This subproject is one of many research subprojects utilizing theresources provided by a Center grant funded by NIH/NCRR. The subproject andinvestigator (PI) may have received primary funding from another NIH source,and thus could be represented in other CRISP entries. The institution listed isfor the Center, which is not necessarily the institution for the investigator.The objective of this double-blind controlled pilot study is to assess whether a core cooling device that has been shown to augment athletic performance in individuals without multiple sclerosis (MS) improves motor function and aerobic exercise capacity in heat-sensitive MS patients with moderate-severe disability. 24 subjects who fulfill inclusion/exclusion criteria will be seen at screening (between 1 p.m. and 4 p.m.), and individuals able to complete the motor tasks and exercise at screening will then be evaluated on two additional afternoons (between 1 p.m. and 4 p.m.) 5-14 days apart. If a study subject is unable to complete the screening assessment and study days 1 and 2, an additional subject will be recruited, such that 24 subjects will complete the study. Individuals will serve as their own controls in this double-blind crossover study (12 in each crossover arm).At each of the visits, patients will carry out a number of motor assessments (9-hole peg testing [right and left], timed 25-foot walk, grip strength by dynamometry [right and left]) and upper extremity exercise with a Monark ergometer until they feel moderately fatigued (Borg scale). At screening, the motor assessments and exercise will be performed, but the palmar vacuum cooling device (AvaCore 'B' unit) will not be utilized. Subjects not able to complete these screening tasks will be excluded from further testing.At visits #1 and #2, some assessments will be carried out after sham- (no vacuum) or vacuum-cooling for 15 minutes, as detailed below. Sham-cooling (cooling without vacuum) serves as a negative control. Studies have shown that without the vacuum applying negative pressure, the palmar arteriovenous network constricts in response to cold alone, with little if any effect on core body temperature.'
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