An Epidermal Stimulation and Sensing Platform for Sensorimotor Prosthetic Control, Management of Lower Back Exertion, and Electrical Muscle Activation

Hybrid Integration of Wearable Devices for Physiological Monitoring

Wearable devices can provide timely, user-friendly, non- or minimally invasive, and continuous monitoring of human health. Recently, multidisciplinary scientific communities have made significant progress regarding fully integrated wearable devices such as sweat wearable sensors, saliva sensors, and wound sensors. However, the translation of these wearables into markets has been slow due to several reasons associated with the poor system-level performance of integrated wearables. The wearability consideration for wearable devices compromises many properties of the wearables. Besides, the limited power capacity of wearables hinders continuous monitoring for extended duration. Furthermore, peak-power operations for intensive computations can quickly create thermal issues in the compact form factor that interfere with wearability and sensor operations. Moreover, wearable devices are constantly subjected to environmental, mechanical, chemical, and electrical interferences and variables that can invalidate the collected data. This generates the need for sophisticated data analytics to contextually identify, include, and exclude data points per multisensor fusion to enable accurate data interpretation. This review synthesizes the challenges surrounding the wearable device integration from three aspects in terms of hardware, energy, and data, focuses on a discussion about hybrid integration of wearable devices, and seeks to provide comprehensive guidance for designing fully functional and stable wearable devices.

Customized surface adhesive and wettability properties of conformal electronic devices

Conformal and body-adaptive electronics have revolutionized the way we interact with technology, ushering in a new era of wearable devices that can seamlessly integrate with our daily lives. However, the inherent mismatch between artificially synthesized materials and biological tissues (caused by irregular skin fold, skin hair, sweat, and skin grease) needs to be addressed, which can be realized using body-adaptive electronics by rational design of their surface adhesive and wettability properties. Over the past few decades, various approaches have been developed to enhance the conformability and adaptability of bioelectronics by (i) increasing flexibility and reducing device thickness, (ii) improving the adhesion and wettability between bioelectronics and biological interfaces, and (iii) refining the integration process with biological systems. Successful development of a conformal and body-adaptive electronic device requires comprehensive consideration of all three aspects. This review starts with the design strategies of conformal electronics with different surface adhesive and wettability properties. A series of conformal and body-adaptive electronics used in the human body under both dry and wet conditions are systematically discussed. Finally, the current challenges and critical perspectives are summarized, focusing on promising directions such as telemedicine, mobile health, point-of-care diagnostics, and human-machine interface applications.

Bioelectronics for electrical stimulation: materials, devices and biomedical applications

Bioelectronics is a hot research topic, yet an important tool, as it facilitates the creation of advanced medical devices that interact with biological systems to effectively diagnose, monitor and treat a broad spectrum of health conditions. Electrical stimulation (ES) is a pivotal technique in bioelectronics, offering a precise, non-pharmacological means to modulate and control biological processes across molecular, cellular, tissue, and organ levels. This method holds the potential to restore or enhance physiological functions compromised by diseases or injuries by integrating sophisticated electrical signals, device interfaces, and designs tailored to specific biological mechanisms. This review explains the mechanisms by which ES influences cellular behaviors, introduces the essential stimulation principles, discusses the performance requirements for optimal ES systems, and highlights the representative applications. From this review, we can realize the potential of ES based bioelectronics in therapy, regenerative medicine and rehabilitation engineering technologies, ranging from tissue engineering to neurological technologies, and the modulation of cardiovascular and cognitive functions. This review underscores the versatility of ES in various biomedical contexts and emphasizes the need to adapt to complex biological and clinical landscapes it addresses.

Electronic Skin for Health Monitoring Systems: Properties, Functions, and Applications

Electronic skin (e-skin), a skin-like wearable electronic device, holds great promise in the fields of telemedicine and personalized healthcare because of its good flexibility, biocompatibility, skin conformability, and sensing performance. E-skin can monitor various health indicators of the human body in real time and over the long term, including physical indicators (exercise, respiration, blood pressure, etc.) and chemical indicators (saliva, sweat, urine, etc.). In recent years, the development of various materials, analysis, and manufacturing technologies has promoted significant development of e-skin, laying the foundation for the application of next-generation wearable medical technologies and devices. Herein, the properties required for e-skin health monitoring devices to achieve long-term and precise monitoring and summarize several detectable indicators in the health monitoring field are discussed. Subsequently, the applications of integrated e-skin health monitoring systems are reviewed. Finally, current challenges and future development directions in this field are discussed. This review is expected to generate great interest and inspiration for the development and improvement of e-skin and health monitoring systems.

Evolution of Musculoskeletal Electronics

The musculoskeletal system, constituting the largest human physiological system, plays a critical role in providing structural support to the body, facilitating intricate movements, and safeguarding internal organs. By virtue of advancements in revolutionized materials and devices, particularly in the realms of motion capture, health monitoring, and postoperative rehabilitation, "musculoskeletal electronics" has actually emerged as an infancy area, but has not yet been explicitly proposed. In this review, the concept of musculoskeletal electronics is elucidated, and the evolution history, representative progress, and key strategies of the involved materials and state-of-the-art devices are summarized. Therefore, the fundamentals of musculoskeletal electronics and key functionality categories are introduced. Subsequently, recent advances in musculoskeletal electronics are presented from the perspectives of "in vitro" to "in vivo" signal detection, interactive modulation, and therapeutic interventions for healing and recovery. Additionally, nine strategy avenues for the development of advanced musculoskeletal electronic materials and devices are proposed. Finally, concise summaries and perspectives are proposed to highlight the directions that deserve focused attention in this booming field.

Sweat as a source of non-invasive biomarkers for clinical diagnosis: An overview

Sweat has excellent potential as one of the sources of non-invasive biomarkers for clinical diagnosis. It is relatively easy to collect and process and may contain different disease-specific markers and drug metabolites, making it ideal for various clinical applications. This article discusses the anatomy of sweat glands and their role in sweat production, as well as the history and development of multiple sweat sample collection and analysis techniques. Another primary focus of this article is the application of sweat detection in clinical disease diagnosis and other life scenarios. Finally, the limitations and prospects of sweat analysis are discussed.

