Wearable technologies for observing disorders of movement: Providing key insights on treatment effects in the real world

Movement disorders present a substantial challenge by adversely affecting daily routines and overall well-being through a diverse spectrum of motor symptoms. Traditionally, motor symptoms have been evaluated through manual observational methods and patient-reported outcomes. While those approaches are valuable, they are limited by their subjectivity. In contrast, wearable technologies (wearables) provide objective assessments while actively supporting rehabilitation through continuous tracking, real-time feedback, and personalized physical therapy-based interventions. The aim of this literature review is to examine current research on the use of wearables in the rehabilitation of motor symptoms, focusing on their features, applications, and impact on improving motor function. By exploring research protocols, metrics, and study findings, this review aims to provide a comprehensive overview of how wearables are being used to support and optimize rehabilitation outcomes. To achieve that aim, a systematic search of the literature was conducted. Findings reveal that gait disturbance and postural balance are the primary motor symptoms extensively studied with tremor and freezing of gait (FoG) also receiving attention. Wearable sensing ranges from bespoke inertial and/or electromyography to commercial units such as personal devices (i.e., smartwatch). Interactive (virtual reality, VR and augmented reality, AR) and immersive technologies (headphones), along with wearable robotic systems (exoskeletons), have proven to be effective in improving motor skills. Auditory cueing (via smartwatches or headphones), aids gait training with rhythmic feedback, while visual cues (via VR and AR glasses) enhance balance exercises through real-time feedback. The development of treatment protocols that incorporate personalized cues via wearables could enhance adherence and engagement to potentially lead to long-term improvements. However, evidence on the sustained effectiveness of wearable-based interventions remains limited.