Neuromodulation in MS Using Translingual Stimulation

Translingual Stimulation Combined With Physiotherapy to Improve Walking and Balance in Multiple Sclerosis: an RCT

The overarching aim of this study is to examine if there is additional benefit to adding trans-lingual electrical stimulation to physiotherapy aimed at improving walking and balance in people with multiple sclerosis (MS).

This is a two arm, participant-blinded, interventionist blinded, and research assessor-blinded RCT Participants with walking problems due to MS (Patient Determined Disease Steps PDDS 3-6) will be randomized 1:1 after baseline assessment stratified into 2 arms (lower walking disabilities PDDS 3+4, and higher walking disabilities PDDS 5+6) Following a 14 week balance and walking training intervention, participants will be instructed to continue to exercise independently according to the evidence-based Physical Activity Guidelines in MS for a subsequent 12 weeks. They will be reassessed at the end of that time (FOLLOW-UP).

Inclusion Criteria:

• confirmed diagnosis of multiple sclerosis
• gait deficit due to MS but still able to walk (EDSS less than 6.5, PDDS 3-6)
• older than 18 and less than 70 years of age
• agree to the study time commitment.

Exclusion Criteria:

• currently attending physical rehabilitation for walking and/or balance training,
• currently already functional community ambulators (gait speed>120cm/s)
• contra-indications to the use of translingual electrical stimulation (active or suspected malignant tumor; recent bleeding or open wounds in mouth; women who are pregnant, or sensitivity to nickel, gold or copper)