Evidence report · Version 1.0, October 2026
Evidence and impact
Results, limitations and pilot measurement. For homecare providers in the UK.
All results come from routine practice without a control group. The limitations are set out below and in the report.
On this page Summary Denmark Netherlands Care hours Research Pilot Limitations
Summary
Nearly half
of Denmark’s 98 municipalities use DigiRehab
45+ municipalities, according to DigiRehab
25,000+
programmes completed, mainly in Danish municipalities
According to DigiRehab, 2026
25 h
less care per person in the year after starting
121 clients, one Dutch care group. Up to 78 h against each client’s own rising trend.
DigiRehab is a twelve-week strength and balance programme for older people, carried out at home by care workers with a tablet. The tablet runs standardised tests, builds an individual exercise programme from the results and records progress.
ACTIVE
Self-funding clients and the start of a new care package. Build strength before needs settle into a pattern, and offer a service your clients can buy.
REHAB
Clients whose needs are rising. Reduce dependency and free up hours your workforce can give to the next client.
Pressure on homecare
Homecare in the UK runs on hours that are hard to staff and hard to price. The figures below are for England, the largest of the four nations; Scotland, Wales and Northern Ireland publish their own data.
9.9%
of posts in domiciliary care in England vacant in 2024/25
Skills for Care, England, 2025
23.7%
staff turnover in domiciliary care in England in 2024/25
Skills for Care, England, 2025
£24.10
average hourly rate paid by councils in England in 2025/26, against a Minimum Price of £34.42 for 2026/27
Homecare Association, England, 2025 and 2026
Since 22 July 2025, UK immigration rules no longer allow providers to recruit new care workers from overseas through the Health and Care Worker visa.
Home Office, statement of changes in immigration rules HC 997, July 2025.
Practice in Denmark
DigiRehab was developed in Denmark and spread through practice. Nearly half of the country’s 98 municipalities use it in their homecare services.
Danish municipalities judge DigiRehab on their own data. Since 2021, DigiRehab has calculated the effect on the care records of the municipalities it works with and reported it every year. What municipalities see is that people manage more for themselves, and that staff time and money are saved. Those results are the reason they continue, and the reason few separate trials have been done.
45+ of 98 Danish municipalities use DigiRehab. Each square is one municipality.
According to DigiRehab; digirehab.dk, October 2026.
According to DigiRehab; annual effect reports on municipal care records since 2021.
25,000+
training programmes completed
~100
effect analyses on routine municipal data
7 in 10
complete: at least ten sessions over at least eight weeks
According to DigiRehab, 2024 and 2026. Most participants are in their eighties and already receive homecare; DigiRehab attributes the completion rate partly to the twice-weekly visits.
KL and Deloitte case
In 2022 the Danish association of municipalities (KL) and Deloitte selected ten technologies with documented time savings in public services. DigiRehab, in one Danish municipality, was one of them.
27 h
fewer hours of care need per citizen per year
55%
of participants improved their physical capacity
81%
of completers kept or reduced their need for help
DKK 1m+
net saving in 2021
KL and Deloitte, case analysis of time-saving technologies with documented effect, 2022 (published 2023). This is the only DigiRehab result described by an outside party. It describes one municipality’s results and how they were measured; DigiRehab’s other analyses were not audited.
Early signal
ACTIVE: transition to personal care
An early comparison in two Danish municipalities looked at older people who received help with housework only.
Did not train: 144 people. 26% moved on to personal care during follow-up, on average after 423 days. Moving on added about 2.2 hours of care a week.
Trained: 19 comparable people. One person (5%) had moved on at the time of analysis. The others were still on housework help only, and nine of them no longer received any.
The trained group is small, the comparison is with an earlier group, and follow-up continues. DigiRehab itself calls it too early for a final figure. Source: DigiRehab, evidence summary, September 2026 (unpublished).
Results in the Netherlands
Since 2022 DigiRehab has been used by Dutch homecare organisations and in municipal prevention projects. Six groups between April 2022 and June 2026: 425 people screened, 301 with a first and a last screening.
In 301 Dutch clients with a first and last screening, around seven in ten improved on standard tests of walking speed, standing up and getting up and going.
Share of clients within the safe range, first and last screening
Walking speed at least 0.8 m/s; Timed Up and Go 12 seconds or less; 30-second chair stand at least 8 repetitions.
DigiRehab Netherlands, effect data 2022–2026. No control group; Dutch organisations are not named.
Care use
A large Dutch care group linked training data to its own care records for 121 clients who completed the programme, and followed each of them for 52 weeks before and 52 weeks after their first screening. The care measured was home nursing and personal care.
82%
needed more care in the year before, on average 53 hours more
25 h
less care on average in the 52 weeks after starting
78 h
difference against each client’s own trend
64% received less or the same care after starting; 36% received more.
DigiRehab, Effect of home-based training on care use, 2026. 121 clients who completed, one Dutch care group.
Care hours and their value
The same data give three figures, depending on the comparison. The most cautious figure is the headline; the highest is the upper limit.
Fewer hours of care per client in the 52 weeks after starting
121 clients who completed the programme, one Dutch care group. Training time not deducted.
DigiRehab, Effect of home-based training on care use, 2026. Danish reference: +38 hours a year.
