# Aerobic exercise to improve mobility in multiple sclerosis: optimizing design and execution for a full-scale multimodal remyelination clinical trial

> **NIH NIH K23** · OREGON HEALTH & SCIENCE UNIVERSITY · 2021 · $159,729

## Abstract

PROJECT SUMMARY/ABSTRACT
Multiple sclerosis (MS) is a common neurologic disease that can result in significant restriction in activity and
participation. MS is caused by intermittent inflammation causing demyelination and axonal damage. The
promotion of remyelination is a promising therapeutic strategy to overcome and prevent MS disability by
improving the conduction velocity of action potentials and providing neuroprotective insulation for the axon.
Effective remyelination will likely require a multimodal approach, including rehabilitative and pharmacologic
therapies, to stimulate remyelination along neural pathways. In animal models of MS, aerobic exercise can
promote remyelination alone or synergistically with pharmacotherapy. However, it is currently uncertain how to
measure remyelination in people with MS and this lack of a reproducible and reliable measure of myelin status
is a major obstacle to the development of remyelination therapies. Prior to the successful development of
large-scale multimodal clinical trials, there is a crucial need to 1) determine the optimal outcomes to assess the
extent of remyelination, and 2) demonstrate the feasibility and study design of a rehabilitative aerobic exercise
intervention.
The central hypotheses of this study are that 1) spinal cord demyelination in MS, as measured by prolongation
of somatosensory evoked potential (SSEP) latency, is associated with reduced function, activity and
participation in people with MS, and 2) aerobic stationary cycling is a safe and feasible rehabilitative
intervention in people with MS to improve mobility. Besides addressing these hypotheses, we will gather
preliminary data on the effects of aerobic exercise on SSEP latencies, walking speed, and other measures of
activity and participation. SSEPs are an ideal objective measure as they are inexpensive, reproducible,
commercially available, and provide a functional measure reflecting myelination in the spinal cord. This
proposed study will explore the association between myelination, as assessed by SSEPs, and a panel of
outcome measures of body structure, function, activity and participation, to determine optimal clinical outcomes
to monitor remyelination. This study will also determine the safety and feasibility of a 24-week aerobic
stationary cycling intervention as compared to an MS symptom education control intervention in a randomized,
single-blind, parallel clinical trial in people with MS. An experimental aim will explore if aerobic stationary
cycling is associated with improvements in mobility and remyelination of the spinal cord, as measured by
SSEP. The goal of this study is to lay the ground work needed to design and implement a future, R01-funded,
multimodal, randomized clinical trial of aerobic stationary cycling and pharmacotherapy to stimulate
remyelination in people with MS.

## Key facts

- **NIH application ID:** 10164840
- **Project number:** 5K23HD101667-02
- **Recipient organization:** OREGON HEALTH & SCIENCE UNIVERSITY
- **Principal Investigator:** Lindsey Brianna Wooliscroft
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $159,729
- **Award type:** 5
- **Project period:** 2020-07-01 → 2025-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10164840

## Citation

> US National Institutes of Health, RePORTER application 10164840, Aerobic exercise to improve mobility in multiple sclerosis: optimizing design and execution for a full-scale multimodal remyelination clinical trial (5K23HD101667-02). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10164840. Licensed CC0.

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