E-Tattoos: Toward Functional but Imperceptible Interfacing with Human Skin

The human body continuously emits physiological and psychological information from head to toe. Wearable electronics capable of noninvasively and accurately digitizing this information without compromising user comfort or mobility have the potential to revolutionize telemedicine, mobile health, and both human-machine or human-metaverse interactions. However, state-of-the-art wearable electronics face limitations regarding wearability and functionality due to the mechanical incompatibility between conventional rigid, planar electronics and soft, curvy human skin surfaces. E-Tattoos, a unique type of wearable electronics, are defined by their ultrathin and skin-soft characteristics, which enable noninvasive and comfortable lamination on human skin surfaces without causing obstruction or even mechanical perception. This review article offers an exhaustive exploration of e-tattoos, accounting for their materials, structures, manufacturing processes, properties, functionalities, applications, and remaining challenges. We begin by summarizing the properties of human skin and their effects on signal transmission across the e-tattoo-skin interface. Following this is a discussion of the materials, structural designs, manufacturing, and skin attachment processes of e-tattoos. We classify e-tattoo functionalities into electrical, mechanical, optical, thermal, and chemical sensing, as well as wound healing and other treatments. After discussing energy harvesting and storage capabilities, we outline strategies for the system integration of wireless e-tattoos. In the end, we offer personal perspectives on the remaining challenges and future opportunities in the field.

Soft Sensors and Actuators for Wearable Human-Machine Interfaces

Haptic human-machine interfaces (HHMIs) combine tactile sensation and haptic feedback to allow humans to interact closely with machines and robots, providing immersive experiences and convenient lifestyles. Significant progress has been made in developing wearable sensors that accurately detect physical and electrophysiological stimuli with improved softness, functionality, reliability, and selectivity. In addition, soft actuating systems have been developed to provide high-quality haptic feedback by precisely controlling force, displacement, frequency, and spatial resolution. In this Review, we discuss the latest technological advances of soft sensors and actuators for the demonstration of wearable HHMIs. We particularly focus on highlighting material and structural approaches that enable desired sensing and feedback properties necessary for effective wearable HHMIs. Furthermore, promising practical applications of current HHMI technology in various areas such as the metaverse, robotics, and user-interactive devices are discussed in detail. Finally, this Review further concludes by discussing the outlook for next-generation HHMI technology.

Conductive and Eco-friendly Biomaterials-based Hydrogels for Noninvasive Epidermal Sensors: A Review

As noninvasive wearable electronic devices, epidermal sensors enable continuous, real-time, and remote monitoring of various human physiological parameters. Conductive biomaterials-based hydrogels as sensor matrix materials have good biocompatibility, biodegradability, and efficient stimulus response capabilities and are widely applied in motion monitoring, healthcare, and human-machine interaction. However, biomass hydrogel-based epidermal sensing devices still need excellent mechanical properties, prolonged stability, multifunctionality, and extensive practicality. Therefore, this paper reviews the common biomass hydrogel materials for epidermal sensing (proteins, polysaccharides, polyphenols, etc.) and the various types of noninvasive sensing devices (strain/pressure sensors, temperature sensors, glucose sensors, electrocardiograms, etc.). Moreover, this review focuses on the strategies of scholars to enhance sensor properties, such as strength, conductivity, stability, adhesion, and self-healing ability. This work will guide the preparation and optimization of high-performance biomaterials-based hydrogel epidermal sensors.

Bioadhesive Technology Platforms

Bioadhesives have emerged as transformative and versatile tools in healthcare, offering the ability to attach tissues with ease and minimal damage. These materials present numerous opportunities for tissue repair and biomedical device integration, creating a broad landscape of applications that have captivated clinical and scientific interest alike. However, fully unlocking their potential requires multifaceted design strategies involving optimal adhesion, suitable biological interactions, and efficient signal communication. In this Review, we delve into these pivotal aspects of bioadhesive design, highlight the latest advances in their biomedical applications, and identify potential opportunities that lie ahead for bioadhesives as multifunctional technology platforms.

Facile Fabrication of "Tacky", Stretchable, and Aligned Carbon Nanotube Sheet-Based Electronics for On-Skin Health Monitoring

Point-of-care monitoring of physiological signals such as electrocardiogram, electromyogram, and electroencephalogram is essential for prompt disease diagnosis and quick treatment, which can be realized through advanced skin-worn electronics. However, it is still challenging to design an intimate and nonrestrictive skin-contact device for physiological measurements with high fidelity and artifact tolerance. This research presents a facile method using a "tacky" surface to produce a tight interface between the ACNT skin-like electronic and the skin. The method provides the skin-worn electronic with a stretchability of up to 70% strain, greater than that of most common epidermal electrodes. Low-density ACNT bundles facilitate the infiltration of adhesive and improve the conformal contact between the ACNT sheet and the skin, while dense ACNT bundles lessen this effect. The stretchability and conformal contact allow the ACNT sheet-based electronics to create a tight interface with the skin, which enables the high-fidelity measurement of physiological signals (the Pearson's coefficient of 0.98) and tolerance for motion artifacts. In addition, our method allows the use of degradable substrates to enable reusability and degradability of the electronics based on ACNT sheets, integrating "green" properties into on-skin electronics.

A systematic review on functional electrical stimulation based rehabilitation systems for upper limb post-stroke recovery

Background

Stroke is one of the most common neurological conditions that often leads to upper limb motor impairments, significantly affecting individuals' quality of life. Rehabilitation strategies are crucial in facilitating post-stroke recovery and improving functional independence. Functional Electrical Stimulation (FES) systems have emerged as promising upper limb rehabilitation tools, offering innovative neuromuscular reeducation approaches.

Objective

The main objective of this paper is to provide a comprehensive systematic review of the start-of-the-art functional electrical stimulation (FES) systems for upper limb neurorehabilitation in post-stroke therapy. More specifically, this paper aims to review different types of FES systems, their feasibility testing, or randomized control trials (RCT) studies.

Methods

The FES systems classification is based on the involvement of patient feedback within the FES control, which mainly includes "Open-Loop FES Systems" (manually controlled) and "Closed-Loop FES Systems" (brain-computer interface-BCI and electromyography-EMG controlled). Thus, valuable insights are presented into the technological advantages and effectiveness of Manual FES, EEG-FES, and EMG-FES systems.

Results and discussion

The review analyzed 25 studies and found that the use of FES-based rehabilitation systems resulted in favorable outcomes for the stroke recovery of upper limb functional movements, as measured by the FMA (Fugl-Meyer Assessment) (Manually controlled FES: mean difference = 5.6, 95% CI (3.77, 7.5), P < 0.001; BCI-controlled FES: mean difference = 5.37, 95% CI (4.2, 6.6), P < 0.001; EMG-controlled FES: mean difference = 14.14, 95% CI (11.72, 16.6), P < 0.001) and ARAT (Action Research Arm Test) (EMG-controlled FES: mean difference = 11.9, 95% CI (8.8, 14.9), P < 0.001) scores. Furthermore, the shortcomings, clinical considerations, comparison to non-FES systems, design improvements, and possible future implications are also discussed for improving stroke rehabilitation systems and advancing post-stroke recovery. Thus, summarizing the existing literature, this review paper can help researchers identify areas for further investigation. This can lead to formulating research questions and developing new studies aimed at improving FES systems and their outcomes in upper limb rehabilitation.

