With the booming development of smart wearable devices, flexible multifunctional composites with high sensitivity and well health therapy have evoked great interest for next-generation healthcare electronics. However, the weak biocompatibility, low breathability, and narrow sensing range greatly hinder the development of healthcare sensors. Herein, a porous, flexible and conductive MXene/Polydimethylsiloxane/Polydopamine/Polyurethane Sponge (MXene/PDMS/PDA/PU) nanocomposite is developed as a promising motion-detecting device with good flexibility, breathability, sensing performance, photothermal therapy and antibacterial activity. Benefiting from the porous structure and biocompatible surface, this multifunctional sensor is further fabricated into a diagnostic and therapeutic system for monitoring human body motion and performing hot therapy/antibacterial treatment in the application of sports injury site. Moreover, both the wireless smart insole and cushion are constructed to gait monitoring and sit position detecting. This multifunctional hybrid sponge not only demonstrates great potential for motion monitoring sensors but also exhibits wide potential in wearable medical assistive and therapeutic systems.