Recruiting: Developing an Activity Pacing Framework: Feasibility and Acceptability, Antcliff et al

Andy · Sep 3, 2019

Not a recommendation. Although there has been something published recently by the same people running this trial I think this is something different, albeit related.

This study explores whether it is feasible to use a newly developed activity pacing framework to standardise how activity pacing is instructed by healthcare professionals in rehabilitation programmes for patients with chronic pain/fatigue.

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 existing rehabilitation programmes for chronic pain/fatigue. Patients will attend rehabilitation programmes at the study sites as per usual practice. Patients' participation in this study involves their completion of a booklet of questionnaires. The aim of this feasibility study is to explore whether the activity pacing framework is usable in the clinical setting, to 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 also 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.
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https://bepartofresearch.nihr.ac.uk/trial-details/trial-detail?trialId=2460&location=&distance=

Trish · Sep 3, 2019

Looks like it's well under way and due to finish early next year.

I see they are using the Chalder Fatigue Questionnaire as their measure of fatigue. Lots of other questionnaires. No doubt they will cherry pick any results that happen to improve a bit. No control group so completely meaningless outcomes.

And the cohort is so broad as to be meaningless - anyone with chronic pain and/or fatigue, including ME/CFS.

Their aim seems to be feasibility of using their methods, not effectiveness.

Do these people have no idea how to do research.

Sly Saint · Sep 3, 2019

I can't remember who said it but it was something along the lines of 'for a therapy to be accepted as valid it has to have a manual'.
Take a common sense intuative approach to an illness/symptom and turn it into a marketable regime.

so we had APT (invented to fail), now the 'Activity Pacing framework'. Book to follow no doubt.

eta:
Dr Deborah Antcliff

Research interests
My research interests align with my clinical background as an Advanced Physiotherapy Practitioner with a specialism in the management of persistent pain/fatigue (including chronic low back pain, chronic widespread pain/fibromyalgia and chronic fatigue syndrome/myalgic encephalomyelitis). I am interested in bio-psychosocial approaches for the management of the complex symptoms that present with long-term conditions/somatic symptom disorders; together with the underpinning health behaviours/health psychology.
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https://medicinehealth.leeds.ac.uk/healthcare/staff/990/dr-deborah-antcliff

The Development of an Activity Pacing Questionnaire for Chronic Pain and/or Fatigue
Antcliff, Deborah Claire 2014

Pacing has not been clearly operationalised, and existing descriptions are diverse and include strategies that encourage both increasing and decreasing activities. Moreover, there are few validated scales to measure activity pacing.Aim: To develop an activity pacing questionnaire (APQ) for adult patients with chronic pain and/or fatigue, and to determine its psychometric properties and acceptability
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or later to be called the Antcliff Pacing questionnaire?
https://www.escholar.manchester.ac.uk/jrul/item/?pid=uk-ac-man-scw:227500

Annamaria · Sep 3, 2019

@PhysiosforME

Amw66 · Sep 3, 2019

@PhysiosforME - may be of interest

adambeyoncelowe · Sep 3, 2019

Following.

PhysiosforME · Sep 3, 2019

Amw66 said: ↑

@PhysiosforME - may be of interest

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Thanks for the tag - we are looking at the detail of this and hoping to make contact with the authors. We will update as we know more

rvallee · Sep 3, 2019

In what world do people live in that "pace yourself" could ever mean "go faster"?

Newspeak was not an instruction manual. Just because some people use up when they mean down does not mean we should pay attention to this new inverted meaning.

Just embarrassing. What a waste.

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Recruiting: Developing an Activity Pacing Framework: Feasibility and Acceptability, Antcliff et al

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