by Keyword: Wearable

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Blanco-Almazan, D., Groenendaal, W., Lozano-Garcia, M., Estrada-Petrocelli, L., Lijnen, L., Smeets, C., Ruttens, D., Catthoor, F., Jané, R., (2021). Combining bioimpedance and myographic signals for the assessment of COPD during loaded breathing IEEE Transactions on Biomedical Engineering 68, (1), 298-307

Chronic Obstructive Pulmonary Disease (COPD) is one of the most common chronic conditions. The current assessment of COPD requires a maximal maneuver during a spirometry test to quantify airflow limitations of patients. Other less invasive measurements such as thoracic bioimpedance and myographic signals have been studied as an alternative to classical methods as they provide information about respiration. Particularly, strong correlations have been shown between thoracic bioimpedance and respiratory volume. The main objective of this study is to investigate bioimpedance and its combination with myographic parameters in COPD patients to assess the applicability in respiratory disease monitoring. We measured bioimpedance, surface electromyography and surface mechanomyography in forty-three COPD patients during an incremental inspiratory threshold loading protocol. We introduced two novel features that can be used to assess COPD condition derived from the variation of bioimpedance and the electrical and mechanical activity during each respiratory cycle. These features demonstrate significant differences between mild and severe patients, indicating a lower inspiratory contribution of the inspiratory muscles to global respiratory ventilation in the severest COPD patients. In conclusion, the combination of bioimpedance and myographic signals provides useful indices to noninvasively assess the breathing of COPD patients.

Keywords: Bioimpedance, Chronic obstructive pulmonary disease, Inspiratory threshold protocol, Myographic signals, Wearables

Ruano, G., Díaz, A., Tononi, J., Torras, J., Puiggalí, J., Alemán, C., (2020). Biohydrogel from unsaturated polyesteramide: Synthesis, properties and utilization as electrolytic medium for electrochemical supercapacitors Polymer Testing 82, 106300

The utilization of hydrogels derived from biopolymers as solid electrolyte (SE) of electrochemical supercapacitors (ESCs) is a topic of increasing interest because of their promising applications in biomedicine (e.g. for energy storage in autonomous implantable devices). In this work an unsaturated polyesteramide that contains phenylalanine, butenediol and fumarate as building blocks has been photo-crosslinked to obtain a hydrogel (UPEA-h). The structure of UPEA-h, which is characterized by a network of open interconnected pores surrounded by regions with compact morphology, favors ion transport, while the biodegradability and biocompatibility conferred by the α-amino acid unit and the ester group are appropriated for its usage in the biomedical field. Voltammetric and galvanostatic assays have been conducted to evaluate the behavior of UPEA-h when used as SE in ESCs with poly(3,4-ethylenedioxythiophene) (PEDOT) electrodes. Hence, PEDOT/UPEA-h devices displayed supercapacitor response of up 179 F/g and capacitance retention higher than 90%. Moreover, the long-term stability, leakage-current, and self-discharging response of PEDOT/UPEA-h ESCs reflect the great potential of UPEA-h as ion-conductive electrolyte. Indeed, the performance of PEDOT/UPEA-h is higher than found in analogous devices constructed using other biohydrogels as SE (e.g. κ-carrageenan, poly-γ-glutamic acid and cellulose hydrogels).

Keywords: Energy storage, Hydrogel electronics, Ion conductivity, Photo-crosslinking, Wearable electronics

Blanco-Almazan, D., Romero, D., Groenendaal, W., Lijnen, L., Smeets, C., Ruttens, D., Catthoor, F., Jané, R., (2020). Relationship between heart rate recovery and disease severity in chronic obstructive pulmonary disease patients Computers in Cardiology (CinC) 2020 Computing in Cardiology , IEEE (Rimini, Italy) 47, 1-4

