Telerehabilitation
Exercise library, personalized treatment plans, guided sessions with video, clinical measurement tools, and progress tracking.
Telerehabilitation is the core of what makes RestartiX different from generic clinic management software. It's a complete system for prescribing, delivering, tracking, and measuring rehabilitation programs — whether the patient is in the clinic room or at home.
Exercise Library
A searchable video catalog of rehabilitation exercises, organized by:
- Body region — shoulder, knee, lumbar spine, hip, etc.
- Category — stretching, strengthening, balance, mobility
- Difficulty — beginner, intermediate, advanced
- Equipment — bodyweight, resistance band, dumbbell, stability ball
- Contraindications — clinical warnings about conditions where the exercise should not be performed or requires caution
Each exercise includes a video demonstration and step-by-step text instructions covering preparation, movement technique, breathing cues, and safety notes. These are manual text inputs — whoever creates the exercise (the platform team for global exercises, or a clinic admin/specialist for clinic exercises) writes each instruction step by hand when adding or editing the exercise. Instructions are organized by role:
- Preparation — setup and starting position
- Step — the movement itself
- Form cue — technique reminders to maintain correct form
- Breathing — when to inhale/exhale
- Safety — warnings and when to stop
Each step can optionally include an image for visual reference. When cloning a platform exercise, all instructions are copied and can be freely edited to match the clinic's preferred technique or language.
Two levels of exercises
- Platform exercises — curated by RestartiX, shared across all clinics. Standard rehabilitation exercises like "Bird Dog", "Wall Slide", "Clamshell". These come with pre-written contraindications, instructions, and metadata maintained by the platform team. Clinics can use them as-is.
- Clinic exercises — created from scratch or cloned from the platform library and customized for the clinic's specific protocols. Only visible within that clinic. When cloning, all contraindications and instructions are copied — the clinic can then edit, add, or remove them to match their protocols.
Clinics typically start with platform exercises and gradually build their own library as specialists develop custom protocols.
Contraindications
Each exercise can have clinical contraindications — warnings or restrictions tied to specific conditions (e.g., "Herniated Disc", "Acute Knee Injury"). Each contraindication has a severity level:
- Warning — the exercise can be performed but with caution (e.g., "Reduce range of motion if shoulder impingement is present")
- Contraindicated — the exercise should not be performed by patients with this condition
Platform exercises ship with standard contraindications maintained by the RestartiX clinical team. Clinics manage contraindications on their own exercises — they can add, edit, or remove them when creating exercises or when cloning from the platform library. The platform does not auto-enforce contraindications (e.g., blocking assignment); they are displayed as clinical guidance for the prescribing specialist.
Treatment Plans
A treatment plan is a structured rehabilitation program — a sequence of sessions, each containing specific exercises with defined parameters (sets, reps, hold duration, rest periods).
Exercise modes
Each exercise in a session is configured in one of two modes:
Rep-based — for exercises with discrete repetitions (e.g., squats, leg raises). The specialist prescribes sets, reps, and optionally a hold duration per rep — how long the patient should maintain the end position before releasing. For example, "3 sets × 10 reps × 5s hold" means: perform the movement, hold at the end range for 5 seconds, release, repeat 10 times, rest, do 3 sets. This is common for stretching and isometric exercises where the therapeutic effect depends on sustained muscle engagement or stretch.
Duration-based — for continuous exercises where discrete reps don't apply (e.g., treadmill walking, stationary cycling, sustained holds). The specialist prescribes sets and a total duration per set. For example, "2 sets × 60s" means: hold the position (or continue the activity) for 60 seconds, rest, repeat.
In both modes, the app controls the timing — the exercise video serves as a visual demonstration of correct form, while the app's timer and rep counter enforce the prescribed pace. The specialist controls exercise tempo through these parameters, not through video playback speed.
How specialists prescribe treatment plans
- Browse the library — specialist searches for exercises by body region, condition, or difficulty
- Build or clone a plan — create from scratch, or clone an existing plan (platform-curated or clinic-shared) and customize it
- Set parameters — for each exercise: mode, sets, reps or duration, hold time, rest between sets
- Organize into sessions — group exercises into daily sessions (e.g., "Session 1: Lower body", "Session 2: Core stability")
- Set frequency — how many sessions per week (e.g., 3x per week)
- Assign to patient — the patient receives the plan in their app
Three scopes of plans
| Scope | Who Creates It | Who Can See It |
|---|---|---|
| Platform plans | RestartiX team | All clinics, all patients with library access |
| Clinic plans | Clinic specialists | Clinic staff, clinic patients with library access |
| Custom plans | Specialist for a specific patient | Clinic staff, the assigned patient only |
Good custom plans can be promoted to the clinic library so other specialists can reuse them.
