Sanoste: personal recipes for physiotherapy

Sanoste offers physiotherapy with AI and gamification and real-time stimulating activities delivered using teleconference technology. They are trying to move quickly, as demand for their solution is bigger than ever before. 

“There are two major challenges regarding physiotherapy,” explains Marianne Dannbom, CEO of Sanoste, “it is very labour-intensive and in no way scalable. Therefore, many countries already see a shortage of physiotherapists. The second problem we see is that when a physiotherapist assigns home exercises, most people don’t do them. According to studies, the number varies, but let’s say 85-90% of people don’t follow the home exercises.”

Sanoste’s solution has incorporated AI and gamification. “We have a video library where a physiotherapist picks out the exercises for home exercising,” describes Dannbom. “Patients will receive the home exercises that they have to perform in front of a laptop. Our competitive edge is that you don’t need any other equipment, such as cameras or sensors. Simply a laptop, as they have integrated cameras. Then we have AI, which is trained to find your 12 main joints, and it automatically tracks the real-time movement of these joints.”

“Let’s say your physiotherapist has picked a video for you,” she continues, “you see the exercise, you do it and AI tracks your movements and calculates what you are doing. For example, if a physiotherapist has said that you should raise your hand 10 times for three sets, then AI calculates what you are doing. If you’re supposed to raise your hand 90 degrees but you do 45, it tells you that you are not raising your hand far enough. Or it tells if you are supposed to do the exercise with your right hand but you are raising your left. Unfortunately, it cannot tell if you are lifting incorrectly, but your physiotherapist can see this.”

As patients are not eager to do their exercises, Sanoste has included a motivational factor in the solution. “There is voice encouragement,” she says with a smile, “ It tells you, ‘Hey, you’re doing good! You’re great, two more times and you are done!’ You also can collect stars. People are saying that they mainly get motivated by the fact that their physiotherapist can see if they have done the exercises. Big brother is watching, so you cannot lie.”

The physiotherapist is also able to change the exercise programme online, so there is no need for a new appointment. “In Finland, face-to-face rehabilitation is prohibited during the coronavirus outbreak. So, the solution is very helpful at this time,” Dannbom points out.

Testing in a living lab

Sanoste attended the Prototron programme and met people from the Connected Health cluster and Estonian Health Insurance Fund. As Marianne Dannbom mentioned her wish to do a pilot, the wish came true and they were able to test the solution in Haapsalu Neurological Rehabilitation Centre.

“We had tested inhouse and this was the first time in a clinical setting,” she says. “We got really valuable feedback and could see that they were professionals in testing; they knew exactly what they were doing. Everything went very smoothly.”

Before testing, Sanoste had two hypotheses: that they can motivate the customer and provide a tool for physiotherapists to make their work scalable.

“We were able to secure the hypothesis that we could motivate the customer,” says Dannbom. “It was even strange that 100% of the patients followed the home instructions. I thought that, according to studies, 80% of the patients would follow if they were motivated, but it was 100%. That wasn’t good, it was excellent! It was so wonderful to obtain those results in the first pilot.

At that time, the physiotherapists couldn’t really benefit from following the patients, as it was a neurological hospital and the patients are specific. But the coronavirus has changed attitudes. The physiotherapists now understand that you can do many things remotely.”

As a result of testing, Sanoste made a video library of exercises for people in a wheelchair. “We didn’t have that, as the patient group in Haapsalu was specific. They made the videos and we made the algorithms to calculate the movements,” Dannbom points out.

Big plans for the future

“We don’t have a product on the market yet, unfortunately,” Dannbom speaks of future plans and expanding to other markets. “We’re about to start working in Tartu, where they teach physiotherapists, and finish a video library for upper extremities. We need videos and algorithms for each exercise. We are planning to have the solution for the upper extremities in 1-2 months, but we are trying to move quickly.

Our system is in English, so translation is necessary as it has to be in the local language. Our neighbours, Scandinavia and Estonia are first under the radar.”