(GREAT article IMHO) Pedometers: A Tool for Pacing
(if: Now this info on pacing is geared towards people with ME/CFS! I couldn't help highlighting some snippets that, to me, illustrate the appropriate use of pacing within the restrictions of ME/CFS. Very different from the other literature we've seen. My bolds and extra spacing)
Pedometers: A Tool for Pacing
By Bruce Campbell
If you have trouble
finding your activity limits and staying within them, using a pedometer might help. These inexpensive instruments give you an idea of your activity level by counting the steps you take.
We discussed pedometers recently with Dr. Charles Lapp, director of the Hunter-Hopkins Center in Charlotte. Dr. Lapp has treated CFS and FM patients for over 25 years and his clinic is one of the few medical practices in the United States to specialize in CFS and FM.
He recommends pedometers to his patients.
Dr. Lapp believes that
between 1,000 and 5,000 steps a day is a good range for many people with CFS and fibromyalgia.
If someone has f
ewer than 500 steps a day, Dr. Lapp usually suggests they gradually increase the number of steps they take.
And if someone is o
ver 5,000 steps a day, Dr. Lapp finds they are usually too active and he advises that them to cut back.
Dr. Lapp's guidelines imply that 10,000 steps a day, an exercise target often suggested for healthy people, will be inappropriate for most people with CFS and FM.
Finding Your Baseline
T
he first goal with a pedometer is to use it to determine your current activity level and its effects on your symptoms. If you wear a pedometer for several days, you should get a good idea of how many steps you are now taking per day and can correlate that with your symptom level and compare it to Dr. Lapp's guidelines.
A number of people in our program have told us that their initial finding was that they were too active. One person wrote that she began by using a pedometer to see how active she was and quickly realized her then-current number of steps was "too much activity and so I used that fact to set activity limits for myself."
Another person said that she used her initial experience to find her limits. She said, "If I had a high number [of steps], it matched the overexertion levels and how awful I felt that night and the next few days." She discovered that initially she could walk only a few hundred steps a day without intensifying her symptoms, though she was gradually able to expand that to about 2,000.
Some people are surprised at how many steps they take, even without an exercise program. One wrote, "What astonished me was that even on days when I didn't go out [of the house], I was still recording 1,500 to 2,000 steps. No wonder I get tired sometimes and don't think that I have done anything during the day to justify the fatigue! I had no idea how much walking I did"
Staying Inside Your Envelope
Once you have found your current limits,
you can use the pedometer to help you stay within them and escape the cycle of push and crash: doing more when symptoms are low and paying for it with time in bed. As one person says, "There are many days I feel I can do more, but if I do I crash and burn. [My pedometer] is a wonderful device for reminding me how much I have done and how much I have left in my energy envelope for that day."
Extending Your Limits
Over time, it may be possible to expand the number of steps you can take without increasing your symptoms. There seem to be two keys to safely increasing steps per day.
The first is to increase
gradually, which might mean no more than 5% at a time. (For example, from 1,000 to 1,050 steps per day.)
The second is to increase only as tolerated by the body. This means that you monitor the consequences of any increase and
return to your previous level if symptoms are intensified.
People in our program have suggested two additional strategies that may be helpful if you want to increase the number of steps you do in a day. The first is to
be attentive to the pace or intensity of their walking. One wrote that she had learned to "stroll" rather than "march." (One way to determine an appropriate intensity is by measuring your heart rate. See the article "Pacing By Numbers: Using Your Heart Rate to Stay Within the Energy Envelope.")
A second strategy is to
combine walking and rest. One person says that "it took many, many months of walking very short distances before I could do a great deal. I used a folding stool and/or sat at intervals on benches. This care prevented me from becoming symptomatic." Another, who had been advised to walk 30 minutes per session, broke up her walking into two or three periods of 10 to 15 minutes each.
There may be a limit on the number of steps you can take without increasing symptoms. One person reported who had moved from about 500 steps a day to 2,000, says "I am working on increasing it, but I will be happy with that number if that's not possible."
Cautions & Summary of Benefits
Although pedometers can be very
useful, they cannot give you a complete picture of your limits.
Activity includes mental work and socializing as well as physical activity.
Also,
symptoms are affected by other factors such as stress, sleep, weather, food, and medical conditions you may have in addition to CFS and FM.
That said, a pedometer
can be a valuable tool. Summarizing the benefits, one person wrote, "Using the pedometer really
helps me stay within my [energy] envelope. The pedometer gives me a measurable way of checking my progress, increasing my activity level in a manageable way,
and --most importantly-- avoiding doing too much."
Resources
Pedometers are widely available, with many models selling for $8 to $25. One place to find information is the Walking section of About.com (
http://walking.about.com/ ), which includes the articles "Before You Buy a Pedometer" and "Top 10 Best Pedometers."
Note: Article reviewed by Dr. Lapp.
