"Being under increasing cost pressure, municipalities have started to explore possibilities of implementing assisted living technologies to provide elderly care and rehabilitation at home without a need of physiotherapist to be present. It is one of the priorities also in Smart Health program of City of Tampere. The range of new technologies currently being evaluated and tested includes wearable sensors and exoskeletons as well as videogames that motivate people to move. " Tapio Jakobsson, Business Development Director, Physilect Oy International Technology Conference Mindtrek 2017 20th - 21st of September, 2017 Tampere, Finland

1. Rehabilitation through VR
Tapio Jakobsson, 21.9.2017

2. • Ineffective rehabilitation causes enormous
costs to the society
• €350 million is KELA’s annual rehabilitation
budget (2015)
• Population is getting older
• Falls (hip fractures) cause €183 million bill to
the society in Finland only*
Prerequisites
* Source: VTT

3. Trends and challenges in healthcare
Population ageing
- Duplication number of over 75 years old by
2040, 420.000 → 950.000 *
- Increasing labour shortage
 Cost pressure of public healthcare
 Decreasing number of institutional care
beds and increasing number of home care
patients
High number of stroke and other
neurological patients
 High need of post-operation rehabilitation
 Increasing pressure to utilize latest
technologies e.g. in remote rehabilitation
Need of new
treatment
methods and
tools, that allows
more
rehabilitation
done at homes
*. Statistics Finland, Medgroup

4. New technologies for rehabilitation
Soft exoskeletons
• to assist people with limited abilities
• expensive, applied to very specific purposes
Exergames
• to boost patient's motivation and engagement
Assistant robots
• to allow remote rehab without physiotherapist’s presence
Wearable sensors
• instant biofeedback
• very accurate tracking of specific part of the body
Non-wearable motion tracking
• instant biofeedback
• cheap and very easy to use
• accurate enough for most applications in rehabilitation
4

5. Current state of rehabilitation in Finland
• Rehabilitation is based on professional
knowledge
• Virtual rehabilitation is not used systematically
• Remote rehabilitation
- Increasing interest towards remote rehabilitation
- Emerging technologies are not widely used in Finland
- Real-time video streaming is accepted as standard for remote
rehabilitation
5

6. Reseach: virtual reality games for seniors
• Positive clinical effects of virtual reality games for
balance and mobility improvements
– Cognitive and motor skills training
– Cost-effective method
• Positive impact on fall prevention
• “Virtual reality games were superior for improving
balance and fear of falling compared with traditional
interventions in an elderly population”
6
Source: Neri, S. G., Cardoso, J. R., Cruz, L., Lima, R. M., de Oliveira, R. J., Iversen,
M. D., & Carregaro, R. L. (2017). Do virtual reality games improve mobility skills and
balance measurements in community-dwelling older adults? Systematic review and
meta-analysis. Clinical Rehabilitation, 0269215517694677.

7. Physilect
A perfect mixture of exergame and virtual
assistant using non-wearable motion tracking
• boosts patient's motivation
• allows remote rehabilitation without physiotherapist’s
presence
• helps designing patient specific rehabilitation program
• provides instant biofeedback to correct the performance
• affordable and very easy to use in home conditions
• allows remote follow-up by a physiotherapist

8. • Doctor
– Correct diagnosis
• Physiotherapist
– Proper selection of exercises
– Rehabilitation plan
– Follow up and adjust the plan upon the progress
• Patient
– Regular exercises
– Correct execution
Ideal course of treatment

9. 25 out of 30 patients, when left alone, do their
exercises irregularly and incorrectly
Why irregularly? => Motivation
Why incorrectly?
Real life

10. Typical instructions

11. Printout from commercial exercise library
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Source: www.physiotools.com

12. Demo
12

13. Skeleton Model
Graph
Skeleton
Joint
Sensor Tracking Sector
One or two Microsoft
Kinect sensor(s)
Skeleton Model Data
Flow
Technology

14. The patient’s view

15. The physiotherapist’s view

16. 16

17. Basic functionality of Physilect
•Easy to follow exercise program
•Real time biofeedback to the patient
•Exercises could be easily adjusted based on
individual need
•Game mode allows most of the exercises to
be done in game mode (with different types
of games)
• -> increases motivation
17

18. Stabilect
• Virtual balance board
• Standard balance tests
without special
equipment
• Measuring balance
and center of mass
separately or during
exercises
18

19. Testing/diagnostics
• Testing/diagnostics allow
to measure each patient
ability to move
- Measuring angles of the
joints
– e.g. knee bending angle
- Monitor progress of
rehabilitation
- Adjust exercises based on
individual needs
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20. Motion lab
•Internal productivity tool
–Allows to digitalize easily new exercises to
Physilect’s exercise library
•Preventive injury diagnostics tool
–Ability to track and analyze movements of
patient very carefully
Example:
recorded jump
20

21. 21

22. • Neurology
– Post-stroke rehabilitation, Parkinson, Cerebral palsy, MS,
etc.
• Orthopedy
– Post-operational and post-trauma rehabilitation
• Geriatry
– Rehabilitation of seniors. Fall prevention.
• Occupational health
– Musculoskeletal disorders are common for office workers
Applications

23. • Total product development effort so far
about 20 men years
• 100+ exercises digitized to the Physilect
library
• Balanced team
– Seasoned IT entrepreneurs engaged
– Expertise in physiotherapy
• Several pilots currently going on
– Fysios Group (Lappeenranta)
– Tampere University Hospital
– Neuron (Kuopio)
– Vetrea Terveys Oy (Kuopio, Joensuu)
Current state of the development

24. • Physilect Professional
– installed at customer’s premises
– two Kinects
• Physilect Home
– installed at patient’s home
– one Kinect
Product alternatives

25. Benefits of the solution
•Shortening hostipal / institutional care stays
•Reducing risks of re-admission
•Decrease number of face-to-face appointments
•Constant monitoring of one’s rehabilitation process
•etc.
Main benefits:
•Improves efficiency of rehabilitation
•Saves healthcare cost
25

26. Example
•Stroke patient exercises
26

27. 27

28. Questions?
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Tapio Jakobsson
Tapio.jakobsson@physilect.com
+358 50 440 6552