Actigraphy and wearable sensor technologies to enhance assessment in health conditions affecting motor function and behaviour

I recently had the opportunity to attend the 2025 ActiGraph Digital Data Summit in Pensacola, FL. It featured excellent presentations and discussions on the potential and challenges of using actigraphy and other wearable sensor technology to improve assessment in various health conditions where motor function and behaviour is impacted.

Pre-Conference ALS Workshop

There was a productive pre-conference workshop on ALS, which featured roundtable discussions aimed at generating consensus on the next steps required for evidence generation and regulatory approval of actigraphy as a digital health technology. I particularly appreciated hearing the input from patients, caregivers, and clinicians when thinking about how to overcome limitations of traditional assessments like the ALSFRS-R.

In the results from a recent survey of patients, a majority of respondents indicated that actigraphy could be valuable in helping to measure ALS progression in clinical trials and capture the impact of ALS in daily life. Respondents also indicated that remote assessment could reduce the travel burden of going to the clinic for assessments, which is one of the key benefits offered by digital assessment methods across modalities.

Wearable Sensors: Broad Applications Across Health Conditions

The conference itself included many excellent presentations that reflected the broad range of diseases and health conditions for which wearable sensor technology can address barriers to conducting objective and scalable clinical assessments. Some notable examples in addition to ALS included cancer cachexia, pulmonary arterial hypertension, and nocturnal scratch, where actigraphy can measure physical functioning and behaviours in the real world and across settings.

Many of the insights and challenges that were discussed are also relevant to other digital health technologies (DHTs) such as digital speech assessment and digital cognitive assessments. Key ways to demonstrate the value of novel DHTs include greater accuracy or sensitivity over existing measures, addressing a current measurement gap, providing greater ecological validity, minimizing administration and scoring errors, and improving access and reducing burden for patients. The Digital Medicine Society has several resources for advancing the validation of DHTs, including the V3 and V3+ frameworks, and disease area-specific guides mapping digital measures onto patient-relevant outcomes (e.g., using digital tools to measure cognition, expressive communication, and non-sedentary behaviour in Alzheimer’s disease and related dementias). Regulatory agencies, such as the FDA, have published important guidance and frameworks for patient-focused clinical outcome assessments and the use of DHTs in a clinical trial context.

I was heartened by how frequently the work presented at the conference helped to focus this topic and think this is a very exciting time for the field, where large clinical datasets (e.g., the ALS Research Collaborative Data Commons) are becoming available to assist in the validation of the next generation of outcome measures and digital biomarkers. I hope to attend the next one!