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Masè M, Micarelli A, Strapazzon G. Hearables: New Perspectives and Pitfalls of In-Ear Devices for Physiological Monitoring. A Scoping Review. Front Physiol 2020; 11:568886. [PMID: 33178038 PMCID: PMC7596679 DOI: 10.3389/fphys.2020.568886] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 09/02/2020] [Indexed: 12/31/2022] Open
Abstract
Technological advancements are opening the possibility of prolonged monitoring of physiological parameters under daily-life conditions, with potential applications in sport science and medicine, and in extreme environments. Among emerging wearable technologies, in-ear devices or hearables possess technical advantages for long-term monitoring, such as non-invasivity, unobtrusivity, good fixing, and reduced motion artifacts, as well as physiological advantages related to the proximity of the ear to the body trunk and the shared vasculature between the ear and the brain. The present scoping review was aimed at identifying and synthesizing the available evidence on the use and performance of in-ear monitoring of physiological parameters, with focus on applications in sport science, sport medicine, occupational medicine, and extreme environment settings. Pubmed, Scopus, and Web of Science electronic databases were systematically searched to identify studies conducted in the last 10 years and addressing the measurement of three main physiological parameters (temperature, heart rate, and oxygen saturation) in healthy subjects. Thirty-nine studies were identified, 24 performing temperature measurement, 12 studies on heart/pulse rate, and three studies on oxygen saturation. The collected evidence supports the premise of in-ear sensors as an innovative and unobtrusive way for physiological monitoring during daily-life and physical activity, but further research and technological advancement are necessary to ameliorate measurement accuracy especially in more challenging scenarios.
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Affiliation(s)
- Michela Masè
- Institute of Mountain Emergency Medicine, Eurac Research, Bolzano, Italy.,Healthcare Research and Innovation Program, IRCS-HTA, Bruno Kessler Foundation, Trento, Italy
| | - Alessandro Micarelli
- Institute of Mountain Emergency Medicine, Eurac Research, Bolzano, Italy.,ITER Center for Balance and Rehabilitation Research (ICBRR), Rome, Italy
| | - Giacomo Strapazzon
- Institute of Mountain Emergency Medicine, Eurac Research, Bolzano, Italy
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Eggenberger P, MacRae BA, Kemp S, Bürgisser M, Rossi RM, Annaheim S. Prediction of Core Body Temperature Based on Skin Temperature, Heat Flux, and Heart Rate Under Different Exercise and Clothing Conditions in the Heat in Young Adult Males. Front Physiol 2018; 9:1780. [PMID: 30618795 PMCID: PMC6295644 DOI: 10.3389/fphys.2018.01780] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Accepted: 11/26/2018] [Indexed: 12/12/2022] Open
Abstract
Non-invasive, multi-parameter methods to estimate core body temperature offer several advantages for monitoring thermal strain, although further work is required to identify the most relevant predictor measures. This study aimed to compare the validity of an existing and two novel multi-parameter rectal temperature prediction models. Thirteen healthy male participants (age 30.9 ± 5.4 years) performed two experimental sessions. The experimental procedure comprised 15 min baseline seated rest (23.2 ± 0.3°C, 24.5 ± 1.6% relative humidity), followed by 15 min seated rest and cycling in a climatic chamber (35.4 ± 0.2°C, 56.5 ± 3.9% relative humidity; to +1.5°C or maximally 38.5°C rectal temperature, duration 20-60 min), with a final 30 min seated rest outside the chamber. In session 1, participants exercised at 75% of their heart rate maximum (HR max) and wore light athletic clothing (t-shirt and shorts), while in session 2, participants exercised at 50% HR max, wearing protective firefighter clothing (jacket and trousers). The first new prediction model, comprising the input of 18 non-invasive measures, i.e., insulated and non-insulated skin temperature, heat flux, and heart rate ("Max-Input Model", standard error of the estimate [SEE] = 0.28°C, R2 = 0.70), did not exceed the predictive power of a previously reported model which included six measures and no insulated skin temperatures (SEE = 0.28°C, R2 = 0.71). Moreover, a second new prediction model that contained only the two most relevant parameters (heart rate and insulated skin temperature at the scapula) performed similarly ("Min-Input Model", SEE = 0.29, R2 = 0.68). In conclusion, the "Min-Input Model" provided comparable validity and superior practicality (only two measurement parameters) for estimating rectal temperature versus two other models requiring six or more input measures.
