Ghali, Alaa, Lacombe, Valentin, Ravaiau, Camille et al. · Journal of translational medicine · 2023 · DOI
This study looked at whether pacing—a strategy where patients carefully manage their activity levels to avoid overexertion—helps people recover from long COVID. Researchers followed 86 patients for about 10 months and found that about one-third returned to work and another quarter improved significantly. Patients who stuck with pacing strategies most consistently had the best outcomes, with 60% recovering compared to only 5.5% of those who didn't follow pacing closely.
Since PCS shares substantial clinical features with ME/CFS and both lack specific curative treatments, evidence supporting pacing effectiveness in PCS populations strengthens the rationale for pacing-based management in ME/CFS. This study provides quantitative support for a low-risk, patient-accessible intervention that appears to meaningfully improve recovery rates in post-viral conditions characterized by post-exertional malaise.
The retrospective design cannot prove causation—high pacing adherence may correlate with recovery rather than cause it, as more motivated or less severely affected patients might both adhere better and recover naturally. The study does not establish which specific pacing elements are most effective, optimal timing for pacing initiation, or whether results generalize to other ME/CFS populations beyond long COVID.
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
Ghali, Alaa, Lacombe, Valentin, Ravaiau, Camille, Delattre, Estelle, Ghali, Maria, Urbanski, Geoffrey, et al. (2023). The relevance of pacing strategies in managing symptoms of post-COVID-19 syndrome.. Journal of translational medicine. https://doi.org/10.1186/s12967-023-04229-w
BibTeX
@article{mecfsatlas-ghali-2023-relevance-pacing,
author = {Ghali, Alaa and Lacombe, Valentin and Ravaiau, Camille and Delattre, Estelle and Ghali, Maria and Urbanski, Geoffrey and Lavigne, Christian},
title = {The relevance of pacing strategies in managing symptoms of post-COVID-19 syndrome.},
journal = {Journal of translational medicine},
year = {2023},
doi = {10.1186/s12967-023-04229-w},
note = {PubMed: 37291581},
url = {https://www.mecfsatlas.com/evidence/ghali-2023-relevance-pacing},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-26. https://www.mecfsatlas.com/evidence/ghali-2023-relevance-pacing
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