The first figure is care that was not delivered: the only one a payer can count as cash. The other two add growth in care that did not happen. That is real, but it is avoided cost, and it rests on an assumption about what would have happened without training.
Calculation. Hours freed in a year = clients who start × 0.7 (completion) × hours per client who completes. Multiply by the hourly rate that applies to you.
| Example: 100 clients start, 70 complete | Hours | At £24.10 / hour | At £34.42 / hour |
|---|---|---|---|
| Measured decline, 25 hours each | 1,750 | £42,200 | £60,200 |
| Upper limit, 78 hours each | 5,460 | £131,600 | £187,900 |
Costs. About 10 to 15 hours of care-worker time per client who completes, the time spent on clients who start and stop, and the licence and implementation.
Research behind the approach
Strength and balance training for older people is one of the best-researched interventions in ageing. The open question for DigiRehab is how much of that effect holds when care workers deliver it at home.
General evidence
A Cochrane review of 108 randomised trials with 23,407 participants found that exercise reduced the rate of falls among older people living in the community by 23%. A review of 26 randomised trials of home exercise supported by digital tools found better chair-rise performance and better scores for activities of daily living. NICE guideline NG249 (April 2025) recommends progressive, individually tailored programmes of strength, balance and coordination for older people at risk of falling.
Sherrington et al., Cochrane Database of Systematic Reviews, 2019; Solis-Navarro et al., Age and Ageing, 2022; NICE NG249, April 2025.
Dose
Strength and function
Falls-prevention research points to more than three hours of balance and functional exercise a week, and the World Falls Guidelines to at least three sessions a week for twelve weeks or more. DigiRehab’s standard programme is built to restore strength and everyday function, and those are the outcomes reported here. This report makes no claim that it prevents falls.
Sherrington et al., 2020; Montero-Odasso et al., World Falls Guidelines, 2022.
Delivery
Care workers as trainers
NICE recommends that falls-prevention programmes are delivered by appropriately trained professionals. DigiRehab is delivered by care workers. A review of physical activity programmes for older people receiving homecare, some delivered by care workers, found limited evidence of effect. DigiRehab’s routine data can help to fill this gap, which is why the measurement method is published.
NICE NG249, 2025; Burton et al., Clinical Interventions in Aging, 2019.
Weekly exercise time
Falls-prevention dose against the DigiRehab standard programme
Dose: Sherrington et al., 2020; World Falls Guidelines, 2022. DigiRehab: two sessions of 20 to 30 minutes a week.
The only peer-reviewed publication about DigiRehab so far is a feasibility study protocol from the European PRECISE project, without outcome data. It was co-authored by people working for DigiRehab.
D’Ambrosio et al., Frontiers in Public Health, 2024.
Measuring a pilot
A pilot is measured on your own care records, with the rules agreed before the start. The method is written down, so an independent party can check or repeat it.
| Step | Part | Content |
|---|---|---|
| 1 | Agree the rules | Which care counts, how training time is recorded, how deaths and admissions are handled, and which result is the headline. Fixed before the first client starts. |
| 2 | Baseline | Care delivered per client over the 52 weeks before the first screening, exported from your care management system, plus the first screening. |
| 3 | Training | Screening at the start and every four weeks. Sessions are recorded on the tablet. |
| 4 | Follow-up | Care delivered over the 52 weeks after the first screening, from the same system and with the same definitions. |
| 5 | Report | Three levels: measured decline (headline), comparison with a reference, comparison with each client’s own trend (upper limit). Plus a check with a randomly chosen start date, which should show no saving if the method itself is sound. |
Data. From you: a client number, dates, minutes of care delivered and the type of care. From DigiRehab: per client number, the dates of first and last screening, sessions completed and the scores. No names are needed. Results are reported for the group, not for individual clients.
Experience in the UK
One independent homecare provider in Kent delivers DigiRehab to its own clients. Structured outcome data from the UK are not yet available; the first will come from pilots measured this way.
Limitations and declarations
Limitations
- No randomised trial. No randomised trial of DigiRehab has been published. All results come from routine practice without a control group.
- Regression to the mean. People often start training when their needs are rising. Part of the later fall in care might have happened anyway. Comparing each client with their own trend addresses this only in part.
- Completers only. Results cover people who completed the programme, about seven in ten of those who start.
- Analysis. Most analyses were carried out by DigiRehab or its distributors. Only one municipal case was described by an outside party.
- Reference. The comparison for avoided growth uses a Danish reference. There is no reference for the UK yet.
- United Kingdom. There are no outcome data from the UK yet.
Regulatory status
DigiRehab supports care providers in screening physical and functional ability, preparing and delivering an individual training programme and recording progress. It is not certified as a medical device. It does not diagnose or treat, and this report makes no claim that it reduces falls. The provider remains responsible for decisions about each client.
Declarations
This report was written by DigiRehab UK, which distributes DigiRehab in the United Kingdom under licence from DigiRehab in Denmark. Danish figures are DigiRehab’s own unless an outside source is given. Dutch figures were analysed by DigiRehab in the Netherlands on anonymised data; the organisations are not named. People working for DigiRehab, including the UK lead, co-authored the PRECISE protocol cited in the research section.
Photographs from the DigiRehab image library, taken in Danish care settings.
References
Full references are in the report (PDF). The care-use method and the Dutch effect data are available for inspection on request.
Arend Roos
UK Lead, Director of DigiRehab UK