The concept of Knowledge Ecosystem (KE) is used to define a community of practice that builds knowledge in a bottom‑up, networked and dynamic fashion. These features define a new kind of digital ecosystem that is domain specific and operate in an open (virtual or real) world. The openness is an ideal situation that needs to apply the unified standards, for instance the Semantic Web Standards and Rules and Web 3.0 that help the building, growth, sharing and forgetting of knowledge across the Knowledge Ecosystems. What makes the KE different from the "classic" view upon the digital ecosystem is an active and dynamic process that involves: the creation of knowledge; the intentional elicitation of knowledge; the ability of share knowledge across the entities; and the possibility to depreciate and forget knowledge. How does the dynamic nature of knowledge influence the nature of knowledge ecosystems? What are the general principles that can be applied to design the sound and enduring knowledge ecosystems? These are some of the questions will try to get answers in our paper work. First of all, we will show that the dynamic evolution of knowledge and the dynamic character of the flows of knowledge are essential for the transition from digital ecosystems to knowledge ecosystems. Having a static collection of pieces of knowledge, processing them and placing them in a digital ecosystem are not really enough for this one to becomes a knowledge ecosystem. Continuous knowledge creation is responsible for transforming the digital ecosystem in a knowledge one. The process of dynamic knowledge building occurs when internal (tacit) knowledge becomes external (explicit). The continuously feedbacks that operate between internal and external knowledge are producing new knowledge among entities and create the energy and permanent innovation that characterizes a knowledge ecosystem. In the second part of the paper we have draw some general principles of accelerating the appearance of new knowledge ecosystems, while in the third section we define the main features of the knowledge healthcare ecosystem design for the home rehabilitation of people with motor disabilities. In order to do so, we are going to extract from these general principles the specific in‑rules that make the agents involved in home health rehabilitation act as a knowledge ecosystem. Alongside the theoretical approach to our paper (that refers to the principles' establishing), there is also the practical one. We conclude the paper work with some remarks on the KE's role and importance in healthcare, and in particular in home rehabilitation field.