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Wearable Monitoring Systems

Annalisa Bonfiglio


Danilo De Rossi


Wearable Monitoring Systems

Editors Annalisa Bonfiglio Department of Electrical and Electronic Engineering University of Cagliari Cagliari, Italy [emailprotected]

Danilo De Rossi Interdepartmental Research Centre “E. Piaggio” University of Pisa Pisa, Italy [emailprotected]

ISBN 978-1-4419-7383-2 e-ISBN 978-1-4419-7384-9 DOI 10.1007/978-1-4419-7384-9 Springer New York Dordrecht Heidelberg London # Springer Science+Business Media, LLC 2011 All rights reserved. This work may not be translated or copied in whole or in part without the written permission of the publisher (Springer Science+Business Media, LLC, 233 Spring Street, New York, NY 10013, USA), except for brief excerpts in connection with reviews or scholarly analysis. Use in connection with any form of information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed is forbidden. The use in this publication of trade names, trademarks, service marks, and similar terms, even if they are not identified as such, is not to be taken as an expression of opinion as to whether or not they are subject to proprietary rights. Printed on acid-free paper Springer is part of Springer Science+Business Media (www.springer.com)


Progress in wearable technologies for monitoring is driven by the same factors that were behind the transition from desktop computing and communication tools to portable devices providing processing and ubiquitous connectivity, namely changes in social and economical factors. This transition is fuelled by the enormous technical advances in microelectronics and communication technologies as well as by the apparently never-ending process of miniaturization. This, in turn, is driven by dramatic changes in demography, lifestyle and the emergence of huge massmarkets that exert a great pulling force for development. As a result, applications of wearable technology will spread far and wide as dictated by these technological development trends, and, more specifically, these wearables will change our lives in becoming exoprostheses able to augment our perceptions of reality with physical, social and emotional contents. The areas of application fostered by intense research or development activities that have been identified as being the most promising by market forecasts span from fashion and leisure, fitness and wellness, healthcare and medical, emergency and work to the space and military domains. Despite the great thrust in evolution, there still remain several technical obstacles that hamper the development of a technology that fully satisfies the needs and expectations of end users. Confronting these obstacles necessitates major performance improvements and real breakthroughs at all levels of the essential subcomponents of wearable systems including: sensors, actuators, low power on-board processing and communication, energy harvesting and storage. Most importantly, these components should all be integrated seamlessly into comfortable, easy-to-use and low cost clothing and garments, which also requires considerable work. This book is a collection of contributions by renowned worldwide experts in research and development or applications of wearable systems that renders a broad overview and critical analysis of the field of wearable technologies. The book is divided into 3 parts. The first part is devoted to a review of the main components of wearables, including sensors, energy generation, signal processing and communications




systems. Integration of previous components is also underlined. Recent work on wearable systems based on a e-textile technology is also reviewed and critically discussed. Chapter 1 provides an overview on sensors technologies for wearable applications, focussing in particular on technologies for monitoring biomechanical and physiological signals. The chapter is centred on the illustration of strategies for an effective integration of such systems in wearable devices. Chapter 2 is dedicated to energy harvesting systems for wearable applications. In particular, the principles and the applications of thermoelectric generation, that is presently the most suitable technique for integration in wearable applications, are reviewed in details. In Chap. 3 wireless communication systems for wearable applications are examined and different proposed solutions are compared. The important issue of integration in wearable applications of all system components is the focus of Chap. 4. On board signal processing in wearable systems, as discussed in Chap. 5, is also a topic of paramount important since highly efficient and fast algorithm are usually required for energy saving and synthetic output in transmitted information. Dealing with large amount of data as might occur in some applications strictly requires proper development and use of data mining techniques; this topic is treated in Chap. 6. The first part of this book ends with Chap. 7 in which textile based wearable systems are described in terms of technologies and application platforms. This subject area is expected to show considerable advances in the years to come. In the second part of this book some key applications of wearable systems in a variety of fields are reported. These applications are the main driving force for the development of the components reviewed in the first part. Applications in sports, wellness and fitness are reported in Chap. 8. Products in these areas are thought by many to be the closest to the market and they might guide development in other fields where market entry resistance is higher. The important area of health monitoring and diagnostics is the focus of Chap. 9. Much research and development effort is nowadays devoted to the development of medical devices and products although strong technical financial and regulatory issues still hamper widespread use. Protective garments for emergency and work in noxious and dangerous environments, as reported in Chap. 10, are also a very important area of application in which wearable systems offer incomparable advantages in terms of better operability and less risk to operators without interfering with comfort and ease of use of garments. In Chap. 11 applications in space and planetary explorations are described. Although being definitely a niche area, developments related to use in such extreme conditions have proved in the past to be seminal to technology transfer to consumers applications. Commercial, social and environmental factors affecting development and use of wearables will definitely condition the success or failure of these pervasive technologies as treated in the third part of this book.



