Vijay Karunakaran of Rewin Health on AI-Driven Digital Rehabilitation, Clinical Validation at Scale, and Building India’s Rehabilitation Infrastructure

StartupTalky presents Recap'25, a series of exclusive interviews where we connect with founders and industry leaders to reflect on their journey in 2025 and discuss their vision for the future.

In this edition of Recap’25, StartupTalky speaks with Vijay Karunakaran, Founder & CEO of Rewin Health, who reflects on a landmark year defined by rapid expansion, strong clinical validation, and growing adoption of AI-driven digital rehabilitation across India’s healthcare ecosystem. Karunakaran shares how Rewin scaled across hospitals, government systems, and owned clinics, the role of immersive VR and data intelligence in improving patient outcomes, and the behavioural shifts among clinicians, hospitals, and patients toward evidence-backed digital care. He also discusses regulatory and operational learnings, the emergence of rehabilitation as a core healthcare priority, and Rewin Health’s vision to build India’s rehabilitation infrastructure through public partnerships, insurance integration, and advanced clinical intelligence—offering a clear roadmap for the future of digital therapeutics in India.

StartupTalky: How would you summarise this year for Rewin Health in terms of growth, key initiatives, and impact across patient or provider outcomes? 

Vijay Karunakaran: 2025 has been a pivotal business expansion year for Rewin Health, driven by strong traction across both B2B and B2C channels. On the institutional side, we deepened partnerships with leading networks such as Apollo Hospitals, MIOT, SRM, PSG, Manipal, HCAH, and multiple rehabilitation centres - collectively scaling to 80+ hospitals and clinics across seven states. These partnerships have strengthened our enterprise revenue pipeline and positioned Rewin as the preferred digital therapeutics platform for multi-specialty rehab.

In parallel, we accelerated our retail strategy by launching 10 Rewin-owned physiotherapy and VR-enabled rehab clinics, establishing a replicable model for Tier 1 - 3 city expansion. Across our footprint, we have treated 15,000+ patients and delivered 1,25,000+ VR therapy sessions, supported by 500+ trained clinicians.

Clinical outcomes continue to be a core business differentiator. Studies across Apollo ICUs and partner institutions show 90% improvement in patient quality of life and 91% reduction in anxiety and depression through immersive VR therapy . This evidence base - including published stroke, pulmonary, orthopaedic, and government-led studies - has accelerated hospital adoption, shortened sales cycles, and reinforced Rewin’s position as India’s most validated and scalable digital rehab platform.

StartupTalky: What breakthrough innovations or clinical validations did your team achieve this year, especially in areas like AI, digital therapeutics, remote care, or device intelligence? 

Vijay Karunakaran: This year, Rewin advanced the scientific foundation of digital therapeutics in India through a series of high-quality clinical studies, multi-centre pilots, and validated technological breakthroughs. Our most significant innovation was the evolution of the Rewin Smart Rehab Engine, integrating full-body motion sensors, computer vision, and immersive VR to quantify gait, balance, posture, endurance and fine-motor function with clinical-grade precision.

Across multiple institutions — including Apollo Hospitals, Medway Institute of Pulmonology, and government rehabilitation centres — our studies demonstrated robust improvements. In ICU and cardio-thoracic cohorts, immersive VR relaxation therapy achieved 81–91% reduction in anxiety and depression within 2-5 sessions. In pulmonary rehabilitation, VR-integrated PR produced significantly superior gains in DLCO, FEV₁%, and psychological outcomes (HAM-A, HAM-D) compared to standard PR (p < 0.05) .

Our 200-patient stroke RWE study reported 80% motor recovery improvement and 70% functional independence gains , while the orthopaedic 200-patient study showed marked reductions in disability scores across NDI, SPADI, ODI and KOOS . Additionally, our Frontiers in Neurology feasibility study confirmed Rewin’s acceptability, usability and scalability in real-world Indian conditions.

Together, these findings reinforce Rewin’s position as a scientifically validated, outcomes-driven digital therapeutics platform.

StartupTalky: Healthtech adoption has accelerated across hospitals, insurers, and consumers. What notable shifts or behavioural patterns did you observe in the Indian healthcare ecosystem this year? 

Vijay Karunakaran: In 2025, India’s healthcare ecosystem underwent a decisive behavioural shift toward digitisation, automation, and evidence-based decision-making. Hospitals moved from exploring digital tools to actively integrating AI-driven workflows across physiotherapy, ICU care, pulmonary rehab, oncology recovery, and chronic disease management. Clinical leaders increasingly prioritised solutions that delivered measurable outcomes, which is why multi-centre evidence from Apollo, MIOT, Medway, and Tamil Nadu government rehab hospitals accelerated adoption of VR- and AI-enabled rehab models. ICU and cardio-thoracic teams in particular recognised the role of digital therapeutics in psychological stabilisation, with Rewin’s VR protocols producing 80–90% reduction in anxiety and depression in high-stress units.

