Developing an activity pacing framework: Feasibility and acceptability
Research type
Research Study
Full title
Developing an activity pacing framework for the management of chronic pain/fatigue. Stage III: Feasibility and acceptability studies
IRAS ID
242203
Contact name
Deborah Antcliff
Contact email
Sponsor organisation
Salford Royal Foundation NHS Trust and The Pennine Acute Hospitals NHS Trust
Duration of Study in the UK
1 years, 10 months, 2 days
Research summary
Activity pacing is frequently advised in the management of chronic pain/fatigue, including chronic low back pain, chronic widespread pain/fibromyalgia and chronic fatigue syndrome/myalgic encephalomyelitis. However, there is no agreed definition of ‘activity pacing’ and it is instructed in various ways. For some, pacing involves adapting/limiting activities (for example, breaking down tasks/having rests); while for others, pacing involves having consistent activities/gradually increasing activities. Furthermore, pacing has been associated with both improved symptoms (decreased fatigue/anxiety/depression) and worsened symptoms (increased pain/disability).
Due to the high prevalence and cost (personal and financial) of chronic pain/fatigue, it is imperative that coping strategies such as pacing are clearly defined and evidence-based. This study involves Stage III in the development of an activity pacing framework to standardise how pacing is instructed by healthcare professionals. Stage I: Online Survey of pacing involved 92 healthcare professionals (doctors/nurses/physiotherapists/occupational therapists/clinical psychologists). The survey findings, together with existing research were used to develop the pacing framework. The framework was further developed in Stage II: Nominal Group Technique (consensus meeting), involving four patients and six healthcare professionals.
Stage III will test the feasibility of implementing the pacing framework clinically, by using it to underpin rehabilitation programmes for chronic pain/fatigue. We will explore recruitment/retention rates, together with changes in symptoms between the start and end of treatment, and at 3-months follow-up. Stage III will explore the acceptability of the framework by undertaking interviews with the patients and healthcare professionals involved in the rehabilitation programmes. Stage III is expected to last 22 months.
Future study will test the framework in a clinical trial to assess the effects of pacing on patients’ symptoms. The pacing framework has the potential to improve treatments by providing guidance on the components of pacing found to have benefits for patients.
This study is funded by a HEE/NIHR ICA Clinical Lectureship.
REC name
London - Surrey Research Ethics Committee
REC reference
18/LO/0655
Date of REC Opinion
2 May 2018
REC opinion
Further Information Favourable Opinion