More Stamina app may help MS patients better manage fatigue
Gamified app tracks changes in energy levels across each day's activities
More Stamina, a gamified mobile app, helped a small group of people with multiple sclerosis (MS) better manage their fatigue by becoming more aware of their energy levels and planning their activities more effectively, according to a study from Finland.
“Fatigue is an invisible but life-altering symptom of MS,” Guido Giunti, MD, PhD, a digital health expert at the University of Oulu who led the More Stamina project and is the study’s lead author, said in a university news story. “Managing [fatigue] requires more than just medication. More Stamina gives people the tools to understand their energy levels, take control of their day, and communicate their needs more effectively.”
The study, “Feasibility and usability evaluation of a gamified fatigue management mobile application for persons with multiple sclerosis in everyday life,” was published in Multiple Sclerosis and Related Disorders.
Fatigue with MS can be challenging to manage day by day
In MS, the immune system attacks the myelin sheath that covers nerve cells in the brain and spinal cord, causing damage that results in varied disease symptoms. While extreme fatigue with MS is quite common, it can be challenging to manage on a day-to-day basis.
Giunti and other scientists at the University of Oulu designed More Stamina, a gamified mobile app to help manage fatigue more effectively. They tested its use over two months in 20 adults with a diagnosis of MS being followed at Oulu University Hospital. Most had relapsing-remitting MS and had been living with the disease for a median of 6.6 years; all were familiar with digital health tools.
Patients used More Stamina to track daily activities, and completed standardized scales to rate their fatigue over one month. The researchers also analyzed how often patients used the mobile app and collected feedback through interviews.
The app essentially provides a visual representation of a patient’s daily energy. Each day, it displays 100 Stamina Credits, representing the person’s daily energy reserve, and participants can select a range of activities, or add new ones, allocating the amount of credits they anticipate such an activity will require.
After completing a task, the system asks a user whether their effort was correctly estimated, so that a more realistic energy expenditure can be properly accounted for the next time they do that task.
“After an activity has been entered a certain number of times and the system has established a trend (e.g., the user tends to underestimate how tiring walking the dog is), the next time that the user enters that activity, the system cautions the user with a message (e.g., usually this activity makes you more tired than you think, if you want to continue, consider rearranging some of your other tasks for today),” the researchers noted.
Patients tracked activities across types: physical, cognitive, social
Patients were divided into three groups based on how frequently they engaged with the app: power users (the top 25%), light users (the bottom 25%), and regular users (those with use between other two groups).
Over time, the app’s usability scores improved, indicating that patients became more comfortable using it. Patients tracked different types of daily activities, from physical tasks like walking, swimming, cleaning the house, or shopping, to cognitive tasks such as working or studying, and social tasks, such as dating, spending time with friends, or going to a party.
More Stamina helped patients better understand their fatigue and communicate their needs with family and healthcare providers, with power users reporting higher fatigue but better quality of life compared with light users. Some also used it as a journal to track fatigue patterns for medical appointments.
While some adults faced challenges such as technical issues and stress from having to enter data regularly, More Stamina was found to be useful in helping to manage fatigue. It made patients more aware of their energy levels so they might plan their activities more effectively, especially those experiencing severe fatigue.
“Managing MS fatigue has always been a challenge, as it varies from person to person,” said Mervi Ryytty, MD, PhD, a neurologist at Oulu University Hospital. “Having a tool that helps patients visualize and plan their energy levels can make a real difference in how they manage their symptoms.”
About the Author
