ALPIMS · RESHAPE
Shape support around you.
Adapt care, activities and surroundings to your health, capacity and what matters to you.
Explore RESHAPE ↓
RESHAPE is an ALPIMS planning framework, not a diagnosis, clinical test or cure.
What is the RESHAPE Plan? A flexible menu of care and practical support.
RESHAPE brings together rest, appropriate movement, sleep, healthcare, environmental adaptations, pacing and emotional or autonomic support.
Choose what fits your needs. A clinician, family member or supporter can help you plan. Review the effort involved as well as any benefit.
The approach draws on general wellbeing guidance, including NIH Your Healthiest Self, and condition-specific adaptations. The combined RESHAPE framework has not been tested as a treatment programme.
Choose one part of RESHAPE
Tap a coloured button ↗.
R · Rest & recovery Make room for recovery.
Try a pause, comfortable supported position or break from conversation and sensory input. Ask for help with a demanding task.
Small prompt: “What would make this pause restorative?”
Adapt: rest may need to be quiet and low input for ME/CFS or migraine. For others, comfortable music or familiar movement may feel better. With FND, agree how recovery fits alongside rehabilitation.
My rest & recovery options — Coming soonE · Exercise or movement as appropriate Match movement to your condition and capacity.
Movement may mean everyday activity, changing position, supported movement or an individually planned rehabilitation activity.
Small prompt: “What movement is suitable for me today?”
Adapt: joint instability may need physiotherapy focused on control and support. Dizziness may affect safe positioning. FND may benefit from specific movement retraining. For ME/CFS or PEM, avoid fixed increases and pushing through; activity needs individual energy management.
Movement that fits my needs — Coming soonS · Sleep support Make sleep more accessible.
Explore a comfortable sleep setting and a manageable routine. Discuss persistent sleep problems, snoring, breathing pauses, pain or medication effects with your clinician.
Small prompt: “What makes sleep harder, and what support might help?”
Adapt: consider sensory preferences, positioning and flexible timing. With ME/CFS, daytime rest may still be needed. Sleep difficulties are not a personal failure.
My sleep support plan — Coming soonH · Healthcare & support Bring treatment and practical help together.
Arrange assessment, condition-specific treatment and help with daily activities. Identify who coordinates care and what you need from appointments.
Small prompt: “What needs clinical care? What needs practical help?”
Adapt: request written information, shorter appointments, processing time or accessible formats. FND needs a clear diagnostic explanation; other conditions still need their own care. Include trusted supporters with your consent.
My care team & support plan — Coming soonA · Adapt the environment Change what makes life harder.
Adjust sound, light, temperature, seating, access or materials. Keep useful items within reach and reduce unnecessary demands.
Small prompt: “What could we change around me?”
Adapt: neurodivergent people may need less or more comfortable sensory input. Migraine may need reduced glare. Known allergies or irritants need specific precautions. Accessibility includes communication and social expectations.
My environment & accessibility checklist — Coming soonP · Pace & simplify Reduce effort and unnecessary decisions.
Prioritise, shorten, break up or delegate a task. Leave recovery space and use a brief list or reminder if useful.
Small prompt: “What can be smaller, later or shared?”
Adapt: for PEM, consider delayed effects of physical, cognitive, emotional and social effort. For executive difficulties, use one visible next step. Pacing is flexible and does not require automatic activity increases.
My pacing & simplification plan — Coming soonE · Emotional & autonomic support Choose coping support and appropriate medical care.
Emotional support: try a trusted person, a pause, clear choices or an optional grounding practice. Choose approaches that feel comfortable.
Autonomic care: dizziness, fainting or palpitations may need assessment and a condition-specific plan. Relaxation alone does not treat every autonomic problem.
Small prompt: “Do I need emotional support, physical care or both?”
Adapt: breathing exercises and body-focused attention are optional. Avoid breath-holding or forcing deep breaths. Fluid, salt, compression or medication changes should follow individual advice when relevant.
My emotional & autonomic support options — Coming soonHow this may help across ALPIMS Possible supports—not promises of treatment.
Anxiety & Autonomic: predictable activities, less overload and emotional support, alongside medical care for autonomic symptoms.
Laxity & Connective Tissue: supported positioning, accessible equipment and individually planned movement.
Pain & Bodily Sensitivity: more comfortable tasks, sleep support, reduced demands and appropriate pain care.
Immune & Inflammatory: environments suited to known allergies or irritants, practical help and condition-specific treatment.
Mood & Trauma: choice, supportive relationships, manageable routines and adapted professional care.
Sensory & Neurodevelopmental: sensory adjustments, accessible communication, predictable transitions and planning support.
Make the plan fit your experience
Neurodivergence Support access, choice and preferred ways of working.
Use short written or visual plans, one instruction at a time and time to process. Offer preferred communication, comfortable sensory input and advance notice of changes.
Build around interests and needs. Support should not depend on hiding differences. Avoid making the plan another demanding checklist.
RESHAPE adaptations for neurodivergence — Coming soonME/CFS & PEM Energy management runs through every part.
Count physical, cognitive, emotional and social effort. Symptoms may worsen after a delay, so review recovery as well as how an activity felt at the time.
Avoid fixed activity increases and pushing through. Movement is individually assessed and may need to be reduced or deferred. Maintaining capacity and preventing worsening can be the goal.
RESHAPE adaptations for ME/CFS & PEM — Coming soonFND Combine understanding, rehabilitation and everyday support.
Include a clear explanation of the diagnosis and symptom-specific rehabilitation. Physiotherapy, occupational therapy or speech and swallowing therapy may be relevant.
Use recovery and adaptations alongside agreed rehabilitation goals. Where FND and ME/CFS coexist, account for PEM. Assess new symptoms separately.
