An optical fibre-based sensor for respiratory monitoring

A numerical analysis of ventilation motion after chest surgery with a RESPIRholter device

This case report presents a numerical evaluation of respiration in terms of biomechanical parameters of chest motion. This experimental evaluation is performed with RESPIRholter, a wearable device specifically developed to monitor the movement in the ribcage through the motion of the sixth rib whose characteristic motion is considered as representative of the motion of the thorax. Here we present test results acquired with a RESPIRholter device in a 6-h acquisition. These results characterize respiration biomechanics for diagnostic purposes in a chest surgery patient, highlighting the diagnostic utility of RESPIRholter in the identification of post-operation respiratory problem.

Advances in Respiratory Monitoring: A Comprehensive Review of Wearable and Remote Technologies

This article explores the importance of wearable and remote technologies in healthcare. The focus highlights its potential in continuous monitoring, examines the specificity of the issue, and offers a view of proactive healthcare. Our research describes a wide range of device types and scientific methodologies, starting from traditional chest belts to their modern alternatives and cutting-edge bioamplifiers that distinguish breathing from chest impedance variations. We also investigated innovative technologies such as the monitoring of thorax micromovements based on the principles of seismocardiography, ballistocardiography, remote camera recordings, deployment of integrated optical fibers, or extraction of respiration from cardiovascular variables. Our review is extended to include acoustic methods and breath and blood gas analysis, providing a comprehensive overview of different approaches to respiratory monitoring. The topic of monitoring respiration with wearable and remote electronics is currently the center of attention of researchers, which is also reflected by the growing number of publications. In our manuscript, we offer an overview of the most interesting ones.

Wearable Optical Fiber Sensors in Medical Monitoring Applications: A Review

Wearable optical fiber sensors have great potential for development in medical monitoring. With the increasing demand for compactness, comfort, accuracy, and other features in new medical monitoring devices, the development of wearable optical fiber sensors is increasingly meeting these requirements. This paper reviews the latest evolution of wearable optical fiber sensors in the medical field. Three types of wearable optical fiber sensors are analyzed: wearable optical fiber sensors based on Fiber Bragg grating, wearable optical fiber sensors based on light intensity changes, and wearable optical fiber sensors based on Fabry-Perot interferometry. The innovation of wearable optical fiber sensors in respiration and joint monitoring is introduced in detail, and the main principles of three kinds of wearable optical fiber sensors are summarized. In addition, we discuss their advantages, limitations, directions to improve accuracy and the challenges they face. We also look forward to future development prospects, such as the combination of wireless networks which will change how medical services are provided. Wearable optical fiber sensors offer a viable technology for prospective continuous medical surveillance and will change future medical benefits.

A Low-Cost Flexible Perforated Respiratory Sensor Based on Platinum for Continuous Respiratory Monitoring

Monitoring sleep conditions is of importance for sleep quality evaluation and sleep disease diagnosis. Accurate respiration detection provides key information about sleep conditions. Here, we propose a perforated temperature sensor that can be worn below the nasal cavity to monitor breath. The sensing system consists of two perforated temperature sensors, signal conditioning circuits, a transmission module, and a supporting analysis algorithm. The perforated structure effectively enhances the sensitivity of the system and shortens the response time. The sensor's response time is 0.07 s in air and sensitivity is 1.4‱°C^-1. The device can achieve a monitoring respiratory temperature range between normal room temperature and 40 °C. The simple and standard micromachining process ensures low cost and high reproducibility. We achieved the monitoring of different breathing patterns, such as normal breathing, panting, and apnea, which can be applied to sleep breath monitoring and exercise information recording.

Multimode optical fiber specklegram smart bed sensor array

SIGNIFICANCE

Monitoring the movement and vital signs of patients in hospitals and other healthcare environments is a significant burden on healthcare staff. Early warning systems using smart bed sensors hold promise to relieve this burden and improve patient outcomes. We propose a scalable and cost-effective optical fiber sensor array that can be embedded into a mattress to detect movement, both sensitively and spatially.

AIM

Proof-of-concept demonstration that a multimode optical fiber (MMF) specklegram sensor array can be used to detect and image movement on a bed.

APPROACH

Seven MMFs are attached to the upper surface of a mattress such that they cross in a 3  ×  4 array. The specklegram output is monitored using a single laser and single camera and movement on the fibers is monitored by calculating a rolling zero-normalized cross-correlation. A 3  ×  4 image is formed by comparing the signal at each crossing point between two fibers.

RESULTS

The MMF sensor array can detect and image movement on a bed, including getting on and off the bed, rolling on the bed, and breathing.

CONCLUSIONS

The sensor array shows a high sensitivity to movement, which can be used for monitoring physiological parameters and patient movement for potential applications in healthcare settings.

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.

The Current State of Optical Sensors in Medical Wearables

Optical sensors play an increasingly important role in the development of medical diagnostic devices. They can be very widely used to measure the physiology of the human body. Optical methods include PPG, radiation, biochemical, and optical fiber sensors. Optical sensors offer excellent metrological properties, immunity to electromagnetic interference, electrical safety, simple miniaturization, the ability to capture volumes of nanometers, and non-invasive examination. In addition, they are cheap and resistant to water and corrosion. The use of optical sensors can bring better methods of continuous diagnostics in the comfort of the home and the development of telemedicine in the 21st century. This article offers a large overview of optical wearable methods and their modern use with an insight into the future years of technology in this field.

