The Energy Management Program in Support of Restoration and Renewal for Persons with MS (EMPIRe2): An Initial Evaluation

Background: Fatigue is one of the most debilitating symptoms of Multiple Sclerosis (MS) and interferes with employment as well as daily life activities. The Energy Management Program in support of Restoration and Renewal for persons with MS (EMPIRe2) was developed to address the gap in occupation focused, group based interventions for MS fatigue. The EMPIRe2 is a 5-session program that builds upon the principles of self-efficacy to provide persons with MS the tools and strategies to effectively self-manage physical, cognitive and emotional fatigue in the context of their daily activities.

Objectives: (1) To determine if the EMPIRe2 is acceptable to participants with MS; (2) To determine if there are benefits in participating in the EMPIRe2 for persons with MS; (3) To describe the experience of fatigue among a group of persons with MS.

Methods: A retrospective case series was used. 27 patients with MS completed the EMPIRe2 program. Pre and post measures include the Fatigue Severity Scale (FSS), the Self-Efficacy for Performing Energy Conservation (SEPESCA) and the Patient Health Questionnaire-9 (PHQ-9). An evaluation tool was completed at the 5^th session. The Comprehensive Fatigue Assessment Battery for Person with MS (CFAB-MS) was used to characterize the population. Analysis includes descriptive statistics to characterize the population, parametric statistics to analyze the pre-post intervention trends for client perceived fatigue severity, fatigue management self-efficacy and depression.

Results: Data from the CFAB-MS will allow researchers to accurately describe the characteristics of the MS-related fatigue. Data from pre and post measures will reveal changes in fatigue severity, self-management self-efficacy and depression.

Conclusions: This study adds to the research literature describing the characteristics of MS-related fatigue. It also provides an initial evaluation of a group based, occupation focused intervention to address fatigue and its impact on daily function.