Wearable Monitors Research Articles

Raw Photoplethysmography as an Enhancement for Research-Grade Wearable Activity Monitors.

Wearable monitors continue to play a critical role in scientific assessments of physical activity. Recently, research-grade monitors have begun providing raw data from photoplethysmography (PPG) alongside standard raw data from inertial sensors (accelerometers and gyroscopes). Raw PPG enables granular and transparent estimation of cardiovascular parameters such as heart rate, thus presenting a valuable alternative to standard PPG methodologies (most of which rely on consumer-grade monitors that provide only coarse output from proprietary algorithms). The implications for physical activity assessment are tremendous, since it is now feasible to monitor granular and concurrent trends in both movement and cardiovascular physiology using a single noninvasive device. However, new users must also be aware of challenges and limitations that accompany the use of raw PPG data. This viewpoint paper therefore orients new users to the opportunities and challenges of raw PPG data by presenting its mechanics, pitfalls, and availability, as well as its parallels and synergies with inertial sensors. This includes discussion of specific applications to the prediction of energy expenditure, activity type, and 24-hour movement behaviors, with an emphasis on areas in which raw PPG data may help resolve known issues with inertial sensing (eg, measurement during cycling activities). We also discuss how the impact of raw PPG data can be maximized through the use of open-source tools when developing and disseminating new methods, similar to current standards for raw accelerometer and gyroscope data. Collectively, our comments show the strong potential of raw PPG data to enhance the use of research-grade wearable activity monitors in science over the coming years.

Insertable Biosensors: Combining Implanted Sensing Materials with Wearable Monitors.

Insertable biosensor systems are medical diagnostic devices with two primary components: an implantable biosensor within the body and a wearable monitor that can remotely interrogate the biosensor from outside the body. Because the biosensor does not require a physical connection to the electronic monitor, insertable biosensor systems promise improved patient comfort, reduced inflammation and infection risk, and extended operational lifetimes relative to established percutaneous biosensor systems. However, the lack of physical connection also presents technical challenges that have necessitated new innovations in developing sensing chemistries, transduction methods, and communication modalities. In this review, we discuss the key developments that have made insertables a promising option for longitudinal biometric monitoring and highlight the essential needs and existing development challenges to realizing the next generation of insertables for extended-use diagnostic and prognostic devices.

94 Reducing Exposure to Respirable Crystalline Silica in the Construction and Minerals Industry by Using Wearable Real Time Respirable Dust Monitors

Abstract Real time monitoring of respirable dust (as a surrogate for RCS) opens the opportunity to warn workers when entering work areas with increased dust levels to provide them the information to fit RPE properly or exit the area. However in the past, the adoption of such monitoring approaches has been limited due to the bulkiness and price of devices. This paper reflects on how the miniaturisation of Optical Particle Counters has enabled light weight (<150g) wearable devices to be developed which are convenient for workers in the construction and minerals industry to wear on all working days. It provides an overview of the Optical particle counter. its performance in measuring respirable dust and how it has been integrated into a battery powered ' DustCanary; wearable device. Due to its size and convenience the DustCanary provides protection to both those at first line risk due to the areas they work (eg stone cutters, plant operatives) who by wearing such can devices can help identify changes in performance of Local Exhaust Ventilation (LEV). or controls so that remedial action can be taken secondary risk on a plant who are not necessarily wearing RPE (such as delivery drivers) who can be warned when they enter an area where there are elevated respirable dust levels Case study data and examples will be shared.

Abstract P5-08-11: Objective Comparison of Post-operative Activity after Sentinel Lymph Node Biopsy versus Axillary Lymph Node Dissection Using Wearable Activity Monitors – The ‘BRACELET’ Study