An Ultra-Thin MXene Film for Multimodal Sensing of Neuroelectrical Signals with Artifacts Removal

Neuroelectrical signals transmitted onto the skin tend to decay to an extremely weak level, making them highly susceptible to interference from the environment and body movement. Meanwhile, for comprehensively understanding cognitive nerve conduction, multimodal sensing of neural signals, such as magnetic resonance imaging (MRI) and functional near-infrared spectroscopy (fNIRS), is highly required. Previous metal or polymer conductors cannot either provide a seamless on-skin feature for accurate sensing of neuroelectrical signals or be compatible with multimodal imaging techniques without opto- and magnet- artifacts. Herein, a ≈20 nm thick MXene film that is able to simultaneously detect electrophysiological signals and perform imaging by MRI and fNIRS with high fidelity is reported. The ultrathin film is made of crosslinked Ti3 C2 Tx film via poly (3,4-ethylene dioxythiophene): polystyrene sulfonate (PEDOT: PSS), showing a record high electroconductivity and transparency combination (11 000 S cm-1 @89%). Among them, PEDOT: PSS not only plays a cross-linking role to stabilize MXene film but also shortens the interlayer distance for effective charge transfer and high transparency. Thus, it can achieve a low interfacial impedance with skin or neural surfaces for accurate recording of electrophysiological signals with low motion artifacts. Besides, the high transparency originating from the ultrathin feature leads to good compatibility with fNIRS and MRI without optical and magnetic artifacts, enabling multimodal cognitive neural monitoring during prolonged use.

Robust, self-adhesive and anti-bacterial silk-based LIG electrodes for electrophysiological monitoring

Flexible wearable electrodes have been extensively used for obtaining electrophysiological signals towards smart health monitoring and disease diagnosis. Here, low-cost, and non-conductive silk fabric (SF) have been processed into highly conductive laser induced graphene (LIG) electrodes while maintaining the original structure of SF. A CO2-pulsed laser was utilized to produce LIG-SF with controlled sheet resistance and mechanical properties. Laser processing of SFs under optimized conditions yielded LIG-SF electrodes with a high degree of homogeneity on both, top and bottom layers. Silk fibroin/Ca2+ adhesive layers effectively promoted the adhesive, anti-bacterial properties and provided a conformal contact of LIG-SF electrodes with human skin. Compared with conventional Ag/AgCl electrodes, LIG-SF electrodes possesses a much lower contact impedance in contact with human skin enabling highly stable electrophysiological signals recording. The applicability of adhesive LIG-SF electrodes to acquire electrocardiogram (ECG) signals was investigated. ECG signals recordings of adhesive LIG-SF electrodes showed excellent performance compared to conventional Ag/AgCl electrodes at intense body movements while running at different speeds for up to 9 km over a duration of 24 h. Therefore, our proposed adhesive LIG-SF electrodes can be applied for long-term personalized healthcare monitoring and sports management applications.

Bioinspired Environment-Adaptable and Ultrasensitive Multifunctional Electronic Skin for Human Healthcare and Robotic Sensations

Multifunctional electronic skins (e-skins) that can sense various stimuli have demonstrated increasing potential in many fields. However, most e-skins are human-oriented that cannot work in hash environments such as high temperature, underwater, and corrosive chemicals, impairing their applications, especially in human-machine interfaces, intelligent machines, robotics, and so on. Inspired by the crack-shaped sensory organs of spiders, an environmentally robust and ultrasensitive multifunctional e-skin is developed. By developing a polyimide-based metal crack-localization strategy, the device has excellent environment adaptability since polyimide has high thermal stability and chemical durability. The localized cracked part serves as an ultrasensitive strain sensing unit, while the non-cracked serpentine part is solely responsible for temperature. Since the two units are made of the same material and process, the signals are decoupled easily. The proposed device is the first multifunctional e-skin that can be used in harsh environments, therefore is of great potential for both human and robot-oriented applications.

Sensorized Skin With Biomimetic Tactility Features Based on Artificial Cross-Talk of Bimodal Resistive Sensory Inputs

Tactility in biological organisms is a faculty that relies on a variety of specialized receptors. The bimodal sensorized skin, featured in this study, combines soft resistive composites that attribute the skin with mechano- and thermoreceptive capabilities. Mimicking the position of the different natural receptors in different depths of the skin layers, a multi-layer arrangement of the soft resistive composites is achieved. However, the magnitude of the signal response and the localization ability of the stimulus change with lighter presses of the bimodal skin. Hence, a learning-based approach is employed that can help achieve predictions about the stimulus using 4500 probes. Similar to the cognitive functions in the human brain, the cross-talk of sensory information between the two types of sensory information allows the learning architecture to make more accurate predictions of localization, depth, and temperature of the stimulus contiguously. Localization accuracies of 1.8 mm, depth errors of 0.22 mm, and temperature errors of 8.2 °C using 8 mechanoreceptive and 8 thermoreceptive sensing elements are achieved for the smaller inter-element distances. Combining the bimodal sensing multilayer skins with the neural network learning approach brings the artificial tactile interface one step closer to imitating the sensory capabilities of biological skin.

Soft Bioelectronics for Therapeutics

Soft bioelectronics play an increasingly crucial role in high-precision therapeutics due to their softness, biocompatibility, clinical accuracy, long-term stability, and patient-friendliness. In this review, we provide a comprehensive overview of the latest representative therapeutic applications of advanced soft bioelectronics, ranging from wearable therapeutics for skin wounds, diabetes, ophthalmic diseases, muscle disorders, and other diseases to implantable therapeutics against complex diseases, such as cardiac arrhythmias, cancer, neurological diseases, and others. We also highlight key challenges and opportunities for future clinical translation and commercialization of soft therapeutic bioelectronics toward personalized medicine.

Highly stretchable, tough and conductive chitin nanofiber composite hydrogel as a wearable sensor

To meet the requirements of eco-friendly and sustainability in the 21st century, hydrogels based on biopolymer with conductivity and stretchable property have attained increasing attention for strain sensor. However, the as-prepared of hydrogel sensor with excellent mechanical property and high strain sensitivity is still a challenge. In this study, chitin nanofiber (ChNF) reinforced composite hydrogels of PACF are fabricated via a facile one-pot method. The obtained PACF composite hydrogel exhibits good transparency (80.6 % at 800 nm)and excellent mechanical properties (tensile strength, 261.2 kPa; tensile strain as high as 550.3 %). Moreover, the composite hydrogels also demonstrate excellent anti-compression performance. The composite hydrogels own good conductivity (1.20 S/m) and strain sensitivity. Most importantly, the hydrogel can be assembled as a strain/pressure sensor for detecting large-scale and small-scale human motion. Therefore, flexible conductive hydrogel strain sensors will have broad application prospects in artificial intelligence, electronic skin, and personal health.

