Anna Kratz, PhD, associate professor of Physical Medicine & Rehabilitation, and a nonclinical research psychologist, University of Michigan Medicine

Anna Kratz, PhD

“Taking a multidisciplinary approach allows you to tweak across a bunch of different domains, potentially. If somebody is just on a medication, for instance, your options for tweaking their care over time are really limited. It's really about making care more patient-centered, [and] more tailored to every person at a given time.”

A multidisciplinary approach to multiple sclerosis (MS) treatment can generate benefits, and when addressing fatigue, both cognitive behavioral therapy and acceptance and commitment therapy can be particularly effective in the short- and long-term treatment plan. Anna Kratz, PhD, associate professor of Physical Medicine & Rehabilitation and a research nonclinical psychologist, University of Michigan Medicine, spoke with 

® on the integration of these therapies, which she noted many MS clinicians may be surprised to learn are available for their patients as a tool for symptom management.

Kratz further stressed the need to consider a variety of options for patients and identifying “what works for whom,” while also considering how treatment plans might change or need to be modified over the disease course. Precision health and tailored interventions for fatigue were the main focus of her presentation at the 

2021 Annual Meeting of the Consortium of Multiple Sclerosis Centers (CMSC)

, October 25-28, where she presented alongside her colleagues, Nora Fritz, PhD, PT, DPT, NCS, from Wayne State University, and Tiffany Braley, MD, MS, from the University of Michigan

REFERENCE
Kratz A. Combined approaches to fatigue in MS. Presented at: CMSC 2021; October 25-28, 2021; Orlando, FL. REHAB1.

Videos

Discussing cognitive behavioral therapy for patients with MS, the associate professor of Physical Medicine and Rehabilitation and research nonclinical psychologist at the University of Michigan Medicine mentioned different therapeutic options that can benefit this patient population. [WATCH TIME: 3 minutes]

Therapeutic Approaches to Fatigue in Multiple Sclerosis: Anna Kratz, PhD

“One of the things that I think we really need to do a better job at in MS research and clinical care is providing access to high-quality multidisciplinary care in a way that's accessible. Whether that is digitally delivered interventions that can go across the country, or something else.”

Addressing and treating fatigue in patients with multiple sclerosis (MS) can be challenging, as clinicians may be unsure of or unequipped with strategies to treat this “invisible” symptom, which may not be addressed like others of this variety, namely pain and depression. Anna Kratz, PhD, associate professor of Physical Medicine & Rehabilitation and a research nonclinical psychologist, University of Michigan Medicine, sat down with 

 to discuss the challenges surrounding treatment of fatigue, as well as the need for clinicians to engage with more multidisciplinary care interventions, particularly when they can be accessible remotely or via digital platforms. 

, October 25-28, Kratz presented on the broader issue of fatigue in the MS field alongside colleagues Nora Fritz, PhD, PT, DPT, NCS, from Wayne State University, and Tiffany Braley, MD, MS, from the University of Michigan.

Kratz referenced a website she designed— 

—that incorporates cognitive behavioral therapy for the treatment of fatigue within a self-managed, psychology-based platform. Digital platforms such as these may help to address the “scarcity of services” within the multidisciplinary care model, and while Kratz believes more should be developed, she also mentioned the need to put digital services through the same variety of trial testing that traditional interventions undergo in order to assess their effectiveness.

REFERENCE

Kratz A. Combined approaches to fatigue in MS. Presented at: CMSC 2021; October 25-28, 2021; Orlando, FL. REHAB1.

The associate professor of Physical Medicine & Rehabilitation and research nonclinical psychologist at the University of Michigan Medicine discussed challenges when addressing fatigue, as well as the need to integrate digital tools for patients with MS. [WATCH TIME: 4 minutes]

Strategies, Tools for Treating Fatigue in Multiple Sclerosis: Anna Kratz, PhD

“I really believe that if we can take this kind of biopsychosocial approach, where we're addressing health behaviors—exercise, sleep—as well as the psychosocial—stress, depression—all the kind of negative cognitions that can come around fatigue, and then also applying any medical kinds of approaches that would be helpful, that's an ideal approach.”

Addressing the issue of fatigue for patients with multiple sclerosis (MS) can be complex, and with the additional burden it places on patients, experts in the field continue to search for ways to combat and address it. Anna Kratz, PhD, associate professor of Physical Medicine & Rehabilitation, and a nonclinical research psychologist, University of Michigan Medicine, spoke with 

 on the importance of implementing a multidisciplinary approach to fatigue, one of the “unseen” or “invisible” symptoms of MS. 

According to Kratz, fatigue can negatively impact quality of life for people with MS, but it is not always inquired about or treated as seriously as mobility issues. She proposed a “biopsychosocial approach” where multiple health behaviors are analyzed, such as exercise and sleep, in addition to the psychosocial symptoms that may require medical approaches.

Kratz and her colleague colleagues, Nora Fritz, PhD, PT, DPT, NCS, from Wayne State University, and Tiffany Braley, MD, MS, from the University of Michigan, led a session on MS symptoms, primarily cognitive functioning, at the 

, October 25-28. While strategies and approaches for managing fatigue were the crux of Kratz’s presentation, Fritz also discussed exercise and physical activity interventions, while Braley commented on medical interventions. 

REFERENCE
Kratz A. Combined Approaches to Fatigue in MS. Presented at: CMSC 2021; October 25-28; REHAB1.

The associate professor of Physical Medicine & Rehabilitation and nonclinical research psychologist at University of Michigan Medicine discussed the complexities of fatigue as a symptom following her presentation at CMCS 2021.  

Anna Kratz, PhD

Articles

Therapeutic Approaches to Fatigue in Multiple Sclerosis: Anna Kratz, PhD

Strategies, Tools for Treating Fatigue in Multiple Sclerosis: Anna Kratz, PhD

A Multidisciplinary Approach to Fatigue in Multiple Sclerosis: Anna Kratz, PhD