{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T23:38:09Z","timestamp":1792798689946,"version":"4.5.0"},"reference-count":53,"publisher":"BMJ","issue":"12","license":[{"start":{"date-parts":[[2021,12,8]],"date-time":"2021-12-08T00:00:00Z","timestamp":1638921600000},"content-version":"unspecified","delay-in-days":7,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Health Education England\/National Institute for Health Research","award":["ICA-CL-2015-01-019"],"award-info":[{"award-number":["ICA-CL-2015-01-019"]}],"id":[{"id":"https:\/\/ror.org\/0187kwz08","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2021,10,25]]},"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To test the feasibility of using a new activity pacing framework to standardise healthcare professionals\u2019 instructions of pacing, and explore whether measures of activity pacing\/symptoms detected changes following treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Single-arm, repeated measures study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>One National Health Service (NHS) Pain Service in Northern England, UK.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Adult patients with chronic pain\/fatigue, including chronic low back pain, chronic widespread pain, fibromyalgia and chronic fatigue syndrome\/myalgic encephalomyelitis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interventions<\/jats:title>\n                    <jats:p>Six-week rehabilitation programme, standardised using the activity pacing framework.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Outcome measures<\/jats:title>\n                    <jats:p>Feasibility was explored via patients\u2019 recruitment\/attrition rates, adherence and satisfaction, and healthcare professionals\u2019 fidelity. Questionnaire data were collected from patients at the start and end of the programme (T1 and T2, respectively) and 3\u2009months\u2019 follow-up (T3). Questionnaires included measures of activity pacing, current\/usual pain, physical\/mental fatigue, depression, anxiety, self-efficacy, avoidance, physical\/mental function and quality of life. Mean changes in activity pacing and symptoms between T1-T2, T2-T3 and T1-T3 were estimated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of the 139 eligible patients, 107 patients consented (recruitment rate=77%); 65 patients completed T2 (T1-T2 attrition rate=39%), and 52 patients completed T3 (T1-T3 attrition rate=51%). At T2, patients\u2019 satisfaction ratings averaged 9\/10, and 89% attended \u22655 rehabilitation programme sessions. Activity pacing and all symptoms improved between T1 and T2, with smaller improvements maintained at T3.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The activity pacing framework was feasible to implement and patients\u2019 ability to pace and manage their symptoms improved. Future work will employ a suitable comparison group and test the framework across wider settings to explore the effects of activity pacing in a randomised controlled trial.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"clintrialgov\" xlink:href=\"NCT03497585\">NCT03497585<\/jats:ext-link>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2020-045398","type":"journal-article","created":{"date-parts":[[2021,12,8]],"date-time":"2021-12-08T11:57:22Z","timestamp":1638964642000},"page":"e045398","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":31,"title":["Testing a newly developed activity pacing framework for chronic pain\/fatigue: a 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