Sanal-Hayes, Nilihan Em, Hayes, Lawrence D, Mair, Jacqueline L et al. · Nature communications · 2026 · DOI
Researchers tested whether a smartphone app called 'Pace Me' combined with an activity tracker could help people with long COVID manage their energy better and reduce post-exertional malaise (the worsening of symptoms after activity). Over 6 months, some participants used the app with the tracker and received helpful messages when they approached their daily activity limit, while others used a basic version of the app. Both groups improved slightly, but there was no meaningful difference between them.
Energy management is central to long COVID and ME/CFS treatment approaches, yet evidence-based digital tools remain limited. This study tests whether real-time activity tracking and adaptive messaging—scalable interventions that could reach many patients—actually reduce post-exertional malaise, a key outcome for these conditions.
This study does not prove that energy management approaches are ineffective; rather, it suggests the specific app-and-tracker combination tested here did not outperform a basic control app in long COVID. The authors acknowledge that natural recovery in long COVID may have masked true intervention effects, meaning the results may not generalise to ME/CFS or other non-recovering populations. The study also does not address whether energy management itself is beneficial versus the delivery mechanism.
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
Sanal-Hayes, Nilihan Em, Hayes, Lawrence D, Mair, Jacqueline L, Iacono, Antonio Dello, Ingram, Joanne, Mclaughlin, Marie, et al. (2026). A digital platform with activity tracking for energy management support in long COVID: a randomised controlled trial.. Nature communications. https://doi.org/10.1038/s41467-025-64831-y
BibTeX
@article{mecfsatlas-sanal-hayes-2026-digital-platform,
author = {Sanal-Hayes, Nilihan Em and Hayes, Lawrence D and Mair, Jacqueline L and Iacono, Antonio Dello and Ingram, Joanne and Mclaughlin, Marie and Ormerod, Jane and Carless, David and Hilliard, Natalie and Meach, Rachel and Sculthorpe, Nicholas F},
title = {A digital platform with activity tracking for energy management support in long COVID: a randomised controlled trial.},
journal = {Nature communications},
year = {2026},
doi = {10.1038/s41467-025-64831-y},
note = {PubMed: 41629267},
url = {https://www.mecfsatlas.com/evidence/sanal-hayes-2026-digital-platform},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/sanal-hayes-2026-digital-platform
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