Abstract
Digital rehabilitation and wearable sensor–based physiotherapy have emerged as transformative innovations for improving rehabilitation outcomes by enabling continuous patient monitoring, personalized treatment, and evidence-based clinical decision-making. Despite their growing adoption in developed healthcare systems, empirical evidence regarding their effectiveness in improving functional recovery among musculoskeletal patients in developing countries, particularly Pakistan, remains limited. This study examined the influence of digital rehabilitation and wearable sensor–based physiotherapy on functional recovery outcomes among musculoskeletal patients in Pakistan. Specifically, it investigated the mediating role of patient engagement in rehabilitation and the moderating role of digital health literacy. Grounded in Task–Technology Fit (TTF) Theory, the study employed a quantitative, cross-sectional, explanatory research design. Primary data were collected from musculoskeletal patients receiving physiotherapy services in public and private hospitals and rehabilitation centers across Pakistan using a structured questionnaire. The proposed conceptual framework was evaluated using Partial Least Squares Structural Equation Modeling (PLS-SEM). The findings indicate that digital rehabilitation and wearable sensor–based physiotherapy significantly enhance patient engagement and functional recovery outcomes. Patient engagement was found to partially mediate the relationship between digital rehabilitation and functional recovery, suggesting that active participation in rehabilitation is a key mechanism through which digital technologies improve clinical outcomes. Furthermore, digital health literacy significantly moderated the relationship between digital rehabilitation and patient engagement, indicating that patients with higher digital competencies benefited more from wearable sensor technologies. The study extends Task–Technology Fit Theory by integrating patient engagement and digital health literacy into a comprehensive framework explaining rehabilitation effectiveness in a developing healthcare context. The findings provide important theoretical, clinical, managerial, and policy implications for healthcare administrators, physiotherapists, and policymakers seeking to accelerate digital health transformation, improve rehabilitation quality, and promote the integration of wearable sensor technologies into physiotherapy services in Pakistan