Pacing (activity management) explained

Pacing is an activity management technique for managing a long-term health condition or disability, aiming to maximize what a person can do while reducing, or at least controlling, any symptoms that restrict activity. Pacing is commonly used to help manage conditions that cause chronic pain or chronic fatigue.^[1]

Aims

Pacing aims to manage symptoms by avoiding the "boom and bust" cycle that is common among people exceeding their current, limited capacities. This often leads to being forced to stop their activities as a result of pain, fatigue or other symptoms, and then requiring a large amount of rest before being able to resume their activity. The cycle then repeats.

Elements of pacing

There is no consensus regarding what elements are part of pacing. Pacing typically involves:

• planning activities in advance
• taking regular rest breaks
• choosing activities based on available energy
• prioritizing activities^{[2] [3]}

Uses

Pacing has been used to help manage a wide variety of different illnesses and disabilities, including neuromuscular diseases like Charcot-Marie-Tooth disease (CMT), rheumatoid or immune-mediated diseases like rheumatoid arthritis, juvenile arthritis and fibromyalgia, ME/CFS,^[4] Ehlers–Danlos syndromes (EDS), and Long COVID.^[5]

Outcomes

Pacing has been shown to reduce post-exertional symptom exacerbation in people with long COVID.

In many health conditions, there are no clinical trials to establish the effectiveness of pacing.

See also

• Spoon theory

Notes and References

1. Book: Hakim. Alan J.. Hypermobility, Fibromyalgia and Chronic Pain E-Book. Keer. Rosemary J.. Grahame. Rodney. 2010-09-15. Elsevier Health Sciences. 978-0-7020-4993-4. en.
2. Book: Ryan, Sarah. Nursing Older People with Arthritis and other Rheumatological Conditions. 2020-02-17. Springer Nature. 978-3-030-18012-6. 88. en.
3. Book: Stokes. Maria. Physical Management for Neurological Conditions E-Book: [Formerly Physical Management in Neurological Rehabilitation E-Book]]. Stack. Emma. 2011-04-19. Elsevier Health Sciences. 978-0-7020-4712-1. en.
4. Grach . Stephanie L. . Seltzer . Jaime . Chon . Tony Y. . Ganesh . Ravindra . October 2023 . Diagnosis and Management of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome . Mayo Clinic Proceedings . en . 98 . 10 . 1544–1551 . 10.1016/j.mayocp.2023.07.032. free . 37793728 .
5. Parker . Megan . Sawant . Hannah Brady . Flannery . Thuvia . Tarrant . Rachel . Shardha . Jenna . Bannister . Rebecca . Ross . Denise . Halpin . Stephen . Greenwood . Darren C. . Sivan . Manoj . 2022-12-02 . Effect of using a structured pacing protocol on post-exertional symptom exacerbation and health status in a longitudinal cohort with the post-COVID-19 syndrome . Journal of Medical Virology . en . 95 . 1 . e28373 . 10.1002/jmv.28373 . 0146-6615 . 9878088 . 36461167.