Bridging the Gap: How HoustonBionics is Revolutionizing Home Rehab for Stroke Survivors with Yagiz Sisman - Episode 165

Are you or a loved one navigating the difficult journey of stroke recovery? You are not alone—and more importantly, you don't have to face it without the right tools.

In this episode of the Caregiver Relief Podcast, I sat down with Yagiz Sisman, co-founder of HoustonBionics, to discuss how they are changing the game for stroke and traumatic brain injury (TBI) survivors. With the current landscape of healthcare rationing and shortened rehabilitation windows, many families are being sent home with nowhere to turn.

Yagiz shares how their neuro-rehabilitation platform, X-Rehab, is bringing high-intensity, high-repetition therapy right into the living room, bridging the critical gap in care after hospital discharge.

HoustonBionics | Upper Extremity Rehabilitation

At HoustonBionics, we are revolutionizing stroke recovery through innovative, connected, and accessible at-home rehabilitation solutions.

Houston Bionics

🎙️ Highlights from this Episode:

• The Reality of Modern Rehab: We break down why the "90-day" therapy window is often not what it used to be and how families are being asked to provide more care with fewer professional resources.
• Technology Meets Therapy: Discover how X-Rehab uses hardware to isolate specific physiological movements while utilizing engaging, game-based software to keep survivors motivated and moving.
• The Power of Data: Learn how the platform tracks range of motion and progress, providing objective feedback that you can share with your physicians and therapists to show real-time improvement.
• Community & Connection: It’s not just about physical movement; it’s about social connection. Yagiz explains how their platform allows survivors to compete and connect with one another, combatting the isolation that often accompanies recovery.
• Hope Beyond the "Plateau": Hear why, even years post-stroke, it is never too late to see improvements through consistent, goal-oriented practice.

Why This Matters for Caregivers

As a former rehab nurse, I know how frightening it is to be discharged into an "unknown." This technology isn't meant to replace your occupational therapist—it’s a powerful companion tool that ensures your loved one can keep doing the work required for neuroplasticity, even when they can't get to a clinic.

Remember: You are the most important part of the caregiving equation. If you’re feeling overwhelmed, please know that you are doing meaningful, incredible work, and you deserve support.

🔗 Connect with HoustonBionics

Interested in learning if this is a viable solution for your situation? Yagiz and his team invite you to reach out directly to discuss your specific needs.

• Website: houstonbionics.com
• Next Step: Visit their site to schedule a consultation—they are happy to speak with you and even coordinate with your existing therapists to ensure a seamless care plan.

Podcast Episode Transcript

Diane: Welcome to the Caregiver Relief Podcast, dedicated to empowering family caregivers and seniors with the knowledge and tools to navigate today's challenging healthcare landscape. I'm your host, Diane Carbo, rn, and to today, we're tackling a critical issue, the ongoing healthcare crisis. Driven by Medicare's reimbursement cuts, Medicare is moving towards a cost sharing platform and families, or more specifically, the family caregiver is expected to provide care once provided by healthcare professionals.

And it's a big dilemma and I'm doing a series and we're exploring options and solutions because the future of Healthcare means you'll likely pay out of pocket or go without. And sadly, Medicaid recipients have faced this reality for decades. But there's hope on the horizon. Today I'm joined by Yagiz Sisman, co-founder and Chief Business Officer of Houston Bionics, a company revolutionizing home rehab for stroke survivors, and those recovering from neurological injuries, their technology.

Structured goal-oriented upper extremity practice at home, maintaining active participation and bridging the gap in care after discharge.

Diane: Yagiz , I hope I'm saying that your name right?

Yagiz: It's actually pronounced is, but it's, you're doing a great job. No worries.

Diane: I come from Pittsburgh, Pennsylvania, and you is a term we use for you all.

So I know that word thank you for being here. And I'd like to dive into how Houston Bionic is helping caregivers and patients thrive amid these challenges.

Yagiz: definitely. thank you Diane. And first of all, I'm really glad to be here and. Really appreciate the invitation and, I'm the co-founder of Onic.

As you mentioned, we are a medical device company, focus on helping stroke survivors, primarily, but also TBI patients, traumatic brain injury patients to regain arm and hand function at home.