AI-enabled photonic smart garment for movement analysis

Smart textiles are novel solutions for remote healthcare monitoring which involve non-invasive sensors-integrated clothing. Polymer optical fiber (POF) sensors have attractive features for smart textile technology, and combined with Artificial Intelligence (AI) algorithms increase the potential of intelligent decision-making. This paper presents the development of a fully portable photonic smart garment with 30 multiplexed POF sensors combined with AI algorithms to evaluate the system ability on the activity classification of multiple subjects. Six daily activities are evaluated: standing, sitting, squatting, up-and-down arms, walking and running. A k-nearest neighbors classifier is employed and results from 10 trials of all volunteers presented an accuracy of 94.00 (0.14)%. To achieve an optimal amount of sensors, the principal component analysis is used for one volunteer and results showed an accuracy of 98.14 (0.31)% using 10 sensors, 1.82% lower than using 30 sensors. Cadence and breathing rate were estimated and compared to the data from an inertial measurement unit located on the garment back and the highest error was 2.22%. Shoulder flexion/extension was also evaluated. The proposed approach presented feasibility for activity recognition and movement-related parameters extraction, leading to a system fully optimized, including the number of sensors and wireless communication, for Healthcare 4.0.

An Analysis of Respiration with the Smart Sensor SENSIRIB in Patients Undergoing Thoracic Surgery

The paper examines the problem of respiration monitoring with easily wearable instrumentation by using a smart device that is properly designed and implemented with small and light components. The practical implementation is presented both in practical aspects and from experimental results by following a properly defined method with a medical-like protocol and specific procedure of testing. The results of a statistically significant campaign of experimental tests are reported with the characteristic data from the angles and acceleration components of a sensed rib both to validate the smart device and the procedure for respiration monitoring.

Respiratory fabric sensor based on the side luminescence and photosensitivity mechanism of polymer optical fibers

It is significant to monitor respiration conveniently and in real time for people suffering from respiratory diseases. Polymer optical fibers (POFs) have the advantages of flexibility and light weight, which is highly desirable for wearable respiratory monitoring. However, in most current applications, the POFs are stitched on the textile substrates in the form of macro-bending. This method is complex to fix the bending with certain curvatures and uncomfortable compared with the POF sensors woven into the textile. In this paper, a respiratory fabric sensor based on the side luminescence and photosensitivity mechanism of POF is proposed and demonstrated. The 750µm-diameter POFs were woven into a fabric as warp and laser marking was performed at their designed positions to make them release or couple light. The spacing change between the POFs caused by the respiratory movement accordingly makes the light intensity change in the photosensitive fiber. We chose four fabric widths (10cm, 8cm, 6cm and 4cm) and four fabric weaves (plain weave, honeycomb weave, 1/3 right twill weave and 8/3 warp satin weave) to implement the full-factor experiment for exploring the measurement effect of the respiratory fabric sensor. The result is that the fabric with width of 4cm and weave of 8/3 warp satin is optimal. The calm and deep respiratory tests of the human chest and abdomen in sitting and standing posture were carried out and the test performance of the fabric sensor is almost comparable to that of the medical monitor. The proposed respiratory fabric sensor is comfortable, easily woven and high in precision, which is expected to realize industrialized scale production.

A Comprehensive Review on the Optical Micro-Electromechanical Sensors for the Biomedical Application

This study presented an overview of current developments in optical micro-electromechanical systems in biomedical applications. Optical micro-electromechanical system (MEMS) is a particular class of MEMS technology. It combines micro-optics, mechanical elements, and electronics, called the micro-opto electromechanical system (MOEMS). Optical MEMS comprises sensing and influencing optical signals on micron-level by incorporating mechanical, electrical, and optical systems. Optical MEMS devices are widely used in inertial navigation, accelerometers, gyroscope application, and many industrial and biomedical applications. Due to its miniaturised size, insensitivity to electromagnetic interference, affordability, and lightweight characteristic, it can be easily integrated into the human body with a suitable design. This study presented a comprehensive review of 140 research articles published on photonic MEMS in biomedical applications that used the qualitative method to find the recent advancement, challenges, and issues. The paper also identified the critical success factors applied to design the optimum photonic MEMS devices in biomedical applications. With the systematic literature review approach, the results showed that the key design factors could significantly impact design, application, and future scope of work. The literature of this paper suggested that due to the flexibility, accuracy, design factors efficiency of the Fibre Bragg Grating (FBG) sensors, the demand has been increasing for various photonic devices. Except for FBG sensing devices, other sensing systems such as optical ring resonator, Mach-Zehnder interferometer (MZI), and photonic crystals are used, which still show experimental stages in the application of biosensing. Due to the requirement of sophisticated fabrication facilities and integrated systems, it is a tough choice to consider the other photonic system. Miniaturisation of complete FBG device for biomedical applications is the future scope of work. Even though there is a lot of experimental work considered with an FBG sensing system, commercialisation of the final FBG device for a specific application has not been seen noticeable progress in the past.

An Overview of Wearable Piezoresistive and Inertial Sensors for Respiration Rate Monitoring

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.

Verification of the Propagation Range of Respiratory Strain Using Signal Waveform Measured by FBG Sensors

The FBG (Fiber Bragg grating) sensor is an optical fiber type strain sensor. When a person breathes, strain occurs in the lungs and diaphragm. This was verified using an FBG sensor to which part of the living body this respiratory strain propagates. When measured in the abdomen, the signal waveforms were significantly different between breathing and apnea. The respiratory cycle measured by the temperature sensor attached to the mask and the strain cycle measured by the FBG sensor almost matched. Respiratory strain was measured in the abdomen, chest, and shoulder, and the signal amplitude decreased with distance from the abdomen. In addition, the respiratory rate could be calculated from the measured strain signal. On the other hand, respiratory strain did not propagate to the elbows and wrists, which were off the trunk, and the respiratory time, based on the signal period, could not be calculated at these parts. Therefore, it was shown that respiratory strain propagated in the trunk from the abdomen to the shoulder, but not in the peripheral parts of the elbow and wrist.