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Affiliation(s)
- Patrick Eggenberger
- Empa, Swiss Federal Laboratories for Materials Science and Technology, Laboratory for Biomimetic Membranes and Textiles, St. Gallen, Switzerland
| | - Braid A. MacRae
- Empa, Swiss Federal Laboratories for Materials Science and Technology, Laboratory for Biomimetic Membranes and Textiles, St. Gallen, Switzerland
- Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
| | - Shelley Kemp
- Empa, Swiss Federal Laboratories for Materials Science and Technology, Laboratory for Biomimetic Membranes and Textiles, St. Gallen, Switzerland
| | - Michael Bürgisser
- Empa, Swiss Federal Laboratories for Materials Science and Technology, Laboratory for Biomimetic Membranes and Textiles, St. Gallen, Switzerland
- Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
| | - René M. Rossi
- Empa, Swiss Federal Laboratories for Materials Science and Technology, Laboratory for Biomimetic Membranes and Textiles, St. Gallen, Switzerland
| | - Simon Annaheim
- Empa, Swiss Federal Laboratories for Materials Science and Technology, Laboratory for Biomimetic Membranes and Textiles, St. Gallen, Switzerland
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Poveda VDB, Nascimento ADS. Intraoperative body temperature control: esophageal thermometer versus infrared tympanic thermometer. Rev Esc Enferm USP 2016; 50:946-952. [DOI: 10.1590/s0080-623420160000700010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Accepted: 09/23/2016] [Indexed: 09/19/2023] Open
Abstract
Abstract OBJECTIVE To verify the correlation between temperature measurements performed using an infrared tympanic thermometer and an esophageal thermometer during the intraoperative period. METHOD A longitudinal study of repeated measures was performed including subjects aged 18 years or older undergoing elective oncologic surgery of the digestive system, with anesthesia duration of at least 1 hour. Temperature measurements were performed simultaneously by a calibrated esophageal thermometer and by a calibrated infrared tympanic thermometer, with laboratory reading precision of ±0.2ºC. The operating room temperature remained between 19 and 21ºC. RESULTS The study included 51 patients, mostly men (51%), white (80.4%). All patients were kept warm by a forced-air heating system, for an average of 264.14 minutes (SD = 87.7). The two temperature measurements showed no different behavior over time (p = 0.2205), however, tympanic measurements were consistently 1.24°C lower (p<0.0001). CONCLUSION The tympanic thermometer presented reliable results but reflected lower temperatures than the esophageal thermometer.
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Lloyd A, Hodder S, Havenith G. The interaction between peripheral and central fatigue at different muscle temperatures during sustained isometric contractions. Am J Physiol Regul Integr Comp Physiol 2015; 309:R410-20. [PMID: 26041110 DOI: 10.1152/ajpregu.00061.2015] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2015] [Accepted: 06/02/2015] [Indexed: 01/13/2023]
Abstract
Changes in central fatigue have been linked to active and passive changes in core temperature, as well as integration of sensory feedback from thermoreceptors in the skin. However, the effects of muscle temperature (Tm), and thereby metaboreceptor and local afferent nerve temperature, on central fatigue (measured using voluntary activation percentage) during sustained, high muscle fatigue exercise remain unexamined. In this study, we investigated Tm across the range of cold to hot, and its effect on voluntary activation percentage during sustained isometric contractions of the knee extensors. The results suggest that contrary to brief contractions, during a sustained fatiguing contraction Tm significantly (P < 0.001) influences force output (-0.7%/°C increase) and central fatigue (-0.5%/°C increase), showing a negative relationship across the Tm continuum in moderately trained individuals. The negative relationship between voluntary activation percentage and Tm indicates muscle temperature may influence central fatigue during sustained and high muscle fatigue exercise. On the basis of on an integrative analysis between the present data and previous literature, the impact of core and muscle temperature on voluntary muscle activation is estimated to show a ratio of 5.5 to 1, respectively. Accordingly, Tm could assume a secondary or tertiary role in the reduction of voluntary muscle activation when body temperature leaves a thermoneutral range.
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Affiliation(s)
- Alex Lloyd
- Environmental Ergonomics Research Centre, Loughborough University, Loughborough, United Kingdom
| | - Simon Hodder
- Environmental Ergonomics Research Centre, Loughborough University, Loughborough, United Kingdom
| | - George Havenith
- Environmental Ergonomics Research Centre, Loughborough University, Loughborough, United Kingdom
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Niedermann R, Psikuta A, Rossi RM. Heat flux measurements for use in physiological and clothing research. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2014; 58:1069-1075. [PMID: 23824222 DOI: 10.1007/s00484-013-0697-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2012] [Revised: 03/22/2013] [Accepted: 06/11/2013] [Indexed: 06/02/2023]
Abstract
Scientists use passive heat flow meters to measure body heat exchanges with the environment. In recent years, several such sensors have been developed and concerns about their proper calibration have been addressed. However, calibration methods have differed in the geometry of the heated device as well as in the heat transfer mechanism. Therefore, a comparison of calibration methods is needed in order to understand the obtained differences in calibration lines. We chose three commercially available heat flux sensors and placed them on four different heated devices: a hot plate, double hot plate, nude cylinder and a cylinder covered with a spacer material. We found differences between the calibration line of the manufacturer and our own measurements, especially when forced convection was involved as the main heat transfer mechanism. The results showed clearly that the calibration method should be chosen according to the intended purpose of use. In addition, we recommend use a thin, light heat flux sensor with good thermal conduction in human subject studies.
