Rehabilitation has often been one of the quieter areas of healthcare. It rarely attracts the same public attention as emergency medicine, surgery or acute hospital care. Yet, across Europe, rehabilitation is becoming increasingly central to one of the most urgent challenges facing health systems: how to support more people to recover, regain function and maintain independence in the face of ageing populations, chronic disease and growing pressure on care services.
The new TeleRehaB DSS Market Access Report highlights the scale of this challenge. Nearly 394 million people could benefit from rehabilitation services within the WHO European Region. This figure reflects a profound shift in healthcare needs. More people are living longer, often with chronic conditions, mobility limitations, neurological impairments or an increased risk of falling. At the same time, many rehabilitation systems are facing workforce shortages, fragmented care pathways and unequal access between urban and rural areas.
In this context, the European project TeleRehaB DSS is working to bring artificial intelligence closer to everyday clinical practice. The project is developing an AI-based Decision Support System designed to support balance rehabilitation training and help healthcare professionals deliver more personalised, accessible and effective interventions for patients at risk of falling.
A growing need across clinical areas
The Market Access Report identifies stroke, Long COVID-19 and vestibular disorders as three clinical areas where rehabilitation needs are particularly acute. Together, they illustrate both the scale of unmet need and the potential value of digital, home-based and AI-supported rehabilitation.
Stroke remains one of the most important causes of long-term disability in Europe. In 2019, approximately 1.8 million people were diagnosed with stroke across 53 European countries, with cases increasing by 4% between 2010 and 2019. The incidence of stroke in the EU is projected to rise by 34% by 2035, mainly due to population ageing. The economic impact is also significant: stroke-related costs in Europe reached €60 billion in 2017 and could rise to €86 billion by 2040 if current trends continue.
Rehabilitation plays a decisive role in stroke recovery, but access is not equal across Europe. In some countries, outpatient therapies are limited, while specialist rehabilitation is often concentrated in urban centres. This can leave rural populations and underserved communities with fewer opportunities to receive timely and continuous support after hospital discharge.
Long COVID-19 is also placing new demands on rehabilitation services. Around 36 million people in the WHO European Region developed Long COVID-19 during the first three years of the pandemic. Many experience persistent symptoms such as fatigue, breathlessness, cognitive dysfunction and psychological distress, often requiring multidisciplinary rehabilitation. Digital tools and home-based programmes are becoming increasingly relevant as healthcare systems seek to support these patients beyond traditional hospital-based pathways.
Vestibular disorders are particularly relevant to the work of TeleRehaB DSS because they affect balance and spatial orientation. These conditions can cause dizziness, vertigo, unsteadiness and nausea, and they become more common with age. In the UK, dizziness and balance disorders affect approximately 20–30% of adults, while nearly one in four people aged 65 and over experience dizziness. Falls related to vestibular dysfunction account for an estimated €25 billion annually in healthcare and social costs in the EU.
These figures show why balance rehabilitation is not a marginal issue. It is directly linked to independence, fall prevention, quality of life and the sustainability of health and social care systems.
The case for home-based and digital rehabilitation
One of the clearest findings from the report is that home-based rehabilitation can help improve access and reduce pressure on healthcare services. A modelling study across 32 European countries found that home-based stroke rehabilitation could save €237 million in health and social care costs and add approximately 61,890 quality-adjusted life years.
This does not mean replacing clinicians. Rather, it points to the need for better tools that can support healthcare professionals, extend the reach of rehabilitation services and help patients continue their recovery in more flexible settings.
TeleRehaB DSS responds to this need by focusing on AI-supported balance rehabilitation. The project aims to provide healthcare professionals with decision-support tools that can help personalise interventions, monitor progress and support rehabilitation pathways across clinical and remote care settings.
Artificial intelligence can play an important role in this transformation, but only if it is developed around real clinical needs. For TeleRehaB DSS, the objective is not simply to introduce technology into rehabilitation. It is to make AI useful, practical and clinically meaningful in daily care.
From innovation to evidence
The Market Access Report also makes clear that successful adoption of telerehabilitation will depend on more than technological promise. Healthcare systems need evidence. Digital rehabilitation solutions must demonstrate clinical value, cost-effectiveness, usability and impact on services.
This includes evidence on patient outcomes, quality-adjusted life years, workforce impact, staff time saved and improved access to care. These indicators will be essential for health technology assessment, reimbursement and procurement decisions across Europe.
For this reason, the clinical validation activities of TeleRehaB DSS are central to the project’s future impact. By generating evidence in real-world rehabilitation contexts, the project aims to support the long-term adoption of AI-enabled rehabilitation solutions and contribute to a more sustainable model of care.
Supporting clinicians, reaching patients
Europe’s rehabilitation challenge is not only a question of capacity. It is also a question of equity. Patients in rural areas, older adults, people with lower digital literacy and communities with fewer specialist services often face additional barriers to accessing rehabilitation.
AI-enabled telerehabilitation can help address some of these gaps by supporting remote monitoring, home-based exercise, personalised rehabilitation planning and better continuity between clinical teams and patients. However, these tools must be designed with usability, accessibility and clinical integration in mind.
This is where TeleRehaB DSS can make a meaningful contribution. By bringing together artificial intelligence, clinical expertise and balance rehabilitation, the project is helping to explore how digital tools can support both patients and professionals in a practical way.
Towards a new rehabilitation model
The findings of the Market Access Report point to a wider transformation in European healthcare. Rehabilitation is moving from the margins to the centre of health system planning. As populations age and chronic conditions become more common, the ability to deliver effective rehabilitation at scale will become increasingly important.
TeleRehaB DSS is part of this shift. Its work reflects a future in which rehabilitation can be more personalised, more accessible and more closely connected to patients’ everyday lives.
The challenge is substantial. But so is the opportunity: to use AI and digital health not as a replacement for care, but as a way to make rehabilitation more responsive, evidence-based and sustainable for the people who need it most.