Domiciliary Hospitalization through Wearable Biomonitoring Patches: Recent Advances, Technical Challenges, and the Relation to Covid-19

This article reviews recent advances and existing challenges for the application of wearable bioelectronics for patient monitoring and domiciliary hospitalization. More specifically, we focus on technical challenges and solutions for the implementation of wearable and conformal bioelectronics for long-term patient biomonitoring and discuss their application on the Internet of medical things (IoMT). We first discuss the general architecture of IoMT systems for domiciliary hospitalization and the three layers of the system, including the sensing, communication, and application layers. In regard to the sensing layer, we focus on current trends, recent advances, and challenges in the implementation of stretchable patches. This includes fabrication strategies and solutions for energy storage and energy harvesting, such as printed batteries and supercapacitors. As a case study, we discuss the application of IoMT for domiciliary hospitalization of COVID 19 patients. This can be used as a strategy to reduce the pressure on the healthcare system, as it allows continuous patient monitoring and reduced physical presence in the hospital, and at the same time enables the collection of large data for posterior analysis. Finally, based on the previous works in the field, we recommend a conceptual IoMT design for wearable monitoring of COVID 19 patients.

Textile-integrated polymer optical fibers for healthcare and medical applications

With ever growing interest in far-reaching solutions for pervasive healthcare and medicine, polymer optical fibers have been rendered into textile forms. Having both fiber-optic functionalities and traditional fabric-like comfort, textile-integrated polymer optical fibers have been advocated to remove the technical barriers for long-term uninterrupted health monitoring and treatment. In this context, this paper spotlights and reviews the recently developed textile-integrated polymer optical fibers in conjunction with fabrication techniques, applications in long-term continuous health monitoring and treatment, and future perspectives in the vision of mobile health (mHealth), as well as the introductory basics of polymer optical fibers. It is designed to serve as a topical guidepost for scientists and engineers on this highly interdisciplinary and rapidly growing topic.

Machine-learning enabled wireless wearable sensors to study individuality of respiratory behaviors

Respiratory behaviors provide useful measures of lung health. The current methods have limited capabilities of continuous characterization of respiratory behaviors, often required to assess respiratory disorders and diseases. This work presents a system equipped with a machine learning algorithm, capable of continuously monitoring respiratory behaviors. The system, consisting of two wireless wearable sensors, accurately extracts and classifies the features of respiratory behaviors of subjects within various postures, wirelessly transmitting the temporal respiratory behaviors to a laptop. The sensors were attached on the midway of the xiphoid process and the costal margin, and 1 cm above the umbilicus, respectively. The wireless wearable sensor, consisting of ultrasound emitter, ultrasound receiver, data acquisition and wireless transmitter, has a small footprint and light weight. The sensors correlate the mechanical strain at wearing sites to lung volume by measuring the local circumference changes of the chest and abdominal walls simultaneously. Eleven subjects were recruited to evaluate the wireless wearable sensors. Three different random forest classifiers, including generic, individual, and weighted-adaptive classifiers, were used to process the wireless data of the subjects at four different postures. The results demonstrate the respiratory behaviors are individual- and posture-dependent. The generic classifier merely reaches the accuracy of classifying postures of 21.9 ± 1.7% while individual and weighted-adaptive classifiers mark substantially high, up to 98.9 ± 0.6% and 98.8 ± 0.6%, respectively. The accurate monitoring of respiratory behaviors can track the progression of respiratory disorders and diseases, including chronic respiratory obstructive disease (COPD), asthma, apnea, and others for timely and objective approaches for control.

Sensing Systems for Respiration Monitoring: A Technical Systematic Review

Respiratory monitoring is essential in sleep studies, sport training, patient monitoring, or health at work, among other applications. This paper presents a comprehensive systematic review of respiration sensing systems. After several systematic searches in scientific repositories, the 198 most relevant papers in this field were analyzed in detail. Different items were examined: sensing technique and sensor, respiration parameter, sensor location and size, general system setup, communication protocol, processing station, energy autonomy and power consumption, sensor validation, processing algorithm, performance evaluation, and analysis software. As a result, several trends and the remaining research challenges of respiration sensors were identified. Long-term evaluations and usability tests should be performed. Researchers designed custom experiments to validate the sensing systems, making it difficult to compare results. Therefore, another challenge is to have a common validation framework to fairly compare sensor performance. The implementation of energy-saving strategies, the incorporation of energy harvesting techniques, the calculation of volume parameters of breathing, or the effective integration of respiration sensors into clothing are other remaining research efforts. Addressing these and other challenges outlined in the paper is a required step to obtain a feasible, robust, affordable, and unobtrusive respiration sensing system.

High-Sensitivity Wearable and Flexible Humidity Sensor Based on Graphene Oxide/Non-Woven Fabric for Respiration Monitoring

The popularity of humidity sensing for respiratory analysis of patients is gradually increasing because of its portability and cost-effectiveness. However, current flexible humidity sensors are mainly made of polymer films, whose poor hygroscopicity and breathability reduce their sensitivity and comfort. In this study, a highly sensitive humidity sensor was developed using non-woven fabric (NWF) coated with graphene oxide (GO). Bovine serum albumin was used to improve the adsorption of GO onto the NWF, and its effect on sensitivity was investigated by adjusting its concentration. High-humidity sensitivity was experimentally validated by testing different relative humidity levels, and its fast response and excellent feasibility under diverse breathing conditions were verified by successful monitoring of fast and deep breathing, differentiating nose and mouth breathing, and even identifying simple spoken words. This study developed a breathable and skin-friendly humidity sensor based on GO/NWF, which is a promising device for human healthcare.