Abstract Introduction Axillary de-escalation is driven by both a desire to minimize injury and a growing awareness of the oncological safety of axillary conservation. However, the evidence of the impact of axillary procedures is largely subjective and based on patient questionnaires. Sensing technologies such as Wearable Activity Monitors (WAM) can acquire functional postoperative data, enabling objective analysis of patients’ physical activity (PA) levels. This technology implementation would help surgeons better comprehend the post-operative recovery phase and provide individualized interventions for patients. We aimed to use WAMs in order to investigate differences in physical recovery between axillary lymph node dissection (ALND) and sentinel lymph node biopsy (SLNB) – with a hypothesis that the ALND group has slower recovery compared to SLNB. Methods A single centre, prospective non-randomized observational study was conducted from September 2019 to May 2022. Consecutive patients undergoing breast and axillary surgery were identified from theatre lists. Patients with movement disorders or upper limb impairment and those using mobility devices or aids were excluded. Eligible consented patients wore WAMs (AX3, Axivity, UK – triaxial accelerometer) on both wrists at least one day pre- and up to two weeks post-operatively. The Mann-Whitney U test and the Wilcoxon Signed Rank Test were performed to analyze the PA levels between arms and surgeries. Patient demographics and potential confounders such as concomitant breast/reconstruction surgery were recorded. Results A total of 53 patients were recruited. Greater PA level was observed in the control arm compared to the surgically treated side in both SLNB and ALND groups in week 1 (SLNB: 69.6% vs 61.1%, p=0.006; ALND: 75.3% vs 60.4%, p< 0.001) and 2 (SLNB: 77.6% vs 71.1%, p=0.113; ALND: 81.9% vs 70.2%, p< 0.001) respectively. When comparing activities of the surgically treated side only, the ALND patients had significantly lower PA level compared to SLNB group in post-operative day 7-9 (65.4% vs 72.5%, p=0.035). Subgroup analysis was performed to compare surgically treated side of ‘Mastectomy Only and SLNB’ versus ‘Mastectomy Only and ALND’. PA level was significantly lower in the latter than the former in week 2 (78.5% vs 83.5%, p=0.027). There were no significant differences in demographics between the 2 groups. Conclusion ALND consistently results in decreased PA level compared to SLNB. The findings also demonstrate the longitudinal impact of SLNB, which impacts PA levels, even up to 2 weeks after surgery. Monitoring recovery objectively after breast cancer surgery provides patients and surgeons with more information about the likely outcomes of their treatment and may help them choose the best option, particularly where oncological outcomes are equivocal. This information could also be used to improve outcomes by identifying vulnerable patients who would benefit from early exercise intervention, encouraging physical activity, and keeping track of individualised PA that could be added to the feedback rehabilitation care plan. Citation Format: Nur Amalina Che Bakri, Richard Kwasnicki, Luqman Tenang, Emmanuel Giannas, Kieran Dhillon, Ara Darzi, Daniel Leff. Objective Comparison of Post-operative Activity after Sentinel Lymph Node Biopsy versus Axillary Lymph Node Dissection Using Wearable Activity Monitors – The ‘BRACELET’ Study [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P5-08-11.

Validity of Wearable Monitors and Smartphone Applications for Measuring Steps in Semi-Structured and Free-Living Settings

Wearable technologies have become powerful tools for health and fitness and are indispensable everyday tools for many individuals; however, significant limitations exist related to the validity of the metrics these monitors purport to measure. Thus, the purpose of the present study was to validate the step count of three wearable monitors (i.e., Yamax 3D Power-Walker, Garmin Vivofit 3 and Medisana Vifit), as well as two Android apps (i.e., Accupedo Pedometer and Pedometer 2.0), in a sample of healthy adults. These monitors and apps were evaluated in a lab-based semi-structured study and a 3-day field study under habitual free-living conditions. A convenience sample of 24 healthy adults (14 males and 10 females; 32.6 ± 2.5 years) participated in both studies. Direct step observation and Actigraph served as the criterion methods and validity was evaluated by comparing each monitor and app with the criterion measure using mean absolute percentage errors (MAPE), Bland–Altman plots, and Intraclass Correlation Coefficients. The results revealed high validity for the three wearable monitors during the semi-structured study, with MAPE values approximately 5% for Yamax and Vifit and well below 5% for Vivofit, while the two apps showed high MAPE values over 20%. In the free-living study all monitors and apps had high MAPE, over 10%. The lowest error was observed for Yamax, Vifit and Pedometer app, while Accupedo app had the highest error, overestimating steps by 32%. The present findings cannot support the value of wearable monitors and apps as acceptable measures of PA and step count in free-living contexts. Wearable monitors and apps that might be valid in one context, might not be valid in different contexts and vice versa, and researchers should be aware of this limitation.

