Thompson, D P, Antcliff, D, Woby, S R · Physiotherapy · 2018 · DOI
This study looked at whether activity pacing—a common strategy where people with ME/CFS carefully manage their activity levels to avoid worsening symptoms—actually helps reduce pain, fatigue, or disability. Researchers surveyed 114 ME/CFS patients and tracked 35 others through a symptom management program. They found no clear link between how much patients used pacing and their symptom levels, suggesting that pacing alone may not be the key factor in controlling ME/CFS symptoms.
Activity pacing is widely recommended to ME/CFS patients as a core self-management strategy, yet this study questions its direct clinical benefit when measured objectively. These findings highlight the need for more rigorous investigation into which coping strategies actually improve outcomes, potentially redirecting clinical practice and patient guidance toward interventions with stronger evidence.
This study does not prove that pacing is harmful or unhelpful for all patients—it only shows no statistically significant association in this sample. The cross-sectional design cannot establish causality. The study also does not rule out that pacing may prevent symptom worsening compared to no pacing at all, only that variation in pacing levels does not correlate with symptom variation.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
Spotted an error in this entry? Report it →