Unravelling the diversity of pacing behaviours in adults with chronic conditions: a cross-sectional study

This study aimed to (1) examine if activity fluctuations over 1 week differ between two groups: individuals who have received fatigue management advice versus those who have not, (2) examine the associations between activity fluctuations and fatigue, engagement in pacing, perceived risk of overactivity, quality of life, self-regulation and physical activity (PA) and if they differ for the two groups and (3) explore whether there are distinct pacing patterns across the week in adults with chronic conditions.

Exploratory cross-sectional observational study.

Participants were recruited from a fatigue management clinic in the UK and through university networks.

29 adults with chronic conditions who experience fatigue (18 received fatigue management advice; 11 did not).

The primary outcome was activity fluctuations (SD of accelerometer-derived vector magnitude counts per minute), measured using the ActiGraph wGT3X-BT over 7 consecutive days. Secondary outcomes included fatigue (Fatigue Severity Scale), engagement in activity pacing, perceived risk of overactivity, quality of life (Functional Assessment of Cancer Therapy-General Instrument), self-regulation of PA (Physical Activity Self-Regulation scale) and self-reported PA (International Physical Activity Questionnaire-short form).

No difference in activity fluctuations during the day was found between groups. Associations between self-regulation of PA and device-based PA with activity fluctuations significantly differed between groups (respectively, standardised regression (β)=1686.14; p=0.006 and β=288.83; p=0.042). Five distinct activity pacing patterns were identified through visual inspection of individual activity profiles: (1) high fluctuations in the morning, (2) high fluctuations in the afternoon, (3) high fluctuations at two time points, (4) consistent pacing pattern and (5) varied pacing patterns.

Individuals who received fatigue management advice demonstrated significant associations between activity fluctuations and self-regulation, suggesting a goal-directed approach, which could indicate that tailored support and goal setting could help in balancing rest and activity. This study also identified five distinct activity pacing patterns in individuals with chronic conditions, emphasising the need for tailored fatigue management instead of a 'one-size-fits-all' approach.

NCT06001970.