Activity pacing has been described as a pattern of activity, a behavior and a coping strategy. Pacing involves modifying activities to improve function and reduce disability. Accordingly, pacing is frequently advised in pain management programs for long-term conditions (LTC), such as chronic low back pain, chronic widespread pain/fibromyalgia and chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME). However, pacing is often interpreted in different manners and there is an absence of a widely accepted pacing scale.
In a recent study entitled “Exploring patients’ opinions of activity pacing and a new activity pacing questionnaire for chronic pain and/or fatigue: a qualitative study” and published in the journal Physiotherapy, a team of researchers from the United Kingdom led by Dr.Deborah Antcliff from the School of Nursing, Midwifery and Social Work, University of Manchester developed the Activity Pacing Questionnaire (APQ), conducting semi-structured telephone interviews to explore patients’ views and beliefs about the concept of pacing, together with the acceptability of the scale.
A total of 16 adult patients that had been referred to physiotherapy out-patients departments in a North West England NHS Trust with primary diagnosis of chronic low back pain, chronic widespread pain/fibromyalgia and/or CFS/ME (all ≥3 months’ duration), took part in the study.
Results revealed that from participants’ descriptions, pacing emerged as a multifaceted concept. The researchers also found that pacing implementation was influenced by patient age, emotions and co-morbidities. In comparison to two existing pacing subscales, the APQ was generally acceptable. Participants undertook activities using quota/symptom-contingent approaches and four behavioural typologies emerged: Task persistence, Task modification (activity pacing), Task avoidance and Task fluctuation (boom-bust).
Based on the findings the researchers mentioned that future work will refine the APQ-26 to increase its clinical utility and acceptability. Participants’ descriptions of activity pacing echoed the multifaceted nature of pacing contained in the APQ-26. The researchers further indicate that future research will explore different behaviour typologies and the pacing facets that are implemented by each typology, which would assist the development of individually tailored pacing programmes.
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