Wearable technology refers to any sensor worn on the person, which as a result makes continuous and remote monitoring available to many people with chronic diseases, including multiple sclerosis (MS). Daily monitoring seems an ideal solution either as an outcome measure or as an adjunct to support rater-based monitoring in both clinical and research settings. There has been an increase in solutions that are available and we look to identify next generation wearables.
To identify all validated wearable solutions for PwMS and identify areas of focus for wearable solutions in multiple sclerosis.
We completed a scoping review (using the PRISMA-ScR guidelines) to summarise the wearable solutions currently available in MS.
Our search strategy utilized subject heading searches: ‘Multiple Sclerosis’ and ‘wearable electronic devices’, as well as keywords ‘wearable technology’, and ‘electronic devices’. The literature search was conducted using MEDLINE (via PubMed) and Embase (via OVID) databases. This search included articles published from database inception to 30 May 2019. Additional searches looked at frequently published authors with different devices, as well as forward and backward citation tracking of included papers.
We identified 35 validated unique solutions that measure gait, cognition, upper limb function, activity, mood and fatigue with most of these solutions being phone applications. Of these, 51% looked at lower limb function with activity levels being looked at by 37% of the total solutions. There was least focus on visual, and mood solutions at 3%, closely followed by quality of life and balance at 5%. Cognition and fatigue accounted for 14% of the total.
Looking forward, there is a change occurring from single measure solutions to multi-measure and multi-sensor solutions, such as the Floodlight Open app, which utilises multiple sensors within a smart-phone to remotely measure gait, cognition and upper limb function. Future research should consider costs and include implementation science as part of their research and design to ensure cost of delivery strategy is also accounted for.
As development in wearable technology in MS is still on-going, we can expect to see newer wearables focusing on other areas with technology advancements that allow for more upper body and cognitive measures. There is a dearth of validated solutions available for fatigue, mood, and pain.