Association of Moderate-to-Vigorous Physical Activity, Sedentary Time, Fat Percentage, and Physical Fitness with Gait Parameters in Women with Fibromyalgia: The Al-Ándalus Project.

Gait impairments have been found in women with fibromyalgia, reducing the physical activity possibilities in this population and leading to a negative correlation with fibromyalgia impact. The aim of this study was to analyze the individual and independent associations of moderate-to-vigorous physical activity (MVPA), sedentary time, fat percentage, and physical fitness with gait parameters in women with fibromyalgia. A total of 84 women with fibromyalgia were included. MVPA and sedentary time were assessed with accelerometry, fat percentage with bioimpedance analysis, and physical fitness with field-based fitness tests. Gait was assessed during a "6 min walk test" and categorized in velocity, cadence, step length, step cycle duration, unipedal stance phase, and bipedal stance phase. Individual relationships were analyzed by partial correlations and independent relationships by linear regressions, adjusting by age and height. MVPA, sedentary time, fat percentage, and physical fitness were correlated with most gait parameters (rpartial between |0.842| and |0.219|; p ≤ 0.05). Physical fitness was independently associated with all gait parameters (ß between |0.346| and |0.761|; p ≤ 0.002). In addition, MVPA was independently associated with velocity and step length (ß = 0.241 and 0.292; both p = 0.004), and fat percentage was associated with bipedal stance phase (ß = 0.242; p = 0.049). Good levels of MVPA, physical fitness, and adequate weight balance are associated with improved gait parameters in women with fibromyalgia.

Lifestyle Behaviours Profile of Spanish Adolescents Who Actively Commute to School.

The aim of this study was to study different 'healthy profiles' through the impact of multiple lifestyle behaviours (sleep patterns, screen time and quality diet) on active commuting to school (ACS) in adolescents. Sixteen secondary schools from four Spanish cities were randomly selected. All participants filled in an "Ad-Hoc" questionnaire to measure their mode of commuting and distance from home to school and their lifestyle behaviours. A multivariate logistic regression model was performed to analyse the main predictor variables of ACS. The final sample was 301 adolescents (50.2% girls; mean age ± SD: 14.9 ± 0.48 years). The percentage of ACS was 64.5%. Multiple logistic regressions showed: boys were more active commuters than girls [OR = 2.28 (CI 95%: 1.12−4.64); p = 0.02]; adolescents who lived farther had lower probability to ACS [OR = 0.74 (CI 95%: 0.69−0.80); p < 0.001]; adolescents who met sleep duration recommendations were more likely to ACS [OR = 3.05 (CI 95%: 1.07−8.69); p = 0.04], while with each hour of sleep, the odds of ACS was reduced [OR = 0.51 (CI 95%: 0.30−0.89); p = 0.02]; higher odds were shown to ACS in adolescents who have more adherence to MD [OR = 1.16(CI 95%: 1.00−1.33); p = 0.05]; and habitual breakfast consumption was inversely associated with ACS [OR = 0.41 (CI: 95%: 0.18−0.96); p = 0.04]. ACS was associated with being a boy, living at a shorter distance to school, a daily sleep time ≥ 8 h and presented a higher adherence to MD.

Higher independent mobility to school among adolescents: A secondary analysis using cross-sectional data between 2010 and 2017 in Spanish youth.

AIM: To describe and to analyse the associations between independent mobility to school (IM) with gender and age in Spanish youth aged 6-18 years old from 2010 to 2017. Moreover, to study the changes in the rates of IM from 2010 to 2017 by gender and age. METHODS: Cross-sectional data were obtained from 11 Spanish studies. The study sample comprised 3460 children and 1523 adolescents. Logistic regressions models (IM with gender and age) and multilevel logistic regressions (IM with time period) were used. RESULTS: Boys had higher odds ratio (OR) of IM than girls in children (OR = 1.86; CI: 1.50-2.28, p < 0.01). Adolescents showed higher IM than children: 12-14 years old (OR: 6.30; CI: 1.65-23.97) and 14-16 years old (OR: 7.33; CI: 1.18-45.39) had higher IM than 6-8 years old for boys (all, p < 0.05). Moreover, 12-14 years old (OR: 4.23; CI: 1.01-17.81) had higher IM than 6-8 years old for girls (p < 0.001). IM was not associated with the time period. CONCLUSION: The IM is higher in boys and in adolescents, highlighting the relevance to promote IM strategies targeting girls and children. In these strategies is essential the support of researchers, public health practitioners and families to achieve positive results.

