Evaluation of a Multi-Disciplinary Fatigue Group for Patients with Multiple Sclerosis
Fatigue is one of the most prevalent and debilitating symptoms of MS. Many programs that treat MS fatigue focus on primary fatigue (factors related to disease process) and rarely include management for secondary fatigue (non-disease factors such as sleep problems, mental health, or muscle deconditioning).
This study aimed to evaluate a newly developed multi-disciplinary fatigue group for MS patients that targets primary and secondary factors of fatigue. The group was developed as part of the rehabilitation program for MS patients at an outpatient rehabilitation treatment centre in Calgary, AB.
A total of 36 patients with MS participated over four sessions of fatigue group. Each session of group ran for 7 weeks, with 1.5 hour each week. Outcome measures, administered pre and post group, included Fatigue Severity Scale, Modified Fatigue Impact Scale, Multiple Sclerosis-Fatigue Self Efficacy Scale, Patient Health Questionnaire-9 and a Patient Experience Survey.
Paired sample t-tests were used to examine pre-post differences in scores. Patients reported reduced levels of MS fatigue on the FSS (t (24) = 2.89, p=.008) and reduced depression on the PHQ-9 (t (24) = 3.44, p=.002). No significant differences were found for MFIS or MS-FSE. Effect sizes were classified as medium for both measures of fatigue and depression and small effects for self-efficacy. Overall, patients reported high levels of satisfaction with the group and found it helpful to meet others with similar issues, learn explanations along with tools and tips for coping with fatigue, and develop a new way of thinking.
Initial findings indicate promising results for the multi-disciplinary fatigue group for patients with MS but are limited due to the single group design of the study and small sample size. Future studies should include a control group to evaluate efficacy of the program.