High-Fidelity sEMG Signals Recorded by an on-Skin Electrode Based on AgNWs for Hand Gesture Classification Using Machine Learning

The human forearm is one of the most densely distributed parts of the human body, with the most irregular spatial distribution of muscles. A number of specific forearm muscles control hand motions. Acquiring high-fidelity sEMG signals from human forearm muscles is vital for human-machine interface (HMI) applications based on gesture recognition. Currently, the most commonly used commercial electrodes for detecting sEMG or other electrophysiological signals have a rigid nature without stretchability and cannot maintain conformal contact with the human skin during deformation, and the adhesive hydrogel used in them to reduce skin-electrode impedance may shrink and cause skin inflammation after long-term use. Therefore, developing elastic electrodes with stretchability and biocompatibility for sEMG signal recording is essential for developing HMI. Here, we fabricated a nanocomposite hybrid on-skin electrode by infiltrating silver nanowires (AgNWs), a one-dimensional (1D) nano metal material with conductivity, into polydimethylsiloxane (PDMS), a silicone elastomer with a similar Young's modulus to that of the human skin. The AgNW on-skin electrode has a thickness of 300 μm and low sheet resistance of 0.481 ± 0.014 Ω/sq and can withstand the mechanical strain of up to 54% and maintain a sheet resistance lower than 1 Ω/sq after 1000 dynamic strain cycles. The AgNW on-skin electrode can record high signal-to-noise ratio (SNR) sEMG signals from forearm muscles and can reflect various force levels of muscles by sEMG signals. Besides, four typical hand gestures were recognized by the multichannel AgNW on-skin electrodes with a recognition accuracy of 92.3% using machine learning method. The AgNW on-skin electrode proposed in this study has great potential and promise in various HMI applications that employ sEMG signals as control signals.

A Review of Skin-Wearable Sensors for Non-Invasive Health Monitoring Applications

The early detection of fatal diseases is crucial for medical diagnostics and treatment, both of which benefit the individual and society. Portable devices, such as thermometers and blood pressure monitors, and large instruments, such as computed tomography (CT) and X-ray scanners, have already been implemented to collect health-related information. However, collecting health information using conventional medical equipment at home or in a hospital can be inefficient and can potentially affect the timeliness of treatment. Therefore, on-time vital signal collection via healthcare monitoring has received increasing attention. As the largest organ of the human body, skin delivers significant signals reflecting our health condition; thus, receiving vital signals directly from the skin offers the opportunity for accessible and versatile non-invasive monitoring. In particular, emerging flexible and stretchable electronics demonstrate the capability of skin-like devices for on-time and continuous long-term health monitoring. Compared to traditional electronic devices, this type of device has better mechanical properties, such as skin conformal attachment, and maintains compatible detectability. This review divides the health information that can be obtained from skin using the sensor aspect's input energy forms into five categories: thermoelectrical signals, neural electrical signals, photoelectrical signals, electrochemical signals, and mechanical pressure signals. We then summarize current skin-wearable health monitoring devices and provide outlooks on future development.

Fabrication of gold-doped crystalline-silicon nanomembrane-based wearable temperature sensor

Wearable temperature sensors with high thermal sensitivity are required for precise and continuous body temperature monitoring. Here, we present a protocol for fabricating a thin, stretchable, and ultrahigh thermal-sensitive wearable sensor based on gold-doped crystalline-silicon nanomembrane (SiNM). We provide detailed steps of gold doping technique to SiNM and fabrication processes for gold-doped crystalline-SiNM based wearable temperature sensor. For complete details on the use and execution of this protocol, please refer to Sang et al. (2022).1.

Soft Electronics for Health Monitoring Assisted by Machine Learning

Due to the development of the novel materials, the past two decades have witnessed the rapid advances of soft electronics. The soft electronics have huge potential in the physical sign monitoring and health care. One of the important advantages of soft electronics is forming good interface with skin, which can increase the user scale and improve the signal quality. Therefore, it is easy to build the specific dataset, which is important to improve the performance of machine learning algorithm. At the same time, with the assistance of machine learning algorithm, the soft electronics have become more and more intelligent to realize real-time analysis and diagnosis. The soft electronics and machining learning algorithms complement each other very well. It is indubitable that the soft electronics will bring us to a healthier and more intelligent world in the near future. Therefore, in this review, we will give a careful introduction about the new soft material, physiological signal detected by soft devices, and the soft devices assisted by machine learning algorithm. Some soft materials will be discussed such as two-dimensional material, carbon nanotube, nanowire, nanomesh, and hydrogel. Then, soft sensors will be discussed according to the physiological signal types (pulse, respiration, human motion, intraocular pressure, phonation, etc.). After that, the soft electronics assisted by various algorithms will be reviewed, including some classical algorithms and powerful neural network algorithms. Especially, the soft device assisted by neural network will be introduced carefully. Finally, the outlook, challenge, and conclusion of soft system powered by machine learning algorithm will be discussed.

Development of a Wearable Ultrasound Transducer for Sensing Muscle Activities in Assistive Robotics Applications

Robotic prostheses and powered exoskeletons are novel assistive robotic devices for modern medicine. Muscle activity sensing plays an important role in controlling assistive robotics devices. Most devices measure the surface electromyography (sEMG) signal for myoelectric control. However, sEMG is an integrated signal from muscle activities. It is difficult to sense muscle movements in specific small regions, particularly at different depths. Alternatively, traditional ultrasound imaging has recently been proposed to monitor muscle activity due to its ability to directly visualize superficial and at-depth muscles. Despite their advantages, traditional ultrasound probes lack wearability. In this paper, a wearable ultrasound (US) transducer, based on lead zirconate titanate (PZT) and a polyimide substrate, was developed for a muscle activity sensing demonstration. The fabricated PZT-5A elements were arranged into a 4 × 4 array and then packaged in polydimethylsiloxane (PDMS). In vitro porcine tissue experiments were carried out by generating the muscle activities artificially, and the muscle movements were detected by the proposed wearable US transducer via muscle movement imaging. Experimental results showed that all 16 elements had very similar acoustic behaviors: the averaged central frequency, -6 dB bandwidth, and electrical impedance in water were 10.59 MHz, 37.69%, and 78.41 Ω, respectively. The in vitro study successfully demonstrated the capability of monitoring local muscle activity using the prototyped wearable transducer. The findings indicate that ultrasonic sensing may be an alternative to standardize myoelectric control for assistive robotics applications.