Active Commuting to School among Spanish Preschool Children: A Temporal Change Study between 2013 and 2017.

BACKGROUND: Active commuting to school may increase the total daily physical activity and achieve health benefits among preschool children. Rates of active commuting to school among Spanish children and adolescents have been widely analysed, while the rates of active commuting to school among Spanish preschool children are unknown. AIM: The main objective of this study was to examine the changes in the rates of active commuting to school in a sample of Spanish preschool children between 3 and 6 years old from 2013 to 2017. METHODS: Data were found from five studies carried out across Spain. The study sample comprised 4787 preschool children (4.59 ± 0.77 years old; 51% males). The overall changes in active commuting to school were assessed using multilevel logistic regression analysis. RESULTS: The rates of active commuting to school in Spanish preschool children are around 52%, and the active commuting to school rates have stayed stable throughout the period assessed (odds ratio from 0.40 to 0.58, all p > 0.05). CONCLUSION: In preschool children, the present study obtained a favourable result on active commuting to school, showing a pattern stability in the examined period similar to other ages. It will be of great importance to promote this behaviour to obtain high levels of active commuting to school.

Testing the Mystic School Mobile Application to Promote Active Commuting to School in Spanish Adolescents: The PACO Study.

Active commuting to and/or from school (ACS) is an opportunity to increase daily physical activity (PA) levels in young people. Mobile-device interventions focused on promoting the practice of health-related PA can be more cost-effective than traditional interventions in this population. OBJECTIVE: To analyze the adolescents' opinion of the mobile application (app) Mystic School, which was designed to promote ACS in Spanish adolescents. METHODS: A total of 44 students (14-15 years old) from Granada and Jaén participated in the test of the Mystic School app during two phases: phase 1 (n = 10) for 2 weeks and phase 2 (n = 34) for 1 month. Each phase included an app presentation, a follow-up, and focus group sessions. The qualitative analysis was carried out through NVivo software. RESULTS: In phase 1, adolescents reported improvements in the design and functioning, such as the avatar movement, virtual steps utilities, and multiplayer function. These suggestions were included in phase 2. After phase 2, adolescents reported that it is important to add the possibility of playing without an Internet connection to the game, to include more competitive options, prizes, and to increase the difficulty of the levels. In both phases, problems with the step number counting remained. CONCLUSION: The Mystic School app can be a useful tool for the physical education teacher to integrate the content from this curriculum related to the promotion of PA, such as ACS.

The Effect of a School-Based Intervention on Children's Cycling Knowledge, Mode of Commuting and Perceived Barriers: A Randomized Controlled Trial.

The low rates of active commuting to/from school in Spain, especially by bike, and the wide range of cycling interventions in the literature show that this is a necessary research subject. The aims of this study were: (1) to assess the feasibility of a school-based cycling intervention program for adolescents, (2) to analyse the effectiveness of a school-based cycling intervention program on the rates of cycling and other forms of active commuting to/from school (ACS), and perceived barriers to active commuting in adolescents. A total of 122 adolescents from Granada, Jaén and Valencia (Spain) participated in the study. The cycling intervention group participated in a school-based intervention program to promote cycling to school during Physical Education (PE) sessions in order to analyse the changes in the dependent variables at baseline and follow up of the intervention. Wilcoxon, Signs and McNemar tests were undertaken. The association of the intervention program with commuting behaviour, and perceived barriers to commuting, were analysed by binary logistic regression. There were improvements in knowledge at follow-up and the cycling skill scores were medium-low. The rates of cycling to school and active commuting to/from school did not change, and only the "built environment (walk)" barrier increased in the cycling group at follow-up. School-based interventions may be feasibly effective tools to increase ACS behaviour, but it is necessary to implement a longer period and continue testing further school-based cycling interventions.

