A new approach to ballistocardiographic measurements using fibre Bragg grating-based sensors

Fiber Bragg Grating-Based Smart Garment for Monitoring Human Body Temperature

Body temperature provides an insight into the physiological state of a person, and body temperature changes reflect much information about human health. In this study, a garment for monitoring human body temperature based on fiber Bragg grating (FBG) sensors is reported. The FBG sensor was encapsulated with a PMMA tube and calibrated in the thermostatic water bath. The results showed that FBG sensors had good vibration resistance, and the wavelength changed about 0–1 pm at a 0.5–80 Hz vibration frequency. The bending path of the optical fiber after integration with clothing is discussed. When the bending radius is equal to or greater than 20 mm, a lower bending loss can be achieved even under the bending and stretching of the human body. The FBG sensor, the optical fiber, and the garment were integrated together using hot melt glue by the electric iron and the hot press machine. Through experiments of monitoring human body temperature, the sensor can reach the human armpit temperature in about 10–15 min with the upper arm close to the torso. Because it is immune to electromagnetic interferences, the smart garment can be used in some special environments such as ultrasonography, magnetic resonance (MR), and aerospace.

Wearable Pressure Sensors for Pulse Wave Monitoring

Cardiovascular diseases remain the leading cause of death worldwide. The rapid development of flexible sensing technologies and wearable pressure sensors have attracted keen research interest and have been widely used for long-term and real-time cardiovascular status monitoring. Owing to compelling characteristics, including light weight, wearing comfort, and high sensitivity to pulse pressures, physiological pulse waveforms can be precisely and continuously monitored by flexible pressure sensors for wearable health monitoring. Herein, an overview of wearable pressure sensors for human pulse wave monitoring is presented, with a focus on the transduction mechanism, microengineering structures, and related applications in pulse wave monitoring and cardiovascular condition assessment. The conceptualizations and methods for the acquisition of physiological and pathological information related to the cardiovascular system are outlined. The biomechanics of arterial pulse waves and the working mechanism of various wearable pressure sensors, including triboelectric, piezoelectric, magnetoelastic, piezoresistive, capacitive, and optical sensors, are also subject to systematic debate. Exemple applications of pulse wave measurement based on microengineering structured devices are then summarized. Finally, a discussion of the opportunities and challenges that wearable pressure sensors face, as well as their potential as a wearable intelligent system for personalized healthcare is given in conclusion.

Deep learning-based method for the continuous detection of heart rate in signals from a multi-fiber Bragg grating sensor compatible with magnetic resonance imaging

A method for the continuous detection of heart rate (HR) in signals acquired from patients using a sensor mat comprising a nine-element array of fiber Bragg gratings during routine magnetic resonance imaging (MRI) procedures is proposed. The method is based on a deep learning neural network model, which learned from signals acquired from 153 MRI patients. In addition, signals from 343 MRI patients were used for result verification. The proposed method provides automatic continuous extraction of HR with the root mean square error of 2.67 bpm, and the limits of agreement were -4.98-5.45 bpm relative to the reference HR.

Monitoring and Synchronization of Cardiac and Respiratory Traces in Magnetic Resonance Imaging: A Review

Synchronization of human vital signs, namely the cardiac cycle and respiratory excursions, is necessary during magnetic resonance imaging of the cardiovascular system and the abdominal cavity to achieve optimal image quality with minimized artifacts. This review summarizes techniques currently available in clinical practice, as well as methods under development, outlines the benefits and disadvantages of each approach, and offers some unique solutions for consideration.

Modification of the mechanical cardiac performance during end-expiratory voluntary apnea recorded with ballistocardiography and seismocardiography

OBJECTIVE

To assess if micro-accelerometers and gyroscopes may provide useful information for the detection of breathing disturbances in further studies.

APPROACH

Forty-three healthy volunteers performed a 10 s end-expiratory breath-hold, while ballistocardiograph (BCG) and seismocardiograph (SCG) determined changes in kinetic energy and its integral over time (iK, J · s). BCG measures overall body accelerations in response to blood mass ejection into the main vasculature at each cardiac cycle, while SCG records local chest wall vibrations generated beat-by-beat by myocardial activity. This minimally intrusive technology assesses linear accelerations and angular velocities in 12 degrees of freedom to calculate iK during the whole cardiac cycle. iK produced during systole and diastole were also computed.

MAIN RESULTS

The iK during normal breathing was 87.1 [63.3; 132.8] µJ · s for the SCG and 4.5 [3.3; 6.2] µJ · s for the BCG. Both increased to 107.1 [69.0; 162.0] µJ · s and 6.1 [4.4; 9.0] µJ · s, respectively, during breath-holding (p   =  0.003 and p   <  0.0001, respectively). The iK of the SCG further increased during spontaneous respiration following apnea (from 107.1 [69.0; 162.0] µJ · s to 160.0 [96.3; 207.3] µJ · s, p   <  0.0001). The ratio between the iK of diastole and systole increased from 0.35 [0.24; 0.45] during apnea to 0.49 [0.31; 0.80] (p   <  0.0001) during the restoration of respiration.

