Staci R. Stevens, MA1; Todd E. Davenport, PT, DPT, OCS2


1 Executive Director, Pacific Fatigue Laboratory, Department of Sport Sciences, University of the Pacific, Stockton, CA, USA

2 Assistant Professor, Department of Physical Therapy, Thomas J. Long School of Pharmacy and Health Sciences, University of the Pacific, Stockton, CA, USA

We certify that no party having a direct interest in the results of the research supporting this article has or will confer a benefit on us or on any organization with which we are associated.



This case study aimed to document the effect of pacing self-management and short-duration exercise on physiological functioning and disability in an individual with chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME).  A 28-year-old woman with CFS/ME received a rehabilitation program that involved:  (1) pacing self-management using a heart rate monitor to maintain heart rate below ventilatory threshold and (2) a pragmatic approach to restorative strengthening and flexibility exercises conducted at an intensity below anaerobic threshold, which were completed 3 times weekly.  Cardiopulmonary exercise testing (CPET) with analysis of expired gases and functional self-report were obtained before and 1 year after initiation of intervention.  At 1-year follow-up, the patient reported she was able to complete daily activities without reproducing symptoms and 75% improvement in time to recover from CPET.  Prior to intervention, patient demonstrated impaired cardiovascular and pulmonary responses at peak and anaerobic threshold, which improved at 1-year follow-up.  Pacing self-management combined with short-duration restorative exercise resulted in a favorable clinical outcome in this patient with CFS/ME.  Additional research is necessary to determine the efficacy and mechanism of action for this treatment.

KEYWORDS: Chronic fatigue syndrome, myalgic encephalomyelitis, rehabilitation, exercise, intervention.