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 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.

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.

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.

Longitudinal associations between weather, season, and mode of commuting to school among Spanish youths.

AIM: To study the associations of weather conditions with the travel mode choice for commuting to and from school. METHODS: A total of 6979 Spanish youths aged 7 to 18 years old (80% adolescents aged 12-18 years old, 51% male) completed a 5-day survey of mode of commuting to school in autumn, winter, and spring. Weather data from the nearest weather station to each school were registered. We used Google Maps™ to calculate the distance from home to school. Multilevel logistic regression models were used to estimate odds of active travel based on weather and season. RESULTS: We analyzed a total of 163 846 discrete journeys. In winter, children (aged 7 to 11 years old) were less likely to choose an active mode of commuting to school (OR: 0.72, 95% CI: 0.59-0.89, P = 0.003). In spring, adolescents were more likely to choose an active mode of commuting to school (OR: 1.43, 95% CI: 1.19-1.73, P < 0.001). With higher mean temperatures, adolescents were more likely to choose an active mode of commuting from school (OR: 1.02, 95% CI: 1.00-1.04, P = 0.029). CONCLUSION: Certain weather conditions seem to influence the travel mode choice for commuting to and from school in youth, including season and temperature.

Convergent validation of a questionnaire to assess the mode and frequency of commuting to and from school.

AIMS: The purposes of this research were to study the convergent validity of the Mode and Frequency of Commuting To and From School Questionnaire using objectively assessed steps and time spent in different physical activity intensities and to compare the self-reported versus objective journey time in Spanish youths. METHODS: Three hundred and eighty-nine Spanish youth aged 7-19 years were asked to complete the questionnaire and wore an accelerometer for five days. The objective commuting distance and time from home to school were estimated using Google MapsTM. RESULTS: There were significant differences between passive and walking participants on step numbers, sedentary time and physical activity levels (except for vigorous physical activity in children). For children, a mean difference of -4.03 minutes between objective measured and self-reported journey time was found (95% limits of agreement were 13.55 and -21.60 minutes). For adolescents, the mean difference was -1.39 minutes (95% limits of agreement were 15.23 and -18.02 minutes). CONCLUSIONS: The findings indicated that the Mode of Commuting To and From School Questionnaire showed a convergent validity to assess this behaviour in Spanish youths. Self-reported journey time for walking is comparable to Google MapsTM in adolescents but not in children.

Parental perceptions of barriers to active commuting to school in Spanish children and adolescents.

Background: : Understanding parental barriers is crucial to promote active commuting to school since the parental perceptions influence how young people commute. This study examined parental barriers to active commuting to school among Spanish children and adolescents, and their association with their gender and the usual mode of commuting. Parents of children ( n = 628) and parents of adolescents ( n = 151) from Granada (Spain) completed a paper-based questionnaire about perceived parental barriers to active commuting to school and mode of commuting. Data were analyzed using the Chi-square test. Among Spanish parents, the most common barriers reported by parents of children were traffic volume and dangerous intersections, whereas the most frequent barriers reported by parents of adolescents were distance to school and dangerous intersections. Compared to parents of children, a greater proportion of parents of adolescents reported distance to school and crime and smaller proportion reported traffic volume as barriers to active commuting to school. Among parents of children, crime was a more commonly reported as a barrier by parents of girls. Although some barriers reported by parents of passive commuters were similar for children and adolescents (such as distance to school and absence of a policeman at crosswalks), other barriers were specific to parents of children. The main parental barriers to active commuting in children were traffic volume and dangerous intersections whereas for adolescents were distance and dangerous intersections. Among Spanish parents, parental barriers to active commuting are influenced by children's age, gender and mode of commuting to school.

Children who commute to school unaccompanied have greater autonomy and perceptions of safety.