Benchtop Characterization of Wearable Respiratory Monitors for Assessing Feasibility of Measuring Lung Volume

Abstract Objective: This study characterizes three commercially available wearable respiratory monitors (WRMs): (1) Hexoskin Smart Garment, (2) Smartex WWS, and (3) Equivital EQ02 LifeMonitor, each with a unique chest motion sensor technology: respiratory inductance plethysmography, piezoresistor, and strain gauge, respectively. WRMs comprise of a body garment with embedded sensors that measure ambulatory chest motion in real-time. Once calibrated, chest motion waveforms from WRMs can be converted to lung volume waveform, which is then used to derive respiratory topography. The aim of this study is to assess and compare these WRMs in terms of: (i) their response signal to chest motion linearity, which is necessary for successful calibration, and (ii) their ability to measure breath-hold, which is a parameter of interest for lung deposition modeling. Methods: A benchtop test setup was built to simulate chest motion in a controlled way to facilitate comparison across the three devices. A staircase square-wave chest motion profile was used to simultaneously assess both signal linearity and ability to measure breath-hold. The respiratory response from the sensors was compared to the simulated chest motion. Results: The Hexoskin showed the best performance in both metrics, whereas the Equivital had the worst performance in both. The Smartex showed moderate ability to measure breath-hold but poor signal linearity. Conclusion: Of the three WRMs tested, the Hexoskin appears to be the best choice for ambulatory lung volume measurement. Significance: This study demonstrates the feasibility of adapting current technology to observe respiratory behavior valuable in many research domains, including tobacco research.

The Effect of Wearable Activity Monitor Presence on Step Counts.

Objective: In this study, we tested the effect of wearable activity monitors and tracking on physical activity over 2 weeks. Methods: Ninety young adults participated. Prior to initiation of the study, each participant was asked to download an iPhone app that tracked physical activity level (step counts) but were not told the app's purpose. Each participant was then randomly assigned to one of 3 groups (N=30/group): (1) measurement awareness, (2) measurement awareness+track/record, or (3) control. Participants in the measurement awareness and the measurement awareness+track/record groups were given a pedometer to wear for 2 weeks. Additionally, participants in the measurement awareness+track/ record group were instructed to record daily steps and submit their record after 2 weeks. Participants in the control group were not given a pedometer band nor asked track steps. Results: Neither the measurement awareness group nor the measurement awareness+track/record group were statistically different than controls during the intervention (p>.05). However, collapsing the intervention groups and comparing to the control group resulted in a 388.3 (SE=-186.9) higher daily step count during the intervention (p<.05). Conclusion: Wearable monitors modestly increases daily step count. However, the addition of recording daily step counts does not appear to provide an additional benefit in our study.

Experiences of Using Wearable Continuous Glucose Monitors in Adults With Diabetes: A Qualitative Descriptive Study.

The purpose of the study was to understand the experiences of adults with diabetes wearing a continuous glucose monitor (CGM). This qualitative, descriptive study included 19 adults with type 1 diabetes or type 2 diabetes, who had used the FreeStyle Libre CGM for at least 4 weeks, from an outpatient clinic at a university-affiliated hospital in Korea. Data were collected through in-depth interviews and analyzed using an inductive content analysis approach. The content analysis revealed 3 major themes-navigating glucose level fluctuations, reframing diabetes self-care and improving quality of life, and device improvement and service quality. Participants reported that CGMs offered convenient glucose level monitoring, allowed early response to rapid glucose changes, and facilitated effective patient-clinician communication. Participants expressed concerns about the financial burden and limited services, recommending improvements for devices, consumer services, and health insurance coverage. Study findings indicated that using wearable CGMs could improve self-care and quality of life in adults with diabetes. Using CGMs could improve patients' understanding of how diabetes self-care management affects real-time glucose levels. Health care providers could support patients' self-care by using device data. Improvements in quality, services, and insurance coverage could increase user satisfaction and promote self-care.

