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Koh V, Xuan LW, Zhe TK, Singh N, B Matchar D, Chan A. Performance of digital technologies in assessing fall risks among older adults with cognitive impairment: a systematic review. GeroScience 2024; 46:2951-2975. [PMID: 38436792 PMCID: PMC11009180 DOI: 10.1007/s11357-024-01098-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 02/09/2024] [Indexed: 03/05/2024] Open
Abstract
Older adults with cognitive impairment (CI) are twice as likely to fall compared to the general older adult population. Traditional fall risk assessments may not be suitable for older adults with CI due to their reliance on attention and recall. Hence, there is an interest in using objective technology-based fall risk assessment tools to assess falls within this population. This systematic review aims to evaluate the features and performance of technology-based fall risk assessment tools for older adults with CI. A systematic search was conducted across several databases such as PubMed and IEEE Xplore, resulting in the inclusion of 22 studies. Most studies focused on participants with dementia. The technologies included sensors, mobile applications, motion capture, and virtual reality. Fall risk assessments were conducted in the community, laboratory, and institutional settings; with studies incorporating continuous monitoring of older adults in everyday environments. Studies used a combination of technology-based inputs of gait parameters, socio-demographic indicators, and clinical assessments. However, many missed the opportunity to include cognitive performance inputs as predictors to fall risk. The findings of this review support the use of technology-based fall risk assessment tools for older adults with CI. Further advancements incorporating cognitive measures and additional longitudinal studies are needed to improve the effectiveness and clinical applications of these assessment tools. Additional work is also required to compare the performance of existing methods for fall risk assessment, technology-based fall risk assessments, and the combination of these approaches.
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Affiliation(s)
- Vanessa Koh
- Programme in Health Services and Systems Research (HSSR), Duke-NUS Medical School, Singapore, Singapore.
- Centre for Ageing Research and Education (CARE), Duke-NUS Medical School, 8 College Road, Singapore, 169857, Singapore.
| | - Lai Wei Xuan
- Programme in Health Services and Systems Research (HSSR), Duke-NUS Medical School, Singapore, Singapore
| | - Tan Kai Zhe
- Future Health Technologies Programme, Singapore-ETH Centre, Singapore, Singapore
| | - Navrag Singh
- Future Health Technologies Programme, Singapore-ETH Centre, Singapore, Singapore
- Laboratory for Movement Biomechanics, Institute for Biomechanics, ETH Zurich, Zurich, Switzerland
| | - David B Matchar
- Programme in Health Services and Systems Research (HSSR), Duke-NUS Medical School, Singapore, Singapore
- Future Health Technologies Programme, Singapore-ETH Centre, Singapore, Singapore
- Department of Medicine (General Internal Medicine), Duke University Medical Center, Durham, NC, USA
| | - Angelique Chan
- Programme in Health Services and Systems Research (HSSR), Duke-NUS Medical School, Singapore, Singapore
- Centre for Ageing Research and Education (CARE), Duke-NUS Medical School, 8 College Road, Singapore, 169857, Singapore
- Future Health Technologies Programme, Singapore-ETH Centre, Singapore, Singapore
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Becking-Verhaar FL, Verweij RPH, de Vries M, Vermeulen H, van Goor H, Huisman-de Waal GJ. Continuous Vital Signs Monitoring with a Wireless Device on a General Ward: A Survey to Explore Nurses' Experiences in a Post-Implementation Period. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20105794. [PMID: 37239523 DOI: 10.3390/ijerph20105794] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 03/10/2023] [Accepted: 04/20/2023] [Indexed: 05/28/2023]
Abstract
BACKGROUND Nurse engagement, perceived need and usefulness affect healthcare technology use, acceptance and improvements in quality, safety and accessibility of healthcare. Nurses' opinions regarding continuous monitoring appear to be positive. However, facilitators and barriers were little studied. This study explored nurses' post-implementation experiences of the facilitators and barriers to continuously monitoring patients' vital signs using a wireless device on general hospital wards. METHODS This study employed a cross-sectional survey. Vocational and registered nurses from three general wards in a Dutch tertiary university hospital participated in a survey comprising open and closed questions. The data were analysed using thematic analysis and descriptive statistics. RESULTS Fifty-eight nurses (51.3%) completed the survey. Barriers and facilitators were identified under four key themes: (1) timely signalling and early action, (2) time savings and time consumption, (3) patient comfort and satisfaction and (4) preconditions. CONCLUSIONS According to nurses, early detection and intervention for deteriorating patients facilitate the use and acceptance of continuously monitoring vital signs. Barriers primarily concern difficulties connecting patients correctly to the devices and system.
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Affiliation(s)
- Femke L Becking-Verhaar
- Department of Surgery, Radboud University Medical Centre, Huispost 751, Postbus 9101, 6500 HB Nijmegen, The Netherlands
| | - Robin P H Verweij
- Department of Surgery, Radboud University Medical Centre, Huispost 751, Postbus 9101, 6500 HB Nijmegen, The Netherlands
| | - Marjan de Vries
- Department of Surgery, Radboud University Medical Centre, Huispost 751, Postbus 9101, 6500 HB Nijmegen, The Netherlands
| | - Hester Vermeulen
- Scientific Institute for Quality of Healthcare, Radboud Institute for Health Sciences, Radboud University Medical Centre, Huispost 160, Postbus 9101, 6500 HB Nijmegen, The Netherlands
| | - Harry van Goor
- Department of Surgery, Radboud University Medical Centre, Huispost 751, Postbus 9101, 6500 HB Nijmegen, The Netherlands
| | - Getty J Huisman-de Waal
- Department of Surgery, Radboud University Medical Centre, Huispost 751, Postbus 9101, 6500 HB Nijmegen, The Netherlands
- Scientific Institute for Quality of Healthcare, Radboud Institute for Health Sciences, Radboud University Medical Centre, Huispost 160, Postbus 9101, 6500 HB Nijmegen, The Netherlands
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Sharma Y, Cheung L, Patterson KK, Iaboni A. Factors Influencing the Clinical Adoption of Quantitative Gait Analysis Technologies for Adult Patient Populations With a Focus on Clinical Efficacy and Clinician Perspectives: Protocol for a Scoping Review. JMIR Res Protoc 2023; 12:e39767. [PMID: 36947120 PMCID: PMC10131694 DOI: 10.2196/39767] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 12/14/2022] [Accepted: 01/24/2023] [Indexed: 03/23/2023] Open
Abstract
BACKGROUND Quantitative gait analysis can support clinical decision-making. These analyses can be performed using wearable sensors, nonwearable sensors, or a combination of both. However, to date, they have not been widely adopted in clinical practice. Technology adoption literature has highlighted the clinical efficacy of technology and the users' perspective on the technology (eg, ease of use and usefulness) as some factors that influence their widespread adoption. OBJECTIVE To assist with the clinical adoption of quantitative gait technologies, this scoping review will synthesize the literature on their clinical efficacy and clinician perspectives on their use in the clinical care of adult patient populations. METHODS This scoping review protocol follows the Joanna Briggs Institute methodology for scoping reviews. The review will include both peer-reviewed and gray literature (ie, conference abstracts) regarding the clinical efficacy of quantitative gait technologies and clinician perspectives on their use in the clinical care of adult patient populations. A comprehensive search strategy was created in MEDLINE (Ovid), which was then translated to 4 other databases: CENTRAL (Ovid), Embase (Ovid), CINAHL (EBSCO), and SPORTDiscus (EBSCO). The title and abstract screening, full-text review, and data extraction of relevant articles will be performed independently by 2 reviewers, with a third reviewer involved to support the resolution of conflicts. Data will be analyzed using content analysis and summarized in tabular and diagram formats. RESULTS A search of relevant articles will be conducted in all 5 databases, and through hand-searching in Google Scholar and PEDro, including articles published up until December 2022. The research team plans to submit the final scoping review for publication in a peer-reviewed journal in 2023. CONCLUSIONS The findings of this review will be presented at clinical science conferences and published in a peer-reviewed journal. This review will inform future studies designed to develop, evaluate, or implement quantitative gait analysis technologies in clinical practice. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/39767.
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Affiliation(s)
- Yashoda Sharma
- Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada
- KITE - Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
| | - Lovisa Cheung
- Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada
- KITE - Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
| | - Kara K Patterson
- Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada
- KITE - Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
- Department of Physical Therapy, University of Toronto, Toronto, ON, Canada
| | - Andrea Iaboni
- Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada
- KITE - Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
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Sołomacha S, Sowa P, Kiszkiel Ł, Laskowski PP, Alimowski M, Szczerbiński Ł, Szpak A, Moniuszko-Malinowska A, Kamiński K. Patient's Perspective of Telemedicine in Poland-A Two-Year Pandemic Picture. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:115. [PMID: 36612438 PMCID: PMC9819744 DOI: 10.3390/ijerph20010115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 12/10/2022] [Accepted: 12/16/2022] [Indexed: 06/17/2023]
Abstract
The outbreak of the COVID-19 pandemic caused the healthcare system to drastically reduce in-person visits and suddenly switch to telemedicine services to provide clinical care to patients. The implementation of teleconsultation in medical facilities was a novelty for most Polish patients. In Poland, the main telehealth services were provided in the form of telephone consultations. The aim of this study is to determine patients' perceptions of telemedicine in the context of their experiences with the healthcare system during the COVID-19 pandemic. In this study, we presented how the evaluation of telemedicine services from the perspective of patients in Poland changed in the context of the ongoing pandemic. We conducted two surveys (year by year) on a representative quota sample of the Polish population (N = 623). This ensured that our observations took into account the evolution of views on telemedicine over time. We confirmed the well-known relationship that innovations introduced in the healthcare sector require a longer period of adaptation. We also identified significant concerns that limit the positive perception of telemedicine and compared them with experiences described in other countries.
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Affiliation(s)
- Sebastian Sołomacha
- Department of Population Medicine and Lifestyle Diseases Prevention, Medical University of Bialystok, Waszyngtona 13A, 15-089 Białystok, Poland
- Doctoral School, Medical University of Bialystok, 15-089 Bialystok, Poland
| | - Paweł Sowa
- Department of Population Medicine and Lifestyle Diseases Prevention, Medical University of Bialystok, Waszyngtona 13A, 15-089 Białystok, Poland
| | - Łukasz Kiszkiel
- Society and Cognition Unit, University of Bialystok, 15-403 Bialystok, Poland
| | | | - Maciej Alimowski
- Doctoral School of Social Sciences, University of Bialystok, 15-403 Bialystok, Poland
| | - Łukasz Szczerbiński
- Department of Endocrinology, Diabetology and Internal Medicine, Medical University of Bialystok, 15-276 Bialystok, Poland
- Clinical Research Centre, Medical University of Bialystok, 15-276 Białystok, Poland
| | - Andrzej Szpak
- Witold Chodźko Institute of Rural Medicine, 20-090 Lublin, Poland
| | - Anna Moniuszko-Malinowska
- Department of Infectious Diseases and Neuroinfections, Medical University of Bialystok, 15-089 Białystok, Poland
| | - Karol Kamiński
- Department of Population Medicine and Lifestyle Diseases Prevention, Medical University of Bialystok, Waszyngtona 13A, 15-089 Białystok, Poland
- Department of Cardiology, University Hospital of Bialystok, 15-276 Białystok, Poland
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Ban S, Lee YJ, Kim KR, Kim JH, Yeo WH. Advances in Materials, Sensors, and Integrated Systems for Monitoring Eye Movements. BIOSENSORS 2022; 12:1039. [PMID: 36421157 PMCID: PMC9688058 DOI: 10.3390/bios12111039] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 11/11/2022] [Accepted: 11/13/2022] [Indexed: 06/16/2023]
Abstract
Eye movements show primary responses that reflect humans' voluntary intention and conscious selection. Because visual perception is one of the fundamental sensory interactions in the brain, eye movements contain critical information regarding physical/psychological health, perception, intention, and preference. With the advancement of wearable device technologies, the performance of monitoring eye tracking has been significantly improved. It also has led to myriad applications for assisting and augmenting human activities. Among them, electrooculograms, measured by skin-mounted electrodes, have been widely used to track eye motions accurately. In addition, eye trackers that detect reflected optical signals offer alternative ways without using wearable sensors. This paper outlines a systematic summary of the latest research on various materials, sensors, and integrated systems for monitoring eye movements and enabling human-machine interfaces. Specifically, we summarize recent developments in soft materials, biocompatible materials, manufacturing methods, sensor functions, systems' performances, and their applications in eye tracking. Finally, we discuss the remaining challenges and suggest research directions for future studies.
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Affiliation(s)
- Seunghyeb Ban
- School of Engineering and Computer Science, Washington State University, Vancouver, WA 98686, USA
- IEN Center for Human-Centric Interfaces and Engineering, Institute for Electronics and Nanotechnology, Georgia Institute of Technology, Atlanta, GA 30332, USA
| | - Yoon Jae Lee
- IEN Center for Human-Centric Interfaces and Engineering, Institute for Electronics and Nanotechnology, Georgia Institute of Technology, Atlanta, GA 30332, USA
- School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, GA 30332, USA
| | - Ka Ram Kim
- IEN Center for Human-Centric Interfaces and Engineering, Institute for Electronics and Nanotechnology, Georgia Institute of Technology, Atlanta, GA 30332, USA
- George W. Woodruff School of Mechanical Engineering, Georgia Institute of Technology, Atlanta, GA 30332, USA
| | - Jong-Hoon Kim
- School of Engineering and Computer Science, Washington State University, Vancouver, WA 98686, USA
- Department of Mechanical Engineering, University of Washington, Seattle, WA 98195, USA
| | - Woon-Hong Yeo
- IEN Center for Human-Centric Interfaces and Engineering, Institute for Electronics and Nanotechnology, Georgia Institute of Technology, Atlanta, GA 30332, USA
- George W. Woodruff School of Mechanical Engineering, Georgia Institute of Technology, Atlanta, GA 30332, USA
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Tech and Emory University School of Medicine, Atlanta, GA 30332, USA
- Neural Engineering Center, Institute for Materials, Institute for Robotics and Intelligent Machines, Georgia Institute of Technology, Atlanta, GA 30332, USA
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Cardenas A, Petrevska M, Biddiss E, Fehlings D. Clinician perspectives on the implementation of inpatient cycling-based exergames for children with cerebral palsy: A qualitative study. Dev Neurorehabil 2022; 25:531-541. [PMID: 35815548 DOI: 10.1080/17518423.2022.2099474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To understand the perspectives of key stakeholder clinicians in implementing inpatient cycling-based exergames for children with cerebral palsy (CP) into pediatric rehabilitation. METHODS Sixteen clinicians (nurses, physiotherapists, recreational therapists) that participated in a study exploring the feasibility of implementing cycling-based exergames for inpatient children with CP were interviewed. Clinicians' responses were coded using the Theoretical Domains Framework (TDF). Beliefs were generated from each response and relevant domains were identified. RESULTS Ten domains from the TDF were identified as relevant. Key enablers to clinician participation in future implementation included revision of clinician roles and responsibilities, the belief that children with CP will benefit from exergames, and the belief in potential applicability to other pediatric populations. Barriers included clinician limited time and exergame responsibilities not aligning with perceived clinician roles. CONCLUSIONS This study identifies key barriers and enablers that future inpatient pediatric rehabilitation settings should consider when incorporating exergames into rehabilitation practice.
