Acceptability of Wearable Digital Devices for Remote Continuous Mobility Monitoring in People With Parkinson Disease and Carers: Qualitative Study
TL;DR
Wearable mobility monitoring was generally acceptable to people with PD and carers when it offered clear clinical value, fit easily into everyday life, and provided reassurance that remote monitoring would complement rather than replace clinical care.
Abstract
Abstract Background Parkinson disease (PD) impairs mobility and motor function, making accurate mobility assessment important for effective management and treatment planning. Traditional clinical assessments often rely on periodic clinical evaluations, which may not capture day-to-day symptom fluctuations. Wearable devices offer a promising alternative with continuous, objective tracking of mobility (eg, gait). However, although these tools provide valuable insights for patients and clinicians, their successful implementation depends on their acceptability to users. Objective This study aimed to explore the acceptability of wearable devices for remote continuous mobility monitoring in PD from the perspectives of people with PD and informal carers. Methods This international qualitative study used purposive sampling to recruit a diverse sample of 72 people with PD and 20 informal carers from the United Kingdom, Ireland, Belgium, Germany, Spain, and the United States. Participants were recruited between June 2023 and February 2026 through multiple community-based routes. One-to-one semistructured interviews, conducted online, via telephone, or in person, explored views on wearable devices for digital mobility assessment. Interview data were analyzed using Braun and Clarke’s 6-phase reflexive thematic analysis. Results Most people with PD were generally open to wearable monitoring when it could capture motor fluctuations between “on” and “off” periods that were difficult to convey during clinical appointments, reduce reliance on memory, provide objective evidence to support treatment and medication discussions and self-advocacy, and track changes in mobility over time, which some felt could be reassuring. Acceptability depended on devices having a clear purpose, requiring minimal effort, and being easy to use. Tremor, reduced dexterity, and “off” periods could make fastening straps, navigating menus, and charging devices difficult. Carers valued wearable monitoring for the reassurance and safety it offered, particularly fall detection, and for support with both clinical and everyday decision-making but emphasized that devices must operate passively and integrate into daily caregiving without adding burden. Conclusions Wearable mobility monitoring was generally acceptable to people with PD and carers when it offered clear clinical value, fit easily into everyday life, and provided reassurance that remote monitoring would complement rather than replace clinical care. As PD mobility was experienced as a shared concern within the care relationship, the value of monitoring depended on how well it supported the wider care dyad rather than the person with PD alone. These findings suggest that successful implementation will require co-design with people with PD and carers, alongside thoughtful clinical integration, to ensure that wearable technologies are both acceptable and effective in practice.