Revision 7T · Full Tutorial Edition · Updated 1 September 2026
PWR-060 · SUPERVISED full tutorial
Plan activity and rest around available energy, including delayed worsening
Pacing is not an automatic weekly increase. It uses available energy to protect meaningful life without triggering avoidable worsening. The learner maps one day, protects essential activity, breaks a task into parts, places rest before exhaustion and checks delayed symptoms. For post-exertional malaise or complex illness, the clinician controls the budget and progression.
What you will produceWith an occupational therapist or qualified clinician, the learner completes one planned day segment within an agreed energy budget and records immediate and delayed response.
Method8 numbered Power-specific steps
Practice authorityFull method with qualified supervision where stated
Full step-by-step individual tutorial · TLU-PWR-060
With an occupational therapist or qualified clinician, the learner completes one planned day segment within an agreed energy budget and records immediate and delayed response.
Setting the initial activity/rest pattern, supports and monitoring window when delayed symptoms or collapse risk complicate pacing.
Changing rehabilitation, exercise, medication, mobility equipment or return-to-work/care demands.
Never do this from the page alone
Apply a fixed weekly increase when exertion causes delayed worsening or use a brief good period to empty the whole task list.
Defer food, fluids, medication, hygiene, dependent care or another essential need merely to keep an energy score low.
Remove a chair, mobility aid, helper or task adaptation to prove independent stamina.
2 · Get ready
Gather what you need and check the starting conditions
What you need
A one-day timeline with essential, optional and deferrable activities.
A simple personal energy-cost scale with fixed anchors.
Timers, seating, mobility aids and task tools.
A 24–48-hour symptom and recovery record when delayed exacerbation is relevant.
Before you start
The clinician checks diagnosis, post-exertional symptoms, orthostatic issues, nutrition/hydration needs and activities that cannot safely be deferred.
Do not use a fixed graded-exercise increase when symptoms worsen after exertion.
Identify essential self-care and caregiving needs before optional tasks.
Agree an abort plan for dizziness, collapse, severe symptom escalation or inability to complete basic care.
3 · The method
Follow these steps in order
Map the day honestly
List activities from waking through rest, including washing, thinking, travel, sensory load and emotional demands.
Why: Energy use is broader than exercise and hidden tasks can exhaust the budget.
Check: The timeline contains physical, cognitive and social demands.
Mark priorities
Label each item essential today, important but movable, or optional.
Why: Protecting meaningful essentials is different from trying to complete everything.
Check: Every activity has a priority label.
Estimate personal cost
Use the agreed scale to rate expected cost and note which symptoms appeared after similar tasks.
Why: Personal cost and delayed response matter more than a generic calorie estimate.
Check: Ratings use the same anchors and cite recent experience.
Break the chosen task
Divide one essential task into setup, action, pause and finish; move supplies close and use aids.
Why: Task design can remove avoidable demand.
Check: Each part can stop safely and necessary items are ready.
Place rest before the crash
Schedule a low-demand rest or task switch at the planned point, not only after symptoms peak.
Why: Pre-emptive rest can make the day more predictable.
Check: The rest point is on the timeline before activity begins.
Alternate demand types
Where helpful, alternate physical, cognitive, upright and sensory tasks rather than stacking one type.
Why: Different demands can accumulate in different ways.
Check: The schedule avoids an unplanned cluster of high-cost tasks.
Perform only the planned segment
Use the aids and finish rule; defer the optional item rather than borrowing from tomorrow.
Why: Staying inside the plan allows a fair delayed-response check.
Check: Actual activity and deviations are recorded.
Check now and later
Record function and symptoms immediately and at the agreed 24–48-hour times, then revise the budget with the clinician.
Why: Post-exertional worsening may be delayed.
Check: No progression decision is made from immediate feeling alone.
4 · Worked example
See the whole method used once
Scenario
An occupational therapist helps Devon plan showering on a day that also includes a medical appointment.
Walkthrough
They map washing, dressing, travel, waiting, conversation and recovery—not only walking.
Showering and the appointment are marked essential; housework is deferrable.
They prepare a shower chair and clothes, split washing from dressing and schedule seated rest.
Devon completes the planned segment and defers vacuuming despite feeling briefly able.