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Affiliation(s)
- Analyssa Cardenas
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada.,Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Marina Petrevska
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada.,Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Elaine Biddiss
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada.,Institute of Biomaterials & Biomedical Engineering, Faculty of Engineering, University of Toronto, Toronto, ON, Canada
| | - Darcy Fehlings
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada.,Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.,Department of Paediatrics, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
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Rast FM, Labruyère R. Sensor-based outcomes to monitor everyday life motor activities of children and adolescents with neuromotor impairments: A survey with health professionals. FRONTIERS IN REHABILITATION SCIENCES 2022; 3:865701. [PMID: 36311205 PMCID: PMC9596974 DOI: 10.3389/fresc.2022.865701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Accepted: 08/31/2022] [Indexed: 11/05/2022]
Abstract
In combination with appropriate data processing algorithms, wearable inertial sensors enable the measurement of motor activities in children's and adolescents' habitual environments after rehabilitation. However, existing algorithms were predominantly designed for adult patients, and their outcomes might not be relevant for a pediatric population. In this study, we identified the needs of pediatric rehabilitation to create the basis for developing new algorithms that derive clinically relevant outcomes for children and adolescents with neuromotor impairments. We conducted an international survey with health professionals of pediatric neurorehabilitation centers, provided them a list of 34 outcome measures currently used in the literature, and asked them to rate the clinical relevance of these measures for a pediatric population. The survey was completed by 62 therapists, 16 doctors, and 9 nurses of 16 different pediatric neurorehabilitation centers from Switzerland, Germany, and Austria. They had an average work experience of 13 ± 10 years. The most relevant outcome measures were the duration of lying, sitting, and standing positions; the amount of active self-propulsion during wheeling periods; the hand use laterality; and the duration, distance, and speed of walking periods. The health profession, work experience, and workplace had a minimal impact on the priorities of health professionals. Eventually, we complemented the survey findings with the family priorities of a previous study to provide developers with the clinically most relevant outcomes to monitor everyday life motor activities of children and adolescents with neuromotor impairments.
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Affiliation(s)
- Fabian Marcel Rast
- Swiss Children’s Rehab, University Children’s Hospital Zurich, Affoltern am Albis, Switzerland,Children’s Research Center, University Children’s Hospital of Zurich, University of Zurich, Zurich, Switzerland,Rehabilitation Engineering Laboratory, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland,Correspondence: Fabian Rast
| | - Rob Labruyère
- Swiss Children’s Rehab, University Children’s Hospital Zurich, Affoltern am Albis, Switzerland,Children’s Research Center, University Children’s Hospital of Zurich, University of Zurich, Zurich, Switzerland
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Liu KC, Hung KH, Hsieh CY, Huang HY, Chan CT, Tsao Y. Deep-Learning-Based Signal Enhancement of Low-Resolution Accelerometer for Fall Detection Systems. IEEE Trans Cogn Dev Syst 2022. [DOI: 10.1109/tcds.2021.3116228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Kai-Chun Liu
- Research Center for Information Technology Innovation, Academia Sinica, Taipei, Taiwan
| | - Kuo-Hsuan Hung
- Research Center for Information Technology Innovation, Academia Sinica, Taipei, Taiwan
| | - Chia-Yeh Hsieh
- Department of Biomedical Engineering, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Hsiang-Yun Huang
- Department of Biomedical Engineering, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Chia-Tai Chan
- Department of Biomedical Engineering, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Yu Tsao
- Research Center for Information Technology Innovation, Academia Sinica, Taipei, Taiwan
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Banerjee A, Maji D, Datta R, Barman S, Samanta D, Chattopadhyay S. SHUBHCHINTAK: An efficient remote health monitoring approach for elderly people. MULTIMEDIA TOOLS AND APPLICATIONS 2022; 81:37137-37163. [PMID: 35968413 PMCID: PMC9361235 DOI: 10.1007/s11042-022-13539-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Revised: 11/08/2021] [Accepted: 05/30/2022] [Indexed: 06/15/2023]
Abstract
With the proliferation of IoT technology, it is anticipated that healthcare services, particularly for the elderly persons, will become a major thrust area of research in the coming days. Aim of this work is to design a fit-band containing multiple sensors to provide remote healthcare services for the elderly persons. An application has been designed to capture health data from the fit-band, pre-process the data and then send them to cloud for further analysis. A wireless Bluetooth enabled connection is proposed to establish communications between sensors and the application for data transmission. In the proposed application, there are three different front-end interfaces for three different users: system administrator, patient and doctor. The data collected from the patient's fit-band are sent to a cloud data storage, where the data will be analyzed to detect anomaly (e.g., heart attack, sleep apnea, etc.). A Convolution Neural Network (CNN) model is proposed for anomaly detection. For the classification of anomaly, a Long Short Term Memory (LSTM) model is proposed. In the presence of anomaly, the system immediately connects a doctor through a phone call. A prototype system termed as Shubhchintak has been developed in Android/IOS environment and tested with a number of users. The fit-band provides data tracking with an overall accuracy of 99%; the system provides a response with 3000 requests in less than 100 ms. Also, Shubhchintak provides a real-time feedback with an accuracy of 97%. Shubhchintak is also tested by patients and doctors of a nearby hospital. Shubhchintak is shown to be a simple to use, cost effective, comfortable, and efficient system compared to the existing state of the art solutions.
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Affiliation(s)
- Ayan Banerjee
- Department of Computer Science & Engineering, Jalpaiguri Government Engineering College, Jalpaiguri, 735102 India
| | - Dibyendu Maji
- Department of Computer Science & Engineering, Jalpaiguri Government Engineering College, Jalpaiguri, 735102 India
| | - Rajdeep Datta
- Department of Computer Science & Engineering, Jalpaiguri Government Engineering College, Jalpaiguri, 735102 India
| | - Subhas Barman
- Department of Computer Science & Engineering, Jalpaiguri Government Engineering College, Jalpaiguri, 735102 India
| | - Debasis Samanta
- Department of Computer Science & Engineering, Indian Institute of Technology, Kharagpur, 721302 India
| | - Samiran Chattopadhyay
- Institute for Advancing Intelligence, TCG CREST, Salt Lake, Kolkata, 700091 India
- Department of Information Technology, Jadavpur University, Salt Lake City, Kolkata, 700106 India
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Lacey A, Whyte E, O’Keeffe S, O’Connor S, Moran K. A qualitative examination of the factors affecting the adoption of injury focused wearable technologies in recreational runners. PLoS One 2022; 17:e0265475. [PMID: 35793284 PMCID: PMC9258862 DOI: 10.1371/journal.pone.0265475] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 06/10/2022] [Indexed: 11/29/2022] Open
Abstract
Purpose Understanding the perceived efficacy and ease of use of technologies will influence initial adoption and sustained utilization. The objectives of this study were to determine the metrics deemed important by runners for monitoring running-related injury (RRI) risk, and identify the facilitators and barriers to their use of injury focused wearable technologies. Methods A qualitative focus group study was undertaken. Nine semi-structured focus groups with male (n = 13) and female (n = 14) recreational runners took place. Focus groups were audio and video recorded, and transcribed verbatim. Transcripts were thematically analysed. A critical friend approach was taken to data coding, and multiple methods of trustworthiness were executed. Results Excessive loading and inadequate recovery were deemed the most important risk factors to monitor for RRI risk. Other important factors included training activities, injury status and history, and running technique. The location and method of attachment of a wearable device, the design of a smartphone application, and receiving useful injury-related information will affect recreational runners’ adoption of injury focused technologies. Conclusions Overtraining, training-related and individual-related risk factors are essential metrics that need to be monitored for RRI risk. RRI apps should include the metrics deemed important by runners, once there is supporting evidence-based research. The difficulty and/or ease of use of a device, and receiving useful feedback will influence the adoption of injury focused running technologies. There is a clear willingness from recreational runners to adopt injury focused wearable technologies whilst running.
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Affiliation(s)
- Aisling Lacey
- School of Health and Human Performance, Dublin City University, Dublin, Ireland
- Insight SFI Research Centre for Data Analytics, Dublin, Ireland
- * E-mail:
| | - Enda Whyte
- School of Health and Human Performance, Dublin City University, Dublin, Ireland
- Centre for Injury Prevention and Performance, School of Health and Human Performance, Dublin City University, Dublin, Ireland
| | - Sinéad O’Keeffe
- School of Health and Human Performance, Dublin City University, Dublin, Ireland
- Centre for Injury Prevention and Performance, School of Health and Human Performance, Dublin City University, Dublin, Ireland
| | - Siobhán O’Connor
- School of Health and Human Performance, Dublin City University, Dublin, Ireland
- Centre for Injury Prevention and Performance, School of Health and Human Performance, Dublin City University, Dublin, Ireland
| | - Kieran Moran
- School of Health and Human Performance, Dublin City University, Dublin, Ireland
- Insight SFI Research Centre for Data Analytics, Dublin, Ireland
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Wiener-Kronish JP, Bonnici T. Wearables alone will not eliminate failure to rescue. BJA OPEN 2022; 2:100009. [PMID: 37588270 PMCID: PMC10430867 DOI: 10.1016/j.bjao.2022.100009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 03/23/2022] [Indexed: 08/18/2023]
Abstract
Surveys suggest that anaesthesiologists believe that continuous monitoring with wearables will lead to improved patient outcomes. However, evidence suggests that several critical factors, including timely recognition of physiological problems, the presence of a trained team to respond to the alerts, and that the alerts occur far in advance of the deterioration, are required before overall improvement can occur. Wearables alone will not change patients' outcomes, they must be implemented as part of a system change that takes advantage of the higher frequency observations that continuous monitoring provides.
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Affiliation(s)
- Jeanine P. Wiener-Kronish
- Department of Anesthesia, Critical Care and Pain Medicine, Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA
| | - Timothy Bonnici
- University College London Hospitals NHS Foundation Trust, London, UK
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Technical, Regulatory, Economic, and Trust Issues Preventing Successful Integration of Sensors into the Mainstream Consumer Wearables Market. SENSORS 2022; 22:s22072731. [PMID: 35408345 PMCID: PMC9002880 DOI: 10.3390/s22072731] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 03/25/2022] [Accepted: 03/29/2022] [Indexed: 11/17/2022]
Abstract
Sensors that track physiological biomarkers of health must be successfully incorporated into a fieldable, wearable device if they are to revolutionize the management of remote patient care and preventative medicine. This perspective article discusses logistical considerations that may impede the process of adapting a body-worn laboratory sensor into a commercial-integrated health monitoring system with a focus on examples from sleep tracking technology.
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Joshi M, Archer S, Morbi A, Ashrafian H, Arora S, Khan S, Cooke G, Darzi A. Perceptions on the Use of Wearable Sensors and Continuous Monitoring in Surgical Patients: Interview Study Among Surgical Staff. JMIR Form Res 2022; 6:e27866. [PMID: 35147503 PMCID: PMC8881779 DOI: 10.2196/27866] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 10/08/2021] [Accepted: 11/22/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Continuous vital sign monitoring by using wearable sensors may result in the earlier detection of patient deterioration and sepsis. Few studies have explored the perspectives of surgical team members on the use of such sensors in surgical patients. OBJECTIVE This study aims to understand the views of surgical team members regarding novel wearable sensors for surgical patients. METHODS Wearable sensors that monitor vital signs (heart rate, respiratory rate, and temperature) continuously were used by acute surgical patients. The opinions of surgical staff who were treating patients with these sensors were collated through in-depth semistructured interviews to thematic saturation. Interviews were audio recorded, transcribed, and analyzed via thematic analysis. RESULTS A total of 48 interviews were performed with senior and junior surgeons and senior and junior nurses. The main themes of interest that emerged from the interviews were (1) problems with current monitoring, (2) the anticipated impact of wearables on patient safety, (3) the impact on staff, (4) the impact on patients overall, (5) potential new changes, and (6) the future and views on technology. CONCLUSIONS Overall, the feedback from staff who were continuously monitoring surgical patients via wearable sensors was positive, and relatively few concerns were raised. Surgical staff members identify problems with current monitoring and anticipate that sensors will both improve patient safety and be the future of monitoring.
