Given the lack of evidence in support of pacing self-management for patients with chronic fatigue syndrome (CFS), Nijs and colleagues examined whether physical behavior and health status of patients with CFS would improve in response to a different pacing self-management program. The investigators performed an observational study of pacing self-management in seven CFS patients using a single-case study design. Stages A1 and A2 (7-day assessment periods) of the A1-B-A2 design corresponded to the baseline and post-treatment measurements of physical behavior (real-time activity monitoring) and health status (self-reported measures), respectively. Stage B (3 weeks of treatment) consisted of three individual treatment sessions of pacing self-management. When comparing pre- versus post-treatment data, the authors found that the patients' ability to perform daily activities and the severity of their symptom complexes improved (p = 0.043). Concentration difficulties, mood swings, muscle weakness, and intolerance to bright light improved as well. A statistically significant decrease in the mean time spent doing light activity (<3 metabolic equivalents) was observed, but a change in the way physical activity was spread throughout the day was not. The investigators found that three weeks of pacing self-management was accompanied by a modest improvement in symptom severity and daily functioning.

WHAT THE STUDY MAY MEAN TO YOU AS A HEALTH CARE PROVIDER: The outcome of the present study calls for a randomized controlled clinical trial to examine the effectiveness of pacing self-management for people with CFS. As the findings were impressive in what was basically a preliminary study, a study showing similar findings could be of value to many more CFS patients.

WHAT THE STUDY COULD MEAN TO YOU AS A PATIENT: More research on the value of pacing self-management may yield data that could help you better control your condition and permit you to attain a higher quality of life.

J Nijs et al. Can pacing self-management alter physical behavior and symptom severity in chronic fatigue syndrome? A case series. Journal of Rehabilitation Research & Development, 2009;46:985-986.