Self‐Powered Wearable Piezoelectric Monitoring of Human Motion and Physiological Signals for the Postpandemic Era: A Review

AbstractAs society advances, the shift from passive medical care to health management and preventive medical care has become an important issue, with the realization of wearable monitors becoming desirable. In light of the COVID‐19 pandemic, the number of patients who are in urgent need of the monitoring of biological information is increasing. This review focuses on piezoelectric materials and composites that convert kinetic energy into electrical energy to realize self‐powered wearable monitoring sensors, outlining the recent research activity on sensors for use in healthcare monitoring. First, a general description of the principles of piezoelectric monitoring sensors is given. Next, the development status of piezoelectric materials and composites aimed at the application of detecting tiny motions of the human body is introduced, and then the research trends on the detection of larger human body movements are highlighted. Finally, after presenting the performance of current piezoelectric sensors and future research guidelines for developing multifunctional systems in the post COVID‐19 era, the achievements are summarized. Overall, this review will provide guidance to researchers who are seeking to design and develop highly sensitive self‐powered piezoelectric sensors that monitor human motion and physiological signals.

Assessing the Usability of a Novel Wearable Remote Patient Monitoring Device for the Early Detection of In-Hospital Patient Deterioration: Observational Study.

BackgroundPatients admitted to general wards are inherently at risk of deterioration. Thus, tools that can provide early detection of deterioration may be lifesaving. Frequent remote patient monitoring (RPM) has the potential to allow such early detection, leading to a timely intervention by health care providers.ObjectiveThis study aimed to assess the potential of a novel wearable RPM device to provide timely alerts in patients at high risk for deterioration.MethodsThis prospective observational study was conducted in two general wards of a large tertiary medical center. Patients determined to be at high risk to deteriorate upon admission and assigned to a telemetry bed were included. On top of the standard monitoring equipment, a wearable monitor was attached to each patient, and monitoring was conducted in parallel. The data gathered by the wearable monitors were analyzed retrospectively, with the medical staff being blinded to them in real time. Several early warning scores of the risk for deterioration were used, all calculated from frequent data collected by the wearable RPM device: these included (1) the National Early Warning Score (NEWS), (2) Airway, Breathing, Circulation, Neurology, and Other (ABCNO) score, and (3) deterioration criteria defined by the clinical team as a “wish list” score. In all three systems, the risk scores were calculated every 5 minutes using the data frequently collected by the wearable RPM device. Data generated by the early warning scores were compared with those obtained from the clinical records of actual deterioration among these patients.ResultsIn total, 410 patients were recruited and 217 were included in the final analysis. The median age was 71 (IQR 62-78) years and 130 (59.9%) of them were male. Actual clinical deterioration occurred in 24 patients. The NEWS indicated high alert in 16 of these 24 (67%) patients, preceding actual clinical deterioration by 29 hours on average. The ABCNO score indicated high alert in 18 (75%) of these patients, preceding actual clinical deterioration by 38 hours on average. Early warning based on wish list scoring criteria was observed for all 24 patients 40 hours on average before clinical deterioration was detected by the medical staff. Importantly, early warning based on the wish list scoring criteria was also observed among all other patients who did not deteriorate.ConclusionsFrequent remote patient monitoring has the potential for early detection of a high risk to deteriorate among hospitalized patients, using both grouped signal-based scores and algorithm-based prediction. In this study, we show the ability to formulate scores for early warning by using RPM. Nevertheless, early warning scores compiled on the basis of these data failed to deliver reasonable specificity. Further efforts should be directed at improving the specificity and sensitivity of such tools.Trial RegistrationClinicalTrials.gov NCT04220359; https://clinicaltrials.gov/ct2/show/NCT04220359

Validity of Wearable Monitors and Smartphone Applications to Measure Steps and Distance in Adolescents

