Nijs, Jo, van Eupen, Inge, Vandecauter, Jo et al. · Journal of rehabilitation research and development · 2009 · DOI
This small study looked at whether a strategy called "pacing" — learning to balance activity and rest — could help people with ME/CFS feel better and do more. Seven patients received three sessions teaching pacing techniques, and researchers measured their activity levels and symptoms before and after. Patients reported improvements in their ability to do daily tasks and some symptoms like muscle weakness and concentration problems got better, though the changes were modest.
This study addresses an evidence gap by systematically examining pacing, a widely-used self-management strategy in ME/CFS for which rigorous evidence was lacking. The modest but measurable improvements in both objective activity metrics and symptom burden suggest pacing warrants further investigation through larger, controlled trials to establish efficacy.
This study does not prove pacing works—it is a very small uncontrolled case series without a comparison group, so we cannot rule out placebo effect, natural variation, or spontaneous improvement. The brief 3-week intervention and follow-up period do not establish whether improvements persist long-term. Group-level findings cannot be generalized to all ME/CFS patients given heterogeneity and the small sample.
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
Nijs, Jo, van Eupen, Inge, Vandecauter, Jo, Augustinus, Els, Bleyen, Geerte, Moorkens, Greta, et al. (2009). Can pacing self-management alter physical behavior and symptom severity in chronic fatigue syndrome? A case series.. Journal of rehabilitation research and development. https://doi.org/10.1682/jrrd.2009.01.0007
BibTeX
@article{mecfsatlas-nijs-2009-can-pacing,
author = {Nijs, Jo and van Eupen, Inge and Vandecauter, Jo and Augustinus, Els and Bleyen, Geerte and Moorkens, Greta and Meeus, Mira},
title = {Can pacing self-management alter physical behavior and symptom severity in chronic fatigue syndrome? A case series.},
journal = {Journal of rehabilitation research and development},
year = {2009},
doi = {10.1682/jrrd.2009.01.0007},
note = {PubMed: 20104421},
url = {https://www.mecfsatlas.com/evidence/nijs-2009-can-pacing},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-29. https://www.mecfsatlas.com/evidence/nijs-2009-can-pacing
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