To establish feasibility of a teleintervention targeting mobility impairment with at-home exercise and transcranial direct current stimulation (tDCS) in people with multiple sclerosis (MS).

tDCS is a non-invasive brain stimulation technique that has the advantage to be delivered using a portable and handheld device, thus, it is increasingly being deployed through supervised self-administration in the home setting. In our previous study, we successfully piloted the in-clinic use of tDCS targeting the primary motor cortex to improve mobility in people with MS. To overcome the problems of access and adherence to exercise as a treatment for improving mobility, we piloted a telehealth intervention to provide a structured and accessible at-home program of daily exercise paired with our remotely-supervised tDCS (RS-tDCS) protocol.

People with MS (EDSS<6.5) were enrolled in a sham-controlled pilot study to receive 10x20-mins daily at-home sessions of either active or sham tDCS paired with moderate intensity cycling training delivered by a small seated elliptical machine (Cubii Pro). Stimulation was administered over the primary motor cortex (2.5 mA; anode C3/cathode FP2). All stimulation sessions were supervised in real-time. Measurements of gait velocity were collected at baseline and at treatment end.

RS-tDCS paired with exercise offers a widely accessible and easily scalable tool to address mobility impairments in those with MS and it is generalizable for use across a range of neurologic conditions.