Diane: Yeah,

Yagiz: what we built is called X Rehab X, the platform. It's a neuro rehab platform,

Diane: uhhuh.

Yagiz: It's listed, at from upper extremity rehabilitation platform.

Designed specifically for, independent use by stroke survivors. And our goal is simple, is to, which is to extend the high quality, high intensity, high repetition training beyond the hospital, and or the clinic into, everyday life in a way that is safe, motivating, and, clinically meaningful.

Diane: Yeah.

Yagiz: yeah.

Diane: I love this approach. 'cause I'm seeing a lot of unsafe discharges to home right now because Medicare has rationed not only our skilled actually it's rationed to therapies in skilled facilities and rehab. So what we once had the 90 day period where patients can get rehab.

now that 90 day period, although they say we still have it. because the reimbursement is so low for rehab, facilities get paid a higher level of care to not provide therapy. So families are really at a loss because if you have a Medicare advantage, we're seeing even stroke victims being sent home, with Medicare Advantage in 11 to 14, maybe 15 days.

And the traditional Medicare patients are sent home in 20 days. 'cause that's the highest level of reimbursement and it's frightening out there. So my goal is to educate people that they're my clients and my listeners, that their ER resources out there that you can tap into. And as an old rehab nurse, I can tell you I love this.

Can you explain the technology and how it supports structured goal directed practice in home environments?

Yagiz: definitely. first of all. Going back to the platform we build, the platform has two components. One is the hardware and the second one is the software.

The hardware, the design itself enables three physiological movements for wrist and forearm.

Diane: And

Yagiz: the idea here is to make things such as, on and off like a survivor should be able to use this device. Without a requiring any supervision from a caregiver or a therapist whenever they feel confident, comfortable, and put it in a complex structure that they can, keep it at home even in their living room or their bedroom or wherever they want to train.

And the design itself enables, unwanted movements such as. You cannot compensate particular movement with the unimpacted side of your body, which lets you focus on that particular physiological movements and provides you with isolated training. So you're doing just one thing, but that you're focusing on that, crucial aspect of that moment.

Yes. So that's the hardware. The software itself, provides the visual feedback, meaning we, we've done the controlled clinical studies and we've done additional studies, and we understood that like the moment you provide the visual feedback into the therapy in a home setting, the motivation level goes up drastically.

Which is a good thing. and to accomplish that, we have implemented games that are, easy to play. But it's actually in part as, 'cause as you train on the device, the difficulty of the game will increase in a concept called adjust noticeable difference. And this concept is we don't let you know that you're increasing the difficulty, but you're actually challenging yourself, naturally.

So those are the, two capabilities and the third capability actually, of the software side is it provides the data back to you. So now you get to see. How many days you worked out, how many joints you worked out, what was your range of motion, how many successful hits that you accomplish in a given game, and then you can provide and, some additional data and you can provide this data back to your, providers.

It could be your physician or your therapist to also for them to see how you're doing in your home environment. Because for them it's also important that, like you mentioned, unfortunately, the time you can spend in clinic is limited. Yeah. It's it's same for the inpatient and the outpatient. Yep. but it's also valuable for them to see what you're doing when you're not in clinic and how you're progressing.

This is the platform in a nutshell.

Diane: You know what I like about your platform is patients and their caregivers often face limit, barriers, like limited appointments, transportation issues, and fatigue after discharge, especially after a stroke is very real. And, you seem to address all of those issues, making it really easy to do so that a person can not only do it.

On their own, but you actually not only track their progress, but, I, I love that you are, it's encouraging and it makes it easy for a person who does suffer fatigue, to work out when they're at their best in the whatever time that is in the morning, afternoon, or evening.

Yagiz: yeah, 100%. agree.

And,the other reason. That we do have survivors, from many states now using the devices. Going back to the what is available in the market, right? What is available is that you can get one, if you're lucky, two sessions a week. that could be the reason could be your insurance covers that much only, or for an average American, it takes about two to three hours to travel back and forth to the clinic to receive a 45 minute session.

Diane: Yep, yep.