Wearable Belt With Built-In Textile Electrodes for Cardio-Respiratory Monitoring

Unobtrusive and continuous monitoring of vital signs is becoming more and more important both for patient monitoring in the home environment and for sports activity tracking. Even though many gadgets and clinical systems exist, the need for simple, low-cost and easily applicable solutions still remains, especially in view of a more widespread use within everyone’s reach. The paper presents a fully wearable and wireless sensorized belt, suitable to simultaneously acquire respiratory and cardiac signals employing a single acquisition channel. The adopted method relies on a 50-kHz current injected in the subject thorax through a couple of textile electrodes and on envelope detection of the trans-thoracic voltage acquired from a couple of different embedded electrodes. The resulting signal contains both the baseband electrocardiogram (ECG) signal and the trans-thoracic impedance signal, which encodes respiratory acts. The two signals can be easily separated through suitable filtering and the cardio–respiratory rates extracted. The proposed solution yields performances comparable to those of a spirometer and a two-lead ECG. The whole system, with a realization cost below 100 €, a wireless interface, and several hours (or even days) of autonomy, is a suitable candidate for everyday use, especially if complemented by motion artifact removal techniques, currently under implementation.

Wearable Wrist Movement Monitoring Using Dual Surface-Treated Plastic Optical Fibers

Regarding high-sensitivity human wrist joint motion monitoring in exercise rehabilitation; we develop a pair of novel wearable and sensitivity-enhanced plastic optical fiber (POF) strain sensors consisting of an etched grating fiber and a side-polished fiber stitched into a polyamide wrist brace. The two flexible and surface-treated fibers are; respectively; featured with an etched periodic gratings with a pitch of 6 mm and a depth of 0.5 mm and a D-shaped side-polished zone of ~300 µm depth and ~30 mm length; which, correspondingly, show the sensitivities of around 0.0176/° and 0.0167/° in a normalized bending angle by far larger than a conventional commercial POF, because it achieves a more sensitive strain-induced evanescent field interaction with the side-machined fibers. Moreover, in terms of the sensor response to bending deformation in the range of -40°~+40°, the former exhibits a better sensitivity in lower angle change, while the latter is superior as the bending angle increases; thereby arranging the two modified POFs separately at the side and back of the human wrist, in order to decouple the wrist joint behaviors induced by typical flexion-extension or abduction-adduction movements. Then, the circular and pentagonal wrist motion trajectory patterns are investigated, to demonstrate the maximum average single-axis motion error of 2.94° via the transformation of spatial angle to plane coordinate for the fabricated couple of POF sensors, which is lower than a recognized standard of 5°, thus suggesting the great potential in wearable exercise rehabilitation of human joints in the field of medical treatment and healing.

Experimental determination and ray-tracing simulation of bending losses in melt-spun polymer optical fibres

The damping properties and specifically the bend losses of polymer optical fibres (POFs) have so far only been documented by experimental work, investigating bending parameters such as bending radius, length, and distance of the bends. Even though damping mechanisms and causes are well-known, no simple, generally valid formula exists. Here, a simulation technique is shown that allows producing an optical model for any bending geometries of melt-spun polymer optical fibres. The developed model takes all relevant loss mechanisms into account, especially regarding the scattering losses at the interface of core and cladding as well as those of the cladding-air interface. The latter is caused by interfacial roughness for which experimental data have been obtained by atomic force microscopy measurements. To show the validity of the simulation, the model is compared to experimental results for several fibres and a variety of geometries. The variance between model and experimental data is low (S < 4.6%). The model not only contributes to improving the understanding of the optical properties of POFs, but it also has direct applicability to the design of photonic textile sensors for medicine, where the fibres are incorporated with small bending radii.

Optical Waveguides and Integrated Optical Devices for Medical Diagnosis, Health Monitoring and Light Therapies

Optical waveguides and integrated optical devices are promising solutions for many applications, such as medical diagnosis, health monitoring and light therapies. Despite the many existing reviews focusing on the materials that these devices are made from, a systematic review that relates these devices to the various materials, fabrication processes, sensing methods and medical applications is still seldom seen. This work is intended to link these multidisciplinary fields, and to provide a comprehensive review of the recent advances of these devices. Firstly, the optical and mechanical properties of optical waveguides based on glass, polymers and heterogeneous materials and fabricated via various processes are thoroughly discussed, together with their applications for medical purposes. Then, the fabrication processes and medical implementations of integrated passive and active optical devices with sensing modules are introduced, which can be used in many medical fields such as drug delivery and cardiovascular healthcare. Thirdly, wearable optical sensing devices based on light sensing methods such as colorimetry, fluorescence and luminescence are discussed. Additionally, the wearable optical devices for light therapies are introduced. The review concludes with a comprehensive summary of these optical devices, in terms of their forms, materials, light sources and applications.

