Efficacy and feasibility of neuromuscular electrical stimulation in individuals with demyelinating disease and Uhthoff’s phenomenon unable to engage in conventional exercise: a randomized controlled pilot trial protocol

This pilot study investigates the feasibility, safety, and efficacy of neuromuscular electrical stimulation (NMES) as a temperature-tolerant rehabilitation strategy for adults with demyelinating disorders (e.g., MS, MOGAD, NMO) who experience exercise intolerance due to Uhthoff’s phenomenon. Over 12–16 weeks, participants will be randomized to NMES or passive movement/relaxation, with outcomes assessing lower-limb strength, endurance, fatigue, mood, quality of life, and adherence. This research aims to offer a non-thermal alternative to conventional exercise, potentially improving physical and mental health in a population often limited by heat sensitivity and at higher risk for disease progression.