The growing popularity of wearable physical activity (PA) monitors and fitness applications (apps) in recent years and the vast amounts of data that they generate present attractive possibilities for surveillance. However, measurement accuracy is indispensable when tracking PA variables to provide meaningful measures of PA. The purpose of this study was to examine the criterion validity of wearable PA monitors and a combination of GPS and accelerometer free of charge smartphone apps, during self-paced outdoor walking and running. Thirty-eight healthy adolescents (15.3±2.0 years) participated in this cross-sectional study. They were fitted with Garmin Forerunner 310XT, Garmin Vivofit, Medisana Vifit, and smartphones running the Runkeeper, Runtastic, Sports Tracker (GPS), Pedometer, Accupedo, Pedometer and Pedometer 2.0 (accelerometer) apps. They were asked to walk and run 1.22 km for each trial and two researchers counted every step taken during trials with a digital tally counter. Validity was evaluated by comparing each device with the criterion measure using Repeated measures analysis of variance (ANOVA), Mean Absolute Percentage Errors (MAPE) and Bland-Altman plots. MAPE were low for Forerunner and GPS apps for distance in both conditions (2.27%- 9.73%), and significantly higher for the accelerometer monitors and apps (6.92%-39.02%). Vivofit (MAPE=6.51%) and Vifit (MAPE=6.66%) accurately estimated the number of steps during walking, however only Vivofit (MAPE=3.95%) was accurate during running. All accelerometer-based apps had high MAPE for step counting (9.87%-40.26%). The findings suggested that GPS monitors and apps were accurate tools for counting distance during walking and running, while accelerometer- based monitors and apps had higher errors. Vivofit provided accurate estimates of step count in both conditions, and Medisana Vifit was valid during walking. Accupedo was the only app with an acceptable step count error.

Use of Wearable Technology to Measure Activity in Orthopaedic Trauma Patients: A Systematic Review.

Patient-Reported Outcome Measures (PROMs) are widely used for measurement of functional outcomes after orthopaedic trauma. However, PROMs rely on patient collaboration and suffer from various types of bias. Wearable Activity Monitors (WAMs) are increasingly used to objectify functional assessment. The objectives of this systematic review were to identify and characterise the WAMs technology and metrics currently used for orthopaedic trauma research. PubMed and Embase biomedical literature search engines were queried. Eligibility criteria included: Human clinical studies published in the English language between 2010 and 2019 involving fracture management and WAMs. Variables collected from each article included: Technology used, vendor/product, WAM body location, metrics measured, measurement time period, year of publication, study geographic location, phase of treatment studied, fractures studied, number of patients studied, sex and age of the study subjects, and study level of evidence. Six investigators reviewed the resulting papers. Descriptive statistics of variables of interest were used to analyse the data. One hundred and thirty-six papers were available for analysis, showing an increasing trend of publications per year. Accelerometry followed by plantar pressure insoles were the most commonly employed technologies. The most common location for WAM placement was insoles, followed by the waist. The most commonly studied fracture type was hip fractures followed by fragility fractures in general, ankle, "lower extremity", and tibial fractures. The rehabilitation phase following surgery was the most commonly studied period. Sleep duration, activity time or step counts were the most commonly reported WAM metrics. A preferred, clinically validated WAM metric was not identified. WAMs have an increasing presence in the orthopaedic trauma literature. The optimal implementation of this technology and its use to understand patients' pre-injury and post-injury functions is currently insufficiently explored and represents an area that will benefit from future study. PROSPERO ID:210344. The online version contains supplementary material available at 10.1007/s43465-022-00629-0.

Effect of continuous wireless vital sign monitoring on unplanned ICU admissions and rapid response team calls: a before-and-after study

BackgroundContinuous vital sign monitoring may potentially be improved through the use of wearable monitors linked wirelessly to hospital electronic patient records. By improving early detection of physiological deterioration this approach may save lives. MethodsWe performed a single-centre before-and-after study including surgical and medical patients at a university hospital in The Netherlands. The study intervention was continuous vital sign monitoring using wearable monitors linked wirelessly to hospital systems. The co-primary outcomes were unplanned ICU admission and rapid response team calls. Secondary outcomes were length of hospital stay and in-patient death. ResultsOur baseline cohort included 2466 admissions and our intervention cohort included 2303 admissions recruited from August 2017 to July 2019. Patients in the intervention cohort experienced fewer unplanned ICU admissions (84 [3.4%] vs 54 [2.3%]; P=0.03) and fewer rapid response team calls (107 [4.3%] vs 71 [3.1%]; P=0.02). The number of rapid response team calls that did not result in ICU admission also declined (70 [2.8%] vs 45 [2.0%]; P=0.05). The number of rapid response team calls that did result in ICU admission was not significantly different (52 [2.1%] vs 36 [1.6%]; P=0.16). There were no differences in hospital stay or in-patient deaths between the two study periods. ConclusionsContinuous monitoring of patient vital signs using wearable monitoring technology linked wirelessly to hospital systems was associated with a reduction in unplanned ICU admissions and rapid response team calls. Further research is necessary to confirm the impact of this approach on patient survival.

