Augmented reality as a tool to ensure continued training in everyday life following hip replacement


The key aim of the project is to provide training support for patients with total hip replacement during and after clinical rehabilitation in their own home using an augmented reality (AR) exer-game (proof of concept).

While carrying out the individual therapeutic exercises, the patient receives

  • real-time feedback,
  • a standardised documentation of his/her training progress and
  • the opportunity to consult his/her health expert.


Once they have completed clinical rehabilitation, patients with hip replacement usually receive training instructions designed to increase strength, balance and responsiveness. The training is currently not supported or evaluated. The patients must learn to slowly adapt to their new situation without any further support from a health expert. Insecurities or overestimation may lead to asymmetric load distribution or even to a fall. This will require further long and unpleasant medical and therapeutic interventions involving high costs for the social insurance provider. In addition, patients in rural areas lack access to adequate healthcare infrastructure.


The project consortium plans to develop an augmented reality (AR) exer-game tailored to the patients' needs and the requirements of physiotherapists and physicians using the HoloLens head mounted display from Microsoft. The AR exer-game should support patient compliance by motivating hip replacement patients to perform the prescribed regular strength and coordination exercises in their home environment. The AR exer-game will be provided to the participants during their stay in the rehabilitation centre and can be adapted and modified by the physiotherapist.

Pivotal question

What is the added value of a user-centred exer-game following orthopaedic rehabilitation in terms of medical, social and psychological aspects?

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In phase 1 of the pilot study the project team will develop an exer-game for patients who have undergone total hip replacement surgery. The HoloLens head mounted display from Microsoft is used to create a realistic, enjoyable and safe setting for strength and coordination training. The backend is designed to document and visualise key parameters which allow the health expert to respond to the patients' individual needs, for example when they experience pain or movement restrictions or when they have questions. Both primary and secondary users will be involved throughout the development of the frontend and backend in order to take key acceptance factors such as usability, data security and privacy into account at an early stage of the project.

In part A of phase 2 physiotherapists will examine 10 test subjects with total hip replacement following a doctor's prescription. The physiotherapists will select appropriate exercises for the patients from the AR exer-game. They will assess the patients' status from a medical, physical and social perspective both before and after training and document the level of support and care provided by the health expert.

In part B of phase 2, physiotherapists will additionally examine a control group of 10 test subjects with total hip replacement following a doctor's prescription. In this group, the therapists select the exercises for the patients without the help of the AR exer-game. The results and assessments will then be compared with those obtained for the intervention group.