Inclusion Criteria:

• - Persons with relapsing-remitting or progressive forms of MS between the ages of 22 and 75.

• - Ability to ambulate at least 15 minutes throughout the day for five days per week, with or without assistive device.

• - Adequate cognitive and communicative function as assessed via Telephone Interview for Cognitive Status (TICS) to identify persons with dementia.

• - Able to tolerate the Neural Sleeve device for up to 8 hours per day.

• - T25FWT time between 8 and 45 seconds.

• - No recent change in medication or recent exacerbation of symptoms over the last 60 days.

• - Patient-determined Disease Steps score between 3 and 5 or EDSS score between 4 and 6.5.

Exclusion Criteria:

• - Lower motor neuron disease or injury (e.g. peripheral neuropathy) that may impair response to stimulation.

• - Absent sensation in the impacted or more impacted leg.

• - Inadequate response to stimulation, defined by inability to achieve muscle contraction or unable to tolerate stimulation.

• - Inability to ambulate with the sleeve in place of an ankle foot orthosis (AFO)/knee ankle foot orthosis (KAFO) if utilized.

• - History of falls greater than once a week.

• - No use of FES devices in the past year.

• - Demand-type cardiac pacemaker or defibrillator.

• - Malignant tumor in the impacted or more impacted leg.

• - Existing thrombosis in the impacted or more impacted leg.

- Fracture or dislocation in the impacted or more impacted leg that could be adversely affected by motion from stimulation

The randomized within-participants crossover study aims to demonstrate the clinical impact of the Cionic Neural Sleeve for individuals diagnosed with MS. Physical measurements, performance-based tests, and questionnaire responses will be recorded. These include physical activity recorded by an Actigraph; in-person tests measuring disability, spasticity and balance; and questionnaires gauging perceived walking ability, quality of life, and physical and psychological impact of MS. All participants will be assigned a hip-worn Actigraph activity monitor, a Cionic Neural Sleeve on the most impacted leg, and prescribed a home-based intervention of 15 minutes of walking for 5 days a week for 12 weeks. The Actigraph will be worn for the duration of the 12-week walking intervention, while the Cionic Neural Sleeve will be worn for 6 weeks of the study. Participants will be randomized to one of two groups: A or B. Group A will wear the Actigraph and receive stimulation assisted walking from the Neural Sleeve (intervention), while group B will only wear the Actigraph while walking. After 6 weeks, participants in each group will cross over to the other group.

Arms

Experimental: Control

Participants will follow the walking program.

Experimental: Functional electrical stimulation

Participants will follow the walking program and receive stimulation assistance during the walking sessions.

Interventions

Device: - Cionic Neural Sleeve NS-100

The Cionic Neural Sleeve applies functional electrical stimulation as subjects walk to help contract appropriate muscles at appropriate times. The Cionic Neural Sleeve will be worn for 6 weeks.

Device: - Actigraph accelerometer

Physical activity will be recorded using an Actigraph accelerometer worn on the non-dominant hip.