Free-Living Validation and Harmonization of 10 Wearable Step Count Monitors

ABSTRACT This study aimed 1) to determine the step count accuracy of numerous wrist-, hip-, and thigh-worn consumer and research monitors (and their corresponding algorithms) compared with the StepWatch (SW) across all waking hours under free-living conditions and 2) to develop correction methods to calibrate all monitors to the SW. Forty-eight participants 28 ± 12 yr old (mean ± SD) wore monitors across two waking days. Different wrist (Apple Watch Series 2, Fitbit Alta, Garmin vivofit 3, and ActiGraph GT9X), hip (Yamax Digiwalker SW-200, Omron HJ-325, GT9X, and Fitbit Zip), and thigh (activPAL) monitors were worn across 2 d, with the exception of the SW, which was worn on both days. Monitor estimates were compared with SW to compute percent of SW steps, absolute percent error, mean difference, root-mean-square error, and Pearson correlations. Monitor-specific correction factor linear regression models were fit to estimate SW steps and evaluated using leave-one-subject-out cross validation. All monitors were significantly different from the SW (P &lt; 0.05). Consumer wrist and hip monitors underestimated SW steps (72%–91% of SW steps per day), whereas step estimates from research monitors ranged widely (67%–189%). Mean absolute percent error across all devices were greater than 10%. After a correction method was applied, all monitor estimates were not significantly different from SW steps. Overall, some consumer monitors produced step estimates that are closer to the validated SW than research-grade monitors (and their corresponding algorithms) and could be used to measure steps for healthy adults under free-living conditions. The specific correction methods may facilitate comparisons across studies and support research efforts using consumer and research monitors for large-scale population surveillance and epidemiological studies.

Automatic Electrocardiogram Detection of Suspected Hypertrophic Cardiomyopathy: Application to Wearable Heart Monitors.

In this letter, an automatic detection algorithm for hypertrophic cardiomyopathy (HCM) is presented. Of particular interest is the algorithm's ability to differentiate HCM subjects and healthy volunteers from a single lead ECG dataset. Suspected HCM subjects are identified by the primary clinical abnormality associated with HCM: left ventricular hypertrophy (LVH). In total, n = 43 human subjects ECG datasets are investigated: n = 21 healthy volunteers and n = 22 LVH patients. Significant differences of p-value 0.01 and 0.04 were found for the respective ECG parameters, i.e., S-wave amplitude and ST-segment, when differentiating between the LVH patients and healthy human volunteers.

Feasibility of Using the Hexoskin Smart Garment for Natural Environment Observation of Respiration Topography.

Background: Limited research has been done to measure ambulatory respiratory behavior, in particular those associated with tobacco use, in the natural environment due to a lack of monitoring techniques. Respiratory topography parameters provide useful information for modeling particle deposition in the lung and assessing exposure risk and health effects associated with tobacco use. Commercially available Wearable Respiratory Monitors (WRM), such as the Hexoskin Smart Garment, have embedded sensors that measure chest motion and may be adapted for measuring ambulatory lung volume. Methods: Self-reported “everyday” and “some days” Hookah and Cigarette smokers were recruited for a 3-day natural environment observation study. Participants wore the Hexoskin shirt while using their preferred tobacco product. The shirt was calibrated on them prior to, during, and after the observation period. A novel method for calculating the calibration parameters is presented. Results: NH = 5 Hookah and NC = 3 Cigarette participants were enrolled. Calibration parameters were obtained and applied to the observed chest motion waveform from each participant to obtain their lung volume waveform. Respiratory topography parameters were derived from the lung volume waveform. Conclusion: The feasibility of using the Hexoskin for measuring ambulatory respiratory topography parameters in the natural environment is demonstrated.

Wearable Monitors Facilitate Exercise in Adult and Pediatric Stem Cell Transplant.