A crack compensation strategy for highly stretchable conductors based on liquid metal inclusions

Crack control strategies have been proven very useful for enhancing the stretchability of metal film-based stretchable conductors. However, existing strategies often suffer from the drawbacks of complicated preparation and predefined effective directions. Here, we propose a crack compensation strategy for preparing conductors featured with high stretchability by using liquid metal microparticles (LMMPs)-embedded polydimethylsiloxane (PDMS) as the substrate with a thin film of gold (Au) sputtered on the surface. LMMPs can be elongated to connect the cracked Au film upon stretching, which can form a conductive "island-tunnel" (IT) architecture to compensate for the cracks and maintain the conductivity. The high performance of the stretchable conductor is demonstrated by using it as electrodes to record surface electromyography of human brachioradialis and monitor electrocorticography signals of a rat in normal and epileptic states. The developed strategy shows the potential to provide a new perspective for the fabrication of flexible electronics.

A Focused Review on the Flexible Wearable Sensors for Sports: From Kinematics to Physiologies

As an important branch of wearable electronics, highly flexible and wearable sensors are gaining huge attention due to their emerging applications. In recent years, the participation of wearable devices in sports has revolutionized the way to capture the kinematical and physiological status of athletes. This review focuses on the rapid development of flexible and wearable sensor technologies for sports. We identify and discuss the indicators that reveal the performance and physical condition of players. The kinematical indicators are mentioned according to the relevant body parts, and the physiological indicators are classified into vital signs and metabolisms. Additionally, the available wearable devices and their significant applications in monitoring these kinematical and physiological parameters are described with emphasis. The potential challenges and prospects for the future developments of wearable sensors in sports are discussed comprehensively. This review paper will assist both athletic individuals and researchers to have a comprehensive glimpse of the wearable techniques applied in different sports.

Recent Advances in Stretchable and Wearable Capacitive Electrophysiological Sensors for Long-Term Health Monitoring

Over the past several years, wearable electrophysiological sensors with stretchability have received significant research attention because of their capability to continuously monitor electrophysiological signals from the human body with minimal body motion artifacts, long-term tracking, and comfort for real-time health monitoring. Among the four different sensors, i.e., piezoresistive, piezoelectric, iontronic, and capacitive, capacitive sensors are the most advantageous owing to their reusability, high durability, device sterilization ability, and minimum leakage currents between the electrode and the body to reduce the health risk arising from any short circuit. This review focuses on the development of wearable, flexible capacitive sensors for monitoring electrophysiological conditions, including the electrode materials and configuration, the sensing mechanisms, and the fabrication strategies. In addition, several design strategies of flexible/stretchable electrodes, body-to-electrode signal transduction, and measurements have been critically evaluated. We have also highlighted the gaps and opportunities needed for enhancing the suitability and practical applicability of wearable capacitive sensors. Finally, the potential applications, research challenges, and future research directions on stretchable and wearable capacitive sensors are outlined in this review.

Flexible hybrid electronics: Enabling integration techniques and applications

The conventional electronic systems enabled by rigid electronic are prone to malfunction under deformation, greatly limiting their application prospects. As an emerging platform for applications in healthcare monitoring and human-machine interface (HMI), flexible electronics have attracted growing attention due to its remarkable advantages, such as stretchability, flexibility, conformability, and wearing comfort. However, to realize the overall electronic systems, rigid components are also required for functions such as signal acquisition and transmission. Therefore, flexible hybrid electronics (FHE), which simultaneously possesses the desirable flexibility and enables the integration of rigid components for functionality, has been emerging as a promising strategy. This paper reviews the enabling integration techniques for FHE, including technologies for two-dimensional/three-dimensional (2D/3D) interconnects, bonding of rigid integrated circuit (IC) chips to soft substrate, stress-isolation structures, and representative applications of FHE. In addition, future challenges and opportunities involved in FHE-based systems are also discussed.

In Situ Deposition of Skin-Adhesive Liquid Metal Particles with Robust Wear Resistance for Epidermal Electronics

Comfort and mechanical stability are vital for epidermal electronics in daily use. In situ deposition of circuitry without the protection of substrates or encapsulation can produce imperceptible, conformal, and permeable epidermal electronics. However, they are easily destroyed by daily wear because the binding force between deposited materials and skin is usually weak. Here, we in situ deposited skin-adhesive liquid metal particles (ALMP) to fabricate epidermal electronics with robust wear resistance. It represents the most wear-resistant in situ deposited epidermal electronic materials. It can withstand ∼1600 cm, 175 g loaded paper tape wearing by a standard abrasion wear tester. Stretchability, conformality, permeability, and thinness of the ALMP coating provide an imperceptible and comfortable wearing experience. Without degradation of electrical property caused by solvent evaporation, the dry ALMP coating possesses natural advantages over gel electrodes. In situ deposited ALMP is an ideal material for fabricating comfortable epidermal electronics.

4D printing of soft orthoses for tremor suppression

Tremor is an involuntary and oscillatory movement disorder that makes daily activities difficult for affected patients. Hand tremor-suppression orthoses are noninvasive, wearable devices designed to mitigate tremors. Various studies have shown that these devices are effective, economical, and safe; however, they have drawbacks such as large weight, awkward shape, and rigid parts. This study investigates different types of tremor-suppression orthoses and discusses their efficiency, mechanism, benefits, and disadvantages. First, various orthoses (with passive, semi-active, and active mechanisms) are described in detail. Next, we look at how additive manufacturing (AM) has progressed recently in making sensors and actuators for application in tremor orthoses. Then, the materials used in AM are further analyzed. It is found that traditional manufacturing problems can be solved with the help of AM techniques, like making orthoses that are affordable, lighter, and more customizable. Another concept being discussed is using smart materials and AM methods, such as four-dimensional (4D) printing, to make orthoses that are more comfortable and efficient.

Graphic abstract

Laser-Sculptured Hierarchical Spinous Structures for Ultra-High-Sensitivity Iontronic Sensors with a Broad Operation Range

Tactile pressure sensing over a wide operation range (>1 MPa) is challenging for a variety of applications in fields such as aviation, oceanography, and biomedicine. Recently, innovative strategies have been utilized to improve the performances of tactile sensors using specially designed structures, dielectric layers, and electrodes. Here, a hierarchical structural design based on ionic gel films has been utilized to build iontronic pressure sensors with ultrahigh sensitivities and broad operation ranges. Sculptured patterns made by a controlled CO₂ laser scanning process have been produced on polyimide films to achieve two kinds of protrusion structures for high specific surface areas and strength to withstand high pressure. The iontronic sensor has been constructed by adding two screen-printed electrodes of high surface areas to achieve an ultrahigh sensitivity of 2593 kPa^-1 and a wide pressure range from 0 Pa to 3.36 MPa. The prototype device also has a fast response and recovery time of 26 and 13 ms, respectively, and an excellent mechanical durability in the endurance test of over 2700 repeated loading and unloading cycles under a pressure of 1 MPa. Several application examples have been demonstrated, including the detection of physiological signals on human volunteers, the feedback control of intelligent robots, the grasping operation of underwater soft grippers, and the environmental wind-speed monitoring. As such, this work demonstrates a versatile and economical methodology to produce high-performance flexible sensors for various potential applications.