Preliminary Results of a Bicycle Training Course on Adults' Environmental Perceptions and Their Mode of Commuting.

This study was designed to analyze the effects of a bicycle training course on both adults' environmental perceptions and their mode of commuting. Four bicycle training courses for adults were conducted in Granada, Spain in April 2015 and May 2016. The course program was focused on developing practical skills and attitudes on road. From the initial 65 adults who started the course, only 35 adults met the inclusion criteria and were included in the study. Participants completed twice (i.e., before and after the course) a questionnaire about their perceptions of the environment, usual mode of commuting to daily destinations, and sociodemographic characteristics. After finishing the initial questionnaire, the participants completed a bicycle training course based on the methodology "Bikeability" with a duration of 6 h. The results suggest that participants improved their safety perception in relation to the level of crime in the participants' neighborhood after the bicycle training course. Cycling training courses should last longer in order to produce changes in the mode of commuting and in the environmental perceptions.

Convergent Validation of a Self-Reported Commuting to and from School Diary in Spanish Adolescents.

The aim of this study was to examine the convergent validity of self-reported diary times for commuting to and from school with device-measured positional data (Global Positioning System; GPS) in Spanish adolescents. METHODS: Cross-sectional data were obtained from four Spanish public secondary schools in 2021, comprising 47 adolescents and 141 home-school and school-home trips. Participants self-reported the time they left and arrived at home and school through a commuting diary. They wore a GPS device recording the objective time during three trips (i.e., one home-school trip and two school-home trips). Agreement between commuting diary and GPS data regarding home-school trips and school-home trips was evaluated using Bland-Altman plots. RESULTS: Total commuting time differed by 1 min (95% limits of agreement were 16.1 min and -18.1 min) between subjective and objective measures (adolescents reported 0.8 more minutes in home-school trips and 1 more minute in school-home trips compared to objective data). Passive commuters reported 0.7 more minutes and active commuters reported 1.2 more minutes in the total commuting time compared to objective data. CONCLUSIONS: Self-reported commuting diaries may be a useful tool to obtain commuting times of adolescents in epidemiological research or when tools to measure objective times are not feasible.

Is active commuting associated with sedentary behaviour and physical activity in women with fibromyalgia? The al-Ándalus project.

PURPOSE: This study aimed to examine the association between active commuting and sedentary time (ST) and physical activity (PA) in women with fibromyalgia. MATERIALS AND METHODS: This cross-sectional study included 420 women with fibromyalgia (aged 30 to 74 years old) from Spain. The participants wore an accelerometer during seven days to record ST and PA. They also self-reported patterns of active commuting. Linear regression analyses were conducted to examine the relationships between commuting and accelerometer outcomes. Age, pressure pain threshold, and accelerometer wear time were used as confounders. RESULTS: There was a negative association between active commuting and ST whereas active commuting was positively associated with moderate PA, moderate-to-vigorous PA, total PA, and step count (all p ≤ 0.01). No associations were observed in the older group. CONCLUSION: Younger women with fibromyalgia who were active commuters spent less ST and were involved in greater PA than passive commuters. This study highlights the importance of promoting active commuting to increase PA among young women with fibromyalgia, while other sources of PA might be recommended for older patients if levels of active commuting are not increased.Implications for rehabilitationActive commuting is a source to increase PA in women with fibromyalgia.Active commuting alone does not seem to be enough to increase PA levels in older women with fibromyalgia and additional PA strategies should be implemented.Promotion of active commuting in young women with fibromyalgia is recommended.

Patterns of Active Commuting to School in Spanish Preschool Children and Its Associations with Socio-Economic Factors: The PREFIT Project.

