Kos, Daphne, van Eupen, Inge, Meirte, Jill et al. · The American journal of occupational therapy : official publication of the American Occupational Therapy Association · 2015 · DOI
This study tested whether learning to pace activities (doing things gradually and breaking them into manageable chunks) helped women with ME/CFS feel more satisfied with their daily lives. Thirty-three women were split into two groups: one learned activity pacing strategies while the other received relaxation training. Women who learned pacing reported greater satisfaction with their activities and experienced improvements in fatigue levels, suggesting this approach may help people with ME/CFS do more of what matters to them.
Activity pacing is a widely discussed self-management strategy for ME/CFS, but rigorous evidence of its effectiveness has been limited. This controlled study provides evidence that structured activity pacing training may help patients increase participation in meaningful daily activities and reduce fatigue, which could inform clinical recommendations and help patients make informed decisions about management approaches.
This study does not prove that activity pacing is a cure for ME/CFS or that it works equally well for all patients or in all contexts. The small sample size (only women) limits whether findings generalize to men or diverse populations. The study also cannot determine whether improvements were sustained beyond the intervention period, nor can it rule out placebo effects or non-specific therapeutic attention as contributing factors.
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
Kos, Daphne, van Eupen, Inge, Meirte, Jill, Van Cauwenbergh, Deborah, Moorkens, Greta, Meeus, Mira, et al. (2015). Activity Pacing Self-Management in Chronic Fatigue Syndrome: A Randomized Controlled Trial.. The American journal of occupational therapy : official publication of the American Occupational Therapy Association. https://doi.org/10.5014/ajot.2015.016287
BibTeX
@article{mecfsatlas-kos-2015-activity-pacing,
author = {Kos, Daphne and van Eupen, Inge and Meirte, Jill and Van Cauwenbergh, Deborah and Moorkens, Greta and Meeus, Mira and Nijs, Jo},
title = {Activity Pacing Self-Management in Chronic Fatigue Syndrome: A Randomized Controlled Trial.},
journal = {The American journal of occupational therapy : official publication of the American Occupational Therapy Association},
year = {2015},
doi = {10.5014/ajot.2015.016287},
note = {PubMed: 26356665},
url = {https://www.mecfsatlas.com/evidence/kos-2015-activity-pacing},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-25. https://www.mecfsatlas.com/evidence/kos-2015-activity-pacing
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