A Review of Recent Advances in Vital Signals Monitoring of Sports and Health via Flexible Wearable Sensors

Nurses' continuance intention to use electronic health record systems: The antecedent role of personality and organisation support

Nurses play a crucial role in the adoption and continued use of Electronic Health Records (EHRs), especially in developing countries. Existing literature scarcely addresses how personality traits and organisational support influence nurses' decision to persist with EHR use in these regions. This study developed a model combining the Five-Factor Model (FFM) and the Unified Theory of Acceptance and Use of Technology (UTAUT) to explore the impact of personality traits and organisational support on nurses' continuance intention to use EHR systems. Data were collected via a self-reported survey from 472 nurses across 10 public hospitals in Jordan and analyzed using a structural equation modeling approach (Smart PLS-SEM 4). The analysis revealed that personality traits, specifically Openness, Experience, and Conscientiousness, significantly influence nurses' decisions to continue using EHR systems. Furthermore, organisational support, enhanced by Performance Expectancy and Facilitating Conditions, positively affected their ongoing commitment to EHR use. The findings underscore the importance of considering individual personality traits and providing robust organisational support in promoting sustained EHR usage among nurses. These insights are vital for healthcare organisations aiming to foster a conducive environment for EHR system adoption, thereby enhancing patient care outcomes.

Silk Fabric Functionalized by Nanosilver Enabling the Wearable Sensing for Biomechanics and Biomolecules

Integrating biomechanical and biomolecular sensing mechanisms into wearable devices is a formidable challenge and key to acquiring personalized health management. To address this, we have developed an innovative multifunctional sensor enabled by plasma functionalized silk fabric, which possesses multimodal sensing capabilities for biomechanics and biomolecules. A seed-mediated in situ growth method was employed to coat silver nanoparticles (AgNPs) onto silk fibers, resulting in silk fibers functionalized with AgNPs (SFs@Ag) that exhibit both piezoresistive response and localized surface plasmon resonance effects. The SFs@Ag membrane enables accurate detection of mechanical pressure and specific biomolecules during wearable sensing, offering a versatile solution for comprehensive personalized health monitoring. Additionally, a machine learning algorithm has been established to specifically recognize muscle strain signals, potentially extending to the diagnosis and monitoring of neuromuscular disorders such as amyotrophic lateral sclerosis (ALS). Unlike electromyography, which detects large muscles in clinical medicine, sensing data for tiny muscles enhance our understanding of muscle coordination using the SFs@Ag sensor. This detection model provides feasibility for the early detection and prevention of neuromuscular diseases. Beyond muscle stress and strain sensing, biomolecular detection is a critical addition to achieving effective health management. In this study, we developed highly sensitive surface-enhanced Raman scattering (SERS) detection for wearable health monitoring. Finite-difference time-domain numerical simulations ware utilized to analyze the efficacy of the SFs@Ag sensor for wearable SERS sensing of biomolecules. Based on the specific SERS spectra, automatic extraction of signals of sweat molecules was also achieved. In summary, the SFs@Ag sensor bridges the gap between biomechanical and biomolecular sensing in wearable applications, providing significant value for personalized health management.

Fetal QRS extraction from single-channel abdominal ECG using adaptive improved permutation entropy

Fetal electrocardiogram (fECG) monitoring is crucial for assessing fetal condition during pregnancy. However, current fECG extraction algorithms are not suitable for wearable devices due to their high computational cost and multi-channel signal requirement. The paper introduces a novel and efficient algorithm called Adaptive Improved Permutation Entropy (AIPE), which can extract fetal QRS from a single-channel abdominal ECG (aECG). The proposed algorithm is robust and computationally efficient, making it a reliable and effective solution for wearable devices. To evaluate the performance of the proposed algorithm, we utilized our clinical data obtained from a pilot study with 10 subjects, each recording lasting 20 min. Additionally, data from the PhysioNet 2013 Challenge bank with labeled QRS complex annotations were simulated. The proposed methodology demonstrates an average positive predictive value ( + P ) of 91.0227%, sensitivity (Se) of 90.4726%, and F1 score of 90.6525% from the PhysioNet 2013 Challenge bank, outperforming other methods. The results suggest that AIPE could enable continuous home-based monitoring of unborn babies, even when mothers are not engaging in any hard physical activities.

