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Pacing
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=== Increase activity when you are ready === Pacing is about figuring out how much one can do without triggering a relapse. If patients feel their health has stabilized or improved and they no longer experience setbacks, it might be helpful to gradually increase activities to see how it goes. In a consensus document about pacing, [[Ellen Goudsmit|Goudsmit]] & [[Leonard Jason|Jason]] wrote: <blockquote>“If increases in activity do not result in symptom flare-ups for three months and patients feel that they are close to about 60 to 70% of their former functioning, they may wish to change to a gentle form of graded exercise therapy (GET), starting at a low level and increasing incrementally in duration and intensity to further increase their fitness and tolerance thresholds.”<ref name=":8" /></blockquote>One of the other authors of this consensus document, Karen Wallman, tested a symptom-contingent form of graded exercise in a randomized controlled trial in 2004. Patients were allowed to stop or do less if their symptoms became worse while increases in exercise were only advised if patients felt they were coping with the current activity level. After 12 weeks of 'graded exercise with pacing', patients showed improvement on objective outcome measures such as blood lactate production and performance on a Stroop colour word test.<ref>{{Cite journal | last = Wallman | first = Karen E. | last2 = Morton | first2 = Alan R. | last3 = Goodman | first3 = Carmel | last4 = Grove | first4 = Robert | last5 = Guilfoyle | first5 = Andrew M. | date = 2004-05-03| title = Randomised controlled trial of graded exercise in chronic fatigue syndrome|url=https://www.ncbi.nlm.nih.gov/pubmed/15115421|journal=The Medical Journal of Australia|volume=180|issue=9 | pages = 444–448|issn=0025-729X|pmid=15115421}}</ref>
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