Materials for Implantable Surface Electrode Arrays: Current Status and Future Directions

Surface electrode arrays are mainly fabricated from rigid or elastic materials, and precisely manipulated ductile metal films, which offer limited stretchability. However, the living tissues to which they are applied are nonlinear viscoelastic materials, which can undergo significant mechanical deformation in dynamic biological environments. Further, the same arrays and compositions are often repurposed for vastly different tissues rather than optimizing the materials and mechanical properties of the implant for the target application. By first characterizing the desired biological environment, and then designing a technology for a particular organ, surface electrode arrays may be more conformable, and offer better interfaces to tissues while causing less damage. Here, the various materials used in each component of a surface electrode array are first reviewed, and then electrically active implants in three specific biological systems, the nervous system, the muscular system, and skin, are described. Finally, the fabrication of next-generation surface arrays that overcome current limitations is discussed.

Prospects and Challenges of Flexible Stretchable Electrodes for Electronics

The application of flexible electronics in the field of communication has made the transition from rigid physical form to flexible physical form. Flexible electrode technology is the key to the wide application of flexible electronics. However, flexible electrodes will break when large deformation occurs, failing flexible electronics. It restricts the further development of flexible electronic technology. Flexible stretchable electrodes are a hot research topic to solve the problem that flexible electrodes cannot withstand large deformation. Flexible stretchable electrode materials have excellent electrical conductivity, while retaining excellent mechanical properties in case of large deformation. This paper summarizes the research results of flexible stretchable electrodes from three aspects: material, process, and structure, as well as the prospects for future development.

Flexible Electronics and Devices as Human-Machine Interfaces for Medical Robotics

Medical robots are invaluable players in non-pharmaceutical treatment of disabilities. Particularly, using prosthetic and rehabilitation devices with human-machine interfaces can greatly improve the quality of life for impaired patients. In recent years, flexible electronic interfaces and soft robotics have attracted tremendous attention in this field due to their high biocompatibility, functionality, conformability, and low-cost. Flexible human-machine interfaces on soft robotics will make a promising alternative to conventional rigid devices, which can potentially revolutionize the paradigm and future direction of medical robotics in terms of rehabilitation feedback and user experience. In this review, the fundamental components of the materials, structures, and mechanisms in flexible human-machine interfaces are summarized by recent and renowned applications in five primary areas: physical and chemical sensing, physiological recording, information processing and communication, soft robotic actuation, and feedback stimulation. This review further concludes by discussing the outlook and current challenges of these technologies as a human-machine interface in medical robotics.

Breathable, Self-Adhesive Dry Electrodes for Stable Electrophysiological Signal Monitoring During Exercise

On-skin electrodes with high air permeability, low thickness, low elastic modulus, and high adhesion are essential for biomedical signal recordings, which provide data for sports management and biomedical applications. However, nanothickness electrodes interacting with the skin by van der Waals force can be interfered with by sweating, and elastomers with high adhesion prepared by modification are not satisfactory in terms of air permeability. Here, a dry electrode with high stretchability (598%), low elastic modulus (5 MPa), high air permeability (726 g m^-2 d^-1), and high adhesion (6.33 kPa) was fabricated by semi-embedding Ag nanowires into nonyl and glycerol-modified polyvinyl alcohol. Furthermore, a small amount of 40 wt % ethanol was sprayed on the skin to facilitate microdissolution of the substrate and form immediate conformability with skin texture. The dry electrodes can record high-quality electrocardiogram and electromyogram signals through a robust contact with the skin under skin deformation, with a water stream, or after running for 1 h. The film can also be served as the substrate for self-adhesive strain sensors to monitor motion with higher quality than nonadhesive polydimethylsilane-based sensors.

Development of Conductive Hydrogels for Fabricating Flexible Strain Sensors

Conductive hydrogels can be prepared by incorporating various conductive materials into polymeric network hydrogels. In recent years, conductive hydrogels have been developed and applied in the field of strain sensors owing to their unique properties, such as electrical conductivity, mechanical properties, self-healing, and anti-freezing properties. These remarkable properties allow conductive hydrogel-based strain sensors to show excellent performance for identifying external stimuli and detecting human body movement, even at subzero temperatures. This review summarizes the properties of conductive hydrogels and their application in the fabrication of strain sensors working in different modes. Finally, a brief prospectus for the development of conductive hydrogels in the future is provided.

Bio-inspired flexible electronics for smart E-skin

"Learning from nature" provides endless inspiration for scientists to invent new materials and devices. Here, we review state-of-the-art technologies in flexible electronics, with a focus on bio-inspired smart skins. This review focuses on the development of E-skin for sensing a variety of parameters such as mechanical loads, temperature, light, and biochemical cues, with a trend of increased integration of multiple functions. It highlights the most recent advances in flexible electronics inspired by animals such as chameleons, squids, and octopi whose bodies have remarkable camouflage, mimicry, or self-healing attributes. Implantable devices, being overlapped with smart E-skin in a broad sense, are included in this review. This review outlines the remaining challenges in flexible electronics and the prospects for future development for biomedical applications. STATEMENT OF SIGNIFICANCE: This article reviews the state-of-the-art technologies of bio-inspired smart electronic skin (E-skin) developed in a "learning-mimicking-creating" (LMC) cycle. We emphasize the most recent innovations in the development of E-skin for sensing physical changes and biochemical cues, and for integrating multiple sensing modalities. We discuss the achievements in implantable materials, wireless communication, and device design pertaining to implantable flexible electronics. This review will provide prospective insights integrating material, electronics, and mechanical engineering viewpoints to foster new ideas for next-generation smart E-skin.

