Prolonged intervals of being inactive likely worsen symptoms of the disease in women with fibromyalgia (FM), regardless of their overall physical fitness, a recent study suggests.

FM patients should be advised of that possibility by healthcare providers, the researchers recommend.

The study,”Sedentary Time Accumulated in Bouts is Positively Associated with Disease Severity in Fibromyalgia: The Al-Ándalus Project,” was published in the Journal of Clinical Medicine. 

Sedentary behavior, defined as sitting or reclining during waking hours with little energy expenditure, is a recognized risk factor for many conditions, such as cardiovascular disease and diabetes.

Because sedentary behavior may be associated with disease outcomes regardless of one’s physical activity levels, current physical activity guidelines recommend reducing sedentary periods.

Previous findings highlight that both total and pattern of accumulation of sedentary time (ST) also are important.

Research on the benefits of physical activity in fibromyalgia is extensive. Spending longer periods in sedentary behavior has been linked to the risk for developing this disorder and experiencing more severe symptoms that affect quality of life.

However, the link between prolonged ST with symptoms in fibromyalgia remains poorly understood. In addition to promoting physical activity, reducing prolonged ST may be another way to make these patients healthier.

Now, researchers in Spain and their collaborators aimed to assess the effects of bouts of ST (30 and 60 minutes) on disease severity of women with fibromyalgia, as well as the combined effect of total ST and bouts of ST.

A total of 451 women with fibromyalgia participated in the study (average age 51.3). They attended an initial evaluation to assess cognitive ability, tender points, and overall body and physical fitness.

Two days later, the participants received an accelerometer to measure the bouts of ST and moderate-to-vigorous physical activity (MVPA). They also received a sleep diary and several questionnaires, including the Revised Fibromyalgia Impact Questionnaire (FIQR) to assess overall disease impact. The accelerometer and the sleep diary were returned after nine days.

Both 30- and 60-minute bouts were associated with worse function, overall symptoms and greater impact of the disease. This association remained unchanged even after taking into account MVPA and overall physical fitness.

Participants who did not engage in 60 minutes or longer of sedentary bouts presented better function and eased disease severity compared to those who did.

“[T]he high levels of bouted ST observed in women from our study support that regularly breaking up ST might be as important as promoting PA [physical activity] in this population,” the researchers wrote.

Those with low levels of total and prolonged ST presented lower disease severity compared to participants with high total and prolonged ST.

While current guidelines recommend minimizing the amount of time spent in sedentary behavior, these do not specify how often one should take sedentary breaks, the investigators said. Their results are in line with previous research indicating 30 minutes as an important threshold. Also, longer sedentary bouts have an even greater negative impact on patients.

“Overall, the findings in this study may assist in developing novel lifestyle approaches that consider not only exercising, but also the role of sedentary behaviour to potentially reduce the impact of fibromyalgia,” the researchers added.

This is especially important for those with difficulties who adhere to exercise  programs because it shows that an easier task, and interrupting bouts of ST, also can be very relevant to quality of life.