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Minimise fatigue, maximise life (MFML): fatigue management for Multiple Sclerosis

About the programme

MFML logo“Minimise Fatigue, Maximise Life” (MFML) is a self-management programme for fatigue in Multiple Sclerosis developed in New Zealand via collaboration between the MS and Parkinson’s Society Canterbury Inc. and the Centre for Health, Activity, and Rehabilitation Research (CHARR), Otago University (Way Ahead 2016 – see link below). Multiple Sclerosis (MS) is a chronic, neurodegenerative disorder which can have a devastating effect on people’s lives. New Zealand (NZ) has a high, and rising, prevalence of MS. It is usually diagnosed in young adulthood, affecting people during their ‘productive’ years – when working and raising families. Fatigue affects 75-90% of people with MS and can be the most disabling symptom. Fatigue in MS is not remediable with medication.

In NZ, the lack of support for managing fatigue prompted the development of a self-management programme: ‘Minimise Fatigue, Maximise Life: Creating balance with Multiple Sclerosis’. This self-management programme empowers individuals with MS to manage their own symptoms of fatigue, while learning together in a group situation over the course of six weeks.

Research has shown promise for the efficacy and acceptability of the programme and highlighted the need for online delivery of the programme to those who cannot attend face-to-face delivery. Future collaborations between CHARR and the MS and Parkinson’s Society Canterbury Inc. and a research team in Germany aims to develop and deliver an online fatigue management programme for individuals with MS, but with potential for widening the programme for individuals with other long-term conditions. To this end, we are currently 'mapping' the characteristics fo the fatigue programme (with funding support from the School of Physiotherapy) to identify the specfic factors that influence behaviour change.

Publications

Journal articles

Mulligan, H., Wilkinson, A., and Snowdon, J. (2017) A fatigue maangement programme for person with multiple sclerosis: development, theory and practical consideration.  Physical Therapy Reviews. 

Mulligan H, Wilkinson A, Snowdon J. (2016) Perceived impact of a self-management programme for fatigue in multiple sclerosis: A qualitative study. International Journal of MS Care, 18(1), 27-32.

Mulligan, H., Wilkinson, A., Barclay, A., Whiting, H., Heynike, C., & Snowdon, J. (2016). Evaluation of a fatigue self-management programme for people with multiple sclerosis. International Journal of MS Care, 18(3), 116-121.

Mulligan, H., Miyahara, M., & Nichols-Dunsmuir, A. (2016). Multiple perspectives on accessibility to physical activity for people with long-term impairment. Scandinavian Journal of Disability Research, Published online 04 April 2016.

Mulligan, H., Wilkinson, A., Lusty, A., Delorme, A., & Bong, S. (2015). Consumers and health professionals’ perceptions of Participatory Action Research in developing a health resource. New Zealand Journal of Physiotherapy, 43(3), 93-97.

Articles – other

Mulligan, H., Snowdon, J. and Tapper,L. (2016). Consumer involvement in creating a fatigue management programme in New Zealand. Way Ahead, Volume 20, Part 1, pages 9-12 (January 2016) 
www.mstrust.org.uk/health-professionals/practice-resources/way-ahead


Presentations

Mulligan, H., Snowdon, J., & Wilkinson, A. (2015). Outcomes from the Canterbury Fatigue Programme for people with multiple sclerosis: A mixed method feasibility study. Physiotherapy, 101(Suppl. 1), (pp. e1056-e1057). doi: 10.1016/j.physio.2015.03.1937

Mulligan H, Snowdon J and Tapper L (2014). Consumer involvement in the development of a programme to support behaviour change: The Canterbury Fatigue Project. RIMS (Rehabilitation in Multiple Sclerosis) conference Supporting behaviour change. Brighton UK, 6-7 June.

Mulligan H, Snowdon J and Tapper L (2013). Participatory Action Research to develop a programme for self-management of fatigue in multiple sclerosis. PhysioForward, Centennial Conference, 5-6 April, Dunedin. Abstract pg 52

Funding

Funding and support has been received from:

o MS & Parkinson’s Society Canterbury Inc. - To support the development of MFML programme.

o University of Otago Research Grant – To evaluate MFML and to explore the perceived impact of the programme for participants.

o Royal Society of NZ: New Zealand-Germany Science & Technology Programme. Reciprocal funding received to facilitate travel for co-operation between two research groups - Dr Mulligan (Centre for Health, Activity and Rehabilitation Research, University of Otago, NZ) and Professor Pfeifer (Institute of Sport Science and Sport, Friedrich-Alexander University, Erlangen, Germany) in 2015 and 2016.


Our people

Research team

Project lead: Dr Hilda Mulligan hilda.mulligan@otago.ac.nz

Dr Mandy Wilkinson (CHARR, University of Otago)

International collaboration

Professor Pfeifer (Exercise Scientists, Friedrich-Alexander University, Erlangen, Germany)

Further information

Multiple Sclerosis & Parkinson’s Society of Canterbury www.ms-pd.org.nz

Minimise Fatigue, Maximise Life: Creating balance with multiple sclerosis May 2013.
Jessie Snowdon’s presentation to launch MFML.  Jessie’s portion starts at 22:47 Launch video