Yagiz: But before continuing, I wanna say one thing, which is very important that. The device itself, the platform does not replace the occupational therapy. Yeah. We don't make claims. It's a companion tool to occupational therapy. Correct. Simplifies the gain. going through the therapy, going to the clinic is critical.

it's not something that you can replace with a, But as these, the current solutions in the market, but what we have seen from the users, the survivors, the caregivers, that people want to do more.

Diane: Yeah, they do. People

Yagiz: want to do more. They are, some of our users are using the platform fanatically,like a marathon runner, right?

Diane: Oh Lord.

Yagiz: Yeah. Every day they use the platform every day and they give us feedbacks and we took this feedback to take this feedbacks and,make improvements on the platform, which is great for us too. Yeah. But what we have seen is that people want to do more. And X-Ray Apex is just a platform that enables, people who want to do more.

Diane: Yeah.

Yagiz: Given access to the, limited amount of therapy they can get.

Diane: You know what I really like the about it is I have, because we have Medicare cutting, actually rationing rehabilitation therapy, the copays are often, 30, 40, $50 a copay and. In the olden days, back as long as five years ago, you could get, three days a week of therapy and have for six, eight weeks at a time.

And that's what people need. They need that regular continuity. And now, they, especially the Medicare Advantage plans, they actually limit. Oh, you can have six visits in the next six months, and that's just, it's not. Conducive to recovery. there needs to be consistency. There needs to be someone encouraging.

and there has to be a willingness on the stroke victims part to want to improve. You make that possible very easily by having your tool there,your platform that makes it easy for them to do what they can when they. Are able, to,to make progress. And it sounds like you make it fun.

Yagiz: It is. It is fun. This is actually a good feedback. We, keep receiving from our users. Like they love the games and, one aspect is yes, we provide the games, but we also have multiplayer games. so for example, we do have a fellow stroke survivor from Texas playing a game against, like competing against, a person from, Virginia.

So there's a social aspect of Oh wow. Our platform as well. It's not just, Hey, you're alone. Play this game till you get bored. No, you can't make friends,and play against each other.

Diane: Yeah. I love that because number one, socialization . Yes. And social isolation is rampant in, our senior population.

And I can see men more than women my age. 'cause we didn't grow up with a, the sports like other, generation women, generations, passed. so we didn't do that. We didn't, and you build such a. of course I have a competitive nature, but it's not in sports. It's in academics, But, I love that.

I can see, I have two sons, I've had two husbands, I had a father. I know competitiveness in the males is really strong. Even between my si, my brother,my siblings and my sons. I could do this better than you. they get down to. they all like to cook. My, my nephews and my sons like to cook and I laugh because they'd have cookie cooking contests to see who had made the best of Sauer crot or the best whatever, just to, to have fun.

So having a game and having, and you know what else it does, it also gives somebody the, the something to. Look forward to the next day. I'm going to, I'm gonna have an interaction and play a game with so and so in Tennessee, or maybe No, I'm, they're, I'm tired of them. I want somebody more competitive.

I'm going to go to Maine or whatever. So I love that you're, you have this tool that really helps. Now, what kind of feedback are you getting from family caregivers who are now pro supposed to, are expected to provide professional level care?

Yagiz: to summarize the feedback, what I can say is stroke is a burden A on the survivor, but b on the caregivers.

Diane: Yeah.

Yagiz: And I think the biggest positive feedback that we have received so far is caregivers are telling us that, they're the stroke survivor. The person who experienced the stroke is actually, Getting, I wouldn't say happier because that's a big word. They're getting happy. they're happy that they have a platform that they can use ease to understand, like fun.

But some of them sending these, before and after videos.

Diane: Oh, fun.

Yagiz: Yeah. So they are, they get to see, or some of them are looking at the data, which we provide the objective data, like real data based on range of motion and other. Data points and seeing, oh, this is getting better.

Diane: Yeah.

Yagiz: there's a, there's an upward trend in, in the trajectory, which is a good thing.

So it's also motivating for them as well.

Diane: Yeah. The

Yagiz: question is like, what can I do more? What can I do more now is, okay, let's do this more, let's do this more. And for them to see, their significant others, getting. Better, more motivated, actually is a big relief for them. At least. This is the feedback we got from,many caregivers so far.