The aims of this study were to describe patterns of active commuting to school (ACS) of preschool children, and to analyse the relationship between ACS and family socio-economic factors. A total of 2636 families of preschoolers (3-to-5 years old) were asked to complete a questionnaire at home about the mode of commuting to school of their children and marital status, educational level, and profession of both father and mother. Chi-square analyses were applied to compare ACS between school grades and gender of the children. To analyse the association of ACS with socio-economic factors, logistic regression analyses were performed. Almost 50% of participants reported ACS of their offspring, with a higher rate in 3rd preprimary grade (5 years old) than in 1st and 2nd preprimary grades (3- and 4-years old. All, p < 0.05). Those preschool children who had parents with lower educational level and no managerial work had higher odds to ACS than those who had parents with higher educational level and managerial work (all, p ≤ 0.001). Around half of the Spanish preschool children included in this study commuted actively to school and families with lower educational levels or worse employment situation were related to active commuting to school.

A School-Based Randomized Controlled Trial to Promote Cycling to School in Adolescents: The PACO Study.

This manuscript describes the rationale and protocol of a school-based randomized controlled trial called "Cycling and Walk to School" (PACO, by its Spanish acronym) that aims to promote cycling to and from school and physical activity (PA) in adolescents. This study will examine the effects of this intervention in cycling and active commuting to and from school (ACS), PA and several ACS-related factors based on self-determination theory (SDT) and a social-ecological model (SEM). A total of 360 adolescents attending six high schools (three experimental and three control) from three Spanish cities will participate in this randomized controlled trial. The intervention (four cycling sessions; 1-2 h per session, one session per week) will be conducted by the research staff; the control group will continue their usual activities. PA levels will be measured by accelerometers, whereas ACS and the other study variables will be self-reported using questionnaires at baseline and post-intervention. The primary outcomes will be: rates of cycling to school, ACS and PA levels. In addition, SDT-related variables and individual, interpersonal, community, and environment variables relevant to ACS will be based on SEM. The findings will provide a comprehensive understanding of the short-term effects of this school-based intervention on cycling to school behaviour, ACS and PA levels in Spanish adolescents.

Active commuting to school among 36,781 Spanish children and adolescents: A temporal trend study.

This study examines trends in the rates of active commuting to school (ACS) in Spanish children (n = 18 343; 8.93 ± 1.68) and adolescents (n = 18 438; 14.11 ± 1.58) aged 6-18 years from 2010 to 2017. Given the study period included the economic crisis in Spain (2008-2013), the second aim of this study was to compare ACS rates during and after the economic crisis. Data were obtained from 28 studies conducted across Spain. The overall trends in ACS were evaluated using multilevel logistic regression analysis. Among Spanish children and adolescents, the rates of ACS to school ranged around 60% between 2010 and 2017. The rates of ACS in Spanish youth did not change significantly during the 2010-2017 period, except a sporadic increase in the rate of ACS in adolescents in 2012-2013. No significant association between the ACS and the economic crisis time period in youth was found. As conclusion, the ACS remains stable in Spain during the last decade, which is a promising result regarding the evidenced decreasing trend in many countries. Further educational and policy strategies are important to continue promoting this behavior in children and adolescents in the long term.

Feasibility and reliability of the Spanish version of the Youth Activity Profile questionnaire (YAP-Spain) in children and adolescents.

Considerable public health efforts across the globe have focused on promoting physical activity (PA) and minimizing sedentary behaviour (SB) in youths. However, it is important to have valid, reliable and feasible methods to assess these behaviours in youths. The purpose of this study was to analyse the feasibility and reliability of the Spanish version of the previously validated Youth Activity Profile questionnaire (YAP) in children and adolescents. The YAP-S is a 15-item self-report instrument designed to capture PA and SB in youths. A total of 604 children (5-12 years old) and 346 adolescents (12-17 years old) filled out the questionnaire twice (14 days apart). Feasibility was evaluated through required time and number of misunderstood questions by participants. The test-retest reliability was examined using the weighted kappa coefficient (κ) and intraclass correlation coefficient. The average time to complete the questionnaire was 28.85 ± 14.28 and 12.24 ± 9.84 minutes in children and adolescents, respectively. No misunderstanding of questions was reported. The questionnaire showed an adequate reliability for activity at school, out-of-school and sedentary behaviours (k = 0.61-0.77; ICC = 0.77-0.89) in children and adolescents. The YAP-S might be considered a feasible and reliable questionnaire for assessing PA and SB in Spanish children and adolescents.

Psychometric Characteristics of a Commuting-to-School Behaviour Questionnaire for Families.

The purposes of this study were: (a) to describe the patterns of modes of commuting to school (children) and to work (parents) separated by gender and age, (b) to validate the questions on children's mode of commuting to and from school according to their parents, and (c) to analyse the reliability of a family questionnaire focused on commuting to school behaviours. A total of 611 parents (mean age: 43.28 ± 6.25 years old) from Granada (Spain) completed "Family commuting-to-school behaviour" questionnaire in two sessions separated by 14 days, (2016 and 2018). The validation between family and children's questions was assessed using the Kappa and Spearman correlation coefficients, and the test-retest reliability within the family questions was assessed using the Kappa and the weighted Kappa. The children's modes of commuting to school (mean age: 11.44 ± 2.77 years old) were mainly passive (57.7% to school) while parents' modes of commuting to work were mainly active (71.6%). The validity of the mode of commuting was significant with high Kappa and Spearman coefficients. The test-retest reliability presented a good agreement for the mode of commuting to school in children, distance and time to school, and the mode of commuting to work in parents, while the questions on acceptable distance to walk or cycle to school showed a moderate to good agreement. The "Family commuting-to-school behaviour" questionnaire could be a useful tool to assess the mode of commuting of children, distance and time to school for researchers and practitioners.

Different neighborhood walkability indexes for active commuting to school are necessary for urban and rural children and adolescents.

BACKGROUND: Literature focusing on youth has reported limited evidence and non-conclusive associations between neighborhood walkability measures and active commuting to and from school (ACS). Moreover, there is a lack of studies evaluating both macro- and micro-scale environmental factors of the neighborhood when ACS is analyzed. Likewise, most studies on built environment attributes and ACS focus on urban areas, whereas there is a lack of studies analyzing rural residential locations. Moreover, the relationship between built environment attributes and ACS may differ in children and adolescents. Hence, this study aimed to develop walkability indexes in relation to ACS for urban and rural children and adolescents, including both macro- and micro-scale school-neighborhood factors. METHODS: A cross-sectional study of 4593 participants from Spain with a mean age of 12.2 (SD 3.6) years was carried out. Macro-scale environmental factors were evaluated using geographic information system data, and micro-scale factors were measured using observational procedures. Socio-demographic characteristics and ACS were assessed with a questionnaire. Several linear regression models were conducted, including all the possible combinations of six or less built environment factors in order to find the best walkability index. RESULTS: Analyses showed that intersection density, number of four-way intersections, and residential density were positively related to ACS in urban participants, but negatively in rural participants. In rural children, positive streetscape characteristics, number of regulated crossings, traffic calming features, traffic lanes, and parking street buffers were also negatively related to ACS. In urban participants, other different factors were positively related to ACS: number of regulated crossings, positive streetscape characteristics, or crossing quality. Land use mix acted as a positive predictor only in urban adolescents. Distance to the school was a negative predictor on all the walkability indexes. However, aesthetic and social characteristics were not included in any of the indexes. CONCLUSIONS: Interventions focusing on improving built environments to increase ACS behavior need to have a better understanding of the walkability components that are specifically relevant to urban or rural samples.

Feasibility and Reliability of a Questionnaire to Assess the Mode, Frequency, Distance and Time of Commuting to and from School: The PACO Study.

