University of Oulu

Giunti G, Rivera-Romero O, Kool J, Bansi J, Sevillano JL, Granja-Dominguez A, Izquierdo-Ayuso G, Giunta D, Evaluation of More Stamina, a Mobile App for Fatigue Management in Persons with Multiple Sclerosis: Protocol for a Feasibility, Acceptability, and Usability Study, JMIR Res Protoc 2020;9(8):e18196, URL:, DOI: 10.2196/18196, PMID: 32749995, PMCID: 743563

Evaluation of more stamina, a mobile app for fatigue management in persons with multiple sclerosis : protocol for a feasibility, acceptability, and usability study

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Author: Giunti, Guido1; Rivera-Romero, Octavio2; Kool, Jan3;
Organizations: 1University of Oulu, Oulu, Finland
2Universidad de Sevilla, Sevilla, Spain
3Kliniken Valens, Valens, Switzerland
4Hospital Nisa Sevilla, Sevilla, Spain
5Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.4 MB)
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Language: English
Published: JMIR Publications, 2020
Publish Date: 2020-09-24


Background: Multiple sclerosis (MS) is one of the world’s most common neurologic disorders leading to severe disability in young adults. MS-related fatigue directly impacts on the quality of life and activity levels of people with MS. Self-management strategies are used to support them in the care of their health. Mobile health (mHealth) solutions can offer tools to help symptom management. Following a user-centered design and evidence-based process, an mHealth solution called More Stamina was created to help persons with MS manage their fatigue.

Objective: The overall study aims are to explore the feasibility, acceptability, and usability of More Stamina, a mobile app for fatigue self-management for persons with MS.

Methods: A mixed-methods, multicenter study will be used to assess the feasibility, acceptability, and usability of More Stamina. The study will take place during the third and fourth quarters of 2020 (Q3-Q4 2020) in 3 locations: Argentina, Spain, and Switzerland. A longitudinal cohort study will take place, and think-aloud protocols, open-ended interviews, and short answer questionnaires will be used. Persons with MS will be recruited from the different locations. This study seeks to enroll at least 20 patients that meet the criteria from each site for the longitudinal cohort study (total n=60).

Results: Ethical approval has been granted in Argentina and is pending in Spain and Switzerland. Outcomes will be published in peer-reviewed medical journals and presented at international conferences.

Conclusions: Findings from this study will be used to help understand the role that mHealth can play in fatigue management in MS.

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Series: JMIR research protocols
ISSN: 1929-0748
ISSN-E: 1929-0748
ISSN-L: 1929-0748
Volume: 9
Issue: 8
Article number: e18196
DOI: 10.2196/18196
Type of Publication: A1 Journal article – refereed
Field of Science: 113 Computer and information sciences
217 Medical engineering
3121 General medicine, internal medicine and other clinical medicine
318 Medical biotechnology
Funding: The work on this project is funded by the University of Oulu’s Innovation Center grant for the More Stamina project. The present study is also conducted in collaboration with the “Understanding Daily Multiple Sclerosis Related Fatigue: A Participatory Health Informatics Approach” (MSF-PHIA) project, funded by the Fondo Europeo de Desarrollo Regional (FEDER) and the Andalusian Government from Spain (US-1263715). Additionally, the European Union Horizon 2020 Marie Skłodowska-Curie Action CHESS ITN (grant agreement No. 676201), European Network for the Joint Evaluation of Connected Health Technology (ENJECT) (COST Action TD1405), and FinCEAL Plus BRIDGES program from the Finnish Ministry of Education and Culture funded previous activities for this project. We would like to thank Prof. Minna Isomursu, Peter Oesch, PhD, Analia Baum, MD, and Fernando Testa for their cooperation and support.
EU Grant Number: (676201) CHESS - Connected Health Early Stage Researcher Support System
Copyright information: ©Guido Giunti, Octavio Rivera-Romero, Jan Kool, Jens Bansi, Jose Luis Sevillano, Anabel Granja-Dominguez, Guillermo Izquierdo-Ayuso, Diego Giunta. Originally published in JMIR Research Protocols (, 04.08.2020. This is an open-access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Research Protocols, is properly cited. The complete bibliographic information, a link to the original publication on, as well as this copyright and license information must be included.