Part A: Neuromodulation for Functional Recovery in MS: The Role of Spinal Cord Stimulation Spinal cord stimulation is a neuromodulation technique used to amplify sensorimotor recovery after neurologic injury. Historically, the need for implantable epidural stimulators has limited their use. However, a new non-invasive approach, transcutaneous spinal cord stimulation, has been developed and was recently FDA-approved for clinical use following traumatic spinal cord injury. Here, we present evidence for spinal cord stimulation for functional recovery following neurologic injury. First, we will provide an overview of the clinical evidence for transcutaneous spinal cord stimulation, including the studies that led to its FDA approval for improving hand and arm function after traumatic spinal cord injury, as well as the growing body of research demonstrating improvements in sensorimotor and autonomic function across a range of neurological conditions. Next, we will present preliminary data on the use of this method for the recovery of sensorimotor function in people living with multiple sclerosis. These findings include data from our pilot randomized two-arm crossover trial of transcutaneous spinal cord stimulation combined with intensive therapy to promote functional recovery of the hand and arm in adults living with multiple sclerosis. Potential mechanisms, including pre-clinical data supporting the role of spinal cord stimulation in promoting remyelination and neuroprotection, will be discussed. This session is intended for rehabilitation professionals and neurologists with an interest in strategies for both functional recovery and central nervous system repair/preservation for people living with multiple sclerosis. Level of Information: Intermediate Part B: Fatigue is one of the most common and debilitating symptoms experienced by individuals with multiple sclerosis (MS). MS fatigue can affect mental functioning, physical functioning, and the ability to engage in daily activities. Its impact can be pervasive, often limiting participation, productivity, and overall quality of life. This session will provide an intermediate level audience with a concise yet thorough synthesis of contemporary knowledge on MS fatigue. The overview will include the epidemiology of MS fatigue, proposed etiologic mechanisms, and the definitional frameworks used in current research and clinical practice. The session will explain how fatigue is operationalized and assessed by contrasting self-report questionnaires with performance-based assessments as well as clarifying distinctions between fatigue and fatigability. Evidence-based treatment strategies will be reviewed. The role and influence of physical activity and exercise on MS fatigue will be discussed. Findings from two large pragmatic clinical trials conducted by the presenters will be summarized. One trial evaluated an occupational therapy-led fatigue management intervention delivered remotely and in person. The second compared cognitive behavioral therapy and pharmacologic approaches, assessed their independent and combined effects, and incorporated ecological momentary assessments to detect meaningful improvements in daily fatigue. The session will integrate conceptual, methodological and empirical perspectives to advance understanding of fatigue and fatigability and to identify promising avenues for future clinical and research efforts. Level of Information: IntermediatePart A: Neuromodulation for Functional Recovery in MS: The Role of Spinal Cord Stimulation Spinal cord stimulation is a neuromodulation technique used to amplify sensorimotor recovery after neurologic injury. Historically, the need for implantable epidural stimulators has limited their use. However, a new non-invasive approach, transcutaneous spinal cord stimulation, has been developed and was recently FDA-approved for clinical use following traumatic spinal cord injury. Here, we present evidence for spinal cord stimulation for functional recovery following neurologic injury. First, we will provide an overview of the clinical evidence for transcutaneous spinal cord stimulation, including the studies that led to its FDA approval for improving hand and arm function after traumatic spinal cord injury, as well as the growing body of research demonstrating improvements in sensorimotor and autonomic function across a range of neurological conditions. Next, we will present preliminary data on the use of this method for the recovery of sensorimotor function in people living with multiple sclerosis. These findings include data from our pilot randomized two-arm crossover trial of transcutaneous spinal cord stimulation combined with intensive therapy to promote functional recovery of the hand and arm in adults living with multiple sclerosis. Potential mechanisms, including pre-clinical data supporting the role of spinal cord stimulation in promoting remyelination and neuroprotection, will be discussed. This session is intended for rehabilitation professionals and neurologists with an interest in strategies for both functional recovery and central nervous system repair/preservation for people living with multiple sclerosis. Level of Information: Intermediate Part B: Fatigue is one of the most common and debilitating symptoms experienced by individuals with multiple sclerosis (MS). MS fatigue can affect mental functioning, physical functioning, and the ability to engage in daily activities. Its impact can be pervasive, often limiting participation, productivity, and overall quality of life. This session will provide an intermediate level audience with a concise yet thorough synthesis of contemporary knowledge on MS fatigue. The overview will include the epidemiology of MS fatigue, proposed etiologic mechanisms, and the definitional frameworks used in current research and clinical practice. The session will explain how fatigue is operationalized and assessed by contrasting self-report questionnaires with performance-based assessments as well as clarifying distinctions between fatigue and fatigability. Evidence-based treatment strategies will be reviewed. The role and influence of physical activity and exercise on MS fatigue will be discussed. Findings from two large pragmatic clinical trials conducted by the presenters will be summarized. One trial evaluated an occupational therapy-led fatigue management intervention delivered remotely and in person. The second compared cognitive behavioral therapy and pharmacologic approaches, assessed their independent and combined effects, and incorporated ecological momentary assessments to detect meaningful improvements in daily fatigue. The session will integrate conceptual, methodological and empirical perspectives to advance understanding of fatigue and fatigability and to identify promising avenues for future clinical and research efforts. Level of Information: Intermediate