Recent Advances in Materials and Flexible Sensors for Arrhythmia Detection

Arrhythmias are one of the leading causes of death in the United States, and their early detection is essential for patient wellness. However, traditional arrhythmia diagnosis by expert evaluation from intermittent clinical examinations is time-consuming and often lacks quantitative data. Modern wearable sensors and machine learning algorithms have attempted to alleviate this problem by providing continuous monitoring and real-time arrhythmia detection. However, current devices are still largely limited by the fundamental mismatch between skin and sensor, giving way to motion artifacts. Additionally, the desirable qualities of flexibility, robustness, breathability, adhesiveness, stretchability, and durability cannot all be met at once. Flexible sensors have improved upon the current clinical arrhythmia detection methods by following the topography of skin and reducing the natural interface mismatch between cardiac monitoring sensors and human skin. Flexible bioelectric, optoelectronic, ultrasonic, and mechanoelectrical sensors have been demonstrated to provide essential information about heart-rate variability, which is crucial in detecting and classifying arrhythmias. In this review, we analyze the current trends in flexible wearable sensors for cardiac monitoring and the efficacy of these devices for arrhythmia detection.

Ultrahigh Sensitive Au-Doped Silicon Nanomembrane Based Wearable Sensor Arrays for Continuous Skin Temperature Monitoring with High Precision

Monitoring the body temperature with high accuracy provides a fast, facile, yet powerful route about the human body in a wide range of health information standards. Here, the first ever ultrasensitive and stretchable gold-doped silicon nanomembrane (Au-doped SiNM) epidermal temperature sensor array is introduced. The ultrasensitivity is achieved by shifting freeze-out region to intrinsic region in carrier density and modulation of fermi energy level of p-type SiNM through the development of a novel gold-doping strategy. The Au-doped SiNM is readily transferred onto an ultrathin polymer layer with a well-designed serpentine mesh structure, capable of being utilized as an epidermal temperature sensor array. Measurements in vivo and in vitro show temperature coefficient of resistance as high as -37270.72 ppm °C^-1 , 22 times higher than existing metal-based temperature sensors with similar structures, and one of the highest thermal sensitivity among the inorganic material based temperature sensors. Applications in the continuous monitoring of body temperature and respiration rate during exercising are demonstrated with a successful capture of information. This work lays a foundation for monitoring body temperature, potentially useful for precision diagnosis (e.g., continuous monitoring body temperature in coronavirus disease 2019 cases) and management of disease relevance to body temperature in healthcare.

Flexible Wearables for Plants

The excellent stretchability and biocompatibility of flexible sensors have inspired an emerging field of plant wearables, which enable intimate contact with the plants to continuously monitor the growth status and localized microclimate in real-time. Plant flexible wearables provide a promising platform for the development of plant phenotype and the construction of intelligent agriculture via monitoring and regulating the critical physiological parameters and microclimate of plants. Here, the emerging applications of plant flexible wearables together with their pros and cons from four aspects, including physiological indicators, surrounding environment, crop quality, and active control of growth, are highlighted. Self-powered energy supply systems and signal transmission mechanisms are also elucidated. Furthermore, the future opportunities and challenges of plant wearables are discussed in detail.

Pattern transfer of large-scale thin membranes with controllable self-delamination interface for integrated functional systems

Direct transfer of pre-patterned device-grade nano-to-microscale materials highly benefits many existing and potential, high performance, heterogeneously integrated functional systems over conventional lithography-based microfabrication. We present, in combined theory and experiment, a self-delamination-driven pattern transfer of a single crystalline silicon thin membrane via well-controlled interfacial design in liquid media. This pattern transfer allows the usage of an intermediate or mediator substrate where both front and back sides of a thin membrane are capable of being integrated with standard lithographical processing, thereby achieving deterministic assembly of the thin membrane into a multi-functional system. Implementations of these capabilities are demonstrated in broad variety of applications ranging from electronics to microelectromechanical systems, wetting and filtration, and metamaterials.

Emergence of flexible technology in developing advanced systems for post-stroke rehabilitation: a comprehensive review

OBJECTIVE

Stroke is one of the most common neural disorders, which causes physical disabilities and motor impairments among its survivors. Several technologies have been developed for providing stroke rehabilitation and to assist the survivors in performing their daily life activities. Currently, the use of flexible technology (FT) for stroke rehabilitation systems is on a rise that allows the development of more compact and lightweight wearable systems, which stroke survivors can easily use for long-term activities.

APPROACH

For stroke applications, FT mainly includes the "flexible/stretchable electronics", "e-textile (electronic textile)" and "soft robotics". Thus, a thorough literature review has been performed to report the practical implementation of FT for post-stroke application.

MAIN RESULTS

In this review, the highlights of the advancement of FT in stroke rehabilitation systems are dealt with. Such systems mainly involve the "biosignal acquisition unit", "rehabilitation devices" and "assistive systems". In terms of biosignals acquisition, electroencephalography (EEG) and electromyography (EMG) are comprehensively described. For rehabilitation/assistive systems, the application of functional electrical stimulation (FES) and robotics units (exoskeleton, orthosis, etc.) have been explained.

SIGNIFICANCE

This is the first review article that compiles the different studies regarding flexible technology based post-stroke systems. Furthermore, the technological advantages, limitations, and possible future implications are also discussed to help improve and advance the flexible systems for the betterment of the stroke community.

Research Progress of Microtransfer Printing Technology for Flexible Electronic Integrated Manufacturing

In recent years, with the rapid development of the flexible electronics industry, there is an urgent need for a large-area, multilayer, and high-production integrated manufacturing technology for scalable and flexible electronic products. To solve this technical demand, researchers have proposed and developed microtransfer printing technology, which picks up and prints inks in various material forms from the donor substrate to the target substrate, successfully realizing the integrated manufacturing of flexible electronic products. This review retrospects the representative research progress of microtransfer printing technology for the production of flexible electronic products and emphasizes the summary of seal materials, the basic principles of various transfer technology and fracture mechanics models, and the influence of different factors on the transfer effect. In the end, the unique functions, technical features, and related printing examples of each technology are concluded and compared, and the prospects of further research work on microtransfer printing technology is finally presented.

MXene-infused bioelectronic interfaces for multiscale electrophysiology and stimulation

Soft bioelectronic interfaces for mapping and modulating excitable networks at high resolution and at large scale can enable paradigm-shifting diagnostics, monitoring, and treatment strategies. Yet, current technologies largely rely on materials and fabrication schemes that are expensive, do not scale, and critically limit the maximum attainable resolution and coverage. Solution processing is a cost-effective manufacturing alternative, but biocompatible conductive inks matching the performance of conventional metals are lacking. Here, we introduce MXtrodes, a class of soft, high-resolution, large-scale bioelectronic interfaces enabled by Ti3C2 MXene (a two-dimensional transition metal carbide nanomaterial) and scalable solution processing. We show that the electrochemical properties of MXtrodes exceed those of conventional materials and do not require conductive gels when used in epidermal electronics. Furthermore, we validate MXtrodes in applications ranging from mapping large-scale neuromuscular networks in humans to cortical neural recording and microstimulation in swine and rodent models. Last, we demonstrate that MXtrodes are compatible with standard clinical neuroimaging modalities.

