Activity scheduling and pacing
Activity scheduling and pacing are useful techniques when commencing a physical activity plan and setting physical activity goals.
Activity scheduling spreads physically difficult activities throughout the day with regular breaks. This reduces sustained physical loading, and cycles of overexertion followed by inactivity (ie ‘boom-bust’). People with chronic pain need to plan their activity scheduling for the week in advance. This can increase activity levels and help them achieve their goals.
Pacing involves graduated activity to prevent overexertion, causing pain and inactivity. Activity is initiated at a threshold lower than the person’s pain tolerance (eg 80% of their baseline tolerance). Tolerance can be measured by time, distance or number of repetitions. Activity is increased gradually to ensure a specific goal will be achieved within a realistic timeframe. See An example of a pacing plan for an example of a pacing plan.
A patient with chronic pain wants to walk 300 metres daily. They create a pacing plan with their GP to achieve this.
- Calculate baseline activity tolerance—on average, they can currently walk 200 metres daily.
- Initiate activity at a lower threshold than baseline tolerance—the patient will walk 160 metres daily for 1 week, which is 80% of their baseline activity tolerance.
- Gradually increase activity levels by approximately 10 to 20% of baseline activity tolerance—the patient will increase the distance by 20 metres per week (eg week 1, 160 metres daily; week 2, 180 metres daily; week 3, 200 metres daily).
- Ensure the pacing plan matches the physical activity goal—at the rate set with their pacing plan, the patient should be walking 300 metres daily within 8 weeks.
Pacing strategies require activity to be undertaken daily (ie time-contingent behaviour) despite pain. The challenge is to prevent overexertion on days with less pain, and to avoid inactivity on days with more pain (ie pain-contingent behaviour). This is particularly difficult when a person starts their physical activity plan. Reassure them that pain will not worsen despite daily activity, because they are starting activity at a lower threshold than their baseline tolerance.
It is possible to predict when the person will achieve specific goals by using a pacing plan and whether the goals are realistic and achievable; see Helping patients with chronic pain to set management goals for further advice.
For further advice on pacing, see the painHEALTH website. Videos about pacing for children, can be found here: