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.