They record symptoms that evening and the next day before changing the plan.
Result
Devon preserves essential participation with declared aids and no avoidable delayed worsening. The plan does not require doing more each week.
5 · Right and wrong
Compare correct or safer execution with the common wrong version
Right and wrong comparison
Moment
Right / safer
Wrong / riskier
Why it matters
Energy map
Include thinking, sensory and social demand.
Count only steps or exercise minutes.
Non-physical demand can consume the same limited capacity.
Rest timing
Rest before the personal crash point.
Wait until symptoms force total shutdown.
Late rest makes the response less predictable.
Good moment
Protect the written budget and deferred items.
Use all available energy because it is there now.
Borrowing can worsen later function.
Progression
Use immediate and delayed response with the clinician.
Increase activity on a fixed schedule despite worsening.
Fixed increments can be inappropriate, especially with post-exertional malaise.
Independence
Use aids or direct help to preserve the goal.
Remove support to make the task count.
Support can reduce energy cost and increase participation.
6 · Common mistakes
Spot the error and apply the correction
Common mistakes and corrections
Mistake
Fix
Count only steps or exercise minutes.
Include thinking, sensory and social demand.
Wait until symptoms force total shutdown.
Rest before the personal crash point.
Use all available energy because it is there now.
Protect the written budget and deferred items.
Increase activity on a fixed schedule despite worsening.
Use immediate and delayed response with the clinician.
Remove support to make the task count.
Use aids or direct help to preserve the goal.
7 · Practice
Turn the steps into a usable skill
First session
Devon and the occupational therapist map showering, dressing, travel, waiting, appointment conversation, food and recovery on the appointment-day timeline.
They mark showering and the medical appointment essential, vacuuming deferrable, and rate each segment with Devon's agreed recent-experience anchors.
A shower chair, towel and clothes are pre-positioned; washing and dressing are split by a seated low-demand rest before travel.
Devon completes only the shower/dressing plan and defers vacuuming even if a brief energy lift appears.
Immediate, evening, next-day and 48-hour symptoms/function are recorded before one segment or support is revised.
Repeat plan
Use the agreed budget across comparable days and review weekly or after a flare. Progress may mean more predictable recovery, better participation or less assistance—not necessarily more activity. Change one task or support at a time.
Progress when
Essential activities become more predictable.
Delayed exacerbation and recovery time are stable or reduced.
The learner can defer optional work and use supports consistently.
Do not progress when
Delayed symptoms grow in intensity or duration.
Basic nutrition, hygiene, medication or safety needs cannot be met.
A fixed-increase rule overrides the person’s symptom response.
8 · Check the result
Measure what changed
Meaningful activity, delayed symptom exacerbation, recovery and participation
How: Record planned versus completed essential activities, personal cost, aids/help, immediate symptoms, 24–48-hour change and time back to baseline.
Good result: Meaningful essential participation is maintained or improved across comparable days without a longer or more severe delayed exacerbation.
This does not prove: Track personally meaningful activity, delayed symptom exacerbation, recovery time and participation; steps or heart rate alone do not define capacity.
Self-check
Can you demonstrate “Mark priorities”? Every activity has a priority label.
Can you demonstrate “Place rest before the crash”? The rest point is on the timeline before activity begins.
Can you demonstrate “Check now and later”? No progression decision is made from immediate feeling alone.
9 · Stop, adapt or get help
Keep the safety boundary practical
Stop and get help
Seek urgent help for collapse, severe breathlessness, chest pain, acute confusion, new neurological symptoms or inability to meet essential medical needs.
Stop the activity for presyncope, loss of safe movement, severe symptom surge or the predeclared personal threshold.
Contact the care team when recovery no longer returns toward baseline, essential function declines or the plan repeatedly triggers delayed worsening.
Accessibility and adaptations
Use a visual, tactile or audio day timeline and a supporter to move task cards.
Treat seated work, mobility devices, ready-prepared items and directed assistance as valid conservation tools.
Reduce sensory and communication demand as well as physical demand.
10 · Evidence and limits
Why these instructions are here
primary research
A pilot randomised trial compared distinct pacing approaches, showing that pacing is a defined treatment rather than a generic instruction to do more.
