REACT: eHealth to improve after-stroke rehabilitation

The REACT project takes its name from “Re-education Activities through Technology” and it’s part of the broader family of eHealth, namely IT solutions and resources applied to the health market.

With the spread of technology in every aspect of our lives, it was only a matter of time until it was involved in rehabilitation and prevention services targeting both patients and people at risk of developing illnesses. Of course, there are many ways in which technology could come handy in this field, e.g. facilitating the relationship between patients and all medical experts in charge of taking care of their health or helping to analyze the enormous amount of data collected thanks to Electronic Health Records.



REACT is an eHealth solution created with funding from the Lombardy Region and the European Community to improve the rehabilitation process of after-stroke patients. Why the focus on this specific health problem? The answer is related both to quantity and quality reasons. 

Speaking about quantity, it appears to be more than 200 thousands instances of stroke every year just in Italy, the disease representing the third main cause of death in the Country. In relation to quality, resulting issues of this disease can be motor, cognitive, sensory or communication deficits. 

Despite the Italian National Health Service (NHS) providing for hospitalization within rehabilitation centres specialized in the pathology, many problems occur when people have to go back home at the end of that set period of time. Most patients, in fact, complain of not being properly prepared and able to perform Activities of Daily Life (ADL) in a satisfactory way. These negative and unmotivating feelings are of course bad news for the rehabilitation process, which is often slowed down and in the end led to reduce their quality of life



The objective of REACT is to fill the gap between hospitalization and home health care, creating a distance rehabilitation service useful both to patients (and their caregivers) and therapists. 

Through an easy-to-use digital training platform (our LMS Quiddis Join), rehabilitators can create tailor-made exercises in order to follow up on patients even after the discharge from the hospital. On the other side, patients perform assigned exercises at home on their personal devices (tablets or smartphones), safe in the knowledge that therapists are remotely tracking their results. 



Of course, for a health therapy – digital or not – to be proved effective, an essential step is a clinical trial, namely a research investigation with people volunteering to test the new treatment. For this specific solution, the clinical partner both for the creation of exercises and for the testing itself has been the Casa di Cura del Policlinico (CCP), a rehabilitation centre in Milan that is in charge of treating – among others – after-stroke patients. 

The trial objective was to study the satisfaction level and usability of REACT eHealth solution, using two group of patients: the control group received only an informative brochure before leaving the hospital, the test group was instead introduced to REACT and continued to use it once at home. 

At the end, the test group showed higher levels of motivation both in the hospital and at home and responded better to questions about usability and likeability of the therapy. 



Testing REACT with real patients brought to light a number of issues which can be ascribed to eHealth in general, more than to the specific solution. The most important one is that patients like to be “looked after” by a medical professional once returned at home: therefore, it is essential for them to perceive the presence of a therapist on the other side of the digital platform in order to stay focused throughout the process. 

For the same reason, it is advisable to keep patients somehow connected to each other after they return back home: recreating on the platform the positively competitive environment they experience in the hospital seems to help improving motivation



Compared to other eHealth services, REACT’s goal is not to replace existing therapies to treat after-stroke patients: as previously said, it rather aims to fill a gap between hospitalization and home health care, preventing patients to be left alone in the process. Because of that, apart from the many advantages for patients, there are many possible benefits that this eHealth solution could bring in for the NHS too. 

Prompt intervention 

The first is for sure the possibility for therapists and medical professionals to follow up on a number of patients remotely: this would lead to use their valuable time in a more effective way, allowing them to intervene directly only when really needed. At the same time, monitoring patients’ results in real time would help take prompt actions in order to prevent rehospitalization

Support to caregivers 

On another level, a solution like REACT could give more support to caregivers, either professionals or relatives: having a therapist remotely following the rehabilitation process could help them both on a medical and psychological level, better assisting patients with the therapy and keeping high levels of motivation themselves

Low impact and low cost 

A great advantage of REACT is the low cost it has both for the organization (NHS or single hospital) and for patients. A platform like the one used for REACT is in fact all in Cloud and therefore accessible from everywhere. It is also very easy to set up: therapists can create new exercises in collaboration with digital training professionals (if needed) and new patients can be added to the platform and start using the service right away. Affordability is also achieved thanks to the use of very common devices: patients can use their personal ones or receive a hardwired tablet to administer the therapy, with no need of very expensive tools.  

Scalability and replicability 

Talking about the service itself, it can easily be scaled to a much higher number of patients, both because of less time wasted by medical professionals in administering the therapy and of the user-friendliness of the platform for patients. 

Moreover, a very similar structure could be easily replicate to treat different diseases or even for prevention purposes, of course creating new exercises related to the specific issues. 



In the next few years, eHealth will represent a solid part of the health market, gaining people’s trust as a delivery method for treatment, rehabilitation and prevention of different illnesses. While REACT is evolving and improving its effectiveness and enjoyability for patients more and more, a step forward could be thinking about the application of the same principles – user-friendliness, low costs and accessibility, improvement of existing services – to other diseases which have similar characteristics in terms of quantity and quality. One thing we can be sure of is that the future of healthcare runs through customization and a most efficient use of medical professionals’ timeWe are up for the challenge, what about you? 

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