Abstract
Introduction/objectives
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.
Method
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.
Results
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).
Conclusions
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. |
Similar content being viewed by others
References
Sarzi-Puttini P, Buskila D, Carrabba M, Doria A, Atzeni F (2008) Treatment strategy in fibromyalgia syndrome: where are we now? Semin Arthritis Rheum 37:353–365. https://doi.org/10.1016/j.semarthrit.2007.08.008
Wilson HD, Robinson JP, Turk DC (2009) Toward the identification of symptom patterns in people with fibromyalgia. Arthritis Rheum 61:527–534. https://doi.org/10.1002/art.24163
Benlloch IM, De Valencia U (2003) Los efectos de las asimetrías de género en la salud de las mujeres. Anu Psicol / UB J Psychol 34:253–266
Larranaga I, Arregui B, Arpal J (2004) Reproductive or domestic work. Gac Sanit 18(Suppl 1):31–37
Carrasquer P, Torns T, Tejero E, Romero A (1998) El Trabajo Reproductivo. Pap Rev Sociol 95–114
Reisine S, Fifield J, Walsh S, Forrest DD (2008) Employment and health status changes among women with fibromyalgia: a five-year study. Arthritis Rheum 59:1735–1741. https://doi.org/10.1002/art.24309
Segura-Jiménez V, Borges-Cosic M, Soriano-Maldonado A, Estévez-López F, Álvarez-Gallardo IC, Herrador-Colmenero M, Delgado-Fernández M, Ruiz JR (2017) Association of sedentary time and physical activity with pain, fatigue, and impact of fibromyalgia: the al-Ándalus study. Scand J Med Sci Sports 27(1):83–92. https://doi.org/10.1111/sms.12630
Chinchilla Sibaja R (2002) Salud y seguridad en el trabajo. EUNED
Guymer EK, Littlejohn GO, Brand CK, Kwiatek RA (2016) Fibromyalgia onset has a high impact on work ability in Australians. Intern Med J 46:1069–1074. https://doi.org/10.1111/imj.13135
Bossema ER, Kool MB, Cornet D, Vermaas P, de Jong M, van Middendorp H, Geenen R (2012) Characteristics of suitable work from the perspective of patients with fibromyalgia. Rheumatology (Oxford) 51:311–318. https://doi.org/10.1093/rheumatology/ker312
Rivera J, Esteve-Vives J, Vallejo MA, Rejas J (2011) Factors associated with temporary work disability in patients with fibromyalgia. Rheumatol Int 31:1471–1477. https://doi.org/10.1007/s00296-010-1523-1
Rakovski C, Zettel-Watson L, Rutledge D (2012) Association of employment and working conditions with physical and mental health symptoms for people with fibromyalgia. Disabil Rehabil 34:1277–1283. https://doi.org/10.3109/09638288.2011.641658
Collado A, Gomez E, Coscolla R, Sunyol R, Solé E, Rivera J, Altarriba E, Carbonell J, Castells X (2014) Work, family and social environment in patients with fibromyalgia in Spain: an epidemiological study: EPIFFAC study. BMC Health Serv Res 14:513. https://doi.org/10.1186/s12913-014-0513-5
Rohlfs I, Borrell C, Anitua C, Artazcoz L, Colomer C, Escribá V, García-Calvente M, Llacer A, Mazarrasa L, Pasarín M, Peiró R, Valls-Llobet C (2000) The importance of the gender perspective in health interview surveys. Gac Sanit 14:146–155
Wolfe F, Smythe HA, Yunus MB, Bennett RM, Bombardier C, Goldenberg DL, Tugwell P, Campbell SM, Abeles M, Clark P, Fam AG, Farber SJ, Fiechtner JJ, Franklin CM, Gatter RA, Hamaty D, Lessard J, Lichtbroun AS, Masi AT, McCain GA, Reynolds WJ, Romano TJ, Russell IJ, Sheon RP (1990) The American College of Rheumatology 1990. Criteria for the classification of fibromyalgia. Report of the Multicenter Criteria Committee. Arthritis Rheum 33:160–172
Folstein MF, Folstein SE, McHugh PR (1975) “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 12:189–198
Aguilar-Farías N, Brown WJ, Peeters GMEEG (2014) ActiGraph GT3X+ cut-points for identifying sedentary behaviour in older adults in free-living environments. J Sci Med Sport 17:293–299. https://doi.org/10.1016/j.jsams.2013.07.002
Sasaki JE, John D, Freedson PS (2011) Validation and comparison of ActiGraph activity monitors. J Sci Med Sport 14:411–416. https://doi.org/10.1016/j.jsams.2011.04.003
Ruiz-Ruiz J, Mesa JLM, Gutiérrez A, Castillo MJ (2002) Hand size influences optimal grip span in women but not in men. J Hand Surg [Am] 27:897–901
Álvarez-Gallardo IC, Carbonell-Baeza A, Segura-Jiménez V, Soriano-Maldonado A, Intemann T, Aparicio VA, Estévez-López F, Camiletti-Moirón D, Herrador-Colmenero M, Ruiz JR, Delgado-Fernández M, Ortega FB (2017) Physical fitness reference standards in fibromyalgia: the al-Ándalus project. Scand J Med Sci Sports 27:1477–1488. https://doi.org/10.1111/sms.12741
Gronwall DM (1977) Paced auditory serial-addition task: a measure of recovery from concussion. Percept Mot Skills 44:367–373. https://doi.org/10.2466/pms.1977.44.2.367
Tombaugh TN (2006) A comprehensive review of the Paced Auditory Serial Addition Test (PASAT). Arch Clin Neuropsychol 21:53–76. https://doi.org/10.1016/j.acn.2005.07.006
Strauss E, Sherman EMS, Spreen O (2006) A compendium of neuropsychological tests: administration, norms, and commentary, 3rd edn. Oxford University Press, Oxford