SIGNIFICANCE

A brief voluntary apnea generates large and distinct increases in SCG and BCG waveforms. iK monitoring during sleep may prove useful for the detection of respiratory disturbances. ClinicalTrials.gov number: NCT03760159.

Ballistocardiogram signal processing: a review

Across the world, healthcare costs are projected to continue to increase, and the pressure on the healthcare system is only going to grow in intensity as the rate of growth of elderly population increases in the coming decades. As an example, when people age one possible condition that they may experience is sleep-disordered breathing (SDB). SDB, better known as the obstructive sleep apnea (OSA) syndrome, and associated cardiovascular complications are among the most common clinical disorders. The gold-standard approach to accurately diagnose OSA, is polysomnography (PSG), a test that should be performed in a specialist sleep clinic and requires a complete overnight stay at the clinic. The PSG system can provide accurate and real-time data; however, it introduces several challenges such as complexity, invasiveness, excessive cost, and absence of privacy. Technological advancements in hardware and software enable noninvasive and unobtrusive sensing of vital signs. An alternative approach which may help diagnose OSA and other cardiovascular diseases is the ballistocardiography. The ballistocardiogram (BCG) signal captures the ballistic forces of the heart caused by the sudden ejection of blood into the great vessels with each heartbeat, breathing, and body movement. In recent years, BCG sensors such as polyvinylidene fluoride film-based sensors, electromechanical films, strain Gauges, hydraulic sensors, microbend fiber-optic sensors as well as fiber Bragg grating sensors have been integrated within ambient locations such as mattresses, pillows, chairs, beds, or even weighing scales, to capture BCG signals, and thereby measure vital signs. Analysis of the BCG signal is a challenging process, despite being a more convenient and comfortable method of vital signs monitoring. In practice, BCG sensors are placed under bed mattresses for sleep tracking, and hence several factors, e.g., mattress thickness, body movements, motion artifacts, bed-partners, etc. can deteriorate the signal. In this paper, we introduce the sensors that are being used for obtaining BCG signals. We also present an in-depth review of the signal processing methods as applied to the various sensors, to analyze the BCG signal and extract physiological parameters such heart rate and breathing rate, as well as determining sleep stages. Besides, we recommend which methods are more suitable for processing BCG signals due to their nonlinear and nonstationary characteristics.

Highly Sensitive and Durable Structured Fibre Sensors for Low-Pressure Measurement in Smart Skin

Precise measurements of low pressure are highly necessary for many applications. This study developed novel structured fibre sensors embedded in silicone, forming smart skin with high sensitivity, high durability, and good immunity to crosstalk for precise measurement of pressure below 10 kPa. The transduction principle is that an applied pressure leads to bending and stretching of silicone and optical fibre over a purposely made groove and induces the axial strain in the gratings. The fabricated sensor showed high pressure sensitivity up to 26.8 pm/kPa and experienced over 1,000,000 cycles compression without obvious variation. A theoretical model of the sensor was presented and verified to have excellent agreement with experimental results. The prototype of smart leg mannequin and wrist pulse measurements indicated that such optical sensors can precisely measure low-pressure and can easily be integrated for smart skins for mapping low pressure on three-dimensional surfaces.

Fiber-Optic Breath Sensors: A Comparison Study

The paper presents a comparative study of three fiber optic sensors based on the fiber Bragg grating (FBG). The basic monitored parameter is the respiratory rate of the human body. Fiber-optic sensors are immune to electromagnetic interference (EMI). This fact singles them out as ideal for use in magnetic resonance environments (typically in MRI - magnetic resonance imaging) as a prediction of hyperventilation states in patients. These patient conditions arise as a result of the closed tunnel environment in MR scanners. The results (10 volunteers with written consent) were compared with the results using the conventional respiratory belt (RB) in a laboratory environment and processed using the objective Bland-Altman (B-A) method.

