White paper: Extended Reality within telerehabilitation
More than a third of people in the UK live with a musculoskeletal (MSK) condition, while millions more are affected by cardiac and pulmonary conditions. These conditions can have a profound impact on quality of life, independence and employment, with MSK conditions alone leading to more than 30 million lost working days every year. For many patients, comorbidities can add further complexity to their care and rehabilitation needs.
Rehabilitation for these high-demand pathways is often fragmented and inconsistent. Acceptance criteria and models of delivery often vary between regions. Patients are required to engage with multiple services, from primary care to specialist clinicians in the community
Extended reality (XR) presents a significant opportunity to transform rehabilitation delivery. Aligned with the shift from analogue to digital, XR technology could play an important role in enabling scalable, personalised telerehabilitation services that improve patient experience, increase capacity and support better outcomes delivered closer to patients’ homes.
What is telerehabilitation?
Telerehabilitation is the use of digital technologies, such as mobile devices or XRtechnologies, to deliver rehabilitation services remotely for physical and mental health conditions. This may include assessment, monitoring patient symptoms and treatment, such as exercises.
Background
TeleRehaB is a Horizon Europe-funded research and innovation programme focused on developing an AI-enabled Decision Support System (DSS) to support home-based augmented reality (AR) balance rehabilitation The HIN joined the TeleRehaB programme in 2022 through funding provided by Innovate UK.
Early work within TeleRehaB focused on stroke, vestibular disorders and long COVID, demonstrating the potential for immersive technologies to improve access to rehabilitation, reduce the need for travel and increase patient engagement. The work also highlighted practical implementation considerations, including digital inclusion, hardware requirements and service integration.
Building on these insights, the project was extended to explore the potential role of XR within pulmonary, cardiac and MSK rehabilitation pathways. Three roundtables with explored:
- current challenges within rehabilitation services;
- opportunities for XR to support care delivery;
- practical considerations for implementation within routine clinical practice; and
- perceived barriers and enablers to future XR technology adoption.
Findings
The XR within TeleRehaB white paper brings together insights from pulmonary, cardiac and MSK rehabilitation roundtables, providing a cross-pathway perspective on the opportunities, challenges and considerations associated with the adoption of XR. The report also highlights the current digital maturity of these pathways and begins to identify where digital technologies, such as XR, could be integrated into existing models of care.
The key opportunities and considerations identified through the three roundtables are framed around five cross-cutting key themes. These include the importance of clinical value and evidence; patient access and engagement; workforce readiness and implementation; digital infrastructure and system readiness; and integrating with existing rehabilitation pathways.
While many of the opportunities and challenges were common across all three pathways, the report also highlights the importance of clinical context. Differences in patient populations, service delivery models, and levels of digital maturity are shown to have a significant influence on both the pace and nature of digital transformation, shaping how and where XR technologies can be most effectively implemented.
Key considerations for successful implementation of XR for rehabilitation
The white paper also outlines key considerations for healthcare organisations and innovators seeking to develop, evaluate or adopt XR technologies for rehabilitation. Through these insights, it aims to inform future implementations and support the development of solutions that are aligned with the needs of patients, clinicians and rehabilitation services.
Demonstrate clinical value
XR has the potential to extend care beyond face-to-face appointments, supporting areas such as physical activity and self-management. Successful implementation can be strengthened by a clear value proposition; robust evidence bases; measurable pathway-specific clinical outcomes; real-world implementation examples; and cost-effectiveness compared with existing models of care.
Design for inclusive and accessible care
XR has the potential to support patient engagement with greater flexibility and choice. By designing solutions with accessibility, digital literacy and language support in mind, services can maximise participation and help ensure that the benefits of XR are available to a diverse range of patient populations.
Support workforce readiness
XR has the potential to enhance service delivery and workforce capacity. Staff training, ongoing technical support and dedicated time to introduce patients to new digital approaches are all critical in supporting sustainable change.
Ensure digital and operational readiness
XR has the potential to strengthen digital capabilities across pathways with varying levels of digital maturity. Reliable connectivity, appropriate hardware, technical support and interoperability with existing clinical systems are key enablers for successful implementation and long-term scalability.
Embed technology within existing care pathways
XR has the potential to enhance and complement existing rehabilitation models by adding value where there is a clear service need. Integrating XR within established pathways can support clinical oversight, encourage staff engagement and help ensure digital technology strengthens, rather than disrupts, existing models of care.
Read the white paper
Download the full Extended Reality within telerehabilitation white paper using the link below.
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