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Affiliation(s)
- Meera Joshi
- Department of Surgery & Cancer, Imperial College London, London, United Kingdom
| | - Stephanie Archer
- Department of Surgery & Cancer, Imperial College London, London, United Kingdom
| | - Abigail Morbi
- Department of Surgery & Cancer, Imperial College London, London, United Kingdom
| | - Hutan Ashrafian
- Department of Surgery & Cancer, Imperial College London, London, United Kingdom
| | - Sonal Arora
- Chelsea and Westminster Hospital, National Health Service Foundation Trust, London, United Kingdom
| | - Sadia Khan
- Chelsea and Westminster Hospital, National Health Service Foundation Trust, London, United Kingdom
| | - Graham Cooke
- Department of Infectious Diseases, Imperial College London, London, United Kingdom
| | - Ara Darzi
- Department of Surgery & Cancer, Imperial College London, London, United Kingdom
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Saho K, Fujimoto M, Kobayashi Y, Matsumoto M. Experimental Verification of Micro-Doppler Radar Measurements of Fall-Risk-Related Gait Differences for Community-Dwelling Elderly Adults. SENSORS 2022; 22:s22030930. [PMID: 35161674 PMCID: PMC8839600 DOI: 10.3390/s22030930] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 01/19/2022] [Accepted: 01/24/2022] [Indexed: 11/16/2022]
Abstract
In a previous study, we developed a classification model to detect fall risk for elderly adults with a history of falls (fallers) using micro-Doppler radar (MDR) gait measurements via simulation. The objective was to create daily monitoring systems that can identify elderly people with a high risk of falls. This study aimed to verify the effectiveness of our model by collecting actual MDR data from community-dwelling elderly people. First, MDR gait measurements were performed in a community setting, and the efficient gait parameters for the classification of fallers were extracted. Then, a support vector machine model that was trained and validated using the simulated MDR data was tested for the gait parameters extracted from the actual MDR data. A classification accuracy of 78.8% was achieved for the actual MDR data. The validity of the experimental results was confirmed based on a comparison with the results of our previous simulation study. Thus, the practicality of the faller classification model constructed using the simulated MDR data was verified for the actual MDR data.
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Affiliation(s)
- Kenshi Saho
- Department of Intelligent Robotics, Toyama Prefectural University, Imizu 939-0398, Toyama, Japan
- Correspondence:
| | - Masahiro Fujimoto
- Human Augmentation Research Center, National Institute of Advanced Industrial Science and Technology, Kashiwa 277-0882, Chiba, Japan; (M.F.); (Y.K.)
| | - Yoshiyuki Kobayashi
- Human Augmentation Research Center, National Institute of Advanced Industrial Science and Technology, Kashiwa 277-0882, Chiba, Japan; (M.F.); (Y.K.)
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Alizadeh-Meghrazi M, Sidhu G, Jain S, Stone M, Eskandarian L, Toossi A, Popovic MR. A Mass-Producible Washable Smart Garment with Embedded Textile EMG Electrodes for Control of Myoelectric Prostheses: A Pilot Study. SENSORS (BASEL, SWITZERLAND) 2022; 22:666. [PMID: 35062627 PMCID: PMC8779154 DOI: 10.3390/s22020666] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 01/08/2022] [Accepted: 01/12/2022] [Indexed: 06/14/2023]
Abstract
Electromyography (EMG) is the resulting electrical signal from muscle activity, commonly used as a proxy for users' intent in voluntary control of prosthetic devices. EMG signals are recorded with gold standard Ag/AgCl gel electrodes, though there are limitations in continuous use applications, with potential skin irritations and discomfort. Alternative dry solid metallic electrodes also face long-term usability and comfort challenges due to their inflexible and non-breathable structures. This is critical when the anatomy of the targeted body region is variable (e.g., residual limbs of individuals with amputation), and conformal contact is essential. In this study, textile electrodes were developed, and their performance in recording EMG signals was compared to gel electrodes. Additionally, to assess the reusability and robustness of the textile electrodes, the effect of 30 consumer washes was investigated. Comparisons were made between the signal-to-noise ratio (SNR), with no statistically significant difference, and with the power spectral density (PSD), showing a high correlation. Subsequently, a fully textile sleeve was fabricated covering the forearm, with 14 textile electrodes. For three individuals, an artificial neural network model was trained, capturing the EMG of 7 distinct finger movements. The personalized models were then used to successfully control a myoelectric prosthetic hand.
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Affiliation(s)
- Milad Alizadeh-Meghrazi
- The Institute for Biomedical Engineering, University of Toronto, Toronto, ON M5S 3G9, Canada;
- KITE Research Institute, Toronto Rehabilitation Institute, University Health Network (UHN), Toronto, ON M5G 2A2, Canada
- Myant Inc., Toronto, ON M9W 1B6, Canada; (G.S.); (S.J.); (M.S.); (L.E.); (A.T.)
| | - Gurjant Sidhu
- Myant Inc., Toronto, ON M9W 1B6, Canada; (G.S.); (S.J.); (M.S.); (L.E.); (A.T.)
| | - Saransh Jain
- Myant Inc., Toronto, ON M9W 1B6, Canada; (G.S.); (S.J.); (M.S.); (L.E.); (A.T.)
| | - Michael Stone
- Myant Inc., Toronto, ON M9W 1B6, Canada; (G.S.); (S.J.); (M.S.); (L.E.); (A.T.)
- Department of Mechanical and Mechatronics Engineering, University of Waterloo, Waterloo, ON N2L 3G1, Canada
| | - Ladan Eskandarian
- Myant Inc., Toronto, ON M9W 1B6, Canada; (G.S.); (S.J.); (M.S.); (L.E.); (A.T.)
- Department of Materials Science and Engineering, University of Toronto, Toronto, ON M5S 3E4, Canada
| | - Amirali Toossi
- Myant Inc., Toronto, ON M9W 1B6, Canada; (G.S.); (S.J.); (M.S.); (L.E.); (A.T.)
| | - Milos R. Popovic
- The Institute for Biomedical Engineering, University of Toronto, Toronto, ON M5S 3G9, Canada;
- KITE Research Institute, Toronto Rehabilitation Institute, University Health Network (UHN), Toronto, ON M5G 2A2, Canada
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16
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Kristoffersson A, Lindén M. A Systematic Review of Wearable Sensors for Monitoring Physical Activity. SENSORS 2022; 22:s22020573. [PMID: 35062531 PMCID: PMC8778538 DOI: 10.3390/s22020573] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 12/27/2021] [Accepted: 01/05/2022] [Indexed: 01/01/2023]
Abstract
This article reviews the use of wearable sensors for the monitoring of physical activity (PA) for different purposes, including assessment of gait and balance, prevention and/or detection of falls, recognition of various PAs, conduction and assessment of rehabilitation exercises and monitoring of neurological disease progression. The article provides in-depth information on the retrieved articles and discusses study shortcomings related to demographic factors, i.e., age, gender, healthy participants vs patients, and study conditions. It is well known that motion patterns change with age and the onset of illnesses, and that the risk of falling increases with age. Yet, studies including older persons are rare. Gender distribution was not even provided in several studies, and others included only, or a majority of, men. Another shortcoming is that none of the studies were conducted in real-life conditions. Hence, there is still important work to be done in order to increase the usefulness of wearable sensors in these areas. The article highlights flaws in how studies based on previously collected datasets report on study samples and the data collected, which makes the validity and generalizability of those studies low. Exceptions exist, such as the promising recently reported open dataset FallAllD, wherein a longitudinal study with older adults is ongoing.
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17
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Nahavandi D, Alizadehsani R, Khosravi A, Acharya UR. Application of artificial intelligence in wearable devices: Opportunities and challenges. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2022; 213:106541. [PMID: 34837860 DOI: 10.1016/j.cmpb.2021.106541] [Citation(s) in RCA: 45] [Impact Index Per Article: 22.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 11/07/2021] [Accepted: 11/15/2021] [Indexed: 05/13/2023]
Abstract
BACKGROUND AND OBJECTIVES Wearable technologies have added completely new and fast emerging tools to the popular field of personal gadgets. Aside from being fashionable and equipped with advanced hardware technologies such as communication modules and networking, wearable devices have the potential to fuel artificial intelligence (AI) methods with a wide range of valuable data. METHODS Various AI techniques such as supervised, unsupervised, semi-supervised and reinforcement learning (RL) have already been used to carry out various tasks. This paper reviews the recent applications of wearables that have leveraged AI to achieve their objectives. RESULTS Particular example applications of supervised and unsupervised learning for medical diagnosis are reviewed. Moreover, examples combining the internet of things, wearables, and RL are reviewed. Application examples of wearables will be also presented for specific domains such as medical, industrial, and sport. Medical applications include fitness, movement disorder, mental health, etc. Industrial applications include employee performance improvement with the aid of wearables. Sport applications are all about providing better user experience during workout sessions or professional gameplays. CONCLUSION The most important challenges regarding design and development of wearable devices and the computation burden of using AI methods are presented. Finally, future challenges and opportunities for wearable devices are presented.
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Affiliation(s)
- Darius Nahavandi
- Institute for Intelligent Systems Research and Innovation (IISRI), Deakin University, Waurn Ponds, VIC 3216, Australia
| | - Roohallah Alizadehsani
- Institute for Intelligent Systems Research and Innovation (IISRI), Deakin University, Waurn Ponds, VIC 3216, Australia
| | - Abbas Khosravi
- Institute for Intelligent Systems Research and Innovation (IISRI), Deakin University, Waurn Ponds, VIC 3216, Australia.
| | - U Rajendra Acharya
- Department of Electronics and Computer Engineering, Ngee Ann Polytechnic, Singapore; Department of Biomedical Engineering, School of Science and Technology, Singapore University of Social Sciences, Singapore; Department of Bioinformatics and Medical Engineering, Asia University, Taiwan
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18
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Sadeh B, Merdler I, Sadon S, Lupu L, Borohovitz A, Ghantous E, Taieb P, Granot Y, Goldstein O, Soriano JC, Rubio-Oliver R, Ruiz-Rivas J, Zalevsky Z, Garcia-Monreal J, Shatsky M, Polani S, Arbel Y. A novel contact-free atrial fibrillation monitor: a pilot study. EUROPEAN HEART JOURNAL. DIGITAL HEALTH 2021; 3:105-113. [PMID: 36713997 PMCID: PMC9707913 DOI: 10.1093/ehjdh/ztab108] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Revised: 11/21/2021] [Accepted: 12/14/2021] [Indexed: 02/01/2023]
Abstract
Aims Atrial fibrillation (AF) is a major cause of morbidity and mortality. Current guidelines support performing electrocardiogram (ECG) screenings to spot AF in high-risk patients. The purpose of this study was to validate a new algorithm aimed to identify AF in patients measured with a recent FDA-cleared contact-free optical device. Methods and results Study participants were measured simultaneously using two devices: a contact-free optical system that measures chest motion vibrations (investigational device, 'Gili') and a standard reference bed-side ECG monitor (Mindray®). Each reference ECG was evaluated by two board certified cardiologists that defined each trace as: regular rhythm, AF, other irregular rhythm or indecipherable/missing. A total of 3582, 30-s intervals, pertaining to 444 patients (41.9% with a history of AF) were made available for analysis. Distribution of patients with active AF, other irregular rhythm, and regular rhythm was 16.9%, 29.5%, and 53.6% respectively. Following application of cross-validated machine learning approach, the observed sensitivity and specificity were 0.92 [95% confidence interval (CI): 0.91-0.93] and 0.96 (95% CI: 0.95-0.96), respectively. Conclusion This study demonstrates for the first time the efficacy of a contact-free optical device for detecting AF.
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Affiliation(s)
- Ben Sadeh
- Department of Cardiology, Tel Aviv Medical Center, Sackler Faculty of Medicine, affiliated Tel Aviv University, Tel Aviv, Israel
| | - Ilan Merdler
- Department of Cardiology, Tel Aviv Medical Center, Sackler Faculty of Medicine, affiliated Tel Aviv University, Tel Aviv, Israel
| | - Sapir Sadon
- Department of Cardiology, Tel Aviv Medical Center, Sackler Faculty of Medicine, affiliated Tel Aviv University, Tel Aviv, Israel
| | - Lior Lupu
- Department of Cardiology, Tel Aviv Medical Center, Sackler Faculty of Medicine, affiliated Tel Aviv University, Tel Aviv, Israel
| | - Ariel Borohovitz
- Department of Cardiology, Tel Aviv Medical Center, Sackler Faculty of Medicine, affiliated Tel Aviv University, Tel Aviv, Israel
| | - Eihab Ghantous
- Department of Cardiology, Tel Aviv Medical Center, Sackler Faculty of Medicine, affiliated Tel Aviv University, Tel Aviv, Israel
| | - Philippe Taieb
- Department of Cardiology, Tel Aviv Medical Center, Sackler Faculty of Medicine, affiliated Tel Aviv University, Tel Aviv, Israel
| | - Yoav Granot
- Department of Cardiology, Tel Aviv Medical Center, Sackler Faculty of Medicine, affiliated Tel Aviv University, Tel Aviv, Israel
| | - Orit Goldstein
- Donisi Health (formerly ContinUse Biometrics Ltd.), HaNechoshet 6, Tel Aviv, 6971070, Israel
| | | | - Ricardo Rubio-Oliver
- Donisi Health (formerly ContinUse Biometrics Ltd.), HaNechoshet 6, Tel Aviv, 6971070, Israel
| | - Joaquin Ruiz-Rivas
- Donisi Health (formerly ContinUse Biometrics Ltd.), HaNechoshet 6, Tel Aviv, 6971070, Israel
| | - Zeev Zalevsky
- Donisi Health (formerly ContinUse Biometrics Ltd.), HaNechoshet 6, Tel Aviv, 6971070, Israel,Faculty of Engineering, Bar-Ilan University, Ramat Gan, 5290002, Israel
| | - Javier Garcia-Monreal
- Donisi Health (formerly ContinUse Biometrics Ltd.), HaNechoshet 6, Tel Aviv, 6971070, Israel,Department of Optics, University of Valencia, Spain
| | - Maxim Shatsky
- Donisi Health (formerly ContinUse Biometrics Ltd.), HaNechoshet 6, Tel Aviv, 6971070, Israel
| | - Sagi Polani
- Donisi Health (formerly ContinUse Biometrics Ltd.), HaNechoshet 6, Tel Aviv, 6971070, Israel
| | - Yaron Arbel
- Department of Cardiology, Tel Aviv Medical Center, Sackler Faculty of Medicine, affiliated Tel Aviv University, Tel Aviv, Israel,Donisi Health (formerly ContinUse Biometrics Ltd.), HaNechoshet 6, Tel Aviv, 6971070, Israel,Corresponding author. Tel: +972 3 6973395, Fax: +972 3 6962334, The last two authors contributed equally to the study
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19
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Hsu YC, Wang H, Zhao Y, Chen F, Tsui KL. Automatic Recognition and Analysis of Balance Activity in Community-Dwelling Older Adults: Algorithm Validation. J Med Internet Res 2021; 23:e30135. [PMID: 34932008 PMCID: PMC8726020 DOI: 10.2196/30135] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 08/23/2021] [Accepted: 09/22/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Clinical mobility and balance assessments identify older adults who have a high risk of falls in clinics. In the past two decades, sensors have been a popular supplement to mobility and balance assessment to provide quantitative information and a cost-effective solution in the community environment. Nonetheless, the current sensor-based balance assessment relies on manual observation or motion-specific features to identify motions of research interest. OBJECTIVE The objective of this study was to develop an automatic motion data analytics framework using signal data collected from an inertial sensor for balance activity analysis in community-dwelling older adults. METHODS In total, 59 community-dwelling older adults (19 males and 40 females; mean age = 81.86 years, SD 6.95 years) were recruited in this study. Data were collected using a body-worn inertial measurement unit (including an accelerometer and a gyroscope) at the L4 vertebra of each individual. After data preprocessing and motion detection via a convolutional long short-term memory (LSTM) neural network, a one-class support vector machine (SVM), linear discriminant analysis (LDA), and k-nearest neighborhood (k-NN) were adopted to classify high-risk individuals. RESULTS The framework developed in this study yielded mean accuracies of 87%, 86%, and 89% in detecting sit-to-stand, turning 360°, and stand-to-sit motions, respectively. The balance assessment classification showed accuracies of 90%, 92%, and 86% in classifying abnormal sit-to-stand, turning 360°, and stand-to-sit motions, respectively, using Tinetti Performance Oriented Mobility Assessment-Balance (POMA-B) criteria by the one-class SVM and k-NN. CONCLUSIONS The sensor-based approach presented in this study provided a time-effective manner with less human efforts to identify and preprocess the inertial signal and thus enabled an efficient balance assessment tool for medical professionals. In the long run, the approach may offer a flexible solution to relieve the community's burden of continuous health monitoring.