Vital Sign Monitoring and Cardiac Triggering at 1.5 Tesla: A Practical Solution by an MR-Ballistocardiography Fiber-Optic Sensor

This article presents a solution for continuous monitoring of both respiratory rate (RR) and heart rate (HR) inside Magnetic Resonance Imaging (MRI) environments by a novel ballistocardiography (BCG) fiber-optic sensor. We designed and created a sensor based on the Fiber Bragg Grating (FBG) probe encapsulated inside fiberglass (fiberglass is a composite material made up of glass fiber, fabric, and cured synthetic resin). Due to this, the encapsulation sensor is characterized by very small dimensions (30 × 10 × 0.8 mm) and low weight (2 g). We present original results of real MRI measurements (conventionally most used 1.5 T MR scanner) involving ten volunteers (six men and four women) by performing conventional electrocardiography (ECG) to measure the HR and using a Pneumatic Respiratory Transducer (PRT) for RR monitoring. The acquired sensor data were compared against real measurements using the objective Bland⁻Altman method, and the functionality of the sensor was validated (95.36% of the sensed values were within the ±1.96 SD range for the RR determination and 95.13% of the values were within the ±1.96 SD range for the HR determination) by this means. The accuracy of this sensor was further characterized by a relative error below 5% (4.64% for RR and 4.87% for HR measurements). The tests carried out in an MRI environment demonstrated that the presence of the FBG sensor in the MRI scanner does not affect the quality of this imaging modality. The results also confirmed the possibility of using the sensor for cardiac triggering at 1.5 T (for synchronization and gating of cardiovascular magnetic resonance) and for cardiac triggering when a Diffusion Weighted Imaging (DWI) is used.

Augmentation of sensitivity of FBG strain sensor for biomedical operation

The performance of a highly sensitive strain sensor based on nonlinear four wave mixing (FWM) using two uniform fiber Bragg gratings (FBGs) is investigated. Strain is measured by the proposed setup with high resolution and precision. It is observed that the wavelength shift induced by very small strain over the FBG is significantly magnified by the higher-order FWM process. The sensitivity is enhanced by a factor of nine based on a wavelength shift of the eighth-order FWM product. Strain sensitivity of 11.23 pm/μϵ is achieved against initial strain sensitivity of 1.23 pm/μϵ. The proposed scheme can provide a strain measurement range of about 3500 μϵ. Application of the proposed setup in the cardiac and respiratory systems is also studied, and the results are found to be reliable and accurate, even if the applied strain on the FBG is of the order of 0.1 μϵ.

A Phonocardiographic-Based Fiber-Optic Sensor and Adaptive Filtering System for Noninvasive Continuous Fetal Heart Rate Monitoring

This paper focuses on the design, realization, and verification of a novel phonocardiographic- based fiber-optic sensor and adaptive signal processing system for noninvasive continuous fetal heart rate (fHR) monitoring. Our proposed system utilizes two Mach-Zehnder interferometeric sensors. Based on the analysis of real measurement data, we developed a simplified dynamic model for the generation and distribution of heart sounds throughout the human body. Building on this signal model, we then designed, implemented, and verified our adaptive signal processing system by implementing two stochastic gradient-based algorithms: the Least Mean Square Algorithm (LMS), and the Normalized Least Mean Square (NLMS) Algorithm. With this system we were able to extract the fHR information from high quality fetal phonocardiograms (fPCGs), filtered from abdominal maternal phonocardiograms (mPCGs) by performing fPCG signal peak detection. Common signal processing methods such as linear filtering, signal subtraction, and others could not be used for this purpose as fPCG and mPCG signals share overlapping frequency spectra. The performance of the adaptive system was evaluated by using both qualitative (gynecological studies) and quantitative measures such as: Signal-to-Noise Ratio—SNR, Root Mean Square Error—RMSE, Sensitivity—S+, and Positive Predictive Value—PPV.

Fiber bragg grating sensor based device for simultaneous measurement of respiratory and cardiac activities

This paper reports a novel optical ballistocardiography technique, which is non-invasive, for the simultaneous measurement of cardiac and respiratory activities using a Fiber Bragg Grating Heart Beat Device (FBGHBD). The unique design of FBGHBD offers additional capabilities such as monitoring nascent morphology of cardiac and breathing activity, heart rate variability, heart beat rhythm, etc., which can assist in early clinical diagnosis of many conditions associated with heart and lung malfunctioning. The results obtained from the FBGHBD positioned around the pulmonic area on the chest have been evaluated against an electronic stethoscope which detects and records sound pulses originated from the cardiac activity. In order to evaluate the performance of the FBGHBD, quantitative and qualitative studies have been carried out and the results are found to be reliable and accurate, validating its potential as a standalone medical diagnostic device. The developed FBGHBD is simple in design, robust, portable, EMI proof, shock proof and non-electric in its operation which are desired features for any clinical diagnostic tool used in hospital environment.