Estevez-Lopez F, Segura-Jimenez V, Alvarez-Gallardo IC, Borges-Cosic M, Pulido-Martos M, Carbonell-Baeza A, Aparicio VA, Geenen R, Delgado-Fernandez M (2017) Adaptation profiles comprising objective and subjective measures in fibromyalgia: the al-Andalus project. Rheumatology (Oxford) 56:2015–2024. https://doi.org/10.1093/rheumatology/kex302
Segura-Jimenez V, Soriano-Maldonado A, Estevez-Lopez F, Alvarez-Gallardo IC, Delgado-Fernandez M, Ruiz JR, Aparicio VA (2017) Independent and joint associations of physical activity and fitness with fibromyalgia symptoms and severity: the al-Andalus project. J Sports Sci 35:1565–1574. https://doi.org/10.1080/02640414.2016.1225971
Segura-Jimenez V, Estevez-Lopez F, Soriano-Maldonado A, Alvarez-Gallardo IC, Delgado-Fernandez M, Ruiz JR, Aparicio VA (2016) Gender differences in symptoms, health-related quality of life, sleep quality, mental health, cognitive performance, pain-cognition, and positive health in Spanish fibromyalgia individuals: the Al-Andalus project. Pain Res Manag 2016:5135176. https://doi.org/10.1155/2016/5135176
Palstam A, Bjersing JL, Mannerkorpi K (2012) Which aspects of health differ between working and nonworking women with fibromyalgia? A cross-sectional study of work status and health. BMC Public Health 12:1076. https://doi.org/10.1186/1471-2458-12-1076
Salmon J, Owen N, Bauman A, Schmitz MK, Booth M (2000) Leisure-time, occupational, and household physical activity among professional, skilled, and less-skilled workers and homemakers. Prev Med (Baltim) 30:191–199. https://doi.org/10.1006/pmed.1999.0619
Vincent A, Whipple MO, Low PA, Joyner M, Hoskin TL (2016) Patients with fibromyalgia have significant autonomic symptoms but modest autonomic dysfunction. PM R 8:425–435. https://doi.org/10.1016/j.pmrj.2015.08.008
Segura-Jimenez V, Alvarez-Gallardo IC, Estevez-Lopez F, Soriano-Maldonado A, Delgado-Fernandez M, Ortega FB, Aparicio VA, Carbonell-Baeza A, Mota J, Silva P, Ruiz JR (2015) Differences in sedentary time and physical activity between female patients with fibromyalgia and healthy controls: the al-Andalus project. Arthritis Rheumatol (Hoboken, NJ) 67:3047–3057. https://doi.org/10.1002/art.39252
Ericsson A, Mannerkorpi K (2016) How to manage fatigue in fibromyalgia: nonpharmacological options. Pain Manag 6:331–338. https://doi.org/10.2217/pmt-2016-0015
Mannerkorpi K, Nordeman L, Cider A, Jonsson G (2010) Does moderate-to-high intensity Nordic walking improve functional capacity and pain in fibromyalgia? A prospective randomized controlled trial. Arthritis Res Ther 12:R189. https://doi.org/10.1186/ar3159
Glass JM, Park DC, Minear M, Crofford LJ (2005) Memory beliefs and function in fibromyalgia patients. J Psychosom Res 58:263–269. https://doi.org/10.1016/j.jpsychores.2004.09.004
Palstam A, Mannerkorpi K (2017) Work ability in fibromyalgia: an update in the 21st century. Curr Rheumatol Rev 13:180–187. https://doi.org/10.2174/1573397113666170502152955
Palstam A, Larsson A, Bjersing J, Löfgren M, Ernberg M, Bileviciute-Ljungar I, Ghafouri B, Sjörs A, Larsson B, Gerdle B, Kosek E, Mannerkorpi K (2014) Perceived exertion at work in women with fibromyalgia: explanatory factors and comparison with healthy women. J Rehabil Med 46:773–780. https://doi.org/10.2340/16501977-1843
Bilal U, Beltrán P, Fernández E, Navas-Acien A, Bolumar F, Franco M (2016) Gender equality and smoking: a theory-driven approach to smoking gender differences in Spain. Tob Control 25:295–300. https://doi.org/10.1136/tobaccocontrol-2014-051892
Redding EM, Ruiz-Cantero MT, Fernández-Sáez J, Guijarro-Garvi M (2017) Gender inequality and violence against women in Spain, 2006-2014: towards a civilized society. Gac Sanit 31:82–88. https://doi.org/10.1016/j.gaceta.2016.07.025
Gómez Ortiz V (2004) Estrés Y salud en mujeres que desempeñana múltiples roles. Av en Psicol Latinoam 22:117–128
Herrador-Colmenero M, Álvarez-Gallardo IC, Segura-Jiménez V, Estévez-López F, Soriano-Maldonado A, Ruiz-Montero PJ, Tercedor P, Girela-Rejón MJ, Delgado-Fernández M, Chillón P (2016) Associations between patterns of active commuting and socioeconomic factors in women with fibromyalgia: the al-Ándalus project. Clin Exp Rheumatol 34:S67–S73. https://doi.org/10.1016/j.ramd.2014.10.027
Acknowledgments
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.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
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.
Disclosures
None.
Additional information
Publisher’s note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Álvarez-Gallardo, I.C., Estévez-López, F., Torres-Aguilar, X.C. et al. Physical activity, sedentary behaviour, physical fitness, and cognitive performance in women with fibromyalgia who engage in reproductive and productive work: the al-Ándalus project. Clin Rheumatol 38, 3585–3593 (2019). https://doi.org/10.1007/s10067-019-04750-8
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10067-019-04750-8