RESHAPE adaptations for FND — Coming soonMy small RESHAPE plan Three prompts—no scoring or targets.
1. What matters or feels difficult today?
Choose one need or valued activity.
2. Which one support could help?
Choose a RESHAPE option and who can help.
3. What should we keep, change or stop?
Review comfort, effort, delayed symptoms and access.
Sources & further reading General guidance and condition-specific adaptations.
These organisations are independent of ALPIMS. Service pathways vary between countries.
Disclaimer & your care A planning framework alongside individual treatment.
RESHAPE provides general education and planning prompts. It is not a diagnostic tool, validated treatment package or cure. Suitability and benefit vary.
Use individual clinical advice for rehabilitation, medication, diet or autonomic treatment. New, worsening or unexplained symptoms need appropriate assessment. A diagnosis does not explain every future symptom.
The plan is an ALPIMS adaptation; NIH and other linked organisations have not endorsed it. Share only information you choose and check privacy before entering information into online tools.
For immediate danger or a medical emergency in Australia, call 000.
Rest & recovery
Anxiety & Autonomic: a quieter pause may reduce overload. With POTS or orthostatic intolerance, a safe seated or lying position may ease upright symptoms.
Laxity & Pain: supported positioning may reduce strain in HSD/hEDS or improve comfort with persistent pain or migraine.
Immune: practical help during an illness or inflammatory flare can allow recovery; rest does not replace treatment.
Mood & Sensory: a pause from demands may offer breathing space with anxiety, trauma-related distress or autistic overload.
ME/CFS: plan low-input rest around energy limits. FND: agree how rest fits alongside rehabilitation.
Movement as appropriate
Laxity & Pain: suitable strengthening and movement control may support joints in HSD/hEDS. Avoid forcing joints into their end range; agree a programme with a physiotherapist.
Anxiety & Autonomic: enjoyable activity may support wellbeing. Some people with POTS need adapted positions and a clinical plan.
Mood & Sensory: tolerable movement can offer enjoyment or preferred sensory input. Choose a predictable, comfortable setting for autism or ADHD.
Immune: asthma, inflammatory disease or an acute illness may change what is safe or manageable; follow condition-specific advice.
FND: specialist retraining may help functional movement symptoms. ME/CFS or PEM: do not use fixed increases or push through; movement may need to be reduced or deferred.
Sleep support
Pain: assessment and treatment of sleep problems can be part of care for persistent pain and migraine.
Anxiety & Mood: sleep support may help wellbeing alongside treatment for anxiety, depression or PTSD. Nightmares may need specific care.
Sensory: comfortable bedding, light and sound can make the sleep setting more usable for autism or ADHD.
Laxity: supportive positioning may improve comfort. Immune: allergy, asthma or itching that interrupts sleep deserves treatment.
ME/CFS: sleep may remain unrefreshing and daytime rest may be necessary. FND: review sleep as one possible contributor to fatigue. Snoring or breathing pauses warrant assessment for sleep apnoea.
Healthcare & support
Across all six domains: identify what needs assessment, treatment, rehabilitation or practical help. Similar symptoms can have different causes.
Anxiety & Autonomic: distinguish anxiety from POTS, fainting or other medical causes. Laxity & Pain: seek appropriate joint, injury, migraine or pain care.
Immune: allergy, asthma, confirmed mast-cell disorders and autoimmune disease need condition-specific plans.
Mood & Sensory: adapt mental healthcare for trauma, communication and sensory needs; offer accessible support for autism or ADHD.
ME/CFS: coordinate care around PEM. FND: obtain a clear positive diagnostic explanation and suitable rehabilitation. New symptoms still need assessment.
Adapt the environment
Sensory & Pain: reduce uncomfortable glare, noise or smells when relevant to autism, hyperacusis or migraine. Some people prefer more comfortable sensory input.
Anxiety & Mood: clear expectations, choice, privacy and a predictable setting may support comfort in anxiety or PTSD.
Laxity & Autonomic: accessible seating, supported work positions and less prolonged standing may make tasks easier with HSD/hEDS or POTS.
Immune: follow a known allergy or asthma plan; choose tolerated materials and avoid identified triggers. Fragrance-free does not guarantee individual tolerance.
ME/CFS: bring essentials within reach and reduce effort and input. FND: arrange safe access and equipment with the rehabilitation team.
Pace & simplify
Across domains: smaller tasks, fewer decisions and shared work can reduce the effort of living with several conditions.
Pain & Laxity: change positions and split up tasks to reduce prolonged strain. Autonomic: reduce long periods of standing if these worsen symptoms.
Sensory: one visible step, written reminders and transition time may help with autism or ADHD. Mood: make expectations manageable during depression or trauma-related distress.
Immune: share tasks during illness or a flare while continuing appropriate treatment.
ME/CFS: account for delayed PEM and all types of effort; pacing is not a cure or a fixed exercise ladder. FND: balance tasks and recovery with individual rehabilitation goals.
Emotional & autonomic support
Anxiety & Mood: chosen coping skills, co-regulation and adapted therapy may help distress in anxiety, depression or PTSD.
Sensory: reducing uncomfortable input, clear choices and time to respond may help during autistic overload. Do not require eye contact or immediate speech.
Pain & Laxity: coping support may help the burden of persistent symptoms; physical needs still deserve care.
Autonomic: POTS or other dysautonomia may need medical management. Relaxation alone is not sufficient; fluid, salt, compression or medication changes need individual advice.
Immune: emotional support may help coping, but it does not treat anaphylaxis, asthma attacks or autoimmune disease.
FND: psychological support may be relevant without assuming a psychological cause. ME/CFS: keep exercises within capacity; breath work and body-focused attention are optional.