Self-service mode
Patients with a "library access" subscription can browse the plan library themselves — filtered by condition, difficulty, and body region — and start a plan without needing a specialist to assign it. This opens up a scalable, lower-touch rehabilitation model.
Because no specialist is involved in plan selection, the patient must acknowledge a disclaimer before starting a self-service plan — confirming that they are choosing the plan on their own, that it is not a substitute for professional medical advice, and that they should consult their specialist if they have any health concerns or contraindicated conditions. This disclaimer is configured per clinic (clinics can customize the text to match their legal requirements) and is recorded as a signed consent in the patient's record. The platform will not allow a patient to start a self-service plan without signing this disclaimer.
Guided Sessions
When a patient opens their app, they see today's session. The entire flow is automated — the app guides the patient through each exercise without needing a specialist present. The patient just follows along:
- Instructions — exercise name, preparation steps, safety warnings, and equipment needed
- Video plays — demonstrating the exercise with correct form
- Timer / rep counter — tracks sets, reps, and hold duration automatically
- Rest period — timed rest between sets, auto-advances when complete
- Next exercise — moves to the next exercise in the session automatically
- Session complete — post-session questionnaire (pain level, difficulty, notes)
Audio cues
The app uses audio signals to guide the patient through transitions — a sound marks the start of each exercise, the end of a set, the beginning and end of rest periods, and session completion. This lets patients follow along without constantly watching the screen, which is especially important for exercises where the device isn't in their line of sight (e.g., prone exercises, floor work). Audio cues can be muted by the patient.
Flexible scheduling
Plans specify a frequency (e.g., "3 sessions per week") but patients choose when they do them. No rigid day-level scheduling — just "complete 3 sessions this week." If a patient wants to do two sessions in one day, they can — the system counts completions against the weekly target, not daily limits. The system tracks completed vs. expected and maintains a current streak.
Sequential session progression
Sessions are unlocked one at a time — the patient always sees "today's session" (the next one in the sequence), not the entire plan at once. After completing a session, the next one becomes available. This keeps the experience focused and prevents patients from skipping ahead or cherry-picking exercises, which is important for progressive rehabilitation where exercises build on each other.
If a plan has 3 session templates (e.g., "Lower body", "Core", "Upper body"), they rotate in order: Session 1 → Session 2 → Session 3 → Session 1 → Session 2 → ... until the plan is complete. The patient can see their overall progress (sessions completed vs. total), but they always work on one session at a time.
Works on any device
The Patient Portal is a web app that works on phones, tablets, and computers — no app store download required. On mobile, patients can install it directly from the browser (add to home screen) for a native app-like experience with offline access to exercise videos. This means patients can start using the platform immediately after their first login, without needing to find and install an app.
Clinical Measurement Tools
The platform includes camera-based clinical measurement tools that work on any device — a phone at home, a tablet in the clinic room, or a laptop during a video consultation. No specialized hardware is required.
Virtual goniometer
A software-based goniometer that measures joint angles (range of motion) using the device camera and pose detection. The specialist selects a joint and the system measures the angle in degrees — replacing the need for a physical goniometer.
How it works:
- The specialist (or patient, if remote) positions the camera to capture the relevant joint
- The system detects body landmarks using pose estimation
- Joint angle is calculated and displayed in real time
- Measurements are recorded and stored with the patient's clinical data
Use cases:
- Measuring shoulder flexion range of motion before and after treatment
- Tracking knee extension progress over weeks of rehabilitation
- Documenting baseline and follow-up ROM for clinical records
Posture analysis
Camera-based posture assessment that identifies deviations from neutral alignment. The system captures body position and highlights areas of concern — forward head posture, lateral pelvic tilt, shoulder asymmetry.
Movement quality assessment
During exercise execution, the camera tracks body position and evaluates movement quality — whether the patient is performing the exercise with correct form, sufficient range, and proper alignment.
