Effects of Rhythmic Auditory Stimulation Using Sensory Feedback-Based Wearable Devices on the Gait and Balance in Patients with Parkinson’s Disease: A Systematic Review and Meta-Analysis

Background: This paper presents a systematic review and meta-analysis to identify the effects of Rhythmic Auditory Stimulation (RAS) delivered via wearable devices on the gait and balance in patients with Parkinson’s disease. Method: The PICO criteria were established according to the PRISMA 2020 guidelines, and literature searches were performed across five databases covering studies published between 2015 and 2025: PubMed, Embase, Cochrane, Scopus, and Web of Science. After applying the inclusion criteria, eleven randomized controlled trials (RCTs) were selected. The quality of the studies was evaluated using the PEDro Scale and ROB-2. Statistical analyses were performed using Review Manager 5.4 based on the number of samples, means, and standard deviations to calculate the effect sizes. Result: The analysis results showed that wearable RAS significantly improved the gait speed (SMD = 0.49, p < 0.05) and balance ability (SMD = 0.40, p < 0.05), while no significant differences in the gait pattern, FOG-Q, or UPDRS-III were observed. The heterogeneity among studies was low, and the funnel plots were distributed symmetrically, indicating minimal publication bias. The average PEDro score was 7.33, suggesting moderate-to-high methodological quality. Conclusion: wearable RAS was identified as an evidence-based intervention effective in improving the gait speed and balance in patients with Parkinson’s disease.