Diane: I believe that I could tell you that, going home and not having therapy coming to the house, and of course you're not going out to therapy because of the, the rationing of the care. there stroke survivors go into deep depressions, and I think that just giving them a sense of hope, something to look forward to.

And on their own terms even makes it better. Yes, because they wanna work more. They'll work more. But if they're just happy doing just enough, even that's good. As long as they're improving. And I like the fact that you show that they're improving. And I hope that the caregivers, when they don't see any improvement, nudge their family to do a little bit more, try a little or try a different game, something like that, to get them motivated.

because nothing's more motivated than seeing progress in your body. And so many of them want to return to their, baseline before they had the stroke.

Yagiz: a hundred percent. A hundred percent. And it's just Again, the issue is here is the access, Diane. Like we know what the solution is, right?

High intensity, high repetition, training, stroke survivors need, not all of them. Yeah. Some of them are healed. or spend less time in therapy and then get better. Yeah. But most stroke survivors need hundreds of repetitions. Every day, six days a week for a long period of time. We know that the moment you put that into effect, the high intensity repetition training, you'll get better.

This is how the neuroplasticity works.

Diane: yeah. Side

Yagiz: tells that. but having the issue of access to this solution is the problem now. and, knowing that, okay, now we have a solution, That we can use at home.

That will avoid that access problem.

Diane: Yes.

Yagiz: There's a big relief on them.

Diane: yes. And people don't realize that stroke, rehab after a stroke, your rehabilitation is lifelong for many of them to, if they get sick or they have a few days where they just don't feel well, and they sit around and don't do anything. They can lose their muscle, they can lose the progress that they've made.

I've seen it all over. And so it is a lifelong form of rehab and I love that you put it in the form of a game or games and competition that you, they can interact with others because,I'm on several stroke. Survivor groups, and I always get a giggle because they're asking each other, how'd you do today?

What's going on? and they try to encourage one another. And, so I really like this. I really like it a lot's, it's.

Yagiz: I'm sorry to interrupt. It's like you should think about a game console. This is what we wanted to, accomplish actually. Uhhuh game console. I'm not gonna name the brands, but there are

Diane: Yeah,

Yagiz: two of them.

and what you have seen is that. It created one of the largest communities in the world, like online gaming community, right? People love spending time in those game consoles, playing against each other, sometimes playing by themself, but it created a community. So we want this platform, Xia X to, to be one of those game consoles for Structure Virus that they will love, spend not just one hour, but more than one hour.

Yeah.

Diane: Yeah.

Yagiz: As they can. we want their caregivers to say okay, stop using this device. we've been doing this for like hours and hours every day. Yeah. And we're still improving the, software site because we want to make this community a real thing. Yeah. And we want this friendships to be built on this, platform.

Yep.

Diane: I think that's a beautiful thing and with, our aging population, we don't have enough youth to take care of our aging population, and it does cause that social isolation. So if somebody's recovering from a stroke and having a whole community. To, interact with makes 'cause it's all about connection, human connection.

Yes. and that is so important. So you're actually improving the social life of those with a stroke, you're improving their ability to function at a higher level,and get back and work hard to get back to baseline as much as possible, to the level they were. Prior to their stroke. And, you give them a little bit of competitive edge and,I really like this. I can't imagine anybody, not enjoying that.

Yagiz: Yes. So far our users have enjoyed,I'm hoping that like we'll have many more users to grow this community

Diane: Yes.

Yagiz: And also enjoy it. it's exciting times for us and for the stroke community, stroke survivor community.

Diane: you know what, you couldn't had developed it at a better time because like I said, Medicare is rationing care and while we don't wanna replace the therapist, and the therapy, you almost are actually forced.

To be able to look at alternatives to help yourself because, and you can take those six visits once a month for six months, to keep in touch with them. But I can imagine, that I can imagine for me personally. As I've done care management and I can see my clients going into their PCP or their neurologist and or physiatrist even and showing off, look what I can do and why can't I do it?

And telling them, you've gotta try this, you've gotta give this a go. Yeah.

Yagiz: Diane, so we've done the controlled clinical studies, right? And we've generated, meaningful clinical outcomes,

Diane: uhhuh.

Yagiz: But apart from that, I mentioned that some of the caregivers are sending us the before and after videos.

Diane: Yes.

