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=== Activity pacing-self management === Another form of pacing, Activity Pacing Self-Management (APSM) is promoted by the Belgian research group of [[Jo Nijs]], one of the authors of the 2012 consensus document on pacing. His version of pacing is more in line with the tradition of operant conditioning in the chronic pain literature, and less with the principles of energy conservation. According to Nijs, the PACE authors made a mistake by placing pacing and [[Graded exercise therapy|GET]] in opposition to each other, as it is more effective to use both strategies in the treatment of ME/CFS.<ref name=":14">{{Cite journal | last = Kos | first = Daphne | last2 = van Eupen | first2 = Inge | last3 = Meirte | first3 = Jill | last4 = Van Cauwenbergh | first4 = Deborah | last5 = Moorkens | first5 = Greta | last6 = Meeus | first6 = Mira | last7 = Nijs | first7 = Jo| date = Sep 2015 | title = Activity Pacing Self-Management in Chronic Fatigue Syndrome: A Randomized Controlled Trial|url=https://www.ncbi.nlm.nih.gov/pubmed/26356665|journal=The American Journal of Occupational Therapy: Official Publication of the American Occupational Therapy Association|volume=69|issue=5 | pages = 6905290020|doi=10.5014/ajot.2015.016287|issn=1943-7676|pmc=4564796|pmid=26356665}}</ref> Nuñes (2011) also used a pacing approach to physical activity and exercise, with positive results.<ref name="Nunes2011" /> In APSM patients first learn to pace themselves to find a baseline of activity that doesn’t result in relapses. Only if they’ve managed to stabilize their condition - and this might take several weeks - can they proceed to the next phase which aims to gradually increase activities according to time-contingent scheme. In APSM pacing is thus used a stepping stone to graded exercise therapy. Nijs' research group tested the APSM approach in a 2015 randomized control trial in which the control group received relaxation therapy.<ref name=":14" /> The results were favorable for APSM, though no objective performance measures were used. The study was also rather small as only 16 ME/CFS patients were involved in the experimental group, of which 4 (25%) stopped the treatment prematurely. {{See also|Graded exercise therapy}}
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