Goudsmit, Ellen M, Nijs, Jo, Jason, Leonard A et al. · Disability and rehabilitation · 2012 · DOI
This review examined pacing, a strategy where people with ME/CFS carefully manage their energy use to avoid overexertion. The researchers found that pacing is one of the most helpful approaches patients report using, and evidence suggests it can help stabilize symptoms and reduce post-exertional malaise (the characteristic worsening that follows activity). Pacing can be adjusted to fit each person's individual abilities and is generally accepted well by patients.
Pacing is consistently rated as one of the most helpful management strategies by ME/CFS patients themselves, yet it had received minimal scientific attention at the time this review was published. This consensus document legitimizes pacing as a valid therapeutic approach and provides guidance for clinicians seeking to help patients manage their limited energy reserves and reduce symptom exacerbations.
This review does not establish pacing as a cure or primary treatment for ME/CFS, nor does it prove mechanisms underlying why pacing prevents post-exertional malaise. The study cannot determine optimal pacing parameters or long-term outcomes, as it relies on synthesis of existing literature rather than new empirical data. Causation between pacing interventions and symptom improvement is inferred rather than definitively proven.
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
Goudsmit, Ellen M, Nijs, Jo, Jason, Leonard A, & Wallman, Karen E (2012). Pacing as a strategy to improve energy management in myalgic encephalomyelitis/chronic fatigue syndrome: a consensus document.. Disability and rehabilitation. https://doi.org/10.3109/09638288.2011.635746
BibTeX
@article{mecfsatlas-goudsmit-2012-pacing-strategy,
author = {Goudsmit, Ellen M and Nijs, Jo and Jason, Leonard A and Wallman, Karen E},
title = {Pacing as a strategy to improve energy management in myalgic encephalomyelitis/chronic fatigue syndrome: a consensus document.},
journal = {Disability and rehabilitation},
year = {2012},
doi = {10.3109/09638288.2011.635746},
note = {PubMed: 22181560},
url = {https://www.mecfsatlas.com/evidence/goudsmit-2012-pacing-strategy},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-26. https://www.mecfsatlas.com/evidence/goudsmit-2012-pacing-strategy
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