Yagiz: And you can, in those videos, you can actually see there's a significant improvement, like such as a controlled clinical study. This is actually you're seeing it on a video and. In two to three months. And I'm not saying that this will apply to everybody.

Diane: right? I understand that. But

Yagiz: in, two to three months, you're seeing a significant improvement.

for example, a better control of a arm. or switching the light on and off, right? Yeah. turn the lights on. Turn the lights off. Those are like maybe minor things for, non-structured survivors, but, those are big things.

Diane: They're food

Yagiz: in like in a couple of months, and those are not, fresh out of inpatient stroke survivors.

Some of them are like five, six years post stroke.

Diane: yes. Some of them

Yagiz: are, people who, Who were told that okay, this is it. It's not gonna get, it's not gonna get any better.

Diane: It's gonna get better. Yes. But you weren't around then. And now we have a solution and that said, and like I see it is stroke survivors have need rehab for the rest of their life in some form or fashion.

They just do. if your hands not working to full capacity and it's been years. There's still hope if you look into your product and, it can be fun and you might get better use of your hands or your arms. I think that's amazing.

Yagiz: It is. Definitely. And as you said, unfortunately, like many of them needs this becomes a lifelong journey.

Diane: it really does. It really does. Yeah. Yes.

Yagiz: and having this platform at hand. really changes things, but again, as you also continue the clinic sessions. But yeah, we are super excited to see where we are as a company, where the product is right now. And obviously the biggest motivation for us is to hear the good things, from the feedback, the hear, the good feedback from the, survivors themselves as well as the caregivers.

Diane: Yeah,

Yagiz: it, this actually translates into okay, this is what we are doing and this is why we are doing four.

Diane: How can you explain how Houston Bionics compliments existing care plans without replacing professional therapy? How are, actually, I wanna know, how are the occupational therapists or the physical therapists responding to your, your equipment?

Yagiz: So the feedback we got from the clinicians and therapists is everybody knows, again, I'm gonna go back to the high intensity, high reputation training. Everybody knows this is what happens is I'm gonna break this into, this journey into two

of the discharge and, right after discharge and during the outpatient.

So right after discharge, as you said, unfortunately, stroke survivors. Can spend only two, three weeks on average.

Diane: Yes.

Yagiz: to receive that, intense trainings, intense therapy in a hospital setting. They receive, I think on average three hours a day.

Diane: that's a misnomer anymore. F. Yeah,

Yagiz: it's

Diane: not happening.

I can tell you right now, it's not happening. and I can also tell you that if the patient refuses anything, they don't force them or encourage them. They just let them lay there. So I'm seeing a lot of things as an old nurse, I'm finding shocking. but you're right. Okay. Let's pretend we have. Three hours a day therapy for two

Yagiz: weeks.

And this is not my area of expertise. I don't know how the, you know what,

Diane: this is something new that's happening since January of last year when Medicare revamped everything and it's really harming our seniors. in recovery. Which is, so that's why I was so excited to find you guys.

Yeah. Because it's such a sol, it offers a logical solution to a problem when we really are in a crisis and caregivers are expected to, provide more care and pay more outta pocket for it. I'm sorry I interrupted you, but I'm just ex I'm just excited about this, but you're able to do this.

as a compliment, like you said, it's a complimentary service or therapy, along with their professionals. Are you introducing it in the hospitals and in acute care settings?

Yagiz: yes. Very shortly in a, in a few months. Will be, X apex will be available in some selected health systems.

Diane: Okay.

Yagiz: yeah, in few months.

Because they also want to see, the has systems like the platform, the hospitals like the platform because it's compact.

Diane: Yeah.

Yagiz: and because of the, less demanding nature of the supervision, they can provide this to many more people. As you said,even this can go to your room.

You don't have to come to all the way to

Diane: Exactly. Yep. Yep.

Yagiz: how does it compliment is, I'm gonna take a step back and continue what happens after the inpatient discharge?

Diane: Yes, please. The

Yagiz: discharge happens. Unfortunately, patients are discharged into a big unknown. The doctors tell them to, okay. This is the last day at the hospital.