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Affiliation(s)
- Yu-Cheng Hsu
- School of Data Science, City University of Hong Kong, Kowloon, Hong Kong
| | - Hailiang Wang
- School of Design, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Yang Zhao
- School of Public Health (Shenzhen), Sun Yat-sen University, Guangzhou, China
| | - Frank Chen
- Department of Management Sciences, City University of Hong Kong, Kowloon, Hong Kong
| | - Kwok-Leung Tsui
- School of Data Science, City University of Hong Kong, Kowloon, Hong Kong.,Grado Department of Industrial and Systems Engineering, Virginia Polytechnic Institute and State University, Blacksburg, VA, United States
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20
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Espinoza Bernal VC, Hiremath SV, Wolf B, Riley B, Mendonca RJ, Johnson MJ. Classifying and tracking rehabilitation interventions through machine-learning algorithms in individuals with stroke. J Rehabil Assist Technol Eng 2021; 8:20556683211044640. [PMID: 34646574 PMCID: PMC8504690 DOI: 10.1177/20556683211044640] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 08/20/2021] [Indexed: 11/16/2022] Open
Abstract
Introduction Stroke is the leading cause of disability worldwide. It has been well-documented that rehabilitation (rehab) therapy can aid in regaining health and function for individuals with stroke. Yet, tracking in-home rehab continues to be a challenge because of a lack of resources and population-scale demands. In order to address this gap, we implemented a methodology to classify and track rehab interventions in individuals with stroke. Methods We developed personalized classification algorithms, including neural network-based algorithms, to classify four rehab exercises performed by two individuals with stroke who were part of a week-long therapy camp in Jamaica, a low- and middle-income country. Accelerometry-based wearable sensors were placed on each upper and lower limb to collect movement data during therapy. Results The classification accuracy for traditional and neural network-based algorithms utilizing feature data (e.g., number of peaks) from the sensors ranged from 64 to 94%, respectively. In addition, the study proposes a new method to assess change in bilateral mobility over the camp duration. Conclusion The results of this pilot study indicate that personalized supervised learning algorithms can be used to classify and track rehab activities and functional outcomes in resource limited settings such as LMICs.
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Affiliation(s)
| | - Shivayogi V Hiremath
- Department of Health and Rehabilitation Sciences, Temple University, Philadelphia, PA, USA.,Director of Personal Health Informatics & Rehabilitation Engineering Laboratory, Temple University, Philadelphia, PA, USA
| | - Bethany Wolf
- Friends of the Redeemer United, St Elizabeth, Jamaica
| | - Brooke Riley
- Friends of the Redeemer United, St Elizabeth, Jamaica
| | - Rochelle J Mendonca
- Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Michelle J Johnson
- Department of Physical Medicine and Rehabilitation, University of Pennsylvania, Philadelphia, PA, USA.,Director of Rehabilitation Robotics Lab, University of Pennsylvania, Philadelphia, PA, USA
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21
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An Overview of Wearable Piezoresistive and Inertial Sensors for Respiration Rate Monitoring. ELECTRONICS 2021. [DOI: 10.3390/electronics10172178] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The demand for wearable devices to measure respiratory activity is constantly growing, finding applications in a wide range of scenarios (e.g., clinical environments and workplaces, outdoors for monitoring sports activities, etc.). Particularly, the respiration rate (RR) is a vital parameter since it indicates serious illness (e.g., pneumonia, emphysema, pulmonary embolism, etc.). Therefore, several solutions have been presented in the scientific literature and on the market to make RR monitoring simple, accurate, reliable and noninvasive. Among the different transduction methods, the piezoresistive and inertial ones satisfactorily meet the requirements for smart wearable devices since unobtrusive, lightweight and easy to integrate. Hence, this review paper focuses on innovative wearable devices, detection strategies and algorithms that exploit piezoresistive or inertial sensors to monitor the breathing parameters. At first, this paper presents a comprehensive overview of innovative piezoresistive wearable devices for measuring user’s respiratory variables. Later, a survey of novel piezoresistive textiles to develop wearable devices for detecting breathing movements is reported. Afterwards, the state-of-art about wearable devices to monitor the respiratory parameters, based on inertial sensors (i.e., accelerometers and gyroscopes), is presented for detecting dysfunctions or pathologies in a non-invasive and accurate way. In this field, several processing tools are employed to extract the respiratory parameters from inertial data; therefore, an overview of algorithms and methods to determine the respiratory rate from acceleration data is provided. Finally, comparative analysis for all the covered topics are reported, providing useful insights to develop the next generation of wearable sensors for monitoring respiratory parameters.
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22
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Recognizing Physical Activities for Spinal Cord Injury Rehabilitation Using Wearable Sensors. SENSORS 2021; 21:s21165479. [PMID: 34450921 PMCID: PMC8398510 DOI: 10.3390/s21165479] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Revised: 07/24/2021] [Accepted: 08/12/2021] [Indexed: 11/16/2022]
Abstract
The research area of activity recognition is fast growing with diverse applications. However, advances in this field have not yet been used to monitor the rehabilitation of individuals with spinal cord injury. Noteworthily, relying on patient surveys to assess adherence can undermine the outcomes of rehabilitation. Therefore, this paper presents and implements a systematic activity recognition method to recognize physical activities applied by subjects during rehabilitation for spinal cord injury. In the method, raw sensor data are divided into fragments using a dynamic segmentation technique, providing higher recognition performance compared to the sliding window, which is a commonly used approach. To develop the method and build a predictive model, a machine learning approach was adopted. The proposed method was evaluated on a dataset obtained from a single wrist-worn accelerometer. The results demonstrated the effectiveness of the proposed method in recognizing all of the activities that were examined, and it achieved an overall accuracy of 96.86%.
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23
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Moore K, O'Shea E, Kenny L, Barton J, Tedesco S, Sica M, Crowe C, Alamäki A, Condell J, Nordström A, Timmons S. Older Adults' Experiences With Using Wearable Devices: Qualitative Systematic Review and Meta-synthesis. JMIR Mhealth Uhealth 2021; 9:e23832. [PMID: 34081020 PMCID: PMC8212622 DOI: 10.2196/23832] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 01/19/2021] [Accepted: 03/26/2021] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Older adults may use wearable devices for various reasons, ranging from monitoring clinically relevant health metrics or detecting falls to monitoring physical activity. Little is known about how this population engages with wearable devices, and no qualitative synthesis exists to describe their shared experiences with long-term use. OBJECTIVE This study aims to synthesize qualitative studies of user experience after a multi-day trial with a wearable device to understand user experience and the factors that contribute to the acceptance and use of wearable devices. METHODS We conducted a systematic search in CINAHL, APA PsycINFO, PubMed, and Embase (2015-2020; English) with fixed search terms relating to older adults and wearable devices. A meta-synthesis methodology was used. We extracted themes from primary studies, identified key concepts, and applied reciprocal and refutational translation techniques; findings were synthesized into third-order interpretations, and finally, a "line-of-argument" was developed. Our overall goal was theory development, higher-level abstraction, and generalizability for making this group of qualitative findings more accessible. RESULTS In total, we reviewed 20 papers; 2 evaluated fall detection devices, 1 tested an ankle-worn step counter, and the remaining 17 tested activity trackers. The duration of wearing ranged from 3 days to 24 months. The views of 349 participants (age: range 51-94 years) were synthesized. Four key concepts were identified and outlined: motivation for device use, user characteristics (openness to engage and functional ability), integration into daily life, and device features. Motivation for device use is intrinsic and extrinsic, encompassing many aspects of the user experience, and appears to be as, if not more, important than the actual device features. To overcome usability barriers, an older adult must be motivated by the useful purpose of the device. A device that serves its intended purpose adds value to the user's life. The user's needs and the support structure around the device-aspects that are often overlooked-seem to play a crucial role in long-term adoption. Our "line-of-argument" model describes how motivation, ease of use, and device purpose determine whether a device is perceived to add value to the user's life, which subsequently predicts whether the device will be integrated into the user's life. CONCLUSIONS The added value of a wearable device is the resulting balance of motivators (or lack thereof), device features (and their accuracy), ease of use, device purpose, and user experience. The added value contributes to the successful integration of the device into the daily life of the user. Useful device features alone do not lead to continued use. A support structure should be placed around the user to foster motivation, encourage peer engagement, and adapt to the user's preferences.
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Affiliation(s)
- Kevin Moore
- Centre for Gerontology and Rehabilitation, University College Cork, Cork, Ireland
| | - Emma O'Shea
- Centre for Gerontology and Rehabilitation, University College Cork, Cork, Ireland
| | - Lorna Kenny
- Centre for Gerontology and Rehabilitation, University College Cork, Cork, Ireland
| | | | | | | | | | - Antti Alamäki
- Research, Development and Innovation Activities & Physiotherapy Education, Karelia University of Applied Sciences, Karelia, Finland
| | - Joan Condell
- School of Computing, Engineering and Intelligent Systems, Faculty of Computing, Engineering and the Built Environment, Ulster University, Coleraine, United Kingdom
| | - Anna Nordström
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
- School of Sport Sciences, The Arctic University of Norway, Tromsø, Norway
| | - Suzanne Timmons
- Centre for Gerontology and Rehabilitation, University College Cork, Cork, Ireland
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Joshi M, Archer S, Morbi A, Arora S, Kwasnicki R, Ashrafian H, Khan S, Cooke G, Darzi A. Short-Term Wearable Sensors for In-Hospital Medical and Surgical Patients: Mixed Methods Analysis of Patient Perspectives. JMIR Perioper Med 2021; 4:e18836. [PMID: 33885367 PMCID: PMC8103292 DOI: 10.2196/18836] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 12/18/2020] [Accepted: 01/13/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Continuous vital sign monitoring using wearable sensors may enable early detection of patient deterioration and sepsis. OBJECTIVE This study aimed to explore patient experiences with wearable sensor technology and carry out continuous monitoring through questionnaire and interview studies in an acute hospital setting. METHODS Patients were recruited for a wearable sensor study and were asked to complete a 9-item questionnaire. Patients responses were evaluated using a Likert scale and with continuous variables. A subgroup of surgical patients wearing a Sensium Vital Sign Sensor was invited to participate in semistructured interviews. The Sensium wearable sensor measures the vital signs: heart rate, respiratory rate, and temperature. All interview data were subjected to thematic analysis. RESULTS Out of a total of 500 patients, 453 (90.6%) completed the questionnaire. Furthermore, 427 (85.4%) patients agreed that the wearable sensor was comfortable, 429 (85.8%) patients agreed to wear the patch again when in hospital, and 398 (79.6%) patients agreed to wear the patch at home. Overall, 12 surgical patients consented to the interviews. Five main themes of interest to patients emerged from the interviews: (1) centralized monitoring, (2) enhanced feelings of patient safety, (3) impact on nursing staff, (4) comfort and usability, and (5) future use and views on technology. CONCLUSIONS Overall, the feedback from patients using wearable monitoring sensors was strongly positive with relatively few concerns raised. Patients felt that the wearable sensors would improve their sense of safety, relieve pressure on health care staff, and serve as a favorable aspect of future health care technology.
