A systematic review of real-world gait-related digital mobility outcomes in Parkinson’s disease

Clinical assessments of Parkinson’s disease (PD) focus on structured motor tasks, potentially underestimating real-world mobility impairment. Digital mobility outcomes (DMOs) from wearable devices, offer a promising alternative, but their clinical value remains unclear. This study reviewed the clinical utility of real-world DMOs in PD. Eight databases were searched (2000–2024). Eligibility included reports assessing real-world gait-based DMOs in PD. Study selection and data extraction were conducted independently by four reviewers. No meta-analysis was performed. Twenty-seven reports met inclusion criteria, reporting 21 DMOs. Walking speed was most common (92%), followed by step length (59%) and stride time (48%). Devices, assessment durations and walking bout definitions varied. DMOs differentiated PD from controls and real-world from supervised conditions. PD Subgroup analyses and associations with motor severity were inconsistent. Real-world DMOs offer valuable insight into PD mobility. Standardised protocols are needed for comparability. Further research should explore predictive utility and complex or composite DMOs. Trial Registration: PROSPERO 2025 CRD42021281213.