Rewellio, an Austrian software company, is trying to revolutionize stroke rehabilitation by building an app, which integrates with readily available consumer electronic devices such as tablets and virtual reality headsets, to make stroke rehabilitation more engaging and accessible. The company recently launched the first version of its app, which focuses on post-stroke hand rehabilitation, especially in the early stages, where some patients are still unable to achieve any visible movement despite the fact that they have muscle activity in their affected limbs. Rewellio utilizes EMG-biofeedback sensors to detect these minor muscle activities and display them to the patients, giving them real-time feedback during a rehab exercise. This could maximize the involvement of voluntary efforts and help train the brain to regain as much function as possible using its neural plasticity.

Although EMG-driven strategies are not something new to stroke rehab, integrating them into an app that could be easily used by the patient is something unique to rewellio. This could be especially beneficial, since getting the proper rehabilitation using the traditional one-on-one method is not easily attainable, due to time and place constraints.

We at Medgadget had the chance to interview rewellio’s CEO and founder Georg Teufl to learn more about the company and their newly launched app.

Kenan Raddawi, MD, Medgadget: Can you please give our readers a brief overview of rewellio? When was the company first established, and why? Introduce us to your system, please.

Georg Teufl, rewellio: Sure, I’d be glad to. Rewellio is a software company founded in 2017 out of a need – the need to make post-stroke hand recovery more effective. Every year, over 15 million people worldwide suffer a stroke. One-third of those affected will continue to have motor, speech, and/or vision impairments. We know that the success of the rehabilitation process depends on early, intensive, and highly repetitive exercises. Unfortunately, many therapists in rehabilitation centers cannot devote the needed extended attention to the individual due to time and resource constraints. This is why new ways of independent training are necessary to offer more therapy time. Rewellio’s flagship product is an app platform that focuses on post-stroke hand therapy, especially in the early stages, when quite often the muscle contractions are so weak that no visible movements can be seen.

Medgadget: What is the gold standard of care for post-stroke hand rehabilitation when no visible movement is attainable? How does rewellio compare to the gold standard?

Teufl: Traditionally, independent training for hand rehabilitation most commonly consists of mirror therapy and observation of movement. These methods have been used for decades now. However, they do not integrate the minimal muscle activities of the affected hand into the actual exercise, as only the healthy hand is used in front of the mirror. Therefore, it offers no real feedback as to whether or not the exercises were done correctly. We believe rewellio is able to overcome these shortcomings. Our newly launched app, when used with a compatible EMG-biofeedback device, is able to detect any minimal muscle activity in the affected limb and incorporate it into the rehab session to give patients real-time feedback during their exercises.

Medgadget: Could you walk us through what rehabilitation with rewellio’s app looks like from a patient’s point of view?

Teufl: Before a patient initially starts using rewellio, he or she needs to download our app on a tablet and set up an account with us. To begin a training session with our first hand/arm therapy module, a patient will use a compatible EMG-biofeedback device that connects to our app. The EMG-biofeedback device will detect minor muscle activities which are often too weak to move the hand; by transmitting the data to our app, a patient will see a fully functional virtual hand that reflects in real-time the level of activity in the targeted muscles. The aim of this concept is to “trick” the brain so that it relearns which signals produce the right outcome in movement. The repetition of these exercises helps the patient gets back some functional use of the hand, which becomes the basis for other exercises, such as, training for more precise movements of the hand and fingers. For better visualization and a number of videos explaining the concept and what the modules look like, please have a look at our YouTube channel.

Medgadget: Which specific EMG-biofeedback devices rewellio supports today?

Teufl: Rewellio’s objective is to develop its app for devices that are affordable, mobile, and powerful. As of today, we only support two devices: the Myo armband, which has been discontinued by the manufacturer, and the biosignalsplux EMG-biofeedback sensors, which can be purchased through our website. We will add more devices in the near future.

Medgadget: Who are your main competitors, and how does rewellio compare to them? What sets it apart?

Teufl: This is a difficult question to answer, as rewellio has a very unique approach. The technology, which makes many of our product modules possible, is very new; in fact, some of the devices we are building on have not even been launched in the market yet, so there is really nothing like it out there so far. Of course, there are some older companies with a little bit of product overlap, for example, Mindmaze and Saebo.

Medgadget: In the last few years we have seen an influx of new technologies that are changing stroke rehabilitation. Given your experience, how are companies like rewellio shaping the future of stroke rehabilitation? What changes in this field do you foresee?

Teufl: The next few years will be groundbreaking. Technology, especially Virtual Reality (VR), is changing the healthcare environment significantly and is moving forward very fast right now. As a result, this will democratize stroke rehabilitation and provide access to mobile, affordable, and state-of-the-art stroke therapy methods for the masses. This is going to change everything.

Medgadget: Is there anything else you think our readers should know about rewellio?

Teufl: The number of strokes will double in the next 20 years because of demographic changes and because of our lifestyles. This will not only create a tremendous economic burden for individuals, insurance companies, and the public sector but also result in a much-reduced quality of life for many stroke patients out there. Rewellio addresses these issues as it disrupts the industry with newdevices, innovative software approaches, and new therapy concepts, which have never been possible before.

Link: Rewellio homepage…