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Affiliation(s)
- Meera Joshi
- Department of Surgery and Cancer, Imperial College London, London, United Kingdom.,Chelsea and Westminster Hospital NHS Foundation Trust, London, United Kingdom
| | - Stephanie Archer
- Department of Surgery and Cancer, Imperial College London, London, United Kingdom
| | - Abigail Morbi
- Department of Surgery and Cancer, Imperial College London, London, United Kingdom
| | - Sonal Arora
- Chelsea and Westminster Hospital NHS Foundation Trust, London, United Kingdom
| | - Richard Kwasnicki
- Department of Surgery and Cancer, Imperial College London, London, United Kingdom
| | - Hutan Ashrafian
- Department of Surgery and Cancer, Imperial College London, London, United Kingdom
| | - Sadia Khan
- Chelsea and Westminster Hospital NHS Foundation Trust, London, United Kingdom
| | - Graham Cooke
- Department of Infectious Disease, Wright-Fleming Institute, London, United Kingdom
| | - Ara Darzi
- Department of Surgery and Cancer, Imperial College London, London, United Kingdom
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Integrating a Potentiometer into a Knee Brace Shows High Potential for Continuous Knee Motion Monitoring. SENSORS 2021; 21:s21062150. [PMID: 33808554 PMCID: PMC8003398 DOI: 10.3390/s21062150] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 03/09/2021] [Accepted: 03/16/2021] [Indexed: 12/23/2022]
Abstract
Continuous monitoring of knee motion can provide deep insights into patients' rehabilitation status after knee injury and help to better identify their individual therapeutic needs. Potentiometers have been identified as one possible sensor type for continuous monitoring of knee motion. However, to verify their use in monitoring real-life environments, further research is needed. We aimed to validate a potentiometer-embedded knee brace to measure sagittal knee kinematics during various daily activities, as well as to assess its potential to continuously monitor knee motion. To this end, the sagittal knee motion of 32 healthy subjects was recorded simultaneously by an instrumented knee brace and an optoelectronic reference system during activities of daily living to assess the agreement between these two measurement systems. To evaluate the potentiometer's behavior during continuous monitoring, knee motion was continuously recorded in a subgroup (n = 9) who wore the knee brace over the course of a day. Our results show a strong agreement between the instrumented knee brace and reference system across all investigated activities as well as stable sensor behavior during continuous tracking. The presented potentiometer-based sensor system demonstrates strong potential as a device for measuring sagittal knee motion during daily activities as well as for continuous knee motion monitoring.
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Dynamic Segmentation for Physical Activity Recognition Using a Single Wearable Sensor. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app11062633] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Data segmentation is an essential process in activity recognition when using machine learning techniques. Previous studies on physical activity recognition have mostly relied on the sliding window approach for segmentation. However, choosing a fixed window size for multiple activities with different durations may affect recognition accuracy, especially when the activities belong to the same category (i.e., dynamic or static). This paper presents and verifies a new method for dynamic segmentation of physical activities performed during the rehabilitation of individuals with spinal cord injuries. To adaptively segment the raw data, signal characteristics are analyzed to determine the suitable type of boundaries. Then, the algorithm identifies the time boundaries to represent the start- and endpoints of each activity. To verify the method and build a predictive model, an experiment was conducted in which data were collected using a single wrist-worn accelerometer sensor. The experimental results were compared with the sliding window approach, indicating that the proposed method outperformed the sliding window approach in terms of overall accuracy, which exceeded 5%, as well as model robustness. The results also demonstrated efficient physical activity segmentation using the proposed method, resulting in high classification performance for all activities considered.
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Ciniglio A, Guiotto A, Spolaor F, Sawacha Z. The Design and Simulation of a 16-Sensors Plantar Pressure Insole Layout for Different Applications: From Sports to Clinics, a Pilot Study. SENSORS (BASEL, SWITZERLAND) 2021; 21:1450. [PMID: 33669674 PMCID: PMC7922081 DOI: 10.3390/s21041450] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 02/08/2021] [Accepted: 02/16/2021] [Indexed: 11/26/2022]
Abstract
The quantification of plantar pressure distribution is widely done in the diagnosis of lower limbs deformities, gait analysis, footwear design, and sport applications. To date, a number of pressure insole layouts have been proposed, with different configurations according to their applications. The goal of this study is to assess the validity of a 16-sensors (1.5 × 1.5 cm) pressure insole to detect plantar pressure distribution during different tasks in the clinic and sport domains. The data of 39 healthy adults, acquired with a Pedar-X® system (Novel GmbH, Munich, Germany) during walking, weight lifting, and drop landing, were used to simulate the insole. The sensors were distributed by considering the location of the peak pressure on all trials: 4 on the hindfoot, 3 on the midfoot, and 9 on the forefoot. The following variables were computed with both systems and compared by estimating the Root Mean Square Error (RMSE): Peak/Mean Pressure, Ground Reaction Force (GRF), Center of Pressure (COP), the distance between COP and the origin, the Contact Area. The lowest (0.61%) and highest (82.4%) RMSE values were detected during gait on the medial-lateral COP and the GRF, respectively. This approach could be used for testing different layouts on various applications prior to production.
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Affiliation(s)
- Alfredo Ciniglio
- Department of Information Engineering, DEI, University of Padova, 35131 Padova, Italy; (A.C.); (A.G.); (F.S.)
| | - Annamaria Guiotto
- Department of Information Engineering, DEI, University of Padova, 35131 Padova, Italy; (A.C.); (A.G.); (F.S.)
| | - Fabiola Spolaor
- Department of Information Engineering, DEI, University of Padova, 35131 Padova, Italy; (A.C.); (A.G.); (F.S.)
| | - Zimi Sawacha
- Department of Information Engineering, DEI, University of Padova, 35131 Padova, Italy; (A.C.); (A.G.); (F.S.)
- Department of Medicine, DIMED, University of Padova, 35131 Padova, Italy
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Wouda FJ, Jaspar SLJO, Harlaar J, van Beijnum BJF, Veltink PH. Foot progression angle estimation using a single foot-worn inertial sensor. J Neuroeng Rehabil 2021; 18:37. [PMID: 33596942 PMCID: PMC7888122 DOI: 10.1186/s12984-021-00816-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 01/12/2021] [Indexed: 11/16/2022] Open
Abstract
Background The foot progression angle is an important measure used to help patients reduce their knee adduction moment. Current measurement systems are either lab-bounded or do not function in all environments (e.g., magnetically distorted). This work proposes a novel approach to estimate foot progression angle using a single foot-worn inertial sensor (accelerometer and gyroscope). Methods The approach uses a dynamic step frame that is recalculated for the stance phase of each step to calculate the foot trajectory relative to that frame, to minimize effects of drift and to eliminate the need for a magnetometer. The foot progression angle (FPA) is then calculated as the angle between walking direction and the dynamic step frame. This approach was validated by gait measurements with five subjects walking with three gait types (normal, toe-in and toe-out). Results The FPA was estimated with a maximum mean error of ~ 2.6° over all gait conditions. Additionally, the proposed inertial approach can significantly differentiate between the three different gait types. Conclusion The proposed approach can effectively estimate differences in FPA without requiring a heading reference (magnetometer). This work enables feedback applications on FPA for patients with gait disorders that function in any environment, i.e. outside of a gait lab or in magnetically distorted environments.
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Affiliation(s)
- Frank J Wouda
- Faculty of Electrical Engineering, Mathematics and Computer Science, University of Twente, Enschede, The Netherlands.
| | - Stephan L J O Jaspar
- Faculty of Electrical Engineering, Mathematics and Computer Science, University of Twente, Enschede, The Netherlands
| | - Jaap Harlaar
- Department of Rehabilitation Medicine, Amsterdam Movement Sciences, VU University Medical Center, Amsterdam, The Netherlands.,Department of Biomechanical Engineering, Delft University of Technology, Delft, The Netherlands
| | - Bert-Jan F van Beijnum
- Faculty of Electrical Engineering, Mathematics and Computer Science, University of Twente, Enschede, The Netherlands
| | - Peter H Veltink
- Faculty of Electrical Engineering, Mathematics and Computer Science, University of Twente, Enschede, The Netherlands
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Gao RZ, Ren CL. Synergizing microfluidics with soft robotics: A perspective on miniaturization and future directions. BIOMICROFLUIDICS 2021; 15:011302. [PMID: 33564346 PMCID: PMC7861881 DOI: 10.1063/5.0036991] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 01/19/2021] [Indexed: 05/12/2023]
Abstract
Soft robotics has gone through a decade of tremendous progress in advancing both fundamentals and technologies. It has also seen a wide range of applications such as surgery assistance, handling of delicate foods, and wearable assistive systems driven by its soft nature that is more human friendly than traditional hard robotics. The rapid growth of soft robotics introduces many challenges, which vary with applications. Common challenges include the availability of soft materials for realizing different functions and the precision and speed of control required for actuation. In the context of wearable systems, miniaturization appears to be an additional hurdle to be overcome in order to develop truly impactful systems with a high user acceptance. Microfluidics as a field of research has gone through more than two decades of intense and focused research resulting in many fundamental theories and practical tools that have the potentials to be applied synergistically to soft robotics toward miniaturization. This perspective aims to introduce the potential synergy between microfluidics and soft robotics as a research topic and suggest future directions that could leverage the advantages of the two fields.
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Krishnaswami A, Beavers C, Dorsch MP, Dodson JA, Masterson Creber R, Kitsiou S, Goyal P, Maurer MS, Wenger NK, Croy DS, Alexander KP, Batsis JA, Turakhia MP, Forman DE, Bernacki GM, Kirkpatrick JN, Orr NM, Peterson ED, Rich MW, Freeman AM, Bhavnani SP. Gerotechnology for Older Adults With Cardiovascular Diseases: JACC State-of-the-Art Review. J Am Coll Cardiol 2020; 76:2650-2670. [PMID: 33243384 PMCID: PMC10436190 DOI: 10.1016/j.jacc.2020.09.606] [Citation(s) in RCA: 54] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 08/18/2020] [Accepted: 09/21/2020] [Indexed: 12/19/2022]
Abstract
The growing population of older adults (age ≥65 years) is expected to lead to higher rates of cardiovascular disease. The expansion of digital health (encompassing telehealth, telemedicine, mobile health, and remote patient monitoring), Internet access, and cellular technologies provides an opportunity to enhance patient care and improve health outcomes-opportunities that are particularly relevant during the current coronavirus disease-2019 pandemic. Insufficient dexterity, visual impairment, and cognitive dysfunction, found commonly in older adults should be taken into consideration in the development and utilization of existing technologies. If not implemented strategically and appropriately, these can lead to inequities propagating digital divides among older adults, across disease severities and socioeconomic distributions. A systematic approach, therefore, is needed to study and implement digital health strategies in older adults. This review will focus on current knowledge of the benefits, barriers, and use of digital health in older adults for cardiovascular disease management.
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Affiliation(s)
- Ashok Krishnaswami
- Division of Cardiology, Kaiser Permanente Medical Center, San Jose, California.
| | - Craig Beavers
- Division of Pharmacy, University of Kentucky, Lexington, Kentucky
| | - Michael P Dorsch
- College of Pharmacy, University of Michigan, Ann Arbor, Michigan
| | - John A Dodson
- NYU Langone Health, NYU Grossman School of Medicine, New York, New York
| | - Ruth Masterson Creber
- Weill Cornell Medicine, Department of Population Health Sciences, Division of Health Informatics, New York, New York
| | - Spyros Kitsiou
- Department of Biomedical and Health Information Sciences, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, Illinois
| | - Parag Goyal
- Department of Medicine, Weill Cornell Medicine, New York, New York
| | - Mathew S Maurer
- Division of Cardiology, Columbia University Medical Center, New York, New York
| | - Nanette K Wenger
- Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia
| | | | - Karen P Alexander
- Division of Cardiology, Duke Clinical Research Institute, Duke University Medical Center, Durham, North Carolina
| | - John A Batsis
- Department of Medicine, Geisel School of Medicine and The Dartmouth Institute for Health Policy & Clinical Practice, Dartmouth College and Dartmouth-Hitchcock, Lebanon, New Hampshire; Division of Geriatric Medicine, School of Medicine, Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill. Chapel Hill, North Carolina
| | - Mintu P Turakhia
- Center for Digital Health, Stanford University, Stanford, California; Palo Alto Veterans Administration Health Care System, Palo Alto, California
| | - Daniel E Forman
- Division of Geriatric Cardiology, University of Pittsburgh, Geriatric Research, Education and Clinical Center; VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania
| | - Gwen M Bernacki
- Cardiovascular Division, Department of Medicine, Cambia Palliative Care Center of Excellence, University of Washington, Seattle, Washington
| | - James N Kirkpatrick
- Cardiovascular Division, Department of Medicine, Department of Bioethics and Humanities, University of Washington, Seattle, Washington
| | - Nicole M Orr
- Post-Acute Cardiology Care, LCC, Darien, Connecticut; Division of Cardiology, Tufts Medical Center, Boston, Massachusetts
| | - Eric D Peterson
- Division of Cardiology, Duke Clinical Research Institute, Duke University Medical Center, Durham, North Carolina
| | - Michael W Rich
- Cardiovascular Division, Washington University, St. Louis, Missouri
| | - Andrew M Freeman
- Division of Cardiology, Department of Medicine, National Jewish Health, Denver, Colorado
| | - Sanjeev P Bhavnani
- Prebys Cardiovascular Institute, Scripps Clinic & Research Foundation, San Diego, California
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Singh H, Musselman K, Colella TJF, McGilton KS, Iaboni A, Bayley M, Zariffa J. Exploring the perspectives of outpatient rehabilitation clinicians on the challenges with monitoring patient health, function and activity in the community. Disabil Rehabil 2020; 44:2858-2867. [PMID: 33253597 DOI: 10.1080/09638288.2020.1849422] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
PURPOSE Rehabilitation clinicians need information about patient activities in the home/community to inform care. Despite active efforts to develop technologies that can meet this need, clinicians' perspectives regarding how information is collected and used in outpatient rehabilitation have not been comprehensively described. Therefore, we aimed to describe: (1) what data pertaining to a patient's health, function and activity in their home/community are currently collected in outpatient rehabilitation, (2) how these data can impact clinical decisions, and (3) what challenges clinicians encounter when they manage the care of outpatients based on this information. MATERIALS AND METHODS Eight clinicians working in outpatient rehabilitation programs completed qualitative interviews that were analyzed using an inductive thematic analysis. RESULTS Four themes were identified: "Nature of data about a patient's health, function and activity in the home/community and how it is collected by clinicians," "Value of data from the home/community," "Perceived drawbacks of current data collection methods," and "Improving data collection to understand patient trajectory." CONCLUSIONS Clinicians described the importance of understanding patient activities in the home/community, but perspectives varied regarding the suitability of current methods. These perceptions may inform the design of solutions to bridge the gap between the clinic and the community in outpatient rehabilitation.Implications for rehabilitationClinical decision-making in outpatient rehabilitation is guided by verbal and written reports about a patient's health and function in the community and adherence to treatment plans.Differing perceptions on the suitability of current data collection methods indicate that the development of new solutions, such as rehabilitation technologies, needs to carefully consider clinician workflows and what data are perceived as meaningful.Potentially impactful directions for new solutions include providing well validated data on adherence, movement quality, or longitudinal progression, presented in formats that match clinical decision criteria.