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Affiliation(s)
- R Niedermann
- Laboratory for Protection and Physiology, Swiss Federal Laboratories for Materials Science and Technology (EMPA), Lerchenfeldstrasse 5, 9014, St. Gallen, Switzerland
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Niedermann R, Wyss E, Annaheim S, Psikuta A, Davey S, Rossi RM. Prediction of human core body temperature using non-invasive measurement methods. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2014; 58:7-15. [PMID: 23760405 DOI: 10.1007/s00484-013-0687-2] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2012] [Revised: 11/30/2012] [Accepted: 12/03/2012] [Indexed: 05/08/2023]
Abstract
The measurement of core body temperature is an efficient method for monitoring heat stress amongst workers in hot conditions. However, invasive measurement of core body temperature (e.g. rectal, intestinal, oesophageal temperature) is impractical for such applications. Therefore, the aim of this study was to define relevant non-invasive measures to predict core body temperature under various conditions. We conducted two human subject studies with different experimental protocols, different environmental temperatures (10 °C, 30 °C) and different subjects. In both studies the same non-invasive measurement methods (skin temperature, skin heat flux, heart rate) were applied. A principle component analysis was conducted to extract independent factors, which were then used in a linear regression model. We identified six parameters (three skin temperatures, two skin heat fluxes and heart rate), which were included for the calculation of two factors. The predictive value of these factors for core body temperature was evaluated by a multiple regression analysis. The calculated root mean square deviation (rmsd) was in the range from 0.28 °C to 0.34 °C for all environmental conditions. These errors are similar to previous models using non-invasive measures to predict core body temperature. The results from this study illustrate that multiple physiological parameters (e.g. skin temperature and skin heat fluxes) are needed to predict core body temperature. In addition, the physiological measurements chosen in this study and the algorithm defined in this work are potentially applicable as real-time core body temperature monitoring to assess health risk in broad range of working conditions.
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Affiliation(s)
- Reto Niedermann
- Laboratory for Protection and Physiology, EMPA, Swiss Federal Laboratories for Materials Science and Technology, Lerchenfeldstrasse 5, 9014, St. Gallen, Switzerland
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Sinclair WH, Brownsberger JC. Wearing long pants while working outdoors in the tropics does not yield higher body temperatures. Aust N Z J Public Health 2013; 37:70-5. [PMID: 23379809 DOI: 10.1111/1753-6405.12013] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE To compare the thermoregulatory demands of outdoor workers wearing long or knee-length pants while working in situ in a tropical environment. METHODS Fifteen male (35.8 ± 10.5 yr) outdoor Council workers completed their daily occupational duties (construction or gardening) in trials conducted six days apart: once wearing knee-length shorts (SHORTS) and once wearing full-length pants (PANTS). Body mass and hydration were assessed prior to and following each trial with core body (T(C) ) and mean skin temperature (MST; weighted from sites: chest, arm, thigh and calf) assessed at 30-minute intervals throughout each trial. RESULTS No significant differences between SHORTS and PANTS for T(C) , maximum T(C) , heart rate, MST or body mass changes. Skin temperature at the calf was greater for PANTS (33.8 ± 0.4°C) compared to SHORTS (32.9 ± 0.4°C; p<0.05). Hydration assessments identified 36.7% of participants commenced work hypohydrated while the average body mass lost throughout the workday was 2.5 ± 1.5%. Main effects of time were observed for heart rate and MST but no other assessed variable. CONCLUSION The additional exposed surface area available for heat exchange when wearing shorts is insufficient to elicit differences in thermoregulatory demands of outdoor employees under the assessed conditions. IMPLICATIONS These results suggest the use of SHORTS or PANTS can be determined by occupational duty requirements rather than risk of heat-related illness during very-light to moderate workloads completed under warm and humid environmental conditions.
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Affiliation(s)
- Wade H Sinclair
- Institute of Sport and Exercise Science, James Cook University, Queensland.
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