Facial electromyography during exercise using soft electrode array: A feasibility study

The use of wearable sensors for real-time monitoring of exercise-related measures has been extensively studied in recent years (e.g., performance enhancement, optimizing athlete's training, and preventing injuries). Surface electromyography (sEMG), which measures muscle activity, is a widely researched technology in exercise monitoring. However, due to their cumbersome nature, traditional sEMG electrodes are limited. In particular, facial EMG (fEMG) studies in physical training have been limited, with some scarce evidence suggesting that fEMG may be used to monitor exercise-related measurements. Altogether, sEMG recordings from facial muscles in the context of exercise have been examined relatively inadequately. In this feasibility study, we assessed the ability of a new wearable sEMG technology to measure facial muscle activity during exercise. Six young, healthy, and recreationally active participants (5 females), performed an incremental cycling exercise test until exhaustion, while facial sEMG and vastus lateralis (VL) EMG were measured. Facial sEMG signals from both natural expressions and voluntary smiles were successfully recorded. Stable recordings and high-resolution facial muscle activity mapping were achieved during different exercise intensities until exhaustion. Strong correlations were found between VL and multiple facial muscles' activity during voluntary smiles during exercise, with statistically significant coefficients ranging from 0.80 to 0.95 (p<0.05). This study demonstrates the feasibility of monitoring facial muscle activity during exercise, with potential implications for sports medicine and exercise physiology, particularly in monitoring exercise intensity and fatigue.

Advanced biomechanical analytics: Wearable technologies for precision health monitoring in sports performance

Objective

This study investigated the impact of wearable technologies, particularly advanced biomechanical analytics and machine learning, on sports performance monitoring and intervention strategies within the realm of physiotherapy. The primary aims were to evaluate key performance metrics, individual athlete variations and the efficacy of machine learning-driven adaptive interventions.

Methods

The research employed an observational cross-sectional design, focusing on the collection and analysis of real-world biomechanical data from athletes engaged in sports physiotherapy. A representative sample of athletes from Bahawalpur participated, utilizing Dring Stadium as the primary data collection venue. Wearable devices, including inertial sensors (MPU6050, MPU9250), electromyography (EMG) sensors (MyoWare Muscle Sensor), pressure sensors (FlexiForce sensor) and haptic feedback sensors, were strategically chosen for their ability to capture diverse biomechanical parameters.

Results

Key performance metrics, such as heart rate (mean: 76.5 bpm, SD: 3.2, min: 72, max: 80), joint angles (mean: 112.3 degrees, SD: 6.8, min: 105, max: 120), muscle activation (mean: 43.2%, SD: 4.5, min: 38, max: 48) and stress and strain features (mean: [112.3 ], SD: [6.5 ]), were analyzed and presented in summary tables. Individual athlete analyses highlighted variations in performance metrics, emphasizing the need for personalized monitoring and intervention strategies. The impact of wearable technologies on athletic performance was quantified through a comparison of metrics recorded with and without sensors. Results consistently demonstrated improvements in monitored parameters, affirming the significance of wearable technologies.

Conclusions

The study suggests that wearable technologies, when combined with advanced biomechanical analytics and machine learning, can enhance athletic performance in sports physiotherapy. Real-time monitoring allows for precise intervention adjustments, demonstrating the potential of machine learning-driven adaptive interventions.

Prototype of Data Collector from Textronic Sensors

In the era of miniaturization of electronic equipment and the need to connect sensors with textile materials, including clothing, the processing of signals received from the implemented sensors becomes an important issue. Information obtained by measuring the electrical properties of the sensors must be sent, processed, and visualized. For this purpose, the authors of this article have developed a prototype of a data collector obtained from textronic sensors created on composite textile substrates. The device operates in a system consisting of an electronic module based on the nRF52 platform, which supports wireless communication with sensors using Bluetooth technology and transmits the obtained data to a database hosted on the Microsoft Azure platform. A mobile application based on React Native technology was created to control the data stream. The application enables automatic connection to the selected collector, data download and their presentation in the form of selected charts. Initial verification tests of the system showed the correctness and reliability of its operation, and the presented graphs created from the obtained data indicate the usefulness of the device in applications where measurements and recording of impedance, resistance, and temperature are necessary. The presented prototype of a data collector can be used for resistance, impedance, and temperature measurements in the case of textronic structures but also in other wearable electronic systems.

Diagnostic Accuracy of Single-Lead Electrocardiograms Using the Kardia Mobile App and the Apple Watch 4: Validation Study

BACKGROUND

To date, the 12-lead electrocardiogram (ECG) is the gold standard for cardiological diagnosis in clinical settings. With the advancements in technology, a growing number of smartphone apps and gadgets for recording, visualizing, and evaluating physical performance as well as health data is available. Although this new smart technology is innovative and time- and cost-efficient, less is known about its diagnostic accuracy and reliability.