Therapists and physiatrists increasingly embraced AI-driven assessment and progress dashboards. Instead of manual ROM checks and subjective progress notes, clinicians began relying on motion sensors, digital prescription logs, and Brunnstrom/FIM trend visualisations across stroke and orthopaedic cohorts. This aligns with the behaviour seen in our stroke RWE and case-series publications, where digital monitoring enabled earlier intervention and higher adherence.

Patients—particularly seniors, post-surgical individuals, and those in Tier-2/3 towns—became more comfortable with remote and hybrid models of care. Digital literacy improved dramatically; our Frontiers in Neurology feasibility study showed regular home use, even among families new to smartphones.

At the ecosystem level, government, insurers and CSR partners demonstrated heightened interest in digitally measurable, disability-reduction–oriented programs, such as Tamil Nadu’s initiative to deploy VR-enabled physiotherapy clinics in SC/ST regions.

Overall, 2025 saw a clear transition: digital and AI-enabled rehabilitation is no longer viewed as an adjunct, but as a core component of quality care, with stakeholders increasingly expecting data transparency, measurable outcomes, remote continuity, and scalable delivery models.

StartupTalky: How are you using AI, data intelligence, or automation to improve clinical efficiency, reduce costs, or enhance the patient experience? Please share any measurable improvements where possible. 

Vijay Karunakaran: At Rewin, AI and automation sit inside the clinical workflow—not on the side of it. Our Smart Rehab Engine combines motion sensors, computer vision and rules-based clinical logic to auto-capture 40+ parameters (ROM, gait symmetry, trunk control, balance, endurance, fine-motor performance). This reduces manual assessment time for therapists and standardises evaluations across centres, while our therapist app auto-generates progress graphs and reports that can be shared with surgeons and families.

On the patient side, data intelligence drives personalised progression: difficulty levels, exercise types and VR tasks adapt based on performance, fatigue and adherence trends. Digital prescriptions, reminders and home-exercise logs improve continuity and reduce drop-offs, especially in Tier-2/3 settings validated in our feasibility and stroke RWE work.

Rewin Health studies show this translates into meaningful outcomes:

• 90% improvement in quality of life and satisfaction across large cohorts using Rewin’s digital pathways 
• 80% improvement in motor recovery and 70% functional independence gains in our 200-patient stroke RWE study 
• Significant reductions in disability indices for neck, shoulder, back and knee pain in the 200-patient orthopaedic RWE study 
• 81–91% reduction in anxiety and depression for ICU and cardio-thoracic patients using automated VR-relaxation protocols alongside standard care

For hospitals, these gains mean higher therapist productivity, better bed utilisation, and fewer long-term disability risks, making AI-led rehabilitation a clear cost–quality win rather than a pure “nice-to-have” technology layer.

StartupTalky: What were the biggest operational or regulatory challenges your organisation faced, and what helped you navigate them effectively? 

Vijay Karunakaran: One of our most persistent challenges has been scaling a clinically sophisticated platform across highly variable care environments—ICUs, pulmonary units, ortho OPDs, stroke wards, private hospitals, and government rehabilitation centres—while maintaining standardised outcomes. Our feasibility study highlighted early operational barriers: inconsistent connectivity, language gaps, navigation difficulties, therapist workload differences, and the need to adapt therapeutic content for diverse patient profiles. ReWin Health addressed this through multilingual UX, Tamil-first instructions, offline-capable modes, structured therapist certification, and evidence-backed clinical protocols validated across our 200-patient stroke and orthopaedic RWE studies.

A second major challenge is the lack of insurance coverage for physiotherapy, rehabilitation, and digital therapeutics in India. Most insurers reimburse surgery and acute care, but not long-duration rehab—even though stroke, cancer, pulmonary and ortho patients require months of structured recovery. This gap slows adoption and increases out-of-pocket burden. We navigated this by generating strong economic and clinical evidence:

• ICU and cardio-thoracic VR studies showing 80–91% reduction in anxiety and depression, improving recovery experience and reducing stress-related complications.
• Pulmonary VR-PR trial demonstrating superior functional and psychological outcomes vs. standard PR, indicating reduced long-term morbidity.
• Government hospital pilots showing improved balance, pain reduction, and functional independence in stroke and OA patients in public health settings.

