Clinicians and patients endorse wearable tech for real-world rehab progress tracking

The study shows that while clinicians recognize the limitations of in-clinic assessments, understanding alone does not guarantee action. Some clinicians who could not clearly define the constructs still expressed strong support for external monitoring. These findings underscore that both conceptual clarity and workflow alignment will be necessary for wearable technology to reach widespread adoption in rehabilitation.

A shift is underway in rehabilitation care, as patients and clinicians seek better ways to capture meaningful improvements in daily life. In the new study "Perspectives of Key Stakeholders on Integrating Wearable Sensor Technology into Rehabilitation Care: A Mixed-Methods Analysis," published in Frontiers in Digital Health, researchers led by Allison E. Miller at Washington University present compelling evidence that both patients and clinicians view wearable sensor technology as a critical tool to bridge a long-standing practice gap.

The study highlights that traditional rehabilitation often measures what patients can do in clinical settings, activity capacity, but rarely monitors what they actually do in their everyday lives - activity performance. Using surveys and interviews with clinicians and patients at an outpatient rehabilitation center, the research identifies strong support for wearable sensor integration while also uncovering practical barriers and workflow preferences that will shape future implementation.

How do clinicians and patients understand the distinction between activity capacity and performance?

The research confirms that a majority of clinicians, 84.2%, accurately distinguish between activity capacity and activity performance. While activity capacity refers to what a person can do in a structured clinical setting, activity performance describes what a person actually does outside the clinic. This distinction is crucial because historical assumptions that improving clinical performance automatically translates into better daily activity have been disproven by major studies. Clinicians widely acknowledged that current in-clinic measures offer only a “snapshot” and may not reflect how patients function in their real environments.

Patients, though less versed in technical definitions, intuitively valued real-world performance monitoring. Those with personal experience using wearable sensors emphasized how such technology helped them stay accountable, reinforcing behavior change and supporting rehabilitation goals.

The study shows that while clinicians recognize the limitations of in-clinic assessments, understanding alone does not guarantee action. Some clinicians who could not clearly define the constructs still expressed strong support for external monitoring. These findings underscore that both conceptual clarity and workflow alignment will be necessary for wearable technology to reach widespread adoption in rehabilitation.

What methods are currently used to measure activity performance, and what are the barriers?

Clinicians reported two primary methods for tracking patient activity outside the clinic: self-reported activity logs and consumer-grade wearable sensors like Fitbits or Apple Watches. Self-reports were acknowledged as unreliable due to patient recall bias and social desirability effects. Conversely, wearable sensors provided objective, quantifiable data that clinicians found more trustworthy for tailoring interventions.

Despite these advantages, integrating consumer-grade sensors into rehabilitation practice faces several hurdles. Cost was the most frequently cited barrier; clinicians noted that asking patients to purchase devices could be burdensome, especially for those with limited financial resources. Additional concerns included patients’ comfort with technology, physical impairments that limit device usage, and doubts about the accuracy of consumer-grade devices, particularly for individuals with slow gait speeds or assistive devices like walkers.

Patients echoed these concerns. Some cited aesthetic discomfort wearing devices on both wrists, while others mentioned difficulty handling devices independently due to mobility impairments. Interestingly, while about 79% of clinicians had used some form of wearable sensor with patients, only 40% of patients reported collaborating with their clinicians using a sensor during outpatient rehabilitation. This gap suggests that even when clinicians see value in wearable technology, practical barriers can limit patient adoption.

Clinicians proposed several strategies to overcome these barriers, such as maintaining a clinic-owned inventory of sensors, issuing affordable sensor recommendations to patients, and improving education for both staff and patients. These findings highlight the complexity of translating positive attitudes toward wearable monitoring into routine clinical practice.

What are clinicians' and patients' preferences for integrating wearable sensors into rehabilitation workflows?

When it came to implementation logistics, clinicians showed a willingness to spend an average of 16 minutes per session to set up a wearable sensor for a patient, including syncing with mobile apps and training the patient on device use. A majority of clinicians (63%) preferred continuous monitoring, suggesting that patients should wear sensors from initial sessions through to discharge, providing a holistic view of daily activity patterns.

Patients demonstrated high acceptance rates for wearing sensors, with all surveyed participants indicating they would comply with clinician-recommended monitoring. Most were willing to sync their data daily or as often as their therapist instructed. Nevertheless, aesthetic concerns around wearing two devices simultaneously surfaced among some patients, particularly in social settings, indicating that user experience design will play a critical role in long-term adherence.

Clinicians also emphasized the importance of integrating wearable sensor data into electronic health records (EHRs). Easy access to this data within existing clinical systems would increase the likelihood that information is used to inform therapy decisions. Without seamless integration, clinicians feared that sensor data could become another administrative burden.

The study concludes that different models, such as using patient-owned devices, clinic-owned devices, or maintaining hybrid options, each have distinct advantages and challenges. The conceptual model generated from this work provides a roadmap for clinics of varying resources to tailor sensor integration strategies that align with their workflow capacities and patient needs.