OBJECTIVE

This study aimed to examine the agreement between the mobile single-lead ECG measurements of the Kardia Mobile App and the Apple Watch 4 compared to the 12-lead gold standard ECG in healthy adults under laboratory conditions. Furthermore, it assessed whether the measurement error of the devices increases with an increasing heart rate.

METHODS

This study was designed as a prospective quasi-experimental 1-sample measurement, in which no randomization of the sampling was carried out. In total, ECGs at rest from 81 participants (average age 24.89, SD 8.58 years; n=58, 72% male) were recorded and statistically analyzed. Bland-Altman plots were created to graphically illustrate measurement differences. To analyze the agreement between the single-lead ECGs and the 12-lead ECG, Pearson correlation coefficient (r) and Lin concordance correlation coefficient (CCCLin) were calculated.

RESULTS

The results showed a higher agreement for the Apple Watch (mean deviation QT: 6.85%; QT interval corrected for heart rate using Fridericia formula [QTcF]: 7.43%) than Kardia Mobile (mean deviation QT: 9.53%; QTcF: 9.78%) even if both tend to underestimate QT and QTcF intervals. For Kardia Mobile, the QT and QTcF intervals correlated significantly with the gold standard (rQT=0.857 and rQTcF=0.727; P<.001). CCCLin corresponded to an almost complete heuristic agreement for the QT interval (0.835), whereas the QTcF interval was in the range of strong agreement (0.682). Further, for the Apple Watch, Pearson correlations were highly significant and in the range of a large effect (rQT=0.793 and rQTcF=0.649; P<.001). CCCLin corresponded to a strong heuristic agreement for both the QT (0.779) and QTcF (0.615) intervals. A small negative correlation between the measurement error and increasing heart rate could be found of each the devices and the reference.

CONCLUSIONS

Smart technology seems to be a promising and reliable approach for nonclinical health monitoring. Further research is needed to broaden the evidence regarding its validity and usability in different target groups.

Microfluidic Wearable Devices for Sports Applications

This study aimed to systematically review the application and research progress of flexible microfluidic wearable devices in the field of sports. The research team thoroughly investigated the use of life signal-monitoring technology for flexible wearable devices in the domain of sports. In addition, the classification of applications, the current status, and the developmental trends of similar products and equipment were evaluated. Scholars expect the provision of valuable references and guidance for related research and the development of the sports industry. The use of microfluidic detection for collecting biomarkers can mitigate the impact of sweat on movements that are common in sports and can also address the issue of discomfort after prolonged use. Flexible wearable gadgets are normally utilized to monitor athletic performance, rehabilitation, and training. Nevertheless, the research and development of such devices is limited, mostly catering to professional athletes. Devices for those who are inexperienced in sports and disabled populations are lacking. Conclusions: Upgrading microfluidic chip technology can lead to accurate and safe sports monitoring. Moreover, the development of multi-functional and multi-site devices can provide technical support to athletes during their training and competitions while also fostering technological innovation in the field of sports science.

Multiresponsive Cylindrically Symmetric Cholesteric Liquid Crystal Elastomer Fibers Templated by Tubular Confinement

Cylindrically symmetric cholesteric liquid crystal elastomer (CLCE) fibers templated by tubular confinement are reported, displaying mechanochromic, thermochromic, and thermomechanical responses. The synthesis inside a sacrificial tube secures radial orientation of the cholesteric helix, and the ground state retroreflection wavelength is easily tuned throughout the visible spectrum or into the near-infrared by varying the concentration of a chiral dopant. The fibers display continuous, repeatable, and quantitatively predictable mechanochromic response, reaching a blue shift of more than -220 nm for 180% elongation. The cylindrical symmetry renders the response identical in all directions perpendicular to the fiber axis, making them exceptionally useful for monitoring complex strains, as demonstrated in revealing local strain during tying of different knots. The CLCE reflection color can be revealed with high contrast against any background by taking advantage of the circularly polarized reflection. Upon heating, the fibers respond-fully reversibly-with red shift and radial expansion/axial contraction. However, there is no transition to an isotropic state, confirming a largely forgotten theoretical prediction by de Gennes. These fibers and the easy way of making them may open new windows for large-scale application in advanced wearable technology and beyond.

