Skeletal Muscle Aging and Responsiveness in Aged People With MS

Inclusion Criteria:

* 1\. Male or female aged 60 or above 2. Free of unmanaged chronic diseases other than multiple sclerosis 3. No structured exercise program (2 or more bouts/wk) within previous 6 months 4. Cognitively capable of providing informed consent 5. Must meet EDSS score between 2 to 5.5 during screening

Exclusion Criteria:

* 1\. Neuromuscular or musculoskeletal disorder, other than multiple sclerosis, that would limit the ability to perform the exercise and/or testing bouts.

  2\. Cardiopulmonary disorders or reduced breathing capacity

  3\. Metabolic diseases including markers of liver disease (ALT \> 52 U/dl) and type 2 diabetes (HbA1C ≥ 6.5, fasting blood glucose ≥ 126 mg/dl)

  4\. Taking any dose of metformin

  5\. Any other disease or disorder that would influence exercise response (e.g., chronic kidney disease, Alzheimer's, current cancer diagnosis or within 2 yr remission, cerebrovascular)

  6\. History of Chemotherapy within 5 years

  7\. Unchangeable anticoagulant (Coumadin, Pradaxa, etc.) use. To be determined by clinical staff.

  8\. Insulin sensitizing/blood glucose lowering (e.g., metformin) or metabolic (GLP1 agonists) drugs.

  9\. High dose statin (40 mg and above)

  10\. Have a non-correctable visual impairment

  11\. Score less than 29 on the Symbol Digit Test

  12\. Received Botox for spasticity within the prior 3 months of study participation.

  13\. Cannot have any adjustments to Baclofen during study participation.

  13\. Unable to commit to \~4 months required to complete the study.

  14\. Lidocaine allergy

  15\. Tobacco use

  16\. Excessive alcohol consumption (3 drinks/d or 7 drinks/wk for females; 4 drinks/day or drinks/wk for males)

  17\. BMI greater than 35.0 kg/m2