In Chap. 12 an analysis of current developments and needs in Ambient Assistance Living is given. These scenarios should guide and enable technology development since user needs have to be seriously taken into account. At the end, Chap. 13 provides arguments useful to analyse opportunities and barriers to commercial development. Present market penetration of wearable is still marginal and market forecast have not provided till now a reliable and widely shared analysis. The authors provide their view in this respect. The broad and far-reaching range of technologies and applications covered by this book is intended not only to provide an authoritative coverage of the field of wearable monitoring systems, but also to serve as a source of inspiration for possible new technology developments and for new applications enabling the vision of a future of connected people anywhere anytime. The editors would like to thank all the colleagues who contributed to this book and the publisher for the continuous support. The editors would also like to express their gratitude to Dr. Andreas Lymberis, Officer of the Information Society & Media Directorate-General of the European Commission for his passionate promotion and continuous support to the field of Wearable Microsystems.


Part I

Components and Systems


Sensors for Wearable Systems . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 Enzo Pasquale Scilingo, Antonio Lanata`, and Alessandro Tognetti


Energy Harvesting for Self-Powered Wearable Devices . . . . . . . . . . . . . . Vladimir Leonov



Wireless Communication Technologies for Wearable Systems. . . . . . . Steve Warren and Balasubramaniam Natarajan



Design of Wireless Health Platforms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Lawrence Au, Brett Jordan, Winston Wu, Maxim Batalin, and William J. Kaiser



Lightweight Signal Processing for Wearable Body Sensor Networks . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Hassan Ghasemzadeh, Eric Guenterberg, and Roozbeh Jafari



Signal Data Mining from Wearable Systems. . . . . . . . . . . . . . . . . . . . . . . . . . Francois G. Meyer



Future Direction: E-Textiles. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Danilo De Rossi and Rita Paradiso





Part II 8



A Survey of Commercial Wearable Systems for Sport Application. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Sergio Guille´n, Maria Teresa Arredondo, and Elena Castellano Wearable Electronic Systems: Applications to Medical Diagnostics/Monitoring . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Eric McAdams, Asta Krupaviciute, Claudine Gehin, Andre Dittmar, Georges Delhomme, Paul Rubel, Jocelyne Fayn, and Jad McLaughlin




Emergency and Work . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Annalisa Bonfiglio, Davide Curone, Emanuele Lindo Secco, Giovanni Magenes, and Alessandro Tognetti



Augmenting Exploration: Aerospace, Earth and Self . . . . . . . . . . . . . . . . Diana Young and Dava Newman


Part III 12

Environmental and Commercial Scenarios

Scenarios for the Interaction Between Personal Health Systems and Chronic Patients . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Maria Teresa Arredondo, Sergio Guille´n, I. Peinado, and G. Fico


The Commercialization of Smart Fabrics: Intelligent Textiles . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . George Kotrotsios and Jean Luprano


Index. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .




Alessandro Tognetti University of Pisa, Pisa, Italy Alessandro Tognetti Interdepartmental Centre “E. Piaggio”, University of Pisa, Pisa, Italy Antonio Lanata´ University of Pisa, Pisa, Italy Andre´ Dittmar Nanotechnologies Institute of Lyon, Villeurbanne Cedex, France Annalisa Bonfiglio University of Cagliari, Cagliari, Italy Asta Krupaviciute Universite´ de Lyon, Bron, France Balasubramaniam Natarajan Kansas State University, Manhattan, KS, USA Claudine Gehin Nanotechnologies Institute of Lyon, Villeurbanne Cedex, France Danilo De Rossi Interdepartmental Research Centre “E. Piaggio”, University of Pisa, Pisa, Italy Dava Newman Massachusetts Institute of Technology, Cambridge, MA, USA



Davide Curone Eucentre, Pavia, Italy Diana Young Massachusetts Institute of Technology, Cambridge, MA, USA Elena Castellano ITACA, R&D Department, Valencia, Spain Emanuele Lindo Secco Eucentre, Pavia, Italy Enzo Pasquale Scilingo University of Pisa, Pisa, Italy Eric McAdams Nanotechnologies Institute of Lyon, Villeurbanne Cedex, France Eric Guenterberg University of Texas at Dallas, USA Francois G. Meyer University of Colorado, Boulder, CO, USA G. Fico Polytechnic University of Madrid, Madrid, Spain George Kotrotsios CSEM SA, Neuchaˆtel, Switzerland Georges Delhomme Nanotechnologies Institute of Lyon, Villeurbanne Cedex, France Giovanni Magenes Eucentre, Pavia, Italy Hassan Ghasemzadeh University of Texas at Dallas, USA I. Peinado Polytechnic University of Madrid, Madrid, Spain JAD McLaughlin University of Ulster, Belfast, Northern Ireland, UK