Progress is saved only in this browser on this device.
Step-by-step learner mode
Each activity includes its success check, a nearby accessible alternative and an “I’m stuck” correction path. Alternatives preserve the target where possible; when they change the task, Titan labels them as related rather than equivalent.
01
Map the day honestly
List activities from waking through rest, including washing, thinking, travel, sensory load and emotional demands.
Why this step exists
Energy use is broader than exercise and hidden tasks can exhaust the budget.
Success check
The timeline contains physical, cognitive and social demands.
I’m stuck on this step
Reset: Re-read this authored instruction — “List activities from waking through rest, including washing, thinking, travel, sensory load and emotional demands.” — and its success check, then attempt only this step.
Possible snag: Count only steps or exercise minutes.
Correction: Include thinking, sensory and social demand.
Stop / get help: Seek urgent help for collapse, severe breathlessness, chest pain, acute confusion, new neurological symptoms or inability to meet essential medical needs.
02
Mark priorities
Label each item essential today, important but movable, or optional.
Why this step exists
Protecting meaningful essentials is different from trying to complete everything.
Success check
Every activity has a priority label.
I’m stuck on this step
Reset: Re-read this authored instruction — “Label each item essential today, important but movable, or optional.” — and its success check, then attempt only this step.
Possible snag: The result from “Label each item essential today, important but movable, or optional.” does not yet meet this declared check: Every activity has a priority label.
Correction: Return to the start of “Mark priorities”, reduce complexity or pace, and repeat only the part needed to satisfy: “Every activity has a priority label.”
Stop / get help: Seek urgent help for collapse, severe breathlessness, chest pain, acute confusion, new neurological symptoms or inability to meet essential medical needs.
03
Estimate personal cost
Use the agreed scale to rate expected cost and note which symptoms appeared after similar tasks.
Why this step exists
Personal cost and delayed response matter more than a generic calorie estimate.
Success check
Ratings use the same anchors and cite recent experience.
I’m stuck on this step
Reset: Re-read this authored instruction — “Use the agreed scale to rate expected cost and note which symptoms appeared after similar tasks.” — and its success check, then attempt only this step.
Possible snag: The result from “Use the agreed scale to rate expected cost and note which symptoms appeared after similar tasks.” does not yet meet this declared check: Ratings use the same anchors and cite recent experience.
Correction: Return to the start of “Estimate personal cost”, reduce complexity or pace, and repeat only the part needed to satisfy: “Ratings use the same anchors and cite recent experience.”
Stop / get help: Seek urgent help for collapse, severe breathlessness, chest pain, acute confusion, new neurological symptoms or inability to meet essential medical needs.
04
Break the chosen task
Divide one essential task into setup, action, pause and finish; move supplies close and use aids.
Why this step exists
Task design can remove avoidable demand.
Success check
Each part can stop safely and necessary items are ready.
I’m stuck on this step
Reset: Re-read this authored instruction — “Divide one essential task into setup, action, pause and finish; move supplies close and use aids.” — and its success check, then attempt only this step.
Possible snag: Remove support to make the task count.
Correction: Use aids or direct help to preserve the goal.
Stop / get help: Seek urgent help for collapse, severe breathlessness, chest pain, acute confusion, new neurological symptoms or inability to meet essential medical needs.
05
Place rest before the crash
Schedule a low-demand rest or task switch at the planned point, not only after symptoms peak.
Why this step exists
Pre-emptive rest can make the day more predictable.
Success check
The rest point is on the timeline before activity begins.
I’m stuck on this step
Reset: Re-read this authored instruction — “Schedule a low-demand rest or task switch at the planned point, not only after symptoms peak.” — and its success check, then attempt only this step.
Possible snag: Wait until symptoms force total shutdown.
Correction: Rest before the personal crash point.
Stop / get help: Seek urgent help for collapse, severe breathlessness, chest pain, acute confusion, new neurological symptoms or inability to meet essential medical needs.
06
Alternate demand types
Where helpful, alternate physical, cognitive, upright and sensory tasks rather than stacking one type.
Why this step exists
Different demands can accumulate in different ways.
Success check
The schedule avoids an unplanned cluster of high-cost tasks.
