COURSE · PART 4 · MODULE 15
Module 15 — Pacing, Activity, and the Boom-and-Bust Cycle
This module separates noticing an activity pattern, making a flexible plan, and learning from delayed worsening.
In this module
- Activity load can include physical, cognitive, sensory, emotional and practical demands.
- Pacing can protect essentials and valued life without becoming a rigid avoidance rule.
- A flare is information for care and review, not evidence of personal failure.
FND occupational-therapy guidance supports individualized planning. Pacing research borrowed from ME/CFS is mixed and must remain clearly labelled as non-FND-specific. [1][2]
Pages
- Understanding Load, Baselines, and Boom-and-Bust — name a pattern without turning it into blame.
- Plan Activity, Rest, and Capacity Changes — place essentials, valued activities, support and recovery in one flexible plan.
- Review Delayed Worsening and Change the Plan — use the smallest useful record and know when reassessment matters.
Inside each page: Person with FND · Supporters · Clinicians · Research
Every page in this module uses these same four main sections.
Research and Sources
These sources support cautious, individualized planning and show why one pacing formula cannot be presented as established FND treatment. [1][2]
| Citation | Full citation |
|---|---|
| [1] | Nicholson C, Edwards MJ, Carson AJ, et al. Occupational therapy consensus recommendations for functional neurological disorder. Journal of Neurology, Neurosurgery & Psychiatry. 2020;91(10):1037–1045. FND-CIT-0011. https://doi.org/10.1136/jnnp-2019-322281 |
| [2] | Sanal-Hayes NEM, McLaughlin M, Hayes LD, et al. A scoping review of “pacing” for management of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS): lessons learned for the long COVID pandemic. Journal of Translational Medicine. 2023;21:720. FND-CIT-0066. https://doi.org/10.1186/s12967-023-04587-5 |
This overview still needs review by people using different pacing approaches, occupational therapists and accessibility reviewers.
Plain-language draft and research package prepared: September 5, 2026 · Clinical review pending