Active commuting to and from school has several health implications. Self-reporting is the most common assessment tool, but there is a high heterogeneity of questionnaires in the scientific literature. The purpose of this study was to analyse the feasibility and reliability of the Spanish "New Version of Mode and Frequency of Commuting To and From School" questionnaire in children and adolescents. A total of 635 children (5-12 years old) and 362 adolescents (12-18 years old) filled out the questionnaire twice (14 days apart). Feasibility was evaluated using an observational checklist. The test-retest reliability of the "New Version of Mode and Frequency of Commuting To and From School" questionnaire and the distance and time to school were examined using the kappa and weight kappa coefficient (κ). No misunderstanding of questions was reported. The time to complete the questionnaire was 15 ± 3.62 and 9 ± 2.26 min for children and adolescents, respectively. The questionnaire showed substantial and almost perfect kappa coefficients for the overall six items (k = 0.61-0.94) in children and adolescents. The "New Version of Mode and Frequency of Commuting To and From School" questionnaire is a feasible and reliable questionnaire in Spanish children and adolescents.

High Levels of Physical Fitness Are Associated With Better Health-Related Quality of Life in Women With Fibromyalgia: The al-Ándalus Project.

BACKGROUND: Physical fitness is a marker of health and is associated with health-related quality of life (HRQoL). Identifying which components of physical fitness are associated with HRQoL in people with fibromyalgia may contribute to the development of more specific therapeutic strategies. OBJECTIVE: The 2 aims of this study were to examine the association of different components of physical fitness (ie, flexibility, muscle strength, speed and agility, and cardiorespiratory fitness) with HRQoL and to determine the extent to which any association between the components of physical fitness and HRQoL were of clinical relevance to women with fibromyalgia. DESIGN: A cross-sectional design was used. METHODS: This study included 466 women with fibromyalgia from southern Spain (Andalusia). The Senior Fitness Test battery and the handgrip test were used to assess physical fitness, and the 36-Item Short-Form Health Survey (SF-36) was used to assess HRQoL. Tender points, cognitive impairment, anthropometric measurements, and medication usage were also measured. First, multivariate linear regression was used to assess the individual relationship of each physical fitness test with the 8 dimensions of the SF-36. Second, a standardized composite score was computed for each component of physical fitness (flexibility, muscle strength, speed and agility, and cardiorespiratory fitness). A 1-way analysis of covariance to assess the differences in each of the 8 dimensions of the SF-36 across each physical fitness composite score was conducted. Forward stepwise regression was performed to analyze which components of physical fitness were independently associated with the SF-36 physical and mental component scales. RESULTS: Overall, higher levels of physical fitness were associated with higher levels of HRQoL (regardless of the SF-36 subscale evaluated). The effect sizes for HRQoL between participants with the lowest and the highest physical fitness levels ranged from moderate to large (Cohen d = 0.53-0.90). The muscle strength composite score was independently associated with the SF-36 physical component scale, whereas the flexibility composite score and cardiorespiratory fitness were independently associated with the SF-36 mental component scale. LIMITATIONS: A limitation was that the cross-sectional design precluded the establishment of causality. Additionally, only women were included in the study, because fibromyalgia predominantly affects women. CONCLUSIONS: High levels of physical fitness were consistently associated with better HRQoL in women with fibromyalgia; clinically relevant differences were demonstrated between those at extreme physical fitness levels. Muscle strength, flexibility, and cardiorespiratory fitness were independent indicators of HRQoL. These results warrant further prospective research on the potential of fitness to predict HRQoL in this population.

Association of objectively measured physical activity and sedentary time with health-related quality of life in women with fibromyalgia: The al-Ándalus project.