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Affiliation(s)
- Hardeep Singh
- KITE - Toronto Rehabilitation Institute - University Health Network, Toronto, Canada.,Faculty of Medicine, Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
| | - Kristin Musselman
- KITE - Toronto Rehabilitation Institute - University Health Network, Toronto, Canada.,Faculty of Medicine, Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada.,Department of Physical Therapy, University of Toronto, Toronto, Canada
| | - Tracey J F Colella
- KITE - Toronto Rehabilitation Institute - University Health Network, Toronto, Canada.,Faculty of Medicine, Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada.,Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada
| | - Katherine S McGilton
- KITE - Toronto Rehabilitation Institute - University Health Network, Toronto, Canada.,Faculty of Medicine, Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada.,Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada
| | - Andrea Iaboni
- KITE - Toronto Rehabilitation Institute - University Health Network, Toronto, Canada.,Faculty of Medicine, Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada.,Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Mark Bayley
- KITE - Toronto Rehabilitation Institute - University Health Network, Toronto, Canada.,Division of Physical Medicine and Rehabilitation, University of Toronto, Toronto, Canada
| | - José Zariffa
- KITE - Toronto Rehabilitation Institute - University Health Network, Toronto, Canada.,Faculty of Medicine, Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada.,Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, Canada
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Routhier F, Duclos NC, Lacroix É, Lettre J, Turcotte E, Hamel N, Michaud F, Duclos C, Archambault PS, Bouyer LJ. Clinicians' perspectives on inertial measurement units in clinical practice. PLoS One 2020; 15:e0241922. [PMID: 33186363 PMCID: PMC7665628 DOI: 10.1371/journal.pone.0241922] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 10/23/2020] [Indexed: 01/29/2023] Open
Abstract
Inertial measurement units (IMUs) have been increasingly popular in rehabilitation research. However, despite their accessibility and potential advantages, their uptake and acceptance by health professionals remain a big challenge. The development of an IMU-based clinical tool must bring together engineers, researchers and clinicians. This study is part of a developmental process with the investigation of clinicians’ perspectives about IMUs. Clinicians from four rehabilitation centers were invited to a 30-minute presentation on IMUs. Then, two one-hour focus groups were conducted with volunteer clinicians in each rehabilitation center on: 1) IMUs and their clinical usefulness, and 2) IMUs data analysis and visualization interface. Fifteen clinicians took part in the first focus groups. They expressed their thoughts on: 1) categories of variables that would be useful to measure with IMUs in clinical practice, and 2) desired characteristics of the IMUs. Twenty-three clinicians participated to the second focus groups, discussing: 1) functionalities, 2) display options, 3) clinical data reported and associated information, and 4) data collection duration. Potential influence of IMUs on clinical practice and added value were discussed in both focus groups. Clinicians expressed positive opinions about the use of IMUs, but their expectations were high before considering using IMUs in their practice.
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Affiliation(s)
- François Routhier
- Department of Rehabilitation, Université Laval, Quebec City, QC, Canada
- Center for Interdisciplinary Research in Rehabilitation and Social Integration, Centre Intégré Universitaire de Santé et de Services Sociaux de la Capitale-Nationale, Quebec City, QC, Canada
- * E-mail:
| | - Noémie C. Duclos
- Handicap Activity Cognition Health Team-U1219 BPH, University of Bordeaux, Bordeaux, France
- Institut Universitaire des Sciences de la Réadaptation, University of Bordeaux, Bordeaux, France
| | - Émilie Lacroix
- Center for Interdisciplinary Research in Rehabilitation and Social Integration, Centre Intégré Universitaire de Santé et de Services Sociaux de la Capitale-Nationale, Quebec City, QC, Canada
| | - Josiane Lettre
- Center for Interdisciplinary Research in Rehabilitation and Social Integration, Centre Intégré Universitaire de Santé et de Services Sociaux de la Capitale-Nationale, Quebec City, QC, Canada
| | - Elizabeth Turcotte
- Department of Rehabilitation, Université Laval, Quebec City, QC, Canada
- Center for Interdisciplinary Research in Rehabilitation and Social Integration, Centre Intégré Universitaire de Santé et de Services Sociaux de la Capitale-Nationale, Quebec City, QC, Canada
| | - Nathalie Hamel
- IntRoLab–Laboratoire de Robotique Intelligente/Interactive/Intégrée/Interdisciplinaire, Institut Interdisciplinaire d’Innovation Technologique, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - François Michaud
- IntRoLab–Laboratoire de Robotique Intelligente/Interactive/Intégrée/Interdisciplinaire, Institut Interdisciplinaire d’Innovation Technologique, Université de Sherbrooke, Sherbrooke, QC, Canada
- Department of Electrical Engineering and Computer Engineering, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Cyril Duclos
- School of Rehabilitation, Université de Montréal, Montreal, QC, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Institut Universitaire sur la Réadaptation en Déficience Physique de Montréal, Centre Intégré Universitaire de Santé et de Services Sociaux du Centre-Sud-de-l'Île-de-Montréal, Montreal, QC, Canada
| | - Philippe S. Archambault
- School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Jewish Rehabilitation Hospital, Centre Intégré de Santé et de Services Sociaux de Laval, Laval, QC, Canada
| | - Laurent J. Bouyer
- Department of Rehabilitation, Université Laval, Quebec City, QC, Canada
- Center for Interdisciplinary Research in Rehabilitation and Social Integration, Centre Intégré Universitaire de Santé et de Services Sociaux de la Capitale-Nationale, Quebec City, QC, Canada
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Exoskeleton use in post-stroke gait rehabilitation: a qualitative study of the perspectives of persons post-stroke and physiotherapists. J Neuroeng Rehabil 2020; 17:123. [PMID: 32912215 PMCID: PMC7488039 DOI: 10.1186/s12984-020-00750-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Accepted: 08/24/2020] [Indexed: 01/06/2023] Open
Abstract
Background Wearable powered exoskeletons are a new and emerging technology developed to provide sensory-guided motorized lower limb assistance enabling intensive task specific locomotor training utilizing typical lower limb movement patterns for persons with gait impairments. To ensure that devices meet end-user needs it is important to understand and incorporate end-users perspectives, however research in this area is extremely limited in the post-stroke population. The purpose of this study was to explore in-depth, end-users perspectives, persons with stroke and physiotherapists, following a single-use session with a H2 exoskeleton. Methods We used a qualitative interpretive description approach utilizing semi-structured face to face interviews, with persons post-stroke and physiotherapists, following a 1.5 h session with a H2 exoskeleton. Results Five persons post-stroke and 6 physiotherapists volunteered to participate in the study. Both participant groups provided insightful comments on their experience with the exoskeleton. Four themes were developed from the persons with stroke participant data: (1) Adopting technology; (2) Device concerns; (3) Developing walking ability; and, (4) Integrating exoskeleton use. Five themes were developed from the physiotherapist participant data: (1) Developer-user collaboration; (2) Device specific concerns; (3) Device programming; (4) Patient characteristics requiring consideration; and, (5) Indications for use. Conclusions This study provides an interpretive understanding of end-users perspectives, persons with stroke and neurological physiotherapists, following a single-use experience with a H2 exoskeleton. The findings from both stakeholder groups overlap such that four over-arching concepts were identified including: (i) Stakeholder participation; (ii) Augmentation vs. autonomous robot; (iii) Exoskeleton usability; and (iv) Device specific concerns. The end users provided valuable perspectives on the use and design of the H2 exoskeleton, identifying needs specific to post-stroke gait rehabilitation, the need for a robust evidence base, whilst also highlighting that there is significant interest in this technology throughout the continuum of stroke rehabilitation.
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Hua A, Johnson N, Quinton J, Chaudhary P, Buchner D, Hernandez ME. Design of a Low-Cost, Wearable Device for Kinematic Analysis in Physical Therapy Settings. Methods Inf Med 2020; 59:41-47. [PMID: 32535880 DOI: 10.1055/s-0040-1710380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
BACKGROUND Unsupervised home exercise is a major component of physical therapy (PT). This study proposes an inexpensive, inertial measurement unit-based wearable device to capture kinematic data to facilitate exercise. However, conveying and interpreting kinematic data to non-experts poses a challenge due to the complexity and background knowledge required that most patients lack. OBJECTIVES The objectives of this study were to identify key user interface and user experience features that would likely improve device adoption and assess participant receptiveness toward the device. METHODS Fifty participants were recruited to perform nine upper extremity exercises while wearing the device. Prior to exercise, participants completed an orientation of the device, which included examples of software graphics with exercise data. Surveys that measured receptiveness toward the device, software graphics, and ergonomics were given before and after exercise. RESULTS Participants were highly receptive to the device with 90% of the participants likely to use the device during PT. Participants understood how the simple kinematic data could be used to aid exercise, but the data could be difficult to comprehend with more complex movements. Devices should incorporate wireless sensors and emphasize ease of wear. CONCLUSION Device-guided home physical rehabilitation can allow for individualized treatment protocols and improve exercise self-efficacy through kinematic analysis. Future studies should implement clinical testing to evaluate the impact a wearable device can have on rehabilitation outcomes.
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Affiliation(s)
- Andrew Hua
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, Illinois, United States
| | - Nicole Johnson
- Department of Bioengineering, University of Illinois at Urbana-Champaign, Champaign, Illinois, United States
| | - Joshua Quinton
- Department of Physics, University of Illinois at Urbana-Champaign, Champaign, Illinois, United States
| | - Pratik Chaudhary
- Department of Computer Science, University of Illinois at Urbana-Champaign, Champaign, Illinois, United States
| | - David Buchner
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, Illinois, United States
| | - Manuel E Hernandez
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, Illinois, United States
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Timed Up and Go and Six-Minute Walking Tests with Wearable Inertial Sensor: One Step Further for the Prediction of the Risk of Fall in Elderly Nursing Home People. SENSORS 2020; 20:s20113207. [PMID: 32516995 PMCID: PMC7309155 DOI: 10.3390/s20113207] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 05/26/2020] [Accepted: 06/03/2020] [Indexed: 12/13/2022]
Abstract
Assessing the risk of fall in elderly people is a difficult challenge for clinicians. Since falls represent one of the first causes of death in such people, numerous clinical tests have been created and validated over the past 30 years to ascertain the risk of falls. More recently, the developments of low-cost motion capture sensors have facilitated observations of gait differences between fallers and nonfallers. The aim of this study is twofold. First, to design a method combining clinical tests and motion capture sensors in order to optimize the prediction of the risk of fall. Second to assess the ability of artificial intelligence to predict risk of fall from sensor raw data only. Seventy-three nursing home residents over the age of 65 underwent the Timed Up and Go (TUG) and six-minute walking tests equipped with a home-designed wearable Inertial Measurement Unit during two sets of measurements at a six-month interval. Observed falls during that interval enabled us to divide residents into two categories: fallers and nonfallers. We show that the TUG test results coupled to gait variability indicators, measured during a six-minute walking test, improve (from 68% to 76%) the accuracy of risk of fall’s prediction at six months. In addition, we show that an artificial intelligence algorithm trained on the sensor raw data of 57 participants reveals an accuracy of 75% on the remaining 16 participants.
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Using an Accelerometer-Based Step Counter in Post-Stroke Patients: Validation of a Low-Cost Tool. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17093177. [PMID: 32370210 PMCID: PMC7246942 DOI: 10.3390/ijerph17093177] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 04/29/2020] [Accepted: 04/29/2020] [Indexed: 11/29/2022]
Abstract
Monitoring the real-life mobility of stroke patients could be extremely useful for clinicians. Step counters are a widely accessible, portable, and cheap technology that can be used to monitor patients in different environments. The aim of this study was to validate a low-cost commercial tri-axial accelerometer-based step counter for stroke patients and to determine the best positioning of the step counter (wrists, ankles, and waist). Ten healthy subjects and 43 post-stroke patients were enrolled and performed four validated clinical tests (10 m, 50 m, and 6 min walking tests and timed up and go tests) while wearing five step counters in different positions while a trained operator counted the number of steps executed in each test manually. Data from step counters and those collected manually were compared using the intraclass coefficient correlation and mean average percentage error. The Bland–Altman plot was also used to describe agreement between the two quantitative measurements (step counter vs. manual counting). During walking tests in healthy subjects, the best reliability was found for lower limbs and waist placement (intraclass coefficient correlations (ICCs) from 0.46 to 0.99), and weak reliability was observed for upper limb placement in every test (ICCs from 0.06 to 0.38). On the contrary, in post-stroke patients, moderate reliability was found only for the lower limbs in the 6 min walking test (healthy ankle ICC: 0.69; pathological ankle ICC: 0.70). Furthermore, the Bland–Altman plot highlighted large average discrepancies between methods for the pathological group. However, while the step counter was not able to reliably determine steps for slow patients, when applied to the healthy ankle of patients who walked faster than 0.8 m/s, it counted steps with excellent precision, similar to that seen in the healthy subjects (ICCs from 0.36 to 0.99). These findings show that a low-cost accelerometer-based step counter could be useful for measuring mobility in select high-performance patients and could be used in clinical and real-world settings.
