Can pacing self-management alter physical behavior and symptom severity in chronic fatigue syndrome? A case series

J Rehabil Res Dev. 2009;46(7):985-96. doi: 10.1682/jrrd.2009.01.0007.

Abstract

Given the lack of evidence in support of pacing self-management for patients with chronic fatigue syndrome (CFS), we examined whether physical behavior and health status of patients with CFS would improve in response to a pacing self-management program. We 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 posttreatment 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 posttreatment data, we found that the patients' ability to perform daily activities and the severity of their symptom complexes were 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. We found that 3 weeks of pacing self-management was accompanied by a modest improvement in symptom severity and daily functioning. 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.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Exercise Therapy
  • Fatigue Syndrome, Chronic / rehabilitation*
  • Female
  • Health Behavior
  • Humans
  • Middle Aged
  • Monitoring, Ambulatory*
  • Movement*
  • Pilot Projects
  • Self Care*
  • Severity of Illness Index
  • Treatment Outcome
  • Young Adult