You're now going to your home or skilled nursing facility, whichever is appropriate. but you're going to your home, let's say, and you have to do just repetitions, right? Like you will do obviously like eat healthy, sleep well, all the other stuff. But like when it comes to the therapy principles, you need to do high repetition training.

Diane: Yes.

Yagiz: And they give them a couple of exercises and, resources, available resources, but unfortunately they're discharging into, a big unknown because they don't know what they're doing at home.

Diane: Exactly.

Yagiz: So when a patient comes back to the hospital and say okay, it's been a couple of months, I've been, I've been not, I've been doing this training.

So how much, like, how is it going? is there data that I can monitor, track,how are things going? can I see a report so that doesn't exist?

Aex, a, the data will be available for the clinicians and the therapist for them to monitor and see what's going on, and b again, the needed thing is.

think it from foundational perspective. Like you need to build this, small but repetitive movements

Hundreds of times for your e joints. This is the best case. and what happens when you go to the clinic is that with the occupational therapist, instead of for them to spend these like repetitive moments with you They can get the focus on the functional gains such as hey, okay, let's try this particular moment. let's grab a spoon. there's this thing called if you wanna teach someone to eat with a spoon, you have to use a spoon. So the therapist. Focus on this, fine tuned skills.

Diane: Yes.

Yagiz: While we built this foundational gains Yeah.

In, in, at least for our platform in three joints.

Diane: Yeah. That's the idea. Okay. yeah, the fine motor movement is really challenging and many, stroke victims have adaptive equipment where they have this big thing that they can hold onto with a spoon at the end. and the hard part is getting from their.

the plate to their mouth, because they may not have the ability to do that, so they're expected to be fed and this way I can see you can actually improve all of that so that eventually they can eat on their own.

Yagiz: Yes. again, this is, what therapist, will do. It's not our platform's capability.

Yeah. And again, the platform now only covers three physiological movements. The other physiological movements, uhhuh, that has to be covered in the upper extremity. But again, there's a trade off if you want to make things compact is to use at home. you need to. Give away some of the other capabilities.

But we are also, as a company, building a solution for the remaining physiological movements for the upper extremity. It's not just available in the current platform, but even at these three platform three, physiological movements, bringing the high intent side petition training, it's critical. And this is something that therapists are actually loving.

And they not just in a home environment, they also want to use in a clinic as well.

Diane: Yeah. So what do you see for the future of Houston Bionics?

Yagiz: Houston Bionics? I wanna see Houston Bionics becoming, again, giving an example of game consoles, right? We want to create this community first and then provide the needed solutions in an accessible way.

This can be financially, or this can be like a physical size. Et cetera, to that community. So we want to build this community in a way that game consoles built amazing communities, fun communities over the past couple of decades.

Diane: Yeah, and you know what? I can see stroke survivors really loving it.

I really do use, how do they find you?

Yagiz: how can they find us

Diane: Uhhuh

Yagiz: so they can come out to our website. There's a, There's a button that, that they can schedule a session directly with me or my co-founder, ku.

what we do is we first understand, we evaluate the, situation and then we understand, okay.

This might be a viable solution. And then once we understand those things, we also would like to speak with their therapist and also explain this, Hey, this is the platform. Your patient gonna use it. Are you okay with this? Or how we can, accelerate the outcomes from this, platform for your, patient.

But yeah, just go to the website, houston biox.com and schedule a session with us.

Diane: Anybody in the country can call you or set a session. they can.

Yagiz: A hundred percent. Yes.

Diane: That is incredibly awesome. And that's what I think is going to truly make, your organization very successful. I'm so impressed that, I'm so glad because we are struggling right now to find solutions, to, to these issues of not having proper therapy given.

And,I applaud you for your creativity and I'd like to see you expand to help more people. Thank you so much. And for my listeners out there, pay attention that even if you have a stroke survivor with hand issues, that has not had any therapy in years. Contact them and see if they can offer you an opportunity, to really, improve.

Because it doesn't mean they can't, because they've not been, they have not been, given the opportunity to work and. Stroke rehab is lifelong rehab. it is. If you're a stroke survivor, you have to work harder and consistently. So to my family, caregivers out there, you are the most important part of the caregiving equation.

Without you, it all falls apart. So please learn to be gentle with yourself. Practice self-care every day because you are worth it.