Cyclostationary-Based Vital Signs Detection Using Microwave Radar at 2.5 GHz

Non-contact detection and estimation of vital signs such as respiratory and cardiac frequencies is a powerful tool for surveillance applications. In particular, the continuous wave bio-radar has been widely investigated to determine the physiological parameters in a non-contact manner. Since the RF-reflected signal from the human body is corrupted by noise and random body movements, traditional Fourier analysis fails to detect the heart and breathing frequencies. In this effort, cyclostationary analysis has been used to improve the radar performance for non-invasive measurement of respiratory rate and heart rate. However, the preliminary works focus only on one frequency and do not include the impact of attenuation and random movement of the body in the analysis. Hence in this paper, we evaluate the impact of distance and noise on the cyclic features of the reflected signal. Furthermore, we explore the assessment of second order cyclostationary signal processing performance by developing the cyclic mean, the conjugate cyclic autocorrelation and the cyclic cumulant. In addition, the analysis is carried out using a reduced number of samples to reduce the response time. Implementation of the cyclostationary technique using a bi-static radar configuration at 2.5 GHz is shown as an example to demonstrate the proposed approach.

Nano-copper enhanced flexible device for simultaneous measurement of human respiratory and electro-cardiac activities

BACKGROUND

Dysfunction of human respiratory and electro-cardiac activities could affect the ability of the heart to pump blood and the lungs to inhale oxygen. Thus, a device could simultaneously measure electro-cardiac signal and respiratory pressure could provide vital signs for predicting early warning of cardio-pulmonary function-related chronic diseases such as cardiovascular disease, and respiratory system disease.

RESULTS

In this study, a flexible device integrated with piezo-resistive sensing element and voltage-sensing element was developed to simultaneously measure human respiration and electro-cardiac signal (including respiratory pressure, respiration frequency, and respiration rhythm; electro-cardio frequency, electro-cardio amplitude, and electro-cardio rhythm). When applied to the measurement of respiratory pressure, the piezo-resistive performance of the device was enhanced by nano-copper modification, which detection limitation of pressure can reduce to 100 Pa and the sensitivity of pressure can achieve to 0.053 ± 0.00079 kPa-1. In addition, the signal-to-noise ratio during bio-electrical measurement was increased to 10.7 ± 1.4, five times better than that of the non-modified device.

CONCLUSION

This paper presents a flexible device for the simultaneous detection of human respiration and cardiac electrical activity. To avoid interference between the two signals, the layout of the electrode and the strain sensor was optimized by FEA simulation analysis. To improve the piezo-resistive sensitivity and bio-electric capturing capability of the device, a feather-shaped nano-copper was modified onto the surface of carbon fiber. The operation simplicity, compact size, and portability of the device open up new possibilities for multi-parameter monitoring.

Detection of Abnormal Respiration from Multiple-Input Respiratory Signals

In this paper, we propose a novel approach for the detection of abnormal signals from multiple respiration signals. An ultrawide-band (UWB) radar was used to acquire respiration signals that represent a distance from the chest to the radar sensor, i.e., shape variation of the chest due to breathing (inhaling or exhaling) activity provides quantitative information (distance values) about respiratory status. Distribution, shape, and variation of values across time provide information to determine respiratory status, one of the most important indicators of human health. In this paper, respiratory status was categorized into two classes, normal and abnormal. Abnormal respiration (apnea in this paper) was emulated by interrupting breathing activity because it is difficult to acquire real apnea from patients in hospital wards. This paper considered two cases, single and multiple respiration. In the first case, a single normal- or abnormal-respiration signal was used as input, and output was the classified status of respiration. In the second case, multiple respiration signals were simultaneously used as inputs, and we focused on determining the existence of abnormal signals in multiple respiration signals. In the case of multiple inputs, filters with varying cut-off frequency were applied to input signals followed by the analysis of output signals in response to the filters. To substantiate the proposed method, experiment results are provided. In this paper, classification results showed 93% of the successful rate in the case of multiple inputs, and results are promising for applications to monitoring systems of human respiration.

Rapid response flexible humidity sensor for respiration monitoring using nano-confined strategy

Development of wearable devices for continuous respiration monitoring is of great importance for evaluating human health. Here, we propose a new strategy to achieve rapid respiration response by confining conductive polymers into 1D nanowires which facilitates the water molecules absorption/desorption and maximizes the sensor response to moisture. The nanowires arrays were fabricated through a low-cost nanoscale printing approach on flexible substrate. The nanoscale humidity sensor shows a high sensitivity (5.46%) and ultrafast response (0.63 s) when changing humidity between 0% and 13% and can tolerate 1000 repetitions of bending to a curvature radius of 10 mm without influencing its performance. Benefited by its fast response and low power assumption, the humidity sensor was demonstrated to monitor human respiration in real time. Different respiration patterns including normal, fast and deep respiration can be distinguished accurately.

Soft and Stretchable Polymeric Optical Waveguide-Based Sensors for Wearable and Biomedical Applications

The past decades have witnessed the rapid development in soft, stretchable, and biocompatible devices for applications in biomedical monitoring, personal healthcare, and human-machine interfaces. In particular, the design of soft devices in optics has attracted tremendous interests attributed to their distinct advantages such as inherent electrical safety, high stability in long-term operation, potential to be miniaturized, and free of electromagnetic interferences. As the alternatives to conventional rigid optical waveguides, considerable efforts have been made to develop light-guiding devices by using various transparent and elastic polymers, which offer desired physiomechanical properties and enable wearable/implantable applications in optical sensing, diagnostics, and therapy. Here, we review recent progress in soft and stretchable optical waveguides and sensors, including advanced structural design, fabrication strategies, and functionalities. Furthermore, the potential applications of those optical devices for various wearable and biomedical applications are discussed. It is expected that the newly emerged soft and stretchable optical technologies will provide a safe and reliable alternative to next-generation, smart wearables and healthcare devices.