Chronic obstructive pulmonary disease (COPD) patients exhibit impaired autonomic control which can be assessed by heart rate variability analysis. The study aims to evaluate the cardiac autonomic responses of COPD patients after completing a conventional six-minute walk test (6MWT). Fifty COPD patients were included in the study, for which an ECG signal (lead II) was acquired by a wearable device, before, during, and after the test. We used the heart rate (HR) time-series to assess the heart rate dynamic during recovery. The heart rate recovery (HRR) marker was evaluated every 5 s after the 6MWT and showed different dynamic trends among severity groups. We compared the HRR among patient groups classified according to the GOLD standard. Significantly larger normalized HRR values (nHRR) were found in mild COPD patients (n=23, GOLD={1,2}; nHRR 1 =14.B±7.5 %, nHRR 2 =18.6±8.1 %) compared to those with more disease severity (n=23, GOLD={3,4}; nHRR 1 =9.3±5.8 %, p=0.002; and nHRR 2 = 13.7±6.7%, p=0.041). The largest differences were observed around the first 30 s of the recovery phase (nHRR=10.8±6.6 % vs. nHRR=5.6±4 % p=0.001). Our results showed a slower recovery for the severest patients, suggesting that cardiac parameters like the ones we propose here, may provide valuable information for a better characterization of COPD severity.

Keywords: Pulmonary diseases, Wearable computers, Electrocardiography, Market research, Cardiology, Heart rate variability

Rafols-de-Urquia, M., Estrada, L., Estevez-Piorno, J., Sarlabous, L., Jane, R., Torres, A., (2019). Evaluation of a wearable device to determine cardiorespiratory parameters from surface diaphragm electromyography IEEE Journal of Biomedical and Health Informatics 23, (5), 1964-1971

The use of wearable devices in clinical routines could reduce healthcare costs and improve the quality of assessment in patients with chronic respiratory diseases. The purpose of this study is to evaluate the capacity of a Shimmer3 wearable device to extract reliable cardiorespiratory parameters from surface diaphragm electromyography (EMGdi). Twenty healthy volunteers underwent an incremental load respiratory test whilst EMGdi was recorded with a Shimmer3 wearable device (EMGdiW). Simultaneously, a second EMGdi (EMGdiL), inspiratory mouth pressure (Pmouth) and lead-I electrocardiogram (ECG) were recorded via a standard wired laboratory acquisition system. Different cardiorespiratory parameters were extracted from both EMGdiW and EMGdiL signals: heart rate, respiratory rate, respiratory muscle activity and mean frequency of EMGdi signals. Alongside these, similar parameters were also extracted from reference signals (Pmouth and ECG). High correlations were found between the data extracted from the EMGdiW and the reference signal data: heart rate (R = 0.947), respiratory rate (R = 0.940), respiratory muscle activity (R = 0.877), and mean frequency (R = 0.895). Moreover, similar increments in EMGdiW and EMGdiL activity were observed when Pmouth was raised, enabling the study of respiratory muscle activation. In summary, the Shimmer3 device is a promising and cost-effective solution for the ambulatory monitoring of respiratory muscle function in chronic respiratory diseases.

Keywords: Cardiorespiratory monitoring, Chronic respiratory diseases, Fixed sample entropy, Non-invasive respiratory monitoring, Surface diaphragm electromyography, Wearable wireless device

Saborío, M. G., Svelic, P., Casanovas, J., Ruano, G., Pérez-Madrigal, M. M., Franco, L., Torras, J., Estrany, F., Alemán, C., (2019). Hydrogels for flexible and compressible free standing cellulose supercapacitors European Polymer Journal 118, 347-357

Cellulose-based supercapacitors display important advantages in comparison with devices fabricated with other materials, regarding environmental friendliness, flexibility, cost and versatility. Recent progress in the field has been mainly focused on the utilization of cellulose fibres as: structural mechanical reinforcement of electrodes; precursors of electrically active carbon-based materials; or primary electrolytes that act as reservoirs of secondary electrolytes. In this work, a flexible, lightweight, robust, portable and manageable all-carboxymethyl cellulose symmetric supercapacitor has been obtained by assembling two electrodes based on carboxymethyl cellulose hydrogels to a solid electrolytic medium formulated with the same material. Hydrogels, which were made by cross-linking carboxymethyl cellulose paste with citric acid in water, rendered not only effective solid electrolytic media by simply loading NaCl but also electroactive electrodes. For the latter, conducting polymer microparticles, which were loaded into the hydrogel network during the physical cross-linking step, were appropriately connected through the in situ anodic polymerization of a similar conducting polymer in aqueous medium, thus creating conduction paths. The performance of the assembled supercapacitors has been proved by cyclic voltammetry, galvanostatic charge-discharge and electrochemical impedance spectroscopy. This design opens a new window for the green and mass production of flexible cellulose-based supercapacitors.