AIM: We explored the rates of children who actively commuted to school, both accompanied and unaccompanied, and identified their safety perceptions. METHODS: This cross-sectional study focused on 745 children, aged 6-12 years, from public schools in the Spanish Granada region. They completed a questionnaire, providing personal data, their school grade, safety perceptions, whether they were accompanied to school and how they travelled to school. We analysed how active commuters were accompanied to school by age group and assessed the associations between safety perceptions and whether or not they were accompanied. RESULTS: Children aged 10-12 years were more likely to travel to school unaccompanied, more likely to travel actively and had better safety perceptions than younger children. We also found differences in how active commuters between 10 and 12 years and children aged 6-7 and 8-9 years (all p < 0.001) were accompanied to school. Children aged 10-12 years who actively commuted unaccompanied had a better understanding of safety issues than accompanied children (p < 0.010). CONCLUSION: Older children who actively commuted to school unaccompanied had better safety perceptions than other children in this sample of children aged 6-12.

Active commuting to school was inversely associated with academic achievement in primary but not secondary school students.

AIM: Physical activity has numerous benefits for children when it comes to academic achievements. This study determined whether active commuting - walking or cycling - to school, as a way of increasing total physical activity levels, was associated with academic achievements in students aged seven to 18 years. METHODS: A total of 2138 students participated in the study, which took place in the 2012/2013 academic year in three Spanish cities. We used a self-reported questionnaire to assess how the students travelled to and from school and their final school grades. RESULTS: We enrolled 489 primary schoolchildren and 1649 secondary schoolchildren, with similar numbers of boys and girls. The primary schoolchildren who travelled to school by motorbike, car or bus had better grades for all the selected school subjects (p ≤ 0.009) than those who walked or cycled. No significant associations were found for secondary schoolchildren, except for mathematics and their grade point averages. All models were adjusted for sex, age and school. CONCLUSION: Active commuting to school was inversely associated with academic achievement in primary school students but not those at secondary school. Longitudinal and intervention studies are needed to further understand our findings.

Associations between patterns of active commuting and socioeconomic factors in women with fibromyalgia: the al-Ándalus project.

OBJECTIVES: The aims of this study were to know whether active commuting behaviour differs between fibromyalgia patients and controls, and to test whether active commuting is associated with socioeconomic factors in this population. METHODS: This cross-sectional study included 459 women with fibromyalgia (52.2 years) and 214 female control participants (51.3 years) from Andalusia (southern Spain). Participants reported patterns of active commuting and socioeconomic factors (civil status, accompaniment at home, living with, educational level, and current occupational and professional status). RRESULTS: On the age group <51 years, women with fibromyalgia revealed a significant higher percentage of active commuting for the variable active worker commuters than control group (p<0.05). On the age group ≥51 years, control group displayed a significant higher percentage of active commuting for commuting to local shops, super-market and active commuters variables (all, p<0.05). Women with fibromyalgia who lived alone were more active commuters in comparison to either those living accompanied, or living with both partner and children, only partner and only children (all, p<0.05). CONCLUSIONS: The prevalence of active commuting was similar in women with fibromyalgia and controls aged <51 years. However, fibromyalgia participants aged ≥51 years displayed differences: fibromyalgia women who lived alone were more active commuters than those living accompanied; family demands were inversely associated with commuting patterns. Policies focused on reducing family demands for fibromyalgia patients (i.e. social help on housework, childcare or overprotection) might facilitate the inclusion of daily active behaviours.

Association of Physical Fitness with Depression in Women with Fibromyalgia.

OBJECTIVE: The aim of this study was to examine the association between physical fitness and depressive symptoms in women with fibromyalgia (FM). We also assessed whether different fitness components present independent relationships with depressive symptoms. DESIGN: Cross-sectional study. SETTING: University facilities and FM associations. SUBJECTS: Four hundred and forty-four patients with FM according to the 1990 American College of Rheumatology criteria. METHODS: Depressive symptoms were assessed using the Beck Depression Inventory (BDI-II). Physical fitness (aerobic fitness, muscle strength, flexibility, and motor agility) was assessed using the standardized Senior Fitness Test battery and the handgrip strength test. A standardized composite score for fitness was computed and divided into quintiles. RESULTS: Overall, the fitness tests presented inverse associations with the total BDI-II score (P < 0.05). The patients in the highest fitness quintile had 8.4% lower depressive symptoms than the patients in the lowest fitness quintile (P = 0.014). The odds of severe symptoms of depression were between 3.7% and 16.9% lower for each performance unit in the back-scratch, handgrip, arm-curl, and eight-feet up-and-go tests. When all the fitness tests were simultaneously considered, the back-scratch test was the only one independently associated with the total BDI-II score (P = 0.001; R(2) = 0.023). CONCLUSIONS: Although higher physical fitness was generally associated with lower symptoms of depression in women with FM, the observed associations were somewhat weak and inconsistent, differing from those previously observed in healthy adults. Further research to determine the clinical relevance of the association between physical fitness and depression in FM is warranted.