I’m stuck on this step
Reset: Re-read this authored instruction — “Where helpful, alternate physical, cognitive, upright and sensory tasks rather than stacking one type.” — and its success check, then attempt only this step.
Possible snag: The result from “Where helpful, alternate physical, cognitive, upright and sensory tasks rather than stacking one type.” does not yet meet this declared check: The schedule avoids an unplanned cluster of high-cost tasks.
Correction: Return to the start of “Alternate demand types”, reduce complexity or pace, and repeat only the part needed to satisfy: “The schedule avoids an unplanned cluster of high-cost tasks.”
Stop / get help: Seek urgent help for collapse, severe breathlessness, chest pain, acute confusion, new neurological symptoms or inability to meet essential medical needs.
07
Perform only the planned segment
Use the aids and finish rule; defer the optional item rather than borrowing from tomorrow.
Why this step exists
Staying inside the plan allows a fair delayed-response check.
Success check
Actual activity and deviations are recorded.
I’m stuck on this step
Reset: Re-read this authored instruction — “Use the aids and finish rule; defer the optional item rather than borrowing from tomorrow.” — and its success check, then attempt only this step.
Possible snag: The result from “Use the aids and finish rule; defer the optional item rather than borrowing from tomorrow.” does not yet meet this declared check: Actual activity and deviations are recorded.
Correction: Return to the start of “Perform only the planned segment”, reduce complexity or pace, and repeat only the part needed to satisfy: “Actual activity and deviations are recorded.”
Stop / get help: Seek urgent help for collapse, severe breathlessness, chest pain, acute confusion, new neurological symptoms or inability to meet essential medical needs.
08
Check now and later
Record function and symptoms immediately and at the agreed 24–48-hour times, then revise the budget with the clinician.
Why this step exists
Post-exertional worsening may be delayed.
Success check
No progression decision is made from immediate feeling alone.
I’m stuck on this step
Reset: Re-read this authored instruction — “Record function and symptoms immediately and at the agreed 24–48-hour times, then revise the budget with the clinician.” — and its success check, then attempt only this step.
Possible snag: Use all available energy because it is there now.
Correction: Protect the written budget and deferred items.
Possible snag: Increase activity on a fixed schedule despite worsening.
Correction: Use immediate and delayed response with the clinician.
Stop / get help: Seek urgent help for collapse, severe breathlessness, chest pain, acute confusion, new neurological symptoms or inability to meet essential medical needs.
Correct versus incorrect execution
These accessible process diagrams are built from the tutorial’s own right/wrong teaching. They are not anatomical illustrations and do not add technique beyond the canonical tutorial.
Energy map — Non-physical demand can consume the same limited capacity.
Correct / safer
Include thinking, sensory and social demand.
Wrong / riskier
Count only steps or exercise minutes.
Rest timing — Late rest makes the response less predictable.
Correct / safer
Rest before the personal crash point.
Wrong / riskier
Wait until symptoms force total shutdown.
Good moment — Borrowing can worsen later function.
Correct / safer
Protect the written budget and deferred items.
Wrong / riskier
Use all available energy because it is there now.
Progression — Fixed increments can be inappropriate, especially with post-exertional malaise.
Correct / safer
Use immediate and delayed response with the clinician.
Wrong / riskier
Increase activity on a fixed schedule despite worsening.
Independence — Support can reduce energy cost and increase participation.
Correct / safer
Use aids or direct help to preserve the goal.
Wrong / riskier
Remove support to make the task count.
Method-structure checklist
10 of 10 structural checks present
✓ Ordered, Power-specific instructions — present
✓ Every activity has a success check — present
✓ Materials or supplied records are declared — present
✓ Measurement or assessment rule is present — present
✓ Tutorial-specific troubleshooting is present — present
✓ Stopping or escalation boundary is present — present
✓ Every activity has an adjacent alternative — present
✓ Correct-versus-incorrect comparison is present — present
✓ Evidence context is bound to the Power record — present
✓ Planning metadata is present — present
The method-readiness band and presence checklist assess tutorial presentation and are separate from evidence quality for the underlying Power. They are automated editorial aids, not human approval.
Manual editorial sign-off: Pending. This tutorial must not display a human-approved state until an identified editor signs the exact content hash.