Digital Physiotherapy Coaching with Alex

Physiotherapy is a widespread and efficient method for the rehabilitation of various health problems, such as chronic diseases, injuries, and age-related health issues. In addition to face-to-face physiotherapy sessions with health professionals, exercises at home are crucial to ensure ongoing and efficient rehabilitation. However, adherence to home exercises is poor and thus, patients need to be reminded, motivated and coached in performing the exercises correctly.

Common approaches to deliver home exercises are paper-based and video-based instructions. Those have their shortcomings in reminding or motivating patients to do the exercises at home and to provide real-time feedback on how to perform the exercises related to spatial accuracy (i.e., performing an exercise according to pre-defined trajectories), temporal accuracy (i.e., performing an exercise with a pre-defined velocity), and the individual number of repetitions.

The objective of this project is therefore to develop the digital coach Alex, who motivates physiotherapy patients through a smartphone application to perform the exercises on a regular basis. Moreover, Alex leads the training sessions as a hologram in augmented reality space by demonstrating the exercises and providing real-time feedback on the patient’s exercise execution.

Video clips

Visual abstract by T. Kowatsch, March 2021

Video recording of the interaction with the digital physiotherapy coach, January, 2019 (English)

Video recording of the interaction with the digital physiotherapy coach, January, 2019 (German)

SF1, Puls, “Kostenstreit um Physiotherapie – Ersetzen VR-Brillen Therapeuten?”, December 10, 2018 (German)

SF1, gesundheit heute, “Neue Wege in der Reha”, December 1, 2018 (German)

Digital Day Switzerland, “Digitaler Physiotherapie Coach”, October 25, 2018 (German)



Kowatsch, T., Lohse, K.M., Erb, V., Schittenhelm, L., Galliker, H., Lehner, R., Huang, E.M. (2021) Hybrid Ubiquitous Coaching With a Novel Combination of Mobile and Holographic Conversational Agents Targeting Adherence to Home Exercises: 4 Design and Evaluation Studies, Journal of Medical Internet Research, 23(2):e23612, 10.2196/23612 (PDF), Visual Abstract by T. Kowatsch

Related Work

Kowatsch, T., Volland, D., Shih, I., Rüegger, D., Künzler, F., Barata, F., Filler, A., Büchter, D., Brogle, B., Heldt, K., Gindrat, P., Farpour-Lambert, N., l’Allemand, D. (2017) Design and Evaluation of a Mobile Chat App for the Open Source Behavioral Health Intervention Platform MobileCoach, In: Maedche A., vom Brocke J., Hevner A. (eds) Designing the Digital Transformation. DESRIST 2017. Lecture Notes in Computer Science, vol 10243. Springer: Berlin; Germany, 485-489. (Paper-PDF | Poster-PDF | Slide-PDF | Screencast)

Filler, A., Kowatsch, T., Haug, S., Wahle, F., Staake, T. & Fleisch, E. (2015) MobileCoach: A Novel Open Source Platform for the Design of Evidence-based, Scalable and Low-Cost Behavioral Health Interventions – Overview and Preliminary Evaluation in the Public Health Context. Wireless Telecommunications Symposium 2015 (WTS 2015), New York, USA. *** Outstanding Paper Award & Best Graduate Student Paper Award*** (PDF)

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General Information

Increasing Adherence to Home Exercises in Physiotherapy

Working Group

Yanick Lukic, Helen Galliker, Valérie Erb, Leo Schittenhelm, Matthias Heuberger, Prof. Dr. Elgar Fleisch & Prof. Dr. Tobias Kowatsch


June 2018 – March 2021

University of Zurich
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