Multiple Sclerosis Study Explores Fatigue Management in an Organized Program

In a recent study published in the journal BMJ Open, a research team explored the use of fatigue management strategies in patients with multiple sclerosis (MS) who attended a group-based fatigue management program.

The Multiple Sclerosis Council for Clinical Practice Guidelines defines fatigue as “a subjective lack of physical and/or mental energy that is perceived by the individual or caregiver to interfere with usual and desired activities.” Fatigue is one of the most common and debilitating symptoms of MS, affecting up to 86% of the MS patients, with two-thirds considering it to be one of their worst symptoms.

In the United Kingdom, the National Institute for Health and Care Excellence (NICE) clinical guidance for MS suggests that health professionals consider mindfulness therapy, cognitive behavioral therapy (CBT), or fatigue management, and advise that aerobic balance and stretching exercises, including yoga, may be helpful in treating MS-related fatigue.

In the study entitled “Exploring strategies used following a group-based fatigue management programme for people with multiple sclerosis (FACETS) via the Fatigue Management Strategies Questionnaire (FMSQ),” Dr. Sarah Thomas from the Faculty of Health and Social Sciences, Bournemouth University, U.K., and colleagues developed a 6-week manualized group-based fatigue management program (FACETS—Fatigue: Applying Cognitive behavioral and Energy effectiveness Techniques to lifeStyle), combining energy effectiveness approaches and cognitive behavioral techniques to manage fatigue in MS patients.

The study aimed to understand the outcomes of the program in 72 MS patients, who reported fatigue and had attended a minimum of four of the six scheduled FACETS sessions. After fours months of starting the intervention program, all patients were asked to complete the Fatigue Management Strategies Questionnaire (FMSQ), a tool to assess the effectiveness of the programme.

Fifty-nine (82%) of the patients completed the FMSQ. Patients reported that the fatigue management techniques most regularly used since attending FACETS were prioritization (80%), pacing (78%), saying no to others (78%), grading tasks (75%), and challenging unhelpful thoughts (71%).

Including the patients who had been using the fatigue management techniques before taking part in the FACETS, the results showed that at four months follow-up, the three most used strategies were prioritization (55 patients), grading (54 patients) and pacing (53 patients).

“This study provides valuable insights into people’s experiences of a complex intervention for MS-fatigue management and supports the relevance of a cognitive behavioural approach,” concluded the research team.