Pemberton, Sue, Cox, Diane L · Disability and rehabilitation · 2014 · DOI
This study interviewed 14 people with ME/CFS to understand how they experience daily activities. Researchers found that before becoming ill, most participants were very active and had difficulty taking breaks. When they got sick, they tried to keep pushing themselves to do as much as before, which led to worsening symptoms. The study suggests that rehabilitation programs should take into account people's attitudes toward activity and rest, not just focus on changing what they do.
This research challenges common assumptions in ME/CFS treatment by showing that patients' difficulties may stem not from avoiding activity, but from struggling to appropriately limit activity due to pre-existing patterns and beliefs. Understanding these psychological and occupational factors is crucial for designing rehabilitation programs that patients will actually engage with and benefit from, rather than programs that conflict with their deeply held beliefs about activity.
This qualitative study with 14 participants cannot establish cause-and-effect relationships or determine whether pre-illness activity patterns directly cause the cyclical symptom pattern observed. The findings may not generalize to all people with ME/CFS, and the study does not evaluate the effectiveness of any specific rehabilitation approach. It describes participants' experiences and beliefs but does not prove these beliefs are accurate or that changing them would improve outcomes.
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
Pemberton, Sue & Cox, Diane L (2014). Experiences of daily activity in chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) and their implications for rehabilitation programmes.. Disability and rehabilitation. https://doi.org/10.3109/09638288.2013.874503
BibTeX
@article{mecfsatlas-pemberton-2014-experiences-daily,
author = {Pemberton, Sue and Cox, Diane L},
title = {Experiences of daily activity in chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) and their implications for rehabilitation programmes.},
journal = {Disability and rehabilitation},
year = {2014},
doi = {10.3109/09638288.2013.874503},
note = {PubMed: 24369769},
url = {https://www.mecfsatlas.com/evidence/pemberton-2014-experiences-daily},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-26. https://www.mecfsatlas.com/evidence/pemberton-2014-experiences-daily
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