Ageing influence in the evolution of strength and muscle mass in women with fibromyalgia: the al-Ándalus project.

Fibromyalgia is associated with physical disabilities in daily activities. Moreover, patients with fibromyalgia present similar levels of functional capacity and physical condition than elderly people. The aim of this study was to analyse the evolution of strength and muscle mass in women with fibromyalgia along ageing. A total sample of 492 fibromyalgia patients and 279 healthy control women were included in the study. Participants in each group were further divided into four age subgroups: subgroup 1: 30-39 years old, subgroup 2: 40-49 years old, subgroup 3: 50-59 years old and subgroup 4: 60-69 years old. Standardized field-based fitness tests were used to assess muscle strength (30-s chair stand, handgrip strength and arm curl tests). Fibromyalgia patients did not show impairment on muscle mass along ageing, without values of skeletal muscle mass index below 6.76 kg/m(2) in any group. However, in all variables of muscle strength, the fibromyalgia group showed less strength than the healthy group (p < 0.05) for all age groups. As expected, handgrip strength test showed differences along ageing only in the fibromyalgia group (p < 0.001). Age was inversely associated with skeletal muscle mass (r = -0.155, p < 0.01) and handgrip strength (r = -0.230, p < 0.001) in the FM group. Women with fibromyalgia showed a reduction in muscle strength along ageing process, with significantly lower scores than healthy women for each age group, representing a risk of dynapenia.

Reliability of the ALPHA environmental questionnaire and its association with physical activity in female fibromyalgia patients: the al-Ándalus project.

Physical activity attenuates the symptoms of fibromyalgia, and its level is oftentimes associated with the perceived environment of fibromyalgia patients. Within this context, we aimed to study the reliability of the Spanish version of the Assessing Levels of Physical Activity (ALPHA) environmental questionnaire and the mode of commuting questionnaire. We also studied the association between the perceived environment and mode of commuting with physical activity levels among female fibromyalgia patients in Spain. Test-retest reliability was judged by the intra-class correlation coefficient (ICC), weighted kappa statistic, Spearman correlations and the proportion of agreement. We calculated bivariate Pearson's correlations between environmental sum scores and physical activity measured by both International Physical Activity Questionnaire (IPAQ) and accelerometry. More than 70% of the scales and items showed a good reliability regarding the ICC, the weighted kappa, the Spearman correlation and the percentage of inter-agreement (higher than 50%). The perceived environment assessed with the ALPHA showed a low correlation with both IPAQ and accelerometry. The Spanish version of the ALPHA environmental questionnaire proved to be reliable and showed a weak degree of association with physical activity in female fibromyalgia patients.

Assessing modes and frequency of commuting to school in youngsters: a systematic review.

The first objective was to review and analyze self-reported measures used for assessing mode and frequency of commuting to and from school in youngsters (4-18.5 years old). The secondary objective was to conduct a qualitative appraisal of the identified studies. We searched five online databases: PubMed, SportDiscus, ProQuest, National Transportation Library, and Web of Knowledge. Four categories of search terms were identified: self-report, active transportation, school-aged children and school. Titles and abstracts were reviewed to determine whether the studies met the inclusion criteria. The quality of the reporting of the measures was assessed using a tailored list. The electronic search strategy produced 5,898 studies. After applying the inclusion criteria, we identified 158 studies. Sixty-three studies (39.8%) specified the question about modes of commuting to school. One hundred seven studies (67.7%) directly questioned the study subjects (i.e., children and/or adolescents). Twenty studies (12.7%) posed a valid and reliable question. The quality assessment of the self-report measures was medium. The self-report measures used in the literature for assessing commuting to school tend to be heterogeneous and make difficult interstudies comparisons. Therefore we put forward the idea of a standard question designed to elicit reliable, comparable information on commuting to school.

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.

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.

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.

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.

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.