N = 3) engaging in sedentary behaviour. Self-reported questionnaires overestimate sedentary levels with 314.3 min/day (95% CI = 302.0-326.6, p = 0.001, N = 2). PwF spent 36.14 min/day (95% CI = 16.3-55.9, p < 0.001) more in sedentary behaviour than general population controls.

CONCLUSIONS

PwF are more sedentary than the general population. The limited available data should however be considered with caution due to substantial heterogeneity.

Sedentary time is associated with depressive symptoms and state anxiety in women with fibromyalgia. Could physical activity and fitness modify this association? The al-Ándalus project

PURPOSE

To analyze the associations of total and prolonged sedentary time (ST) with depressive symptoms and state anxiety in women with fibromyalgia and whether these associations are modified by moderate-to-vigorous physical activity (MVPA) and physical fitness.

METHODS

This cross-sectional exploratory study included 386 women with fibromyalgia aged 51.2 ± 7.6 years. Total ST, time in prolonged bouts of ST (≥30- and ≥60-min) and MVPA were measured with triaxial accelerometry. Depressive symptoms were assessed with the "Beck Depression Inventory-second edition," state anxiety with the "State-Trait Anxiety Inventory," and physical fitness with the "Senior Fitness Test Battery."

RESULTS

Total and prolonged ST were directly associated with depressive symptoms (total: β = 0.19, ≥30-min bout: β = 0.15, and ≥60-min bout: β = 0.12) and odds of severe depressive symptoms (all, p < 0.001). These associations generally remained significant after adjustments for MVPA and physical fitness (all, p < 0.05). Total and prolonged ST were directly associated with state anxiety (total: β = 0.11, ≥30-min bout: β = 0.12, and ≥60-min bout: β = 0.07; all, p < 0.001). These associations were generally independent of MVPA (p < 0.05) but vanished when considering physical fitness (p > 0.05).

CONCLUSIONS

Higher levels of total and prolonged ST are associated with greater depressive symptoms and state anxiety in women with fibromyalgia. MVPA did not modify these associations, although physical fitness could play a protective role specially for state anxiety.IMPLICATIONS FOR REHABILITATIONReducing sedentary time and avoiding its accumulation in prolonged periods could potentially reduce depressive symptoms and state anxiety in fibromyalgia.Higher sedentary time is associated with more severe depressive symptoms even in patients who engage in moderate-to-vigorous physical activity.Higher levels of physical fitness could attenuate the negative associations of sedentary time with depressive symptoms and, specially, state anxiety."Sit less, move more and exercise to increase your fitness" could be a positive message for people with fibromyalgia in clinical settings.

Correlates of sedentary behavior in people with fibromyalgia: A systematic review

INTRODUCTION

Understanding the correlates of sedentary behavior (SB) is important in the development of interventions which reduce and interrupt SB in people with fibromyalgia (PwF). This systematic review aimed to investigate the correlates of SB in PwF using the socio-ecological model.

METHODS

Three databases (Embase, CINAHL and PubMed) were search from inception until July 21, 2022 using "sedentary" or different types of SB and "fibromyalgia" or "fibrositis" as keywords. The data collected was then analyzed using summary coding.

RESULTS

Out of 23 SB correlates retrieved from 7 reports (n = 1698), no correlates were consistently reported (ie, reported in 4 or more studies). Higher pain intensity was the most commonly reported barrier for reducing/interrupting SB (reported in 3 reports). Other reported barriers to reducing/interrupting SB were experiencing physical and mental fatigue, a more severe disease impact, and a lack of motivation to be physically active (all reported in 1 study). A better experienced social and physical functioning and more vitality were facilitators for reducing/interrupting SB (all reported in 1 study). To date, in PwF no correlates of SB at the interpersonal, environmental and policy levels have been explored.

CONCLUSION

Research on correlates of SB in PwF is still in its infancy. The current preliminary evidence suggests that clinicians should consider physical and mental barriers when aiming to reduce or interrupt SB in PwF. Further research on modifiable correlates at all levels of the socio-ecological model is required to inform future trials aiming to modify SB in this vulnerable population.

A comparative study of heart rate variability and physical fitness in women with moderate and severe fibromyalgia

The aim of this study was to compare the physical fitness and cardiac autonomic activity among women with moderate and severe fibromyalgia (FM) and healthy women. This study included 35 women with FM (age: 46.2±8.9 years) and 17 healthy women (age: 44.3±9.9 years). Participants with FM were divided into moderate FM (n=15) and severe FM (n=20) according to the total score obtained in FM impact questionnaire. The heart rate variability was monitored using a portable cardiac monitor with participants resting in supine position during 10 min. Thereafter, the participants performed the chair sit and reach test, the chair stand test, and the 6-min walk test to measure the lower-body flexibility, lower-body muscle strength, and cardiorespiratory fitness, respectively. The lower-body muscle strength and cardiorespiratory fitness were both reduced in moderate and severe FM compared to healthy women (P<0.01), with greater reduction in severe FM when compared to moderate FM (P<0.05). In addition, the parasympathetic indexes of heart rate variability were all similarly decreased in both moderate and severe FM, when compared to healthy women (P<0.05). The cardiac parasympathetic activity is similarly decreased in women with both moderate and severe FM in comparison to healthy women, despite a greater physical deconditioning in severe FM.