Antcliff, Deborah, Campbell, Malcolm, Woby, Steve et al. · The Clinical journal of pain · 2017 · DOI
This study looked at different ways people with chronic fatigue, fibromyalgia, and chronic pain manage their activities day-to-day. Researchers found that some pacing strategies work better than others: spreading activities consistently throughout the day helped, but drastically cutting back activities was linked to feeling worse. The study suggests that how you pace your activities matters—not all pacing strategies are equally helpful.
For ME/CFS patients, this study clarifies that 'pacing' is not a single intervention but comprises different strategies with opposite effects. Understanding that consistent activity maintenance helps while dramatic activity reduction may worsen symptoms could guide more effective treatment approaches. These findings challenge oversimplified pacing recommendations and suggest the need for personalized, multidimensional pacing strategies.
This study cannot establish causality—it is unclear whether certain pacing strategies actually cause symptom improvement or whether people with better symptoms naturally engage in more consistent pacing. The cross-sectional design means we cannot determine the direction of effects. Additionally, the study does not identify the optimal balance or intensity of activity consistency, nor does it explore whether effects differ by diagnosis or disease severity.
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 →
The first block is for the primary paper and is the citation you should use in research work. The atlas-snapshot line only applies if you are specifically referring to this atlas’s reading of the paper on the date shown.
Primary citation
Antcliff, Deborah, Campbell, Malcolm, Woby, Steve, & Keeley, Philip (2017). Activity Pacing is Associated With Better and Worse Symptoms for Patients With Long-term Conditions.. The Clinical journal of pain. https://doi.org/10.1097/AJP.0000000000000401
BibTeX
@article{mecfsatlas-antcliff-2017-activity-pacing,
author = {Antcliff, Deborah and Campbell, Malcolm and Woby, Steve and Keeley, Philip},
title = {Activity Pacing is Associated With Better and Worse Symptoms for Patients With Long-term Conditions.},
journal = {The Clinical journal of pain},
year = {2017},
doi = {10.1097/AJP.0000000000000401},
note = {PubMed: 27322396},
url = {https://www.mecfsatlas.com/evidence/antcliff-2017-activity-pacing},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-27. https://www.mecfsatlas.com/evidence/antcliff-2017-activity-pacing
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