Keywords: Conducting polymer, Energy storage, Flexible electrodes, In situ polymerization, Wearable electronics

Blanco-Almazan, D., Groenendaal, W., Catthoor, F., Jane, R., (2019). Wearable bioimpedance measurement for respiratory monitoring during inspiratory loading IEEE Access 7, 89487-89496

Bioimpedance is an unobtrusive noninvasive technique to measure respiration and has a linear relation with volume during normal breathing. The objective of this paper was to assess this linear relation during inspiratory loading protocol and determine the best electrode configuration for bioimpedance measurement. The inspiratory load is a way to estimate inspiratory muscle function and has been widely used in studies of respiratory mechanics. Therefore, this protocol permitted us to evaluate bioimpedance performance under breathing pattern changes. We measured four electrode configurations of bioimpedance and airflow simultaneously in ten healthy subjects using a wearable device and a standard wired laboratory acquisition system, respectively. The subjects were asked to perform an incremental inspiratory threshold loading protocol during the measurements. The load values were selected to increase progressively until the 60% of the subject's maximal inspiratory pressure. The linear relation of the signals was assessed by Pearson correlation (r ) and the waveform agreement by the mean absolute percentage error (MAPE), both computed cycle by cycle. The results showed a median greater than 0.965 in r coefficients and lower than 11 % in the MAPE values for the entire population in all loads and configurations. Thus, a strong linear relation was found during all loaded breathing and configurations. However, one out of the four electrode configurations showed robust results in terms of agreement with volume during the highest load. In conclusion, bioimpedance measurement using a wearable device is a noninvasive and a comfortable alternative to classical methods for monitoring respiratory diseases in normal and restrictive breathing.

Keywords: Bioimpedance, Chronic respiratory diseases, Electrode configurations, Inspiratory threshold protocol, Wearable

Rajasekaran, V., Aranda, J., Casals, A., (2015). Compliant gait assistance triggered by user intention Engineering in Medicine and Biology Society (EMBC) 37th Annual International Conference of the IEEE , IEEE (Milan, Italy) , 3885-3888

An automatic gait initialization strategy based on user intention sensing in the context of rehabilitation with a lower-limb wearable robot is proposed and evaluated. The proposed strategy involves monitoring the human-orthosis interaction torques and initial position deviation to determine the gait initiation instant and to modify orthosis operation for gait assistance, when needed. During gait, the compliant control algorithm relies on the adaptation of the joints' stiffness in function of their interaction torques and their deviation from the desired trajectories, while maintaining the dynamic stability. As a reference input, the average of a set of recorded gaits obtained from healthy subjects is used. The algorithm has been tested with five healthy subjects showing its efficient behavior in initiating the gait and maintaining the equilibrium while walking in presence of external forces. The work is performed as a preliminary study to assist patients suffering from incomplete Spinal cord injury and Stroke.

Keywords: Biomedical monitoring, Exoskeletons, Joints, Knee, Legged locomotion, Trajectory, Exoskeleton, adaptive control, gait assistance, gait initiation, rehabilitation, wearable robot

Rajasekaran, V., Aranda, J., Casals, A., (2015). User intention driven adaptive gait assistance using a wearable exoskeleton Robot 2015: Second Iberian Robotics Conference (ed. Paulo Reis, L., Paulo Moreira, A., Lima, P. U., Montano, L., Muñoz-Martinez, V.), Springer International (Lausanne, Switzerland) 418, 289-301

A user intention based rehabilitation strategy for a lower-limb wearable robot is proposed and evaluated. The control strategy, which involves monitoring the human-orthosis interaction torques, determines the gait initiation instant and modifies orthosis operation for gait assistance, when needed. Orthosis operation is classified as assistive or resistive in function of its evolution with respect to a normal gait pattern. The control algorithm relies on the adaptation of the joints’ stiffness in function of their interaction torques and their deviation from the desired trajectories. An average of recorded gaits obtained from healthy subjects is used as reference input. The objective of this work is to develop a control strategy that can trigger the gait initiation from the user’s intention and maintain the dynamic stability, using an efficient real-time stiffness adaptation for multiple joints, simultaneously maintaining their synchronization. The algorithm has been tested with five healthy subjects showing its efficient behavior in initiating the gait and maintaining the equilibrium while walking in presence of external forces. The work is performed as a preliminary study to assist patients suffering from incomplete Spinal cord injury and Stroke.

Keywords: Adaptive control, Exoskeleton, Gait assistance, Gait initiation, Wearable robot