Sleep apnea assessment using declination duration-based global metrics from unobtrusive fiber optic sensors

OBJECTIVE

Sufficient sleep helps to restore the immune, nervous and cardiovascular systems, but is sometimes disturbed by sleep apnea (SA). The early diagnosis of sleep apnea is beneficial for the prevention of diseases. Polysomnography (PSG) recording provides comprehensive data for such assessment, but is not suitable for use at home due to discomfort during measurement and the difficulty of identification. This study proposes an unobtrusive measurement process by placing fiber optic sensors (FOSs) in a pillow (head-neck) or a bed mattress (thoracic-dorsal).

APPROACH

We test two approaches: drop degrees from the baseline to validate the capability of catching respiratory drops, and linear regression models based on a new global measure, the percentage of the total duration of respiratory declination (PTDRD), to estimate the hand-scored apnea/hypopnea index (AHI).

MAIN RESULTS

Based on data recorded from 63 adults, the drop degrees derived from respiratory signals exhibited statistical differences among central sleep apnea (CSA), obstructive sleep apnea (OSA) and normal breathing. The regression models based on the PTDRDs derived from head-neck FOS and thoracic-dorsal FOS also achieved good agreement with manually scored AHIs in Bland-Altman plots as well as oronasal airflow and thoracic wall movement.

SIGNIFICANCE

The aforementioned performance demonstrates the capability of the FOS measurement and the efficacy of the PTDRD metrics for SA assessment.

Polymer Optical Fiber Sensors in Healthcare Applications: A Comprehensive Review

Advances in medicine and improvements in life quality has led to an increase in the life expectancy of the general population. An ageing world population have placed demands on the use of assistive technology and, in particular, towards novel healthcare devices and sensors. Besides the electromagnetic field immunity, polymer optical fiber (POF) sensors have additional advantages due to their material features such as high flexibility, lower Young’s modulus (enabling high sensitivity for mechanical parameters), higher elastic limits, and impact resistance. Such advantages are well-aligned with the instrumentation requirements of many healthcare devices and in movement analysis. Aiming at these advantages, this review paper presents the state-of-the-art developments of POF sensors for healthcare applications. A plethora of healthcare applications are discussed, which include movement analysis, physiological parameters monitoring, instrumented insoles, as well as instrumentation of healthcare robotic devices such as exoskeletons, smart walkers, actuators, prostheses, and orthosis. This review paper shows the feasibility of using POF sensors in healthcare applications and, due to the aforementioned advantages, it is possible to envisage a further widespread use of such sensors in this research field in the next few years.

E-Knitted Textile with Polymer Optical Fibers for Friction and Pressure Monitoring in Socks

The objective of this paper is to study the ability of polymer optical fiber (POF) to be inserted in a knitted fabric and to measure both pressure and friction when walking. Firstly, POF, marketed and in development, have been compared in terms of the required mechanical properties for the insertion of the fiber directly into a knitted fabric on an industrial scale, i.e. elongation, bending rigidity, and minimum bending radius before plastic deformation. Secondly, the chosen optical fiber was inserted inside several types of knitted fabric and was shown to be sensitive to friction and compression. The knitted structure with the highest sensitivity has been chosen for sock prototype manufacturing. Finally, a feasibility study with an instrumented sock showed that it is possible to detect the different phases of walking in terms of compression and friction.

Contact-Based Methods for Measuring Respiratory Rate

There is an ever-growing demand for measuring respiratory variables during a variety of applications, including monitoring in clinical and occupational settings, and during sporting activities and exercise. Special attention is devoted to the monitoring of respiratory rate because it is a vital sign, which responds to a variety of stressors. There are different methods for measuring respiratory rate, which can be classed as contact-based or contactless. The present paper provides an overview of the currently available contact-based methods for measuring respiratory rate. For these methods, the sensing element (or part of the instrument containing it) is attached to the subject's body. Methods based upon the recording of respiratory airflow, sounds, air temperature, air humidity, air components, chest wall movements, and modulation of the cardiac activity are presented. Working principles, metrological characteristics, and applications in the respiratory monitoring field are presented to explore potential development and applicability for each 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.

Ultrasound Sensors for Diaphragm Motion Tracking: An Application in Non-Invasive Respiratory Monitoring

This paper introduces a novel respiratory detection system based on diaphragm wall motion tracking using an embedded ultrasound sensory system. We assess the utility and accuracy of this method in evaluating the function of the diaphragm and its contribution to respiratory workload. The developed system is able to monitor the diaphragm wall activity when the sensor is placed in the zone of apposition (ZOA). This system allows for direct measurements with only one ultrasound PZT5 piezo transducer. The system generates pulsed ultrasound waves at 2.2 MHz and amplifies reflected echoes. An added benefit of this system is that due to its design, the respiratory signal is less subject to motion artefacts. Promising results were obtained from six subjects performing six tests per subject with an average respiration detection sensitivity and specificity of 84% and 93%, respectively. Measurements were compared to a gold standard commercial spirometer. In this study, we also compared our measurements to other conventional methods such as inertial and photoplethysmography (PPG) sensors.

