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

Abstract

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 REHABILITATION

• Reducing 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.

Keywords:

• Chronic pain
• mental health
• GT3X+
• inactivity
• sedentary lifestyle

Acknowledgements

The authors gratefully acknowledge all participants for their collaboration and enthusiasm. We would like to thank the collaborators in the al-Ándalus project and all the members of the Physical Activity for Health Promotion (PA-HELP; CTS-1018) research group.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported by the Spanish Ministry of Economy and Competitiveness [I + D + i DEP2010-15639, I + D + i DEP2013-40908-R to M.D.F.]; the Spanish Ministry of Education [FPU 15/00002 to B.G.-C.]; the Consejería de Turismo, Comercio y Deporte, Junta de Andalucía [CTCD-201000019242-TRA to M.D.-F.]; and the University of Granada, Plan Propio de Investigación 2016, Excellence actions: Units of Excellence; Unit of Excellence on Exercise and Health (UCEES).