Clinical Rheumatology

, Volume 38, Issue 12, pp 3585–3593 | Cite as

Physical activity, sedentary behaviour, physical fitness, and cognitive performance in women with fibromyalgia who engage in reproductive and productive work: the al-Ándalus project

  • Inmaculada C. Álvarez-GallardoEmail author
  • Fernando Estévez-López
  • Xitlali C. Torres-Aguilar
  • Víctor Segura-Jiménez
  • Milkana Borges-Cosic
  • Alberto Soriano-Maldonado
  • Daniel Camiletti-Moirón
  • Inmaculada C. García-Rodríguez
  • Diego Munguía-Izquierdo
  • Ángela Sierras-Robles
  • Manuel Delgado-Fernández
  • María J. Girela-Rejón
Original Article



Reproductive labour refers to activities and tasks directed at caregiving and domestic roles, such as cleaning, cooking, and childcare. Productive labour refers to activities that involve economic remuneration. The aim of the present study was to analyse physical activity, sedentary behaviour, physical fitness, and cognitive performance in women with fibromyalgia who engaged, or did not engage, in productive work.


This cross-sectional study comprised 276 women with fibromyalgia from Andalusia (southern of Spain). Levels of physical activity (light, moderate, and vigorous) and sedentary behaviour were measured by an accelerometer. Physical fitness and cognitive performance were measured with a battery of performance-based tests.


More hours/week of homemaker-related tasks were associated with higher time spend in light physical activity and lower sedentary behaviour (P < 0.001 and P < 0.05, respectively). Furthermore, in comparison with those who only engaged in reproductive labour, women with fibromyalgia who engaged in productive work showed lower levels of sedentary behaviour and higher levels of light and moderate physical activity, physical fitness (except muscular strength), and cognitive performance (all, P < 0.05).


Altogether, our findings suggest that productive work is consistently related to better physical and cognitive functioning in women with fibromyalgia. If future research corroborates causality of our findings, then, to maintain women with fibromyalgia engaging in productive work may be strived for not only because of societal or economic reasons but also for better health. However, we should keep in mind that people with fibromyalgia have a chronic condition, and therefore, adaptations at the workplace are imperative.

Key Points

Women with fibromyalgia, who spend more time in reproductive labour, have higher levels of light physical activity and lower sedentary behaviour; however, it is associated with poorer general health (as lower physical fitness or cognitive performance).

Household tasks are often seen as a responsibility associated with the gender roles that women with fibromyalgia perform, despite the feelings of incapacity they cause. Policies focused on reducing reproductive labour demands for fibromyalgia patients (i.e. social help on housework or childcare) might facilitate the inclusion of daily active behaviours.

People with fibromyalgia who engage in productive work seem to have better health outcomes than those who have not; however, we cannot forget that adaptations and flexibility at the workplace are imperative.


Chronic pain Domestic work Household chores Household tasks Housework Reproductive labour 



We would like to thank all the members involved in the fieldwork, especially members from CTS-1018 research group. We also gratefully acknowledge all the study participants for their collaboration.

Compliance with ethical standards

The study protocol was approved by the Ethics Committee of the Hospital Virgen de las Nieves (Granada, Spain). A total of 616 people with fibromyalgia gave their written consent.




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Copyright information

© International League of Associations for Rheumatology (ILAR) 2019

Authors and Affiliations

  • Inmaculada C. Álvarez-Gallardo
    • 1
    • 2
    Email author
  • Fernando Estévez-López
    • 3
  • Xitlali C. Torres-Aguilar
    • 4
  • Víctor Segura-Jiménez
    • 1
    • 2
  • Milkana Borges-Cosic
    • 4
  • Alberto Soriano-Maldonado
    • 5
    • 6
  • Daniel Camiletti-Moirón
    • 1
    • 2
  • Inmaculada C. García-Rodríguez
    • 4
  • Diego Munguía-Izquierdo
    • 7
    • 8
  • Ángela Sierras-Robles
    • 9
  • Manuel Delgado-Fernández
    • 4
  • María J. Girela-Rejón
    • 10
  1. 1.Department of Physical Education, Faculty of Education SciencesUniversity of CádizCádizSpain
  2. 2.Biomedical Research and Innovation Institute of Cádiz (INiBICA) Research Unit, Puerta del Mar University HospitalUniversity of CádizCadizSpain
  3. 3.Department of Child and Adolescent Psychiatry/PsychologyErasmus MC University Medical CenterRotterdamthe Netherlands
  4. 4.Department of Physical Education and Sport, Faculty of Sport SciencesUniversity of GranadaGranadaSpain
  5. 5.Department of Education, Faculty of Education SciencesUniversity of AlmeríaAlmeríaSpain
  6. 6.SPORT Research Group (CTS-1024), CERNEP Research CenterUniversity of AlmeríaAlmeríaSpain
  7. 7.Physical Performance & Sports Research Center, Department of Sports and Computer Science, Section of Physical Education and Sports, Faculty of Sports SciencesUniversity Pablo de OlavideSevilleSpain
  8. 8.Biomedical Research Networking Center on Frailty and Healthy AgingMadridSpain
  9. 9.Department of Physical Education, Music, and Fine ArtsUniversity of HuelvaHuelvaSpain
  10. 10.Department of Didactic of Corporal Expression, Faculty of Education SciencesUniversity of GranadaGranadaSpain

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