Wearable Health Devices-Vital Sign Monitoring, Systems and Technologies

Wearable Health Devices (WHDs) are increasingly helping people to better monitor their health status both at an activity/fitness level for self-health tracking and at a medical level providing more data to clinicians with a potential for earlier diagnostic and guidance of treatment. The technology revolution in the miniaturization of electronic devices is enabling to design more reliable and adaptable wearables, contributing for a world-wide change in the health monitoring approach. In this paper we review important aspects in the WHDs area, listing the state-of-the-art of wearable vital signs sensing technologies plus their system architectures and specifications. A focus on vital signs acquired by WHDs is made: first a discussion about the most important vital signs for health assessment using WHDs is presented and then for each vital sign a description is made concerning its origin and effect on heath, monitoring needs, acquisition methods and WHDs and recent scientific developments on the area (electrocardiogram, heart rate, blood pressure, respiration rate, blood oxygen saturation, blood glucose, skin perspiration, capnography, body temperature, motion evaluation, cardiac implantable devices and ambient parameters). A general WHDs system architecture is presented based on the state-of-the-art. After a global review of WHDs, we zoom in into cardiovascular WHDs, analysing commercial devices and their applicability versus quality, extending this subject to smart t-shirts for medical purposes. Furthermore we present a resumed evolution of these devices based on the prototypes developed along the years. Finally we discuss likely market trends and future challenges for the emerging WHDs area.

Ultra-fast polymer optical fibre Bragg grating inscription for medical devices

We report the extraordinary result of rapid fibre Bragg grating inscription in doped polymer optical fibres based on polymethyl methacrylate in only 7 ms, which is two orders of magnitude faster than the inscription times previously reported. This was achieved using a new dopant material, diphenyl disulphide, which was found to enable a fast, positive refractive index change using a low ultraviolet dose. These changes were investigated and found to arise from photodissociation of the diphenyl disulphide molecule and subsequent molecular reorganization. We demonstrate that gratings inscribed in these fibres can exhibit at least a 15 times higher sensitivity than silica glass fibre, despite their quick inscription times. As a demonstration of the sensitivity, we selected a highly stringent situation, namely, the monitoring of a human heartbeat and respiratory functions. These findings could permit the inscription of fibre Bragg gratings during the fibre drawing process for mass production, allowing cost-effective, single-use, in vivo sensors among other potential uses.

Estimation of respiratory volume from thoracoabdominal breathing distances: comparison of two models of machine learning

PURPOSE

The purposes of this study were to both improve the accuracy of respiratory volume (V) estimates using the respiratory magnetometer plethysmography (RMP) technique and facilitate the use of this technique.

METHOD

We compared two models of machine learning (ML) for estimating [Formula: see text]: a linear model (multiple linear regression-MLR) and a nonlinear model (artificial neural network-ANN), and we used cross-validation to validate these models. Fourteen healthy adults, aged [Formula: see text] years participated in the present study. The protocol was conducted in a laboratory test room. The anteroposterior displacements of the rib cage and abdomen, and the axial displacements of the chest wall and spine were measured using two pairs of magnetometers. [Formula: see text] was estimated from these four signals, and the respiratory volume was simultaneously measured using a spirometer ([Formula: see text]) under lying, sitting and standing conditions as well as various exercise conditions (working on computer, treadmill walking at 4 and 6 km[Formula: see text], treadmill running at 9 and 12  km [Formula: see text] and ergometer cycling at 90 and 110 W).

RESULTS

The results from the ANN model fitted the spirometer volume significantly better than those obtained through MLR. Considering all activities, the difference between [Formula: see text] and [Formula: see text] (bias) was higher for the MLR model ([Formula: see text] L) than for the ANN model ([Formula: see text] L).

CONCLUSION

Our results demonstrate that this new processing approach for RMP seems to be a valid tool for estimating V with sufficient accuracy during lying, sitting and standing and under various exercise conditions.

Design and preliminary assessment of a smart textile for respiratory monitoring based on an array of Fiber Bragg Gratings

Comfortable and easy to wear smart textiles have gained popularity for continuous respiratory monitoring. Among different emerging technologies, smart textiles based on fiber optic sensors (FOSs) have several advantages, like Magnetic Resonance (MR)-compatibility and good metrological properties. In this paper we report on the development and assessment of an MR-compatible smart textiles based on FOSs for respiratory monitoring. The system consists of six fiber Bragg grating (FBG) sensors glued on the textile to monitor six compartments of the chest wall (i.e., right and left upper thorax, right and left abdominal rib cage, and right and left abdomen). This solution allows monitoring both global respiratory parameters and each compartment volume change. The system converts thoracic movements into strain measured by the FBGs. The positioning of the FBGs was optimized by experiments performed using an optoelectronic system. The feasibility of the smart textile was assessed on 6 healthy volunteers. Experimental data were compared to the ones estimated by an optoelectronic plethysmography used as reference. Promising results were obtained on both breathing period (maximum percentage error is 1.14%), inspiratory and expiratory period, as well as on total volume change (mean percentage difference between the two systems was ~14%). The Bland-Altman analysis shows a satisfactory accuracy for the parameters under investigation. The proposed system is safe and non-invasive, MR-compatible, and allows monitoring compartmental volumes.

Body-monitoring with photonic textiles: a reflective heartbeat sensor based on polymer optical fibres

Knowledge of an individual's skin condition is important for pressure ulcer prevention. Detecting early changes in skin through perfusion, oxygen saturation values, and pressure on tissue and subsequent therapeutic intervention could increase patients' quality of life drastically. However, most existing sensing options create additional risk of ulcer development due to further pressure on and chafing of the skin. Here, as a first component, we present a flexible, photonic textile-based sensor for the continuous monitoring of the heartbeat and blood flow. Polymer optical fibres (POFs) are melt-spun continuously and characterized optically and mechanically before being embroidered. The resulting sensor shows flexibility when embroidered into a moisture-wicking fabric, and withstands disinfection with hospital-type laundry cycles. Additionally, the new sensor textile shows a lower static coefficient of friction (COF) than conventionally used bedsheets in both dry and sweaty conditions versus a skin model. Finally, we demonstrate the functionality of our sensor by measuring the heartbeat at the forehead in reflection mode and comparing it with commercial finger photoplethysmography for several subjects. Our results will allow the development of flexible, individualized, and fully textile-integrated wearable sensors for sensitive skin conditions and general long-term monitoring of patients with risk for pressure ulcer.

