Tailored activity pacing could help manage fatigue and improve physical activity. How-ever, little is known about how to tailor activity pacing for people with multiple sclerosis. This study aims to evaluate the effect of a tailored activity pacing intervention on fatigue and physical activity behaviours in adults with multiple sclerosis. Twenty-one adults with multiple sclerosis, stratified by age and gender, are randomly allocated to either a tailored pacing or control group. Participants wear an accelerometer for seven days that measures physical activity behaviours, and self-report fatigue at the baseline and four-week follow-up. Physical activity behaviours are assessed by exam-ining activity level (seven-day average activity counts per minute) and activity variability (seven-day average highest activity counts each day divided by activity counts on that day). The intervention improves activity levels (mean difference 40.91; 95% confidence interval (CI) 3.84 to 77.96; p = 0.03) and lessens activity variability (mean difference -0.63; 95% CI -1.25 to 0.02); p = 0.04). No significant effect is found for fatigue (mean difference -0.36; 95% CI -1.02 to 0.30); p = 0.27). This investigation shows that tailoring activity pacing based on physical activity behaviours and fatigue is effective in improving physical activity levels, without exacerbating fatigue symptoms.

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