Combined with the Frontiers in Neurology feasibility study validating scalability in real Indian homes, Rewin is now better positioned to advocate for insurer-led rehab coverage and value-based reimbursement. Together, evidence generation, operational standardisation, and proactive engagement with insurers, government bodies and clinicians have enabled us to navigate a still-evolving DTx ecosystem while continuing to scale responsibly.

StartupTalky: As you look ahead to the coming year, what major opportunities do you foresee in India’s healthtech landscape, whether in partnerships, technology, policy, or care delivery? 

Vijay Karunakaran: India is entering a phase where healthcare is shifting from episodic treatment to continuous, functional, and disability-focused care—and this transition creates enormous opportunity for clinically validated digital therapeutics platforms like Rewin.

• Digital Rehabilitation as a Core NCD Intervention: With stroke, cancer, COPD, OA knee, chronic pain and post-surgical recovery driving a massive rehabilitation burden, India needs scalable, standardised models. Rewin’s multi-centre evidence—showing 70–80% functional recovery in stroke, pulmonary and ortho cohorts—positions us to embed digital rehab inside routine clinical pathways, joint-replacement bundles, tumour boards and rehabilitation programmes.
• Public Health Integration, Led by Rewin: A major opportunity ahead is the Tamil Nadu Government’s partnership with Rewin to establish 150 digital physiotherapy clinics across SC/ST regions—making this one of India’s largest state-backed rehabilitation networks. This model provides a blueprint for other states and demonstrates that Rewin is not just a vendor but a strategic rehabilitation partner at a systems level, capable of serving district hospitals, community rehab centres and geriatric day-care hubs.
• Insurance, CSR & Value-Based Care: Indian insurers are beginning to realise that rehabilitation reduces long-term disability, readmissions and caregiver burden. Rewin’s outcomes—such as ICU anxiety/depression reduction (81–91%), pulmonary improvements, and 70% gains in functional independence—give us a strong foundation to co-create digital rehab benefit packages, OPD riders, employer programmes and CSR-funded rural rehab grids.
• New Frontiers: Neuro-behavioural & Paediatric Health: Our Jadhu platform opens a new category in neurodivergent support, anxiety regulation and childhood skill-building—areas with minimal structured solutions. This allows Rewin to extend from post-event rehab into lifespan neurofunctional health, creating opportunities with schools, NGOs and mental-health ecosystems.
• AI as India’s Rehabilitation Infrastructure Layer: With thousands of Rewin sessions captured across hospitals and homes, we see the emergence of a national rehabilitation dataset—powering predictive insights into mobility, balance, adherence, anxiety and long-term outcomes. This positions Rewin not just as a service provider but as a clinical intelligence backbone for India’s rehabilitation system.

StartupTalky: What will be your top three strategic priorities for the new year in terms of product roadmap, market expansion, and strengthening patient trust?

Vijay Karunakaran: The coming year marks a scale-up phase for Rewin Health, now that our digital therapeutics platform is fully validated across hospitals, ICUs, pulmonary units, ortho clinics, stroke centres and government systems. Our strategy centres on three major priorities:

• Deepening Rewin Health’s Product & Clinical Intelligence Stack: Rewin Health will expand its Smart Rehab Engine with advanced AI-driven assessments, multi-sensor analytics, and adaptive VR pathways across stroke, orthopaedics, pulmonary, oncology and cancer-related fatigue. With strong clinical outcomes—such as 80% motor recovery improvement in stroke, superior pulmonary outcomes, and 91% anxiety-depression reduction in ICU settings—Rewin Health is now positioned to become India’s clinical standard for measurable rehabilitation.
• Scaling Distribution Aggressively: With product-market fit firmly established, Rewin Health will scale far beyond its current 80+ hospital partners and 10 Rewin-owned clinics. Our flagship initiative with the Tamil Nadu Government — deploying 150 Rewin-enabled digital physiotherapy centres in SC/ST regions — positions Rewin Health as the backbone of public-sector rehabilitation. This model will be extended across other states and international markets, with Rewin Health aiming for 150–250 hospitals and 150+ clinics in the next phase.
• Accelerating JADHU — Rewin Health’s Neurodivergent Platform: A major growth vector is JADHU, Rewin Health’s AI + Sensors + VR platform for autism, ADHD, anxiety and behavioural challenges. With real-time anxiety detection, therapist dashboards, immersive + non-immersive modules, and parent-guided home pathways, JADHU positions Rewin Health at the intersection of paediatrics, mental health and neurofunctional learning — one of the fastest-growing global healthtech categories.

Together, these priorities firmly establish Rewin Health as India’s most scalable, evidence-backed digital health company — ready for nationwide and international expansion.

Explore more Recap'25 interviews here.