Hematopoietic stem cell transplant (HSCT) is a potentially curative treatment for hematopoietic malignancies, complicated by decreased performance status and quality of life. Exercise therapy improves outcomes in HSCT, but several barriers have prevented exercise from becoming routine clinical practice. Based on existing data that wearable technologies facilitate exercise participation in other sedentary and chronic illness populations, we propose the novel hypothesis that wearable technologies are a valuable tool in transcending barriers and developing exercise therapy programs for HSCT patients.

Wearable Activity Monitors in Home Based Exercise Therapy for Patients with Intermittent Claudication: A Systematic Review

Intermittent claudication (IC) can severely limit functional capacity and quality of life. Supervised exercise therapy is the recommended first line management; however, this is often limited by accessibility, compliance and cost. As such, there has been an increased interest in the use of wearable activity monitors (WAMs) in home based telemonitoring exercise programmes for claudicants. This review aims to evaluate the efficacy of WAM as a feedback and monitoring tool in home based exercise programmes for patients with IC. A search strategy was devised. The databases MEDLINE, EMBASE, and Web of Science were searched through to April 2020. Randomised trials and prospective trials were included. Eligible trials had to incorporate WAMs as a feedback tool to target walking/exercise behaviour. The primary outcome was the change in walking ability. Study quality was assessed with risk of bias tool. A total of 1148 records were retrieved. Of these, eight randomised controlled trials and one prospective cohort study, all of which compared a WAM intervention against standard care and/or supervised exercise, met the inclusion criteria. Owing to heterogeneity between studies, no meta-analysis was conducted. WAM interventions improved measures of walking ability (heterogeneous outcomes such as maximum walking distance, claudication distance and six minute walk distance), increased daily walking activity (steps/day), cardiovascular metrics (maximum oxygen consumption), and quality of life. There is some evidence that home based WAM interventions are beneficial for improving walking ability and quality of life in patients with IC. However, existing studies are limited by inadequate sample size, duration, and appropriate power. Achieving consensus on outcome reporting and study methods, as well as maximising device adherence, is needed.

Feasibility Assessment of Wearable Respiratory Monitors for Ambulatory Inhalation Topography.

Background: Natural environment inhalation topography provides useful information for toxicant exposure, risk assessment and cardiopulmonary performance. Commercially available wearable respiratory monitors (WRMs), which are currently used to measure a variety of physiological parameters such as heart rate and breathing frequency, can be leveraged to obtain inhalation topography, yet little work has been done. This paper assesses the feasibility of adapting these WRMs for measuring inhalation topography. Methods: Commercially available WRMs were compiled and assessed for the ability to report chest motion, data analysis software features, ambulatory observation capabilities, participant acceptability, purchasing constraints and affordability. Results: The following WRMs were found: LifeShirt, Equivital EQ02 LifeMonitor, Smartex WWS, Hexoskin Smart Garment, Zephyr BioHarness, Nox T3&A1, BioRadio, SleepSense Inductance Band, and ezRIP & zRIP Durabelt. None of the WRMs satisfied all six assessment criteria in a manner enabling them to be used for inhalation topography without modification and development. Conclusions: The results indicate that there are WRMs with core technologies and characteristics that can be built upon for ambulatory inhalation topography measurement in the NE.

Value of Wearable Vital-sign Monitors During Perioperative Period

Perioperative mortality has long been a concern. Although the intraoperative mortality rate has made a 10-fold reduction in the past 3 decades, the thirty-day postoperative mortality rate remains high. Patients die because signs of deterioration are missed. Deterioration of patients is often overlooked or not detected at all. One of the reasons is that the intensity of nursing and the frequency of monitoring vital signs are decreased from the Intensive Care Unit via wards to home. Early detection of physiological instability is crucial to prevent death and disability. Therefore, perioperative continuous monitoring of vital signs and other information is crucial to detect physiological instability and may have the potential benefit to reduce the perioperative mortality and the incidence of major postoperative complications. Wearable continuous vital-sign monitors are expected to achieve this vision. Nowadays this kind of device is available, but further research on it is still needed. This article reviewed the current status of vital-sign monitoring and the value of wearable vital-sign monitors during the perioperative period.