Speed Progression

Early education about pacing was considered essential by participants, particularly information about the overall clinical picture and how to manage activity levels. Warnings about overexertion and empathic advice to rest helped some patients avoid crashes. Increasing speed while maintaining friction-based tension intensifies the training effect. Speed should be increased gradually during the training progression. Inappropriate advice to return to previous activity levels without limitation could worsen patient outcomes. Some patients returned to work prematurely because they had not been clearly informed of the potential consequences of failing to rest. After the right friction level is established, movement pace becomes the main progression method. Supervised aerobic exercise with pulse monitoring and instructions to take it easy was described as enabling gradual improvement over several weeks.