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Calvaresi D, Calbimonte JP. Real-Time Compliant Stream Processing Agents for Physical Rehabilitation. SENSORS 2020; 20:s20030746. [PMID: 32013222 PMCID: PMC7038372 DOI: 10.3390/s20030746] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2019] [Revised: 01/27/2020] [Accepted: 01/28/2020] [Indexed: 11/18/2022]
Abstract
Digital rehabilitation is a novel concept that integrates state-of-the-art technologies for motion sensing and monitoring, with personalized patient-centric methodologies emerging from the field of physiotherapy. Thanks to the advances in wearable and portable sensing technologies, it is possible to provide patients with accurate monitoring devices, which simplifies the tracking of performance and effectiveness of physical exercises and treatments. Employing these approaches in everyday practice has enormous potential. Besides facilitating and improving the quality of care provided by physiotherapists, the usage of these technologies also promotes the personalization of treatments, thanks to data analytics and patient profiling (e.g., performance and behavior). However, achieving such goals implies tackling both technical and methodological challenges. In particular, (i) the capability of undertaking autonomous behaviors must comply with strict real-time constraints (e.g., scheduling, communication, and negotiation), (ii) plug-and-play sensors must seamlessly manage data and functional heterogeneity, and finally (iii) multi-device coordination must enable flexible and scalable sensor interactions. Beyond traditional top-down and best-effort solutions, unsuitable for safety-critical scenarios, we propose a novel approach for decentralized real-time compliant semantic agents. In particular, these agents can autonomously coordinate with each other, schedule sensing and data delivery tasks (complying with strict real-time constraints), while relying on ontology-based models to cope with data heterogeneity. Moreover, we present a model that represents sensors as autonomous agents able to schedule tasks and ensure interactions and negotiations compliant with strict timing constraints. Furthermore, to show the feasibility of the proposal, we present a practical study on upper and lower-limb digital rehabilitation scenarios, simulated on the MAXIM-GPRT environment for real-time compliance. Finally, we conduct an extensive evaluation of the implementation of the stream processing multi-agent architecture, which relies on existing RDF stream processing engines.
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Oubre B, Daneault JF, Jung HT, Whritenour K, Miranda JGV, Park J, Ryu T, Kim Y, Lee SI. Estimating Upper-Limb Impairment Level in Stroke Survivors Using Wearable Inertial Sensors and a Minimally-Burdensome Motor Task. IEEE Trans Neural Syst Rehabil Eng 2020; 28:601-611. [PMID: 31944983 DOI: 10.1109/tnsre.2020.2966950] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Upper-limb paresis is the most common motor impairment post stroke. Current solutions to automate the assessment of upper-limb impairment impose a number of critical burdens on patients and their caregivers that preclude frequent assessment. In this work, we propose an approach to estimate upper-limb impairment in stroke survivors using two wearable inertial sensors, on the wrist and the sternum, and a minimally-burdensome motor task. Twenty-three stroke survivors with no, mild, or moderate upper-limb impairment performed two repetitions of one-to-two minute-long continuous, random (i.e., patternless), voluntary upper-limb movements spanning the entire range of motion. The three-dimensional time-series of upper-limb movements were segmented into a series of one-dimensional submovements by employing a unique movement decomposition technique. An unsupervised clustering algorithm and a supervised regression model were used to estimate Fugl-Meyer Assessment (FMA) scores based on features extracted from these submovements. Our regression model estimated FMA scores with a normalized root mean square error of 18.2% ( r2=0.70 ) and needed as little as one minute of movement data to yield reasonable estimation performance. These results support the possibility of frequently monitoring stroke survivors' rehabilitation outcomes, ultimately enabling the development of individually-tailored rehabilitation programs.
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Tully J, Dameff C, Longhurst CA. Wave of Wearables: Clinical Management of Patients and the Future of Connected Medicine. Clin Lab Med 2020; 40:69-82. [PMID: 32008641 DOI: 10.1016/j.cll.2019.11.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
The future of connected health care will involve the collection of patient data or enhancement of clinician workflows through various biosensors and displays found on wearable electronic devices, many of which are marketed directly to consumers. The adoption of wearables in health care is being driven by efforts to reduce health care costs, improve care quality, and increase clinician efficiency. Wearables have significant potential to achieve these goals but are currently limited by lack of widespread integrations into electronic health records, biosensor data collection types, and a lack of scientifically rigorous literature showing benefit.
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Affiliation(s)
- Jeffrey Tully
- Department of Anesthesiology and Pain Medicine, University of California Davis Medical Center, 2315 Stockton Boulevard, Sacramento, CA 95817, USA.
| | - Christian Dameff
- Department of Emergency Medicine, University of California San Diego, 200 West Arbor Drive #8676, San Diego, CA 92103, USA; Department of Biomedical Informatics, UC San Diego Health, University of California San Diego, 9500 Gilman Drive, MC 0728, La Jolla, California 92093-0728, USA; Department of Computer Science and Engineering, University of California San Diego, 9500 Gilman Drive, Mail Code 0404, La Jolla, CA 92093-0404, USA
| | - Christopher A Longhurst
- Department of Medicine, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA; Department of Pediatrics, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA
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Kim Y, Jung HT, Park J, Kim Y, Ramasarma N, Bonato P, Choe EK, Lee SI. Towards the Design of a Ring Sensor-based mHealth System to Achieve Optimal Motor Function in Stroke Survivors. ACTA ACUST UNITED AC 2019. [DOI: 10.1145/3369817] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Maximizing the motor practice in stroke survivors' living environments may significantly improve the functional recovery of their stroke-affected upper-limb. A wearable system that can continuously monitor upper-limb performance has been considered as an effective clinical solution for its potential to provide patient-centered, data-driven feedback to improve the motor dosage. Towards that end, we investigate a system leveraging a pair of finger-worn, ring-type accelerometers capable of monitoring both gross-arm and fine-hand movements that are clinically relevant to the performance of daily activities. In this work, we conduct a mixed-methods study to (1) quantitatively evaluate the efficacy of finger-worn accelerometers in measuring clinically relevant information regarding stroke survivors' upper-limb performance, and (2) qualitatively investigate design requirements for the self-monitoring system, based on data collected from 25 stroke survivors and seven occupational therapists. Our quantitative findings demonstrate strong face and convergent validity of the finger-worn accelerometers, and its responsiveness to changes in motor behavior. Our qualitative findings provide a detailed account of the current rehabilitation process while highlighting several challenges that therapists and stroke survivors face. This study offers promising directions for the design of a self-monitoring system that can encourage the affected limb use during stroke survivors' daily living.
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Affiliation(s)
- Yoojung Kim
- Seoul National University, Seoul, Republic of Korea
| | - Hee-Tae Jung
- University of Massachusetts Amherst, Amherst, Massachusetts, United States
| | - Joonwoo Park
- Smilegreen Child Development Center, Daegu, Republic of Korea
| | - Yangsoo Kim
- Heeyeon Rehabilitation Hospital, Changwon, Republic of Korea
| | | | - Paolo Bonato
- Harvard Medical School, Spaulding Rehabilitation Hospital, Charlestown, Massachusetts, United States
| | - Eun Kyoung Choe
- University of Maryland, College Park, College Park, Maryland, United States
| | - Sunghoon Ivan Lee
- University of Massachusetts Amherst, Amherst, Massachusetts, United States
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Park H, Pei J, Shi M, Xu Q, Fan J. Designing wearable computing devices for improved comfort and user acceptance. ERGONOMICS 2019; 62:1474-1484. [PMID: 31437415 DOI: 10.1080/00140139.2019.1657184] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Accepted: 08/12/2019] [Indexed: 06/10/2023]
Abstract
This study identified acceptable range of physical attributes (form factors, weight, volume and contact area) of wearable computing devices (WCD) on different body areas in relation to human factors, through human performance tests with 41participants. Findings of this study discovered that there is a different level of threshold to discomfort on each part of the body; forearm has the smallest estimated mean of acceptable maximum weight of WCD followed by shirt pocket and collar area. On the other hand, front waist and back waist, when placed on one side, showed significantly higher estimated means of acceptable maximum weight of WCD than any other areas. Similar data trend was found in acceptable maximum volume and contact area of WCD. Body movement and posture influence the users' comfort, as the weight of WCD can cause unhealthy posture over time, and increased energy expenditure, which may cause orthopaedic problems and discomfort. Practitioner summary: This study discovered that in carrying wearable computing devices (WCD), there is a different level of threshold to discomfort on each part of the body, as evidenced by significantly different acceptable maximum weight, volume and contact area of WCD on different body part. Abbreviations: WCD: wearable computing devices.
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Affiliation(s)
- Huiju Park
- Department of Fiber Science & Apparel Design, Cornell University , Ithaca , NY , USA
| | - Jie Pei
- Department of Fiber Science & Apparel Design, Cornell University , Ithaca , NY , USA
| | - Mengyun Shi
- Department of Fiber Science & Apparel Design, Cornell University , Ithaca , NY , USA
| | - Qinwen Xu
- Department of Fiber Science & Apparel Design, Cornell University , Ithaca , NY , USA
| | - Jintu Fan
- Department of Fiber Science & Apparel Design, Cornell University , Ithaca , NY , USA
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42
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Spook SM, Koolhaas W, Bültmann U, Brouwer S. Implementing sensor technology applications for workplace health promotion: a needs assessment among workers with physically demanding work. BMC Public Health 2019; 19:1100. [PMID: 31412839 PMCID: PMC6693286 DOI: 10.1186/s12889-019-7364-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Accepted: 07/24/2019] [Indexed: 01/21/2023] Open
Abstract
Background Workers with physically demanding work may be at risk for injury, illness or other adverse health outcomes due to exposure to different occupational hazards, especially at higher age. Sensor technology applications may be useful in the workplace to unobtrusively measure and monitor work exposures and provide workers with real-time feedback or access to data on demand. Many aspects might impede the implementation of sensor technology applications in the workplace, which should be taken into consideration for a successful implementation. Moreover, needs and preferences of workers regarding the use of sensor technology applications during work performance need to be identified. Therefore, the aim of this study was to identify worker needs and preferences regarding the use of sensor technology applications in the workplace. Methods Four on-site focus group sessions were conducted in four different companies among workers with physically demanding work (n = 30). Semi-structured interview schedules were used to identify which work exposures should be measured, by which kind of sensor technology applications, under which (pre)conditions, how to motivate long-term use of sensor technology applications, and which type of feedback is preferred. For data analysis, a content-analysis with an inductive approach was performed. Results Participants mentioned that they want to use wearable sensor technology applications to measure and monitor physical job demands, occupational heat stress, noise and fatigue. Factors associated with quality, comfort and perceived ease of use were identified as potential barriers for implementation in the workplace. Long-term motivation was attributed to the ability to manage and monitor work exposures, positive feedback and data ownership. Participants indicated a need to both receive real-time feedback and access to data on demand. Conclusions Sensor technology applications may support workers with physically demanding work to measure and monitor their work exposures. Potential barriers for implementation such as privacy aspects and quality, comfort and perceived ease of use of sensor technology applications need to be well considered to ensure successful implementation of sensor technology applications in the workplace. Electronic supplementary material The online version of this article (10.1186/s12889-019-7364-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Sander Mathijn Spook
- Department of Health Sciences, Community and Occupational Medicine, University of Groningen, University Medical Center Groningen, Antonius Deusinglaan 1, P.O. Box 196, FA10, room 620, 9700 AD, Groningen, the Netherlands
| | - Wendy Koolhaas
- Department of Health Sciences, Community and Occupational Medicine, University of Groningen, University Medical Center Groningen, Antonius Deusinglaan 1, P.O. Box 196, FA10, room 620, 9700 AD, Groningen, the Netherlands
| | - Ute Bültmann
- Department of Health Sciences, Community and Occupational Medicine, University of Groningen, University Medical Center Groningen, Antonius Deusinglaan 1, P.O. Box 196, FA10, room 620, 9700 AD, Groningen, the Netherlands
| | - Sandra Brouwer
- Department of Health Sciences, Community and Occupational Medicine, University of Groningen, University Medical Center Groningen, Antonius Deusinglaan 1, P.O. Box 196, FA10, room 620, 9700 AD, Groningen, the Netherlands.
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43
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Mokhlespour Esfahani MI, Nussbaum MA. Classifying Diverse Physical Activities Using "Smart Garments". SENSORS 2019; 19:s19143133. [PMID: 31315261 PMCID: PMC6679301 DOI: 10.3390/s19143133] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Revised: 07/11/2019] [Accepted: 07/14/2019] [Indexed: 12/17/2022]
Abstract
Physical activities can have important impacts on human health. For example, a physically active lifestyle, which is one of the most important goals for overall health promotion, can diminish the risk for a range of physical disorders, as well as reducing health-related expenditures. Thus, a long-term goal is to detect different physical activities, and an important initial step toward this goal is the ability to classify such activities. A recent and promising technology to discriminate among diverse physical activities is the smart textile system (STS), which is becoming increasingly accepted as a low-cost activity monitoring tool for health promotion. Accordingly, our primary aim was to assess the feasibility and accuracy of using a novel STS to classify physical activities. Eleven participants completed a lab-based experiment to evaluate the accuracy of an STS that featured a smart undershirt (SUS) and commercially available smart socks (SSs) in discriminating several basic postures (sitting, standing, and lying down), as well as diverse activities requiring participants to walk and run at different speeds. We trained three classification methods—K-nearest neighbor, linear discriminant analysis, and artificial neural network—using data from each smart garment separately and in combination. Overall classification performance (global accuracy) was ~98%, which suggests that the STS was effective for discriminating diverse physical activities. We conclude that, overall, smart garments represent a promising area of research and a potential alternative for discriminating a range of physical activities, which can have positive implications for health promotion.
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Affiliation(s)
| | - Maury A Nussbaum
- Department of Industrial and Systems Engineering, Virginia Tech, Blacksburg, VA 24060, USA.
