"Pacing" with wearable device for ME/CFS
Posted: Mon Jan 12, 2026 8:30 am
Now I know there's a lot of controversy about graded exercise therapy in ME/CFS. This is not about that - it's about the opposite...
There's a company selling a wearable device (HR monitor) with an app - to help people "pace" themselves - i.e. to avoid increases in activity.
https://www.makevisible.com/
Essentially - it measures HR with daily activities as a proxy for levels of exertion. And through graphs and alerts - encourages people to avoid exceeding some fixed level of "exertion" either at a particular moment, or total exertion over a day - giving a measure of "stability".
So for example, it might record HR increases due to daily activites around the house and then later suggest not going for a walk to avoid exceeding some set fixed amount of total exertion for the day. There are many promotional "influencer" type videos out there with users doing just this - e.g. having a busy morning around the house, looking at their app and then deciding they cannot do something later.
This is really quite concerning - while there might be controversy about whether graded increases in exercise are helpful - there certainly isn't an evidence base to support the opposite - i.e. avoiding increases in activity by avoiding HR increases, rather than based on perceived levels of exhaustion. This would seem almost certain to promote deconditioning.
(Also concerning is some hype in the marketing about measuring heart rate variability. It's an oximeter. It can only really measure pulse rate variability - not true R-R HRV as measured by ECG which is what most epidemiological studies on the importance of HRV have measures).
There's a company selling a wearable device (HR monitor) with an app - to help people "pace" themselves - i.e. to avoid increases in activity.
https://www.makevisible.com/
Essentially - it measures HR with daily activities as a proxy for levels of exertion. And through graphs and alerts - encourages people to avoid exceeding some fixed level of "exertion" either at a particular moment, or total exertion over a day - giving a measure of "stability".
So for example, it might record HR increases due to daily activites around the house and then later suggest not going for a walk to avoid exceeding some set fixed amount of total exertion for the day. There are many promotional "influencer" type videos out there with users doing just this - e.g. having a busy morning around the house, looking at their app and then deciding they cannot do something later.
This is really quite concerning - while there might be controversy about whether graded increases in exercise are helpful - there certainly isn't an evidence base to support the opposite - i.e. avoiding increases in activity by avoiding HR increases, rather than based on perceived levels of exhaustion. This would seem almost certain to promote deconditioning.
(Also concerning is some hype in the marketing about measuring heart rate variability. It's an oximeter. It can only really measure pulse rate variability - not true R-R HRV as measured by ECG which is what most epidemiological studies on the importance of HRV have measures).