Flexible Electrodes for In Vivo and In Vitro Electrophysiological Signal Recording

A variety of electrophysiological signals (electrocardiography, electromyography, electroencephalography, etc.) are generated during the physiological activities of human bodies, which can be collected by electrodes and thus provide critical insights into health status or facilitate fundamental scientific research. The long-term stable and high-quality recording of electrophysiological signals is the premise for their further applications, leading to demands for flexible electrodes with similar mechanical modulus and minimized irritation to human bodies. This review summarizes the latest advances in flexible electrodes for the acquisition of various electrophysiological signals. First, the concept of electrophysiological signals and the characteristics of different subcategory signals are introduced. Second, the invasive and noninvasive methods are reviewed for electrophysiological signal recording with a highlight on the design of flexible electrodes, followed by a discussion on their material selection. Subsequently, the applications of the electrophysiological signal acquisition in pathological diagnosis and restoration of body functions are discussed, showing the advantages of flexible electrodes. Finally, the main challenges and opportunities in this field are discussed. It is believed that the further exploration of materials for flexible electrodes and the combination of multidisciplinary technologies will boost the applications of flexible electrodes for medical diagnosis and human-machine interface.

A Flexible Two-Sensor System for Temperature and Bending Angle Monitoring

A wearable electronic system constructed with multiple sensors with different functions to obtain multidimensional information is essential for making accurate assessments of a person’s condition, which is especially beneficial for applications in the areas of health monitoring, clinical diagnosis, and therapy. In this work, using polyimide films as substrates and Pt as the constituent material of serpentine structures, flexible temperature and angle sensors were designed that can be attached to the surface of an object or the human body for monitoring purposes. In these sensors, changes in temperature and bending angle are converted into variations in resistance through thermal resistance and strain effects with a sensitivity of 0.00204/°C for temperatures in the range of 25 to 100 °C and a sensitivity of 0.00015/° for bending angles in the range of 0° to 150°. With an appropriate layout design, two sensors were integrated to measure temperature and bending angles simultaneously in order to obtain decoupled, compensated, and more accurate information of temperature and angle. Finally, the system was tested by being attached to the surface of a knee joint, demonstrating its application potential in disease diagnosis, such as in arthritis assessment.

Functional Fibers and Fabrics for Soft Robotics, Wearables, and Human-Robot Interface

Soft robotics inspired by the movement of living organisms, with excellent adaptability and accuracy for accomplishing tasks, are highly desirable for efficient operations and safe interactions with human. With the emerging wearable electronics, higher tactility and skin affinity are pursued for safe and user-friendly human-robot interactions. Fabrics interlocked by fibers perform traditional static functions such as warming, protection, and fashion. Recently, dynamic fibers and fabrics are favorable to deliver active stimulus responses such as sensing and actuating abilities for soft-robots and wearables. First, the responsive mechanisms of fiber/fabric actuators and their performances under various external stimuli are reviewed. Fiber/yarn-based artificial muscles for soft-robots manipulation and assistance in human motion are discussed, as well as smart clothes for improving human perception. Second, the geometric designs, fabrications, mechanisms, and functions of fibers/fabrics for sensing and energy harvesting from the human body and environments are summarized. Effective integration between the electronic components with garments, human skin, and living organisms is illustrated, presenting multifunctional platforms with self-powered potential for human-robot interactions and biomedicine. Lastly, the relationships between robotic/wearable fibers/fabrics and the external stimuli, together with the challenges and possible routes for revolutionizing the robotic fibers/fabrics and wearables in this new era are proposed.

Skin-inspired quadruple tactile sensors integrated on a robot hand enable object recognition

Robot hands with tactile perception can improve the safety of object manipulation and also improve the accuracy of object identification. Here, we report the integration of quadruple tactile sensors onto a robot hand to enable precise object recognition through grasping. Our quadruple tactile sensor consists of a skin-inspired multilayer microstructure. It works as thermoreceptor with the ability to perceive thermal conductivity of a material, measure contact pressure, as well as sense object temperature and environment temperature simultaneously and independently. By combining tactile sensing information and machine learning, our smart hand has the capability to precisely recognize different shapes, sizes, and materials in a diverse set of objects. We further apply our smart hand to the task of garbage sorting and demonstrate a classification accuracy of 94% in recognizing seven types of garbage.

Toward the Use of Temporary Tattoo Electrodes for Impedancemetric Respiration Monitoring and Other Electrophysiological Recordings on Skin

The development of dry, ultra-conformable and unperceivable temporary tattoo electrodes (TTEs), based on the ink-jet printing of poly(3,4-ethylenedioxythiophene) polystyrene sulfonate (PEDOT:PSS) on top of commercially available temporary tattoo paper, has gained increasing attention as a new and promising technology for electrophysiological recordings on skin. In this work, we present a TTEs epidermal sensor for real time monitoring of respiration through transthoracic impedance measurements, exploiting a new design, based on the application of soft screen printed Ag ink and magnetic interlink, that guarantees a repositionable, long-term stable and robust interconnection of TTEs with external “docking” devices. The efficiency of the TTE and the proposed interconnection strategy under stretching (up to 10%) and over time (up to 96 h) has been verified on a dedicated experimental setup and on humans, fulfilling the proposed specific application of transthoracic impedance measurements. The proposed approach makes this technology suitable for large-scale production and suitable not only for the specific use case presented, but also for real time monitoring of different bio-electric signals, as demonstrated through specific proof of concept demonstrators.

Controlling sensation intensity for electrotactile stimulation in human-machine interfaces

A barrier to practical use of electrotactile stimulation for haptic feedback has been large variability in perceived sensation intensity due to changes in the impedance of the electrode-skin interface, such as when electrodes peel or users sweat. Here, we show how to significantly reduce this variability by modulating stimulation parameters in response to measurements of impedance. Our method derives from three contributions. First, we created a model between stimulation parameters and impedance at constant perceived sensation intensity by looking at the peak pulse energy and phase charge. Our model fits experimental data better than previous models (mean R² > 0.9) and holds over a larger set of conditions (subjects, sessions, magnitudes of sensation, stimulation locations, electrode sizes). Second, we implemented a controller that regulates perceived sensation intensity by using our model to derive a new current amplitude and pulse duration in response to changes in impedance. Our controller accurately predicts subject-chosen stimulation parameters at constant sensation intensity (mean R² > 0.9). Third, we demonstrated as a proof-of-concept on two subjects with below-elbow amputations-using a prosthesis with electrotactile touch feedback-that our controller can regulate sensation intensity in response to large impedance changes that occur in activities of daily living. These results make electrotactile stimulation for human-machine interfaces more reliable during activities of daily living.