Wireless Monitoring System for Oral-Feeding Evaluation of Preterm Infants

The oral feeding disorder is one of the important indicators for the high risk group of neurodevelopment delay. The procedure of oral feeding requires the coordination of sucking, swallowing, and breathing activities, and it is the most complex sensorimotor process for newborn infants. Premature infants often uneasily complete the procedure of oral feeding. However, the evaluation of the oral feeding disorders and severity are usually dependent on the subjective clinical experience of the physician. Monitoring the sucking-swallowing-breathing activities directly is difficult for preterm infants. In this study, a wireless monitoring system for oral-feeding evaluation of full term and preterm infants was proposed to objectively and quantitatively evaluate the coordination of suck-swallow-respiration function during oral feeding. Moreover, the ratios of the swallowing and breathing event numbers to the sucking event number were defined to evaluate the coordination of suck-swallow-respiration function during oral feeding. Finally, the system performance was validated and the coordination of suck-swallow-respiration function for full term and preterm infants during oral feeding was also investigated.

Smart Textile Based on Fiber Bragg Grating Sensors for Respiratory Monitoring: Design and Preliminary Trials

Continuous respiratory monitoring is important to assess adequate ventilation. We present a fiber optic-based smart textile for respiratory monitoring able to work during Magnetic Resonance (MR) examinations. The system is based on the conversion of chest wall movements into strain of two fiber Bragg grating (FBG) sensors, placed on the upper thorax (UT). FBGs are glued on the textile by an adhesive silicon rubber. To increase the system sensitivity, the FBGs positioning was led by preliminary experiments performed using an optoelectronic system: FBGs placed on the chest surface experienced the largest strain during breathing. System performances, in terms of respiratory period (T_R), duration of inspiratory (T_I) and expiratory (T_E) phases, as well as left and right UT volumes, were assessed on four healthy volunteers. The comparison of results obtained by the proposed system and an optoelectronic plethysmography highlights the high accuracy in the estimation of T_R, T_I, and T_E: Bland-Altman analysis shows mean of difference values lower than 0.045 s, 0.33 s, and 0.35 s for T_R, T_I, and T_E, respectively. The mean difference of UT volumes between the two systems is about 8.3%. The promising results foster further development of the system to allow routine use during MR examinations.

Medical smart textiles based on fiber optic technology: an overview

The growing interest in the development of smart textiles for medical applications is driven by the aim to increase the mobility of patients who need a continuous monitoring of such physiological parameters. At the same time, the use of fiber optic sensors (FOSs) is gaining large acceptance as an alternative to traditional electrical and mechanical sensors for the monitoring of thermal and mechanical parameters. The potential impact of FOSs is related to their good metrological properties, their small size and their flexibility, as well as to their immunity from electromagnetic field. Their main advantage is the possibility to use textile based on fiber optic in a magnetic resonance imaging environment, where standard electronic sensors cannot be employed. This last feature makes FOSs suitable for monitoring biological parameters (e.g., respiratory and heartbeat monitoring) during magnetic resonance procedures. Research interest in combining FOSs and textiles into a single structure to develop wearable sensors is rapidly growing. In this review we provide an overview of the state-of-the-art of textiles, which use FOSs for monitoring of mechanical parameters of physiological interest. In particular we briefly describe the working principle of FOSs employed in this field and their relevant advantages and disadvantages. Also reviewed are their applications for the monitoring of mechanical parameters of physiological interest.

Body-monitoring and health supervision by means of optical fiber-based sensing systems in medical textiles

Long-term monitoring with optical fibers has moved into the focus of attention due to the applicability for medical measurements. Within this Review, setups of flexible, unobtrusive body-monitoring systems based on optical fibers and the respective measured vital parameters are in focus. Optical principles are discussed as well as the interaction of light with tissue. Optical fiber-based sensors that are already used in first trials are primarily selected for the section on possible applications. These medical textiles include the supervision of respiration, cardiac output, blood pressure, blood flow and its saturation with hemoglobin as well as oxygen, pressure, shear stress, mobility, gait, temperature, and electrolyte balance. The implementation of these sensor concepts prompts the development of wearable smart textiles. Thus, current sensing techniques and possibilities within photonic textiles are reviewed leading to multiparameter designs. Evaluation of these designs should show the great potential of optical fibers for the introduction into textiles especially due to the benefit of immunity to electromagnetic radiation. Still, further improvement of the signal-to-noise ratio is often necessary to develop a commercial monitoring system.

Performance of hybrid nanostructured conductive cotton materials as wearable devices: an overview of materials, fabrication, properties and applications

Recent advances and overview of hybrid nanostructured cotton materials will boost an essential encouragement for the development of next generation smart textiles and flexible devices which could be worn by human beings.

Electrically insulated sensing of respiratory rate and heartbeat using optical fibers

Respiratory and heart rates are among the most important physiological parameters used to monitor patients' health. It is important to design devices that can measure these parameters without risking or altering the subject's health. In this context, a novel sensing method to monitor simultaneously the heartbeat and respiratory rate signals of patients within an electrically safety environment was developed and tested. An optical fiber-based sensor was used in order to detect two optical phenomena. Photo-plethysmography and the relation between bending radius and attenuation of optical fiber were coupled through a single beam light traveling along this fiber.