Two modes of operation
| Mode | Who Uses It | Purpose | Status |
|---|---|---|---|
| Specialist tool (initial release) | Specialist views measurements during or after a session | Clinical data for treatment decisions — adjust the plan, assess progress, document outcomes | Included |
| Patient feedback (deferred) | Patient sees real-time guidance during home exercises | "Straighten your back", "Bend deeper" — helping patients maintain correct form without a specialist present | Deferred |
In the initial release, measurement data flows to the specialist only. The patient may see the camera overlay during exercises, but the system does not provide corrective instructions or autonomous guidance. The specialist makes all clinical decisions based on the data.
Real-time patient feedback is intentionally deferred because it introduces autonomous clinical assessment (the software tells the patient what to do without a specialist in the loop), which adds additional regulatory complexity. Under MDR Rule 11, the platform's core clinical features (treatment plan management, progress tracking, adherence monitoring) already place it in Class IIa territory — autonomous patient feedback would further strengthen that classification and complicate the regulatory path. This will be revisited once the certification strategy is finalized.
Why this matters
These tools replace physical instruments that traditionally require an in-person visit. A specialist can now assess a patient's range of motion remotely — the patient holds up their phone, the platform measures the angle, and the specialist sees the result during a video consultation or reviews it afterward. This makes objective clinical measurement available for every session, not just in-person visits.
Medical device implications
The platform's clinical features — treatment plans, progress tracking, adherence monitoring, and camera-based measurement tools — qualify it as a medical device under EU MDR. A regulatory consultation (March 2026) confirmed that even without measurement tools, the core treatment and monitoring features trigger Class IIa classification under MDR Rule 11. See Medical Device Classification for details on classification and the registration strategy.
Progress Tracking
The platform tracks every session:
- Which exercises were completed and which were skipped
- Duration — how long each exercise took
- Prescribed vs. actual — did the patient complete all prescribed sets and reps, or did they stop early?
- Patient-reported feedback — pain level (before and after), perceived difficulty rating (1–5), and free-text notes after each session
- Completion rate — sessions completed vs. planned per week
- Streaks — consecutive days/weeks of adherence
- Video watch percentage — how much of the exercise demonstration video the patient watched before performing the exercise. Helps specialists identify whether patients are reviewing form instructions or skipping them.
Trends
The specialist dashboard shows how key metrics evolve across sessions — not just a single session's snapshot, but the trajectory over the entire treatment plan:
- Pain trend — pre-session and post-session pain levels plotted across all sessions. Example: "Pain went from 7/10 at session 1 down to 4/10 at session 6." Helps specialists see whether the treatment is reducing pain over time.
- Difficulty trend — patient-reported difficulty ratings across sessions. If difficulty is consistently high, the plan may be too aggressive. If it's dropping, the patient may be ready for progression.
- Adherence trend — weekly completion rates. A sudden drop in adherence may signal that the patient needs intervention (follow-up call, plan adjustment, motivation).
These trends are the specialist's primary tool for deciding when to adjust a treatment plan — increase difficulty, reduce exercises, add rest days, or schedule a follow-up consultation.
Camera-based tracking (later phase)
Movement accuracy scoring through camera-based pose tracking (MediaPipe) is a planned later-phase feature. In the initial release, the platform tracks the metrics above — all based on structured data (sets, reps, pain, difficulty) and patient self-reporting. Camera-based ROM measurements are available as a specialist tool (see Clinical Measurement Tools above), but automated movement quality scoring during patient home sessions is not part of the initial phase.
How It Connects to the Rest of the Platform
- Service plans control access: a "telerehab_access" subscription lets specialists assign treatment plans; a "library_access" subscription lets patients self-serve
- Automations can trigger based on treatment events: "when adherence drops below 50%, notify the specialist"
- Forms integrate as post-session questionnaires: pain scales and feedback collected after each session
- Video consultations can use the measurement tools live — specialist sees the patient's range of motion during a video call
- Audit trail — all treatment plan changes, assignments, measurements, and patient interactions are logged and tamper-proof
For developers
Technical details — database schemas, API endpoints, versioning mechanics, session execution flow, pose detection integration, and telemetry — are available in the Exercise Library feature spec and Treatment Plans feature spec.