CORDIS - EU research results

HOMER - Development of Home Rehabilitation system

Periodic Reporting for period 1 - Homer (HOMER - Development of Home Rehabilitation system)

Reporting period: 2016-12-01 to 2017-05-31

Homer is a revolutionary solution that will increase access and automate rehabilitation process by integrating motion capture technology with virtual reality and ICT platforms into a system which will extend limited dose of therapy patients normally receive in hospitals and rehabilitation facilities. It addresses and solves multiple issues in post stroke care and rehabilitation. The system will engage patients in a motivating training environment by gamification of therapy scenarios, thus making it more commercially attractive. Patients will be playing games by moving their affected part of the body. The proposed approach will drastically improve patient’s recovery potential and at the same time significantly reduce cost burden on healthcare systems.

Stroke is a devastating event which affects 15 million people around the world annually. According to the World Health Organization (WHO) stroke is the second single most common cause of death globally and in the EU region. Surviving stroke can be often considered worse than death. Stroke victims are facing an uncertain future and a life that may be severely affected by disability. Number of stroke cases in Europe is likely to increase from 1.1 million per year in 2000 to more than 1.5 million per year in 2025 because of ageing population. Currently there are approximately 8 million stroke survivors in the European Union. The number is expected to rise to over 10 million by the year 2020. Total cost of stroke is staggering, estimated at € 38 billion for EU and $ 65 billion for the USA. Stroke also places an incredible emotional and physical burden on caregivers and family members of stroke survivors.
While the number of stroke cases is growing, the mortality rate has drastically dropped, due to faster and more efficient treatment in the early acute stages. Combining this trend with a stagnating number of occupational and physical therapists we are facing a serious problem in access to rehabilitation. As a consequence more than 75 % of stroke survivors are left disabled and without proper care in the most crucial stages of recovery. On average a stroke patient receives 1 or 2 months of institutionalized recovery. It’s a known fact, backed by several scientific studies, that patients need to continue with a home rehabilitation as the therapy received in a clinic is not sufficient for a full recovery. An extended period of home rehabilitation is crucial for patients to regain motor ability prior to stroke. Studies are confirming that current healthcare recovery plans for stroke rehabilitation are not sufficient to bring patients to the level where they can normally function in society.
Feasibility study of Phase 1 the Homer project has been carried out according to Thompson’s (2003) framework of the Dimensions of Business Viability. The study is comprised of 5 parts: Market viability part of feasibility study includes in-depth market analysis, size, growth, trends, target clients, competitors, general political, economic, social and technological factors. Technological viability part elaborates functional client needs and technical requirements, compares technical solutions, identifies partners, organize user sessions to gather user experience. Business model viability part consists of analysis of business model canvas including key partners, activities, resources, value propositions, customer relationships, channels, customer segments, costs & revenue streams. Economic viability part focuses on estimates of the investment, revenues, costs, break even time, Contribution Margin, EBITDA and ROI %, sensitivity analysis, financial bottlenecks, tax optimization and economic impact. Organizational viability part includes a SWOT analysis, innovation strategy incl. Intellectual Property management, organizational constraints identification and risk analysis, as well as stakeholder management.
Every year there are 1.1 million stroke cases around Europe and 15 million worldwide. On average 16% of the population will suffer a stroke. A third of all stroke victims dies and a third stays permanently disabled. Stroke affects sensory, motor and cognitive functions – reducing patient’s ability to perform self-care and participate in social and community activities. More than 88 % of stroke survivors have upper and/or lower extremity weakness and need an active rehabilitation to get back into an independent or less dependent life.

Rehabilitation process lacks of duration, intensity, accessibility, affordability, objectivity, accessibility of patient data and therapists. These problems are alarming. The proposed project – Homer will fill the gap of intensive rehabilitation in the most crucial periods of recovery. It will extend the rehabilitation dose before and after patients are admitted to rehabilitation facilities. It is an adjunct to conventional therapy which is not always available or provided to the desired level. Virtual reality enables repetitive, intensive and task-specific training and can apply relevant concepts for driving neural plasticity that produces motor function improvements after stroke. The patient benefits from an intensive rehabilitation, leading to better outcomes in comparison with current rehabilitation. Additional benefits include increased independence, reduced financial burden and better therapy decisions due to objective assessment provided for physicians and caregivers through open-source eHealth platform.

Economic benefits of Homer are further elaborated. Cost of stroke are borne by patients, families, caregivers, society and healthcare systems. High costs of stroke reflect in high disability rates and large numbers of long-term care patients. In developed countries stroke accounts for around 4 % of the total healthcare expenditures. In 2006 costs related to stroke in Europe were estimated at € 38 billion – 49% direct costs, 22% indirect costs and 29% informal care cost. The lifetime costs for a patient surviving a major stroke is $ 124.000 and $ 46.000 for a minor stroke survivor. Indirect costs related to productivity and intangible costs due to reduced quality of life are not taken into account. The numbers clearly show the financial burden of stroke.
Bimeo, predecessor of the Homer rehabilitation system