Gamified mobile health app designed to help people with MS manage fatigue

Gamified mobile health app designed to help people with MS manage fatigue

A new study published in Multiple Sclerosis and Related Disorders shows the potential of More Endurance, a mobile health (mHealth) app designed to help people with multiple sclerosis (MS) manage fatigue, one of the disease's most common and debilitating symptoms.

The research by researchers Dr. Guido Giunti and neurologist Dr. Mervi Ryytty and assistant professor Johanna Kruger from the University of Oulu and Oulu University Hospital in Finland, led by the researcher, evaluated the feasibility, ease of use and the impact of increased endurance over a 60-day period.

Fatigue is an invisible but life-changing symptom of MS. It requires more than just medication. Greater stamina gives people the tools to understand their energy levels, take control of their day, and communicate their needs more effectively. “

Guido Giunti, digital health expert at the University of Oulu and leader of the mehr Stamina project

The study followed 20 participants from Oulu University Hospital who used the app daily for two months. The results showed that: • Users became more aware of their fatigue patterns, allowing them to plan their days more effectively. • Higher engagement correlated with increased self-confidence, particularly in patients with more severe fatigue. • The app has helped facilitate discussions with family members and healthcare providers and improve mutual understanding of the effects of fatigue. • Usability improved over time, although some users found data entry cognitively demanding, indicating areas for refinement.

An evidence-driven digital health solutionMore Stamina helps users track their daily activities and energy consumption with “Ausdach Credits,” a gamified approach that visualizes energy consumption and helps users make informed decisions about their daily plans. Unlike many digital health solutions, More Perseverance stands out for its research approach at every stage by identifying the patient's needs for design, prototyping, development and testing. Each phase was accompanied by peer-reviewed research, creating a transparent scientific trail for a mobile health solution. “Digital health solutions are only as good as their foundation,” said Professor Minna Isomursu, user-centered design expert and co-author of the study. "From the beginning, we worked with real patients and medical professionals to build something really useful. That's key to building tools that people actually find useful in their daily lives."

Bringing digital health into MS careFatigue affects up to 80% of MS patients and has a profound impact on their quality of life. Treating fatigue is challenging because it involves physical, cognitive and emotional factors and often leaves patients feeling exhausted, misunderstood and unsupported. While digital health solutions have increasingly been proposed to treat chronic diseases such as MS, few have been rigorously evaluated to ensure their effectiveness and real-world impact. Neurologists at Oulu University Hospital emphasize the potential of such solutions in complementing traditional MS care. “Managing MS fatigue has always been challenging as it varies from person to person,” said Dr. Mervi Ryytty, neurologist at Oulu University Hospital. “A tool that helps patients visualize and plan their energy levels can make a real difference in the way they manage their symptoms.” While the study confirmed that increased endurance is a feasible and acceptable tool, researchers emphasize that larger and longer-term studies are needed to evaluate its full clinical impact. The team is now exploring ways to integrate more endurance into broader MS care strategies: “This study reinforces the role of digital health solutions in MS care,” added Dr. Johanna Krüger, neurologist at Oulu University Hospital, added. “Now we need to refine it, expand access and ensure that digital tools like these can become an effective and comprehensive part of MS care.”

Empower patients and strengthen family dialogueOne of the study's unexpected yet powerful findings was the role that increased persistence played in facilitating conversations between MS patients and their families. Many participants reported that sharing their fatigue patterns with loved ones made them feel understood and supported. “Invisible fatigue is difficult to explain to those who don't experience it, especially since I don't always understand it myself,” said Tonja Molin-Juustila, a patient advocate involved in the project. "More Endurance gives you a concrete tool to look at fatigue and discuss it with family. Instead of repeating "I'm so tired now, it will seem that you need to rest more often. More Endurance was not just about technology, but also about people. Active participation from patient advocates was key to ensuring the app dealt with real life challenges. Beyond its success in MS Fatigue management, this project has achieved success by combining scientific rigor, user-centered design and “We need to go beyond gimmicks and ensure that digital health solutions are truly beneficial,” said Dr. Guido Giunti. "The way we've worked together with more tenacity is proof that when we bring science, technology and patient voices together, we can create tools that actually improve lives. We hope this approach sets a new standard for future digital health solutions."

The study was funded by Business Finland, the Finnish Innovation Fund (SITRA), the Riitta Ja Jorma J. Takanen Foundation and Marie Sklodowska-Kurie actions.

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