Advancing Neurorehabilitation and Recovery Through Human Movement Quantification via Wearable Sensing

Wearable movement sensing has enormous potential to transform the field of neurorehabilitation and neural repair. This perspective paper discusses: (1) the case for wearable sensing as a compelling, scalable measurement tool, (2) moving from first generation to second generation research in wearable movement sensing, (3) the enormity in the potential range of use cases for wearable technology, and (4) challenges that lie ahead for moving from research space into clinical rehabilitation care. Wearable sensors, as a measurement tool, offer a data-rich avenue for measuring numerous dimensions of motor behavior in the clinic and in daily life, complementing other available tools. Second-generation research questions focus on determining how to quantify, for whom, when, and with what variable(s). Answering these second-generation questions requires substantial evidence at the individual use case level; we provide 1 exemplar variable and its evidence within stroke recovery and rehabilitation. Potential use cases for deployment of wearable movement sensors span developmental, acquired, and degenerative neurological conditions and variables extracted can be intended as digital biomarkers and/or digital clinical outcome assessments. As research progresses, we look forward to the translation of this measurement tool into routine clinical care and welcome implementation challenges related to readiness, approach, and presentation in the busy, complex, healthcare arena. Achieving the promise of wearable movement sensing will require extensive collaboration, as exemplified by Dr. Wolf, across research teams, disciplines, institutions, people with lived experience, and other stakeholders.