A Non-Invasive Multichannel Hybrid Fiber-Optic Sensor System for Vital Sign Monitoring

In this article, we briefly describe the design, construction, and functional verification of a hybrid multichannel fiber-optic sensor system for basic vital sign monitoring. This sensor uses a novel non-invasive measurement probe based on the fiber Bragg grating (FBG). The probe is composed of two FBGs encapsulated inside a polydimethylsiloxane polymer (PDMS). The PDMS is non-reactive to human skin and resistant to electromagnetic waves, UV absorption, and radiation. We emphasize the construction of the probe to be specifically used for basic vital sign monitoring such as body temperature, respiratory rate and heart rate. The proposed sensor system can continuously process incoming signals from up to 128 individuals. We first present the overall design of this novel multichannel sensor and then elaborate on how it has the potential to simplify vital sign monitoring and consequently improve the comfort level of patients in long-term health care facilities, hospitals and clinics. The reference ECG signal was acquired with the use of standard gel electrodes fixed to the monitored person’s chest using a real-time monitoring system for ECG signals with virtual instrumentation. The outcomes of these experiments have unambiguously proved the functionality of the sensor system and will be used to inform our future research in this fast developing and emerging field.

Ballistocardiographic Artifacts in PPG Imaging

OBJECTIVE

Photoplethysmography (PPG) is a noninvasive technique to measure the blood-volume pulse and derive various vital signs. Camera-based PPG imaging was recently proposed for clinical microvascular assessment, but motion robustness is still an issue for this technique. Our study aims to quantify cardiac-related, i.e., ballistocardiographic (BCG), motion as a source of artifacts in PPG imaging.

METHODS

In this paper, using the human head as a relevant region of interest, the amplitude of BCG-artifacts was modeled for a Lambertian surface illuminated by a light source. To derive peak-to-peak head displacements for the model, we recorded, on 54 subjects, PPG and inertial sensor data at the pulse and cranial vertex. We simulated the effect of light source location at a mesh representation of a human face and conducted additional experiments on a real subject.

RESULTS

Under nonorthogonal illumination, the relative strength of the BCG artifacts is strong enough, compared to the amplitude of PPG signals, to compromise PPG imaging in realistic scenarios. Particularly affected are the signals obtained in the nongreen part of the spectrum and/or when the incident angle at the skin surface exceeds 45 (°).

CONCLUSION

From the model and an additional experiment conducted on real skin, we were able to prove that homogenous and orthogonal illumination is a means to minimize the problem.

SIGNIFICANCE

Our illumination recommendation provides a simple and effective means to improve the validity of remote PPG-imagers. We hope that it helps to prevent mistakes currently seen in many publications on remote PPG.

Quantifying and Reducing Posture-Dependent Distortion in Ballistocardiogram Measurements

Ballistocardiography is a noninvasive measurement of the mechanical movement of the body caused by cardiac ejection of blood. Recent studies have demonstrated that ballistocardiogram (BCG) signals can be measured using a modified home weighing scale and used to track changes in myocardial contractility and cardiac output. With this approach, the BCG can potentially be used both for preventive screening and for chronic disease management applications. However, for achieving high signal quality, subjects are required to stand still on the scale in an upright position for the measurement; the effects of intentional (for user comfort) or unintentional (due to user error) modifications in the position or posture of the subject during the measurement have not been investigated in the existing literature. In this study, we quantified the effects of different standing and seated postures on the measured BCG signals, and on the most salient BCG-derived features compared to reference standard measurements (e.g., impedance cardiography). We determined that the standing upright posture led to the least distorted signals as hypothesized, and that the correlation between BCG-derived timing interval features (R-J interval) and the preejection period, PEP (measured using ICG), decreased significantly with impaired posture or sitting position. We further implemented two novel approaches to improve the PEP estimates from other standing and sitting postures, using system identification and improved J-wave detection methods. These approaches can improve the usability of standing BCG measurements in unsupervised settings (i.e., the home), by improving the robustness to nonideal posture, as well as enabling high-quality seated BCG measurements.

A method of detecting heartbeat locations in the ballistocardiographic signal from the fiber-optic vital signs sensor

We present a flexible, easy-to-expand digital signal processing method for detecting heart rate (HR) for cardiac vibration signals of fiber Bragg grating (FBG) sensor. The FBG-based method of measuring HR is possible to use during the magnetic resonance imaging procedure, which is its unique advantage. Our goal was to design a detection method with plurality of parameters and to subject these parameters to genetic algorithm optimization technique. In effect, we arrived at a method that is well able to deal with much distorted signals with low SNR. We proved that the method we developed allows automatic adjustment to the shape of the waves of signal carrying useful information about the moments of heartbeat. Thus, we can easily adapt our technique to the analysis of signals, which contains information on HR, from sensors employing different techniques of strain detection. The proposed method has the capabilities of analyzing signals in semi-real-time (online) with beat-to-beat resolution, significantly low delay, and negligible computational power requirements. We verified our method on recordings in a group of seven subjects. Verification included over 6000 heartbeats (82 min 47 s of recordings). The root-mean-square error of our method does not exceed 6.0 bpm.