E3 PreliminaryPreliminaryPEM not requiredCross-SectionalPeer-reviewedReviewed
Mixed methods study of views and experience of non-hospitalised individuals with long COVID of using pacing interventions.
McMullan, Christel, Haroon, Shamil, Turner, Grace et al. · Scientific reports · 2025 · DOI
Quick Summary
This study asked people with Long COVID about their experiences using 'pacing'—a strategy to manage energy by balancing activity and rest. Researchers gave questionnaires to 28 people and interviewed 19 of them. Most participants found pacing helpful for planning activities and staying motivated, though some found it complicated and difficult to follow without clearer guidance.
Why It Matters
Pacing is an established energy-management strategy for ME/CFS, and this study provides preliminary evidence that it may also benefit Long COVID patients who experience similar fatigue and post-exertional malaise. Understanding patient perspectives on pacing feasibility and acceptability is essential for designing effective rehabilitation interventions for both conditions.
Observed Findings
- Participants reported that pacing improved motivation and activity planning.
- Challenges included time constraints in implementing pacing strategies.
- Participants identified the intervention as complex to understand and apply.
- Participants noted insufficient or unclear instructions for using pacing.
- 28 participants completed feasibility questionnaires; 19 completed qualitative interviews.
Inferred Conclusions
- Pacing may be a feasible and potentially beneficial strategy for non-hospitalised Long COVID patients.
- Clear, practical instruction and streamlined intervention design could improve adoption and adherence.
- Pacing warrants further research to establish clinical efficacy and optimal implementation for Long COVID populations.
Remaining Questions
- Does pacing produce objective improvements in functional capacity or post-exertional malaise symptoms compared to usual care or control conditions?
- What specific instruction formats and duration of guidance optimally support patient adherence and outcomes?
- How does pacing effectiveness differ across Long COVID severity levels and symptom profiles?
What This Study Does Not Prove
This feasibility study does not prove that pacing is clinically effective for Long COVID—it only demonstrates that patients can use it and find it acceptable. The study lacks a control group, so any perceived benefits cannot be distinguished from placebo effect or natural recovery. Results are limited to non-hospitalised patients and may not generalise to more severe Long COVID cases.
Tags
Symptom:Cognitive DysfunctionFatigue
Phenotype:Long COVID Overlap
Method Flag:Weak Case DefinitionNo ControlsSmall SampleExploratory Only
Metadata
- DOI
- 10.1038/s41598-025-96319-6
- PMID
- 40280997
- Review status
- Editor reviewed
- Evidence level
- Early hypothesis, preprint, editorial, or weak support
- Last updated
- 12 April 2026
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 →
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