Stress monitoring using wearable sensors: IoT techniques in medical field

The concept "Internet of Things" (IoT), which facilitates communication between linked devices, is relatively new. It refers to the next generation of the Internet. IoT supports healthcare and is essential to numerous applications for tracking medical services. By examining the pattern of observed parameters, the type of the disease can be anticipated. For people with a range of diseases, health professionals and technicians have developed an excellent system that employs commonly utilized techniques like wearable technology, wireless channels, and other remote equipment to give low-cost healthcare monitoring. Whether put in living areas or worn on the body, network-related sensors gather detailed data to evaluate the patient's physical and mental health. The main objective of this study is to examine the current e-health monitoring system using integrated systems. Automatically providing patients with a prescription based on their status is the main goal of the e-health monitoring system. The doctor can keep an eye on the patient's health without having to communicate with them. The purpose of the study is to examine how IoT technologies are applied in the medical industry and how they help to raise the bar of healthcare delivered by healthcare institutions. The study will also include the uses of IoT in the medical area, the degree to which it is used to enhance conventional practices in various health fields, and the degree to which IoT may raise the standard of healthcare services. The main contributions in this paper are as follows: (1) importing signals from wearable devices, extracting signals from non-signals, performing peak enhancement; (2) processing and analyzing the incoming signals; (3) proposing a new stress monitoring algorithm (SMA) using wearable sensors; (4) comparing between various ML algorithms; (5) the proposed stress monitoring algorithm (SMA) is composed of four main phases: (a) data acquisition phase, (b) data and signal processing phase, (c) prediction phase, and (d) model performance evaluation phase; and (6) grid search is used to find the optimal values for hyperparameters of SVM (C and gamma). From the findings, it is shown that random forest is best suited for this classification, with decision tree and XGBoost following closely behind.

Wearable and Portable Devices for Acquisition of Cardiac Signals while Practicing Sport: A Scoping Review

Wearable and portable devices capable of acquiring cardiac signals are at the frontier of the sport industry. They are becoming increasingly popular for monitoring physiological parameters while practicing sport, given the advances in miniaturized technologies, powerful data, and signal processing applications. Data and signals acquired by these devices are increasingly used to monitor athletes' performances and thus to define risk indices for sport-related cardiac diseases, such as sudden cardiac death. This scoping review investigated commercial wearable and portable devices employed for cardiac signal monitoring during sport activity. A systematic search of the literature was conducted on PubMed, Scopus, and Web of Science. After study selection, a total of 35 studies were included in the review. The studies were categorized based on the application of wearable or portable devices in (1) validation studies, (2) clinical studies, and (3) development studies. The analysis revealed that standardized protocols for validating these technologies are necessary. Indeed, results obtained from the validation studies turned out to be heterogeneous and scarcely comparable, since the metrological characteristics reported were different. Moreover, the validation of several devices was carried out during different sport activities. Finally, results from clinical studies highlighted that wearable devices are crucial to improve athletes' performance and to prevent adverse cardiovascular events.

The Use of a Technology Acceptance Model (TAM) to Predict Patients' Usage of a Personal Health Record System: The Role of Security, Privacy, and Usability

Personal health records (PHR) systems are designed to ensure that individuals have access and control over their health information and to support them in being active participants rather than passive ones in their healthcare process. Yet, PHR systems have not yet been widely adopted or used by consumers despite their benefits. For these advantages to be realized, adoption of the system is necessary. In this study, we examined how self-determination of health management influences individuals' intention to implement a PHR system, i.e., their ability to actively manage their health. Using an extended technology acceptance model (TAM), the researchers developed and empirically tested a model explaining public adoption of PHRs. In total, 389 Saudi Arabian respondents were surveyed in a quantitative cross-sectional design. The hypotheses were analysed using structural equation modelling-partial least squares (SEM-PLS4). Results indicate that PHR system usage was influenced by three major factors: perceived ease of use (PEOU), perceived usefulness (PU), and security towards intention to use. PHR PEOU and PHR intention to use were also found to be moderated by privacy, whereas usability positively moderated PHR PEOU and PHR intention to use and negatively moderated PHR PU and PHR intention to use. For the first time, this study examined the use of personal health records in Saudi Arabia, including the extension of the TAM model as well as development of a context-driven model that examines the relationship between privacy, security, usability, and the use of PHRs. Furthermore, this study fills a gap in the literature regarding the moderating effects of privacy influence on PEOU and intention to use. Further, the moderating effects of usability on the relationship between PEOU, PU, and intention to use. Study findings are expected to assist government agencies, health policymakers, and health organizations around the world, including Saudi Arabia, in understanding the adoption of personal health records.