Antcliff, Deborah, Keenan, Anne-Maree, Keeley, Philip et al. · BMJ open · 2021 · DOI
This study tested whether a new framework could help healthcare professionals teach patients with chronic pain and fatigue (including ME/CFS) how to pace their activities more effectively. Patients attended a 6-week rehabilitation program and were asked about their pain, fatigue, mood, and quality of life before the program, at the end, and 3 months later. Most patients felt satisfied with the program, and those who completed it showed improvements in their ability to pace themselves and manage their symptoms.
For ME/CFS patients, this study is important because activity pacing is a core management strategy, yet patients often receive inconsistent or poorly standardized guidance. Demonstrating that a structured pacing framework can be feasibly implemented in NHS settings and produces measurable improvements in symptom management and quality of life provides evidence supporting continued development of this therapeutic approach.
This study does not prove that the activity pacing framework causes the observed improvements, as there is no control group for comparison. The high attrition rate (51% by follow-up) means results may reflect outcomes primarily in patients who tolerated and benefited from the program, not necessarily the broader population. The findings cannot establish the framework's effectiveness across different healthcare settings or patient populations without further testing.
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, Keenan, Anne-Maree, Keeley, Philip, Woby, Steve, & McGowan, Linda (2021). Testing a newly developed activity pacing framework for chronic pain/fatigue: a feasibility study.. BMJ open. https://doi.org/10.1136/bmjopen-2020-045398
BibTeX
@article{mecfsatlas-antcliff-2021-testing-newly,
author = {Antcliff, Deborah and Keenan, Anne-Maree and Keeley, Philip and Woby, Steve and McGowan, Linda},
title = {Testing a newly developed activity pacing framework for chronic pain/fatigue: a feasibility study.},
journal = {BMJ open},
year = {2021},
doi = {10.1136/bmjopen-2020-045398},
note = {PubMed: 34880007},
url = {https://www.mecfsatlas.com/evidence/antcliff-2021-testing-newly},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-26. https://www.mecfsatlas.com/evidence/antcliff-2021-testing-newly
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