PURPOSE: To examine the association of physical activity (PA) intensity levels and sedentary time with health-related quality of life (HRQoL) in women with fibromyalgia and whether patients meeting the current PA guidelines present better HRQoL. METHODS: This cross-sectional study included 407 women with fibromyalgia aged 51.4 ± 7.6 years. The time spent (min/day) in different PA intensity levels (light, moderate, and moderate-to-vigorous physical activity (MVPA) and sedentary time were measured with triaxial accelerometry. The proportion of women meeting the American PA recommendations (≥150 min/week of MVPA in bouts ≥10 min) was also calculated. HRQoL domains (physical function, physical role, bodily pain, general health, vitality, social functioning, emotional role, and mental health), as well as physical and mental components, were assessed using the 36-item Short-Form Health Survey. RESULTS: All PA intensity levels were positively correlated with different HRQoL dimensions (r partial between 0.10 and 0.23, all p < 0.05). MVPA was independently associated with social functioning (p < 0.05). Sedentary time was independently associated with physical function, physical role, bodily pain, vitality, social functioning, and both the physical and mental component summary score (all p < 0.05). Patients meeting the PA recommendations presented better scores for bodily pain (mean = 24.2 (95%CI: 21.3-27.2) vs. mean = 20.4 (95%CI: 18.9-21.9), p = 0.023) and better scores for social functioning (mean = 48.7 (95%CI: 43.9-44.8) vs. mean = 42.3 (95%CI: 39.8-44.8), p = 0.024). CONCLUSION: MVPA (positively) and sedentary time (negatively) are independently associated with HRQoL in women with fibromyalgia. Meeting the current PA recommendations is significantly associated with better scores for bodily pain and social functioning. These results highlight the importance of being physically active and avoiding sedentary behaviors in this population.

Influence of distance, area, and cultural context in active commuting: Continental and insular children.

Commuting by walking or cycling is a way to increase physical activity levels. The objective of this article was to determine the modes of commuting to school and the distance and time of the way to school among children from Easter Island and from the mainland (Valparaíso), in Chile. A total of 666 children and adolescents aged 10 to 18 years old (208 from Easter Island and 458 from Valparaíso) participated and completed a valid questionnaire including data about age, gender, usual commuting mode to and from school, distance, and travel time. There are important differences in the mode of commuting between students of Valparaíso and Easter Island. Private transport is more commonly used in Valparaíso than in Easter Island (p<0.001). Furthermore, it was observed that cycling and public transportation are not used as mode of commuting in Valparaíso and Easter Island respectively. Students from Easter Island, who travel more distance and during more time, are more active than students from Valparaíso (going 24.8% and 17.6%; from: 61% and 28.8% respectively). This situation is influenced by the geographic context of the island, the distances from home to school, and the type of commuting, which fosters the level of active commuting. On the other hand, the passive modes of commuting to school are higher in the mainland urban setting of Valparaíso. It is necessary to study the diverse contexts of the Easter Island population, but, for now, the rural setting of Easter Island seems to be associated with a greater level of active commuting to school.

Lower Fatigue in Fit and Positive Women with Fibromyalgia: The al-Ándalus Project.

OBJECTIVE: To analyze 1) the independent association of physical fitness, positive affect, and negative affect with the different dimensions of fatigue (general fatigue, physical fatigue, reduced activity, reduced motivation, and mental fatigue) and 2) whether the interactions of physical fitness, positive affect, and negative affect were associated with fatigue over and above the independent association. DESIGN: Cross-sectional study in 420 women with fibromyalgia. SETTING: Fibromyalgia associations from southern Spain. METHODS: Physical fitness was measured by performance-based tests, and questionnaires were used to measure positive affect, negative affect, and different dimensions of fatigue (general fatigue, physical fatigue, reduced activity, reduced motivation, and mental fatigue). Age, body mass index, and current pain level were included as potential confounders in all analyses. RESULTS: Physical fitness was independently associated with general fatigue, physical fatigue, and reduced activity (all P ≤ 0.02). Positive affect was independently associated with all fatigue dimensions (all P < 0.001). Negative affect was independently associated with general fatigue, physical fatigue, reduced motivation, and mental fatigue (all P ≤ 0.04). The interaction of overall physical fitness and positive affect was related to general fatigue and physical fatigue (all P ≤ 0.02). Women with fibromyalgia with higher levels of overall physical fitness and positive affect showed the lowest general fatigue and physical fatigue. CONCLUSIONS: In women with fibromyalgia, positive affect was independently and consistently associated with all dimensions of fatigue. The combination of higher levels of overall physical fitness and positive affect might serve as a buffer against general and physical fatigue in women with fibromyalgia.