Wearable Sensor Technology and Rehabilitation Outcomes: Evaluating Patient Engagement, Treatment Adherence, and Functional Recovery in Physiotherapy

Abstract

Wearable sensor technologies offer potential to improve rehabilitation outcomes by enhancing patient engagement, treatment adherence, and functional recovery. Their adoption in low-resource settings, such as Pakistan, remains underexplored. To evaluate the impact of wearable sensor adoption on patient engagement, treatment adherence, and functional recovery in physiotherapy, and to examine the moderating roles of clinician experience and ethical considerations. A cross-sectional study was conducted with 400 patients and 50 physiotherapists across urban and rural clinics in Pakistan. Patients used wearable motion sensors for 4 weeks, while engagement, adherence, and functional outcomes were recorded. Partial Least Squares Structural Equation Modeling (PLS-SEM) assessed relationships among constructs, including mediation and moderation effects. Wearable sensor adoption positively influenced patient engagement (β=0.48, p<0.001) and treatment adherence (β=0.41, p<0.001). Both engagement and adherence significantly predicted functional recovery (β=0.52 and 0.44, respectively; p<0.001). Patient engagement partially mediated the effect of wearable adoption on recovery outcomes. Clinician experience and ethical considerations moderated the impact of wearables on engagement and adherence. Urban clinics showed slightly higher adoption and recovery outcomes, while engagement and adherence were comparable across settings. Wearable sensor integration in physiotherapy enhances patient engagement, adherence, and functional recovery. Clinician expertise and ethical safeguards are critical to maximizing benefits. Policy initiatives should promote training, ethical frameworks, and accessibility to wearable technologies, particularly in low-resource contexts.