Abstract

BackgroundSedentary time (ST) has been associated with detrimental health outcomes in fibromyalgia. Previous evidence in the general population has shown that not only is the total amount of ST harmful but the pattern of accumulation of sedentary behaviors is also relevant to health, with prolonged unbroken periods (ie, bouts) being particularly harmful.ObjectiveTo examine the association of the patterns of ST with health-related quality of life (HRQoL) in women with fibromyalgia and to test whether these associations are independent of moderate-to-vigorous physical activity (MVPA).MethodsA total of 407 women (mean 51.4 years of age [SD 7.6]) with fibromyalgia participated. ST and MVPA were measured with triaxial accelerometry. The percentage of ST accumulated in bouts and the frequency of sedentary bouts of different lengths (≥10 min, ≥20 min, ≥30 min, and ≥60 min) were obtained. Four groups combining total ST and sedentary bout duration (≥30 min) were created. We assessed HRQoL using the 36-item Short-Form Health Survey (SF-36).ResultsA greater percentage of ST spent in all bout lengths was associated with worsened physical function, bodily pain, vitality, social function, and physical component summary (PCS) (all P<.05). In addition, a higher percentage of ST in bouts of 60 minutes or more was related to worsened physical role (P=.04). A higher frequency of bouts was negatively associated with physical function, social function, the PCS (≥30 min and ≥60 min), physical role (≥60 min), bodily pain (≥60 min), and vitality (≥20 min, ≥30 min, and ≥60 min) (all P<.05). Overall, for different domains of HRQoL, these associations were independent of MVPA for higher bout lengths. Patients with high total ST and high sedentary bout duration had significantly worsened physical function (mean difference 8.73 units, 95% CI 2.31-15.15; independent of MVPA), social function (mean difference 10.51 units, 95% CI 2.59-18.44; not independent of MVPA), and PCS (mean difference 2.71 units, 95% CI 0.36-5.06; not independent of MVPA) than those with low ST and low sedentary bout duration.ConclusionsGreater ST in prolonged periods of any length and a higher frequency of ST bouts, especially in longer bout durations, are associated with worsened HRQoL in women with fibromyalgia. These associations were generally independent of MVPA.

Highlights

  • Fibromyalgia is a chronic and heterogeneous condition characterized by pain as the dominant symptom, which is frequently accompanied by fatigue, sleep disorders, or cognitive impairment [1]

  • Greater percentages of Sedentary time (ST) spent in all bout lengths were associated with worse physical function, bodily pain, vitality, and social function domains and the physical component summary (PCS)

  • The main findings of this study suggest that higher percentages of ST spent in different bout lengths were associated with worsened health-related quality of life (HRQoL), including physical function, bodily pain, vitality, and social function domains, as well as the PCS

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Summary

Introduction

Fibromyalgia is a chronic and heterogeneous condition characterized by pain as the dominant symptom, which is frequently accompanied by fatigue, sleep disorders, or cognitive impairment [1]. Fibromyalgia patients, who tend to be highly sedentary, usually reduce their physical activity (PA) levels in order to avoid an aggravation of their symptomatology [2,3]. Adopting this behavior might trigger a worsening of their condition [4,5,6,7,8]. Considering that few patients with fibromyalgia fulfil the recommended level of moderate-to-vigorous PA (MVPA) [11], these patients are at an increased health risk for being highly sedentary and for being inactive [12,13]. Previous evidence in the general population has shown that is the total amount of ST harmful but the pattern of accumulation of sedentary behaviors is relevant to health, with prolonged unbroken periods (ie, bouts) being harmful

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