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44
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Perry B, Geoghegan C, Lin L, McGuire FH, Nido V, Grabert B, Morin SL, Hallinan ZP, Corneli A. Patient preferences for using mobile technologies in clinical trials. Contemp Clin Trials Commun 2019; 15:100399. [PMID: 31312746 PMCID: PMC6610628 DOI: 10.1016/j.conctc.2019.100399] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Revised: 06/14/2019] [Accepted: 06/19/2019] [Indexed: 01/04/2023] Open
Abstract
The use of mobile technologies to collect participant data in clinical trials offers a number of scientific and logistical advantages. However, little is known about potential research participant preferences about how to incorporate mobile technologies into the design and conduct of a trial. Using a web-based survey which described hypothetical mobile clinical trial and traditional clinical trial scenarios, we explored patients’ perceptions of and willingness to participate in mobile and traditional clinical trials, their preferred trial procedures related to the use of mobile technologies, and the preferred attributes of mobile technologies. The majority of survey respondents reported that they would prefer participating in a clinical trial that used mobile technology than a traditional trial that relied on standard in-clinic assessments. They expressed that mobile clinical trials offered greater convenience, a reduction of in-person clinic visits, and greater data collection accuracy. Respondents also reported preferences for the frequency of in-clinic visits during mobile clinical trials, device training and troubleshooting, data privacy and confidentiality, the location of data storage, and user access to data collected by the trial device. As research participants become more involved in capturing their own data to inform trial endpoints, their user-preferences of mobile technology, such as those described here, should be considered in the design and conduct of mobile clinical trials.
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Affiliation(s)
- Brian Perry
- Clinical Trials Transformation Initiative, Durham, NC, USA.,Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA
| | | | - Li Lin
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA
| | - F Hunter McGuire
- Clinical Trials Transformation Initiative, Durham, NC, USA.,Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA.,Department of Health Behavior, University of North Carolina Gillings School of Global Public Health, Chapel Hill, NC, USA
| | | | - Brigid Grabert
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA.,Department of Health Policy and Management, University of North Carolina Gillings School of Global Public Health, Chapel Hill, NC, USA
| | - Steve L Morin
- Office of Health and Constituent Affairs, US Food and Drug Administration, Silver Spring, MD, USA
| | | | - Amy Corneli
- Clinical Trials Transformation Initiative, Durham, NC, USA.,Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA
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45
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Lin D, Papi E, McGregor AH. Exploring the clinical context of adopting an instrumented insole: a qualitative study of clinicians' preferences in England. BMJ Open 2019; 9:e023656. [PMID: 31005908 PMCID: PMC6500285 DOI: 10.1136/bmjopen-2018-023656] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVES This study explores clinicians' views of the clinical uptake of a smart pressure-sensing insole, named Flexifoot, to enhance the care and management of patients with osteoarthritis (OA). Clinicians are key users of wearable technologies, and can provide appropriate feedback for a specific device for successful clinical implementation. DESIGN Qualitative study with in-depth, semi-structured interviews, analysed using inductive analysis to generate key themes. SETTING Conducted in a University setting. PARTICIPANTS 30 clinicians were interviewed (11 physiotherapists, 11 orthopaedic surgeons, 5 general practitioners, 3 podiatrists). RESULTS All clinicians regarded Flexifoot to be useful for the care and management of patients in adjunction to current methods. Responses revealed four main themes: use, data presentation, barriers to use and future development. Flexifoot data were recognised as capable of enhancing information exchange between clinicians and patients, and also between clinicians themselves. Participants supported the use of feedback for rehabilitation, screening and evaluation of treatment progress/success purposes. Flexifoot use by patients was encouraged as a self-management tool that may motivate them by setting attainment goals. The data interface should be secure, concise and visually appealing. The measured parameters of Flexifoot, its duration of wear and frequency of data output would all depend on the rationale for its use. The clinicians and patients must collaborate to optimise the use of Flexifoot for long-term monitoring of disease for patient care in clinical practice. Many identified potential other uses for Flexifoot. CONCLUSIONS Clinicians thought that Flexifoot may complement and improve current methods of long-term patient management for OA or other conditions in clinical settings. Flexifoot was recognised to be useful for objective measures and should be tailored carefully for each person and condition to maximise compliance. Adopting the device, and other similar technologies, requires reducing the main barriers to use (time, cost, patient compliance) before its successful implementation.
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Affiliation(s)
- Denise Lin
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - Enrica Papi
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - Alison H McGregor
- Department of Surgery and Cancer, Imperial College London, London, UK
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46
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Identifying barriers in telemedicine-supported integrated care research: scoping reviews and qualitative content analysis. J Public Health (Oxf) 2019. [DOI: 10.1007/s10389-019-01065-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
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47
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Calvaresi D, Marinoni M, Dragoni AF, Hilfiker R, Schumacher M. Real-time multi-agent systems for telerehabilitation scenarios. Artif Intell Med 2019; 96:217-231. [PMID: 30827696 DOI: 10.1016/j.artmed.2019.02.001] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Revised: 01/08/2019] [Accepted: 02/13/2019] [Indexed: 11/27/2022]
Abstract
Telerehabilitation in older adults is most needed in the patient environments, rather than in formal ambulatories or hospitals. Supporting such practices brings significant advantages to patients, their family, formal and informal caregivers, clinicians, and researchers. This paper presents a focus group with experts in physiotherapy and telerehabilitation, debating on the requirements, current techniques and technologies developed to facilitate and enhance the effectiveness of telerehabilitation, and the still open challenges. Particular emphasis is given to (i) the body-parts requiring the most rehabilitation, (ii) the typical environments, initial causes, and general conditions, (iii) the values and parameters to be observed, (iv) common errors and limitations of current practices and technological solutions, and (v) the envisioned and desired technological support. Consequently, it has been performed a systematic review of the state of the art, investigating what types of systems and support currently cope with telerehabilitation practices and possible matches with the outcomes of the focus group. Technological solutions based on video analysis, wearable devices, robotic support, distributed sensing, and gamified telerehabilitation are examined. Particular emphasis is given to solutions implementing agent-based approaches, analyzing and discussing strength, limitations, and future challenges. By doing so, it has been possible to relate functional requirements expressed by professional physiotherapists and researchers, with the need for extending multi-agent systems (MAS) peculiarities at the sensing level in wearable solutions establishing new research challenges. In particular, to be employed in safety-critical cyber-physical scenarios with user-sensor and sensor-sensor interactions, MAS are requested to handle timing constraints, scarcity of resources and new communication means, crucial to providing real-time feedback and coaching. Therefore, MAS pillars such as the negotiation protocol and the agent's internal scheduler have been investigated, proposing solutions to achieve the aforementioned real-time compliance.
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Affiliation(s)
- Davide Calvaresi
- Scuola Superiore Sant'Anna, Pisa, Italy; University of Applied Science Western Switzerland (HES-SO), Sierre, Switzerland.
| | | | | | - Roger Hilfiker
- University of Applied Science Western Switzerland (HES-SO), Sierre, Switzerland.
| | - Michael Schumacher
- University of Applied Science Western Switzerland (HES-SO), Sierre, Switzerland
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48
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Alt Murphy M, Bergquist F, Hagström B, Hernández N, Johansson D, Ohlsson F, Sandsjö L, Wipenmyr J, Malmgren K. An upper body garment with integrated sensors for people with neurological disorders - early development and evaluation. BMC Biomed Eng 2019; 1:3. [PMID: 32903336 PMCID: PMC7412666 DOI: 10.1186/s42490-019-0002-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Accepted: 01/03/2019] [Indexed: 12/23/2022] Open
Abstract
Background In neurology and rehabilitation the primary interest for using wearables is to supplement traditional patient assessment and monitoring in hospital settings with continuous data collection at home and in community settings. The aim of this project was to develop a novel wearable garment with integrated sensors designed for continuous monitoring of physiological and movement related variables to evaluate progression, tailor treatments and improve diagnosis in epilepsy, Parkinson’s disease and stroke. In this paper the early development and evaluation of a prototype designed to monitor movements and heart rate is described. An iterative development process and evaluation of an upper body garment with integrated sensors included: identification of user needs, specification of technical and garment requirements, garment development and production as well as evaluation of garment design, functionality and usability. The project is a multidisciplinary collaboration with experts from medical, engineering, textile, and material science within the wearITmed consortium. The work was organized in regular meetings, task groups and hands-on workshops. User needs were identified using results from a mixed-methods systematic review, a focus group study and expert groups. Usability was evaluated in 19 individuals (13 controls, 6 patients with Parkinson’s disease) using semi-structured interviews and qualitative content analysis. Results The garment was well accepted by the users regarding design and comfort, although the users were cautious about the technology and suggested improvements. All electronic components passed a washability test. The most robust data was obtained from accelerometer and gyroscope sensors while the electrodes for heart rate registration were sensitive to motion artefacts. The algorithm development within the wearITmed consortium has shown promising results. Conclusions The prototype was accepted by the users. Technical improvements are needed, but preliminary data indicate that the garment has potential to be used as a tool for diagnosis and treatment selection and could provide added value for monitoring seizures in epilepsy, fluctuations in PD and activity levels in stroke. Future work aims to improve the prototype further, develop algorithms, and evaluate the functionality and usability in targeted patient groups. The potential of incorporating blood pressure and heart-rate variability monitoring will also be explored.
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Affiliation(s)
- Margit Alt Murphy
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Per Dubbsgatan 14, 3rd Floor, SE-41345 Gothenburg, Sweden
| | - Filip Bergquist
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Per Dubbsgatan 14, 3rd Floor, SE-41345 Gothenburg, Sweden.,Department of Pharmacology, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Bengt Hagström
- Department of Materials, Swerea IVF, Mölndal, Sweden.,Department of Industrial and Materials Science, Chalmers University of Technology, Gothenburg, Sweden
| | - Niina Hernández
- Swedish School of Textiles, University of Borås, Borås, Sweden
| | - Dongni Johansson
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Per Dubbsgatan 14, 3rd Floor, SE-41345 Gothenburg, Sweden
| | | | - Leif Sandsjö
- MedTech West/Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden.,Department of Industrial and Materials Science, Division of Design & Human Factors, Chalmers University of Technology, Gothenburg, Sweden
| | | | - Kristina Malmgren
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Per Dubbsgatan 14, 3rd Floor, SE-41345 Gothenburg, Sweden.,Department of Neurology, Sahlgrenska University Hospital, Gothenburg, Sweden
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Argent R, Slevin P, Bevilacqua A, Neligan M, Daly A, Caulfield B. Wearable Sensor-Based Exercise Biofeedback for Orthopaedic Rehabilitation: A Mixed Methods User Evaluation of a Prototype System. SENSORS 2019; 19:s19020432. [PMID: 30669657 PMCID: PMC6359655 DOI: 10.3390/s19020432] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Revised: 01/17/2019] [Accepted: 01/18/2019] [Indexed: 01/17/2023]
Abstract
The majority of wearable sensor-based biofeedback systems used in exercise rehabilitation lack end-user evaluation as part of the development process. This study sought to evaluate an exemplar sensor-based biofeedback system, investigating the feasibility, usability, perceived impact and user experience of using the platform. Fifteen patients participated in the study having recently undergone knee replacement surgery. Participants were provided with the system for two weeks at home, completing a semi-structured interview alongside the System Usability Scale (SUS) and user version of the Mobile Application Rating Scale (uMARS). The analysis from the SUS (mean = 90.8 [SD = 7.8]) suggests a high degree of usability, supported by qualitative findings. The mean adherence rate was 79% with participants reporting a largely positive user experience, suggesting it offers additional support with the rehabilitation regime. Overall quality from the mean uMARS score was 4.1 out of 5 (SD = 0.39), however a number of bugs and inaccuracies were highlighted along with suggestions for additional features to enhance engagement. This study has shown that patients perceive value in the use of wearable sensor-based biofeedback systems and has highlighted the benefit of user-evaluation during the design process, illustrated the need for real-world accuracy validation, and supports the ongoing development of such systems.
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Affiliation(s)
- Rob Argent
- Beacon Hospital, Sandyford, Dublin 18, Ireland.
- Insight Centre for Data Analytics, University College Dublin, Dublin 4, Ireland.
- School of Public Health, Physiotherapy and Sport Science, University College Dublin, Dublin 4, Ireland.
| | - Patrick Slevin
- Insight Centre for Data Analytics, University College Dublin, Dublin 4, Ireland.
- School of Public Health, Physiotherapy and Sport Science, University College Dublin, Dublin 4, Ireland.
| | - Antonio Bevilacqua
- Insight Centre for Data Analytics, University College Dublin, Dublin 4, Ireland.
| | | | - Ailish Daly
- Beacon Hospital, Sandyford, Dublin 18, Ireland.
| | - Brian Caulfield
- Insight Centre for Data Analytics, University College Dublin, Dublin 4, Ireland.
- School of Public Health, Physiotherapy and Sport Science, University College Dublin, Dublin 4, Ireland.
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50
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Multi-Functional Soft Strain Sensors for Wearable Physiological Monitoring. SENSORS 2018; 18:s18113822. [PMID: 30413011 PMCID: PMC6263389 DOI: 10.3390/s18113822] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/22/2018] [Revised: 10/26/2018] [Accepted: 10/31/2018] [Indexed: 01/23/2023]
Abstract
Wearable devices which monitor physiological measurements are of significant research interest for a wide number of applications including medicine, entertainment, and wellness monitoring. However, many wearable sensing systems are highly rigid and thus restrict the movement of the wearer, and are not modular or customizable for a specific application. Typically, one sensor is designed to model one physiological indicator which is not a scalable approach. This work aims to address these limitations, by developing soft sensors and including conductive particles into a silicone matrix which allows sheets of soft strain sensors to be developed rapidly using a rapid manufacturing process. By varying the morphology of the sensor sheets and electrode placement the response can be varied. To demonstrate the versatility and range of sensitivity of this base sensing material, two wearable sensors have been developed which show the detection of different physiological parameters. These include a pressure-sensitive insole sensor which can detect ground reaction forces and a strain sensor which can be worn over clothes to allow the measurements of heart rate, breathing rate, and gait.
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