JMIR Publications

ABSTRACT

Introduction: Multiple sclerosis (MS) is a chronic, progressive, and neurodegenerative disease affecting more than 2.8 million people globally. Mobility impairments are among the most significant challenges faced by people with MS (pwMS), leading to physical inactivity, deconditioning, and disability progression (for some, even irreversible disability). This negatively impacts mental health, social participation, and quality of life while placing a considerable economic burden on society. Exercise can improve mobility and mitigate disability progression, but facility-based options are often inaccessible, especially for those in remote areas. Telerehabilitation (TR) offers a promising alternative, but current systems are limited by complexity and hardware requirements.

Methods:

The PLATINUMS project proposes an AI-driven TR system to deliver accessible, cost-effective, and home-based exercise therapy for pwMS. The PLATINUMS project begins with working package (WP) 1, focusing on obtaining ethical approval and recruiting staff. Following this, WP2 involves a 4-week system feasibility and usability study (n=40) to assess and refine the digital platform. WP3 comprises a validity study (n=60) to evaluate remote mobility tests via the system, such as the short physical performance battery (SPPB), Functional Reach, and Sit-to-Stand tests, to ensure their reliability for use in WP4, the feasibility multicenter randomized controlled trial (RCT). The 10-week multicenter feasibility RCT will be conducted in MS centers across Denmark, Ireland, Israel, and Italy, with 96 participants varying in disability levels. The primary objective is to evaluate the efficacy of the AI-powered TR system on mobility outcomes compared to usual care. Finally, WP5 will assess the cost-effectiveness of the TR system by analyzing implementation costs, adherence, and healthcare utilization. The PLATINUMS project aims to revolutionize exercise therapy for pwMS by demonstrating the feasibility, validity, and preliminary efficacy of AI-driven TR system. This approach addresses barriers such as accessibility, privacy, and standardization while promoting patient and therapist acceptance.

Results:

Funding for the PLATINUMS project was accepted in February 2024. WP2 data collection began in April 2025 across four European sites. WP3 is scheduled to launch in July 2025, with WP4 (feasibility RCT) planned for January 2026. Initial WP2 results are expected by October 2025, with first publications anticipated in mid-2026. Discussion: The PLATINUMS project is expected to generate critical insights into the feasibility, usability, and preliminary efficacy of an AI-based TR system for pwMS. By leveraging widely available technology and real-time feedback, the system addresses key barriers to traditional rehabilitation. Findings from this protocol may inform future large-scale trials and support the broader implementation of digital health solutions in neurological rehabilitation.