Development and preliminary evaluation of a 3-week Inpatient Energy Management Education (IEME) program for people with multiple sclerosis-related fatigue

Background: Energy conservation strategies and cognitive behavioral therapy techniques are valid parts of outpatient fatigue management education in persons with multiple sclerosis (pwMS). In many European countries, multidisciplinary rehabilitation for pwMS is chiefly delivered in specialized rehabilitation centers where pwMS benefit from short intensive inpatient rehabilitation, annually. However, no evidence-based and standardized fatigue management education program compatible with the inpatient setting is available. Methods: Based on a literature search and the expertise of occupational therapists (OTs), a manualized group-based Inpatient Energy Management Education (IEME) program for use during 3-week inpatient rehabilitation, which incorporates energy conservation and cognitive behavioral management approaches, was developed. An IEME - pilot operated by trained OTs has included 13 persons with multiple sclerosis-related fatigue. IEME user and OTs experiences were collected during focus groups to refine the program's materials and to verify its feasibility in the inpatient setting. Results: The program was feasible in an inpatient setting and met the needs of the pwMS. Targeted behaviors were trained in all participants within a clinical context. In-charge OTs were able to effect behavioral change through IEME. Conclusions: Users evaluate the evidence-based IEME program positively. The topics, supporting materials, and self-training tasks are useful for the promotion and facilitation of behavioral change. The next step will be a clinical trial to investigate the efficacy of IEME and to evaluate relevant changes in self-efficacy, fatigue impact, and quality of life after patients return home