Jean Luprano CSEM SA, Neuchaˆtel, Switzerland Jocelyne Fayn Universite´ de Lyon, Bron, France Maria Teresa Arredondo Polytechnic University of Madrid, Spain Paul Rubel Universite´ de Lyon, Bron, France Roozbeh Jafari University of Texas at Dallas, USA Rita Paradiso Smartex, Prato, Italy Sergio Guille´n ITACA, Valencia, Spain Steve Warren Kansas State University, Manhattan, KS, USA Vladimir Leonov Imec, Leuven, Belgium William J. Kaiser University of California, Los Angeles, CA, USA


Part I

Components and Systems

Chapter 1

Sensors for Wearable Systems Enzo Pasquale Scilingo, Antonio Lanata`, and Alessandro Tognetti



When designing wearable systems to be used for physiological and biomechanical parameters monitoring, it is important to integrate sensors easy to use, comfortable to wear, and minimally obtrusive. Wearable systems include sensors for detecting physiological signs placed on-body without discomfort, and possibly with capability of real-time and continuous recording. The system should also be equipped with wireless communication to transmit signals, although sometimes it is opportune to extract locally relevant variables, which are transmitted when needed. Most sensors embedded into wearable systems need to be placed at specific body locations, e.g. motion sensors used to track the movements of body segments, often in direct contact with the skin, e.g. physiological sensors such as pulse meters or oximeters. However, it is reasonable to embed sensors within pieces of clothing to make the wearable system as less obtrusive as possible. In general, such systems should also contain some elementary processing capabilities to perform signal pre-processing and reduce the amount of data to be transmitted. A key technology for wearable systems is the possibility of implementing robust, cheap microsystems enabling the combination of all the above functionalities in a single device. This technology combines so-called micro-electro-mechanical systems (MEMS) with advanced electronic packaging technologies. The former allows complex electronic systems and mechanical structures (including sensors and even simple motors) to be jointly manufactured in a single semiconductor chip. A generic wearable system can be structured as a stack of different layers. The lowest layer is represented by the body, where the skin is the first interface with the sensor layer. This latter is comprised of three sub-layers: garment and sensors, conditioning and filtering of the signals and local processing. The processing layer collects the different sensor signals, extracts specific features and classifies the signals to provide high-level outcomes for the

A. Lanata` (*) Interdepartmental Research Center “E. Piaggio”, Faculty of Engineering, University of Pisa, via Diotisalvi 2, 56126 Pisa, Italy e-mail: [emailprotected]

A. Bonfiglio and D. De Rossi (eds.), Wearable Monitoring Systems, DOI 10.1007/978-1-4419-7384-9_1, # Springer Science+Business Media, LLC 2011



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application layer. The application layer can provide the feedback to the user and/or to the professional, according to the specific applications and to the user needs. Recent developments embed signal processing in their systems, e.g. extraction of heart rate, respiration rate and activity level. Activity classification and more advanced processing on e.g. heart signals can be achievable exploiting miniaturization and low-power consumption of the systems. Examples of data classification are [1, 2, 3]: classification of movement patterns such as sitting, walking or resting by using accelerometer data [4] or ECG parameters such as ST distance extracted from raw ECG data [5, 3]; another example is the estimation of the energy consumption of the body [6, 7]; in [8] the combined use of a triaxial accelerometer and a wearable heart rate sensor was exploited to accurately classify human physical activity; estimation of upper limb posture by means of textile embedded flexible piezoresistive sensors [9]. Examples of integrated systems for health monitoring are in [10, 11]. In the following paragraphs, two classes of sensors which can be easily integrated into wearable systems are reported and described. More specifically, inertial sensors to monitor biomechanical parameters of human body and sensors to capture physiological signs are addressed, describing the operating principles and indicating the possible fields of application.


Biomechanical Sensors

Biomechanical sensors are thought to be used to record kinematic parameters of body segments. Knowledge of body movement and gesture can be a means to detect movement disturbances related to a specific pathology or helpful to contextualize physiological information within specific physical activities. An increasing of heart rate, for example, could be either due to an altered cardiac behavior or simply because the subject is running.


Inertial Movement Sensors

Monitoring of parameters related to human movement has a wide range of applications. In the medical field, motion analysis tools are widely used both in rehabilitation [12] and in diagnostics [13, 14]. In the multimedia field, motion tracking is used for the implementation of life-like videogame interfaces and for computer animation [15]. Standard techniques enabling motion analysis are based on stereophotogrammetric, magnetic and electromechanical systems. These devices are very accurate but they operate in a restricted area and/or they require the application of obtrusive parts on the subject body. On the other hand, the recent advances in technology have led to the design and development of new tools in the field of motion detection which are comfortable for the user, portable and easily usable

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in non-structured environments. Current prototypes realized by these emergent technologies utilize micro-transducers applied to the subject body (as described in the current paragraph) or textile-based strain sensors (as reported in [16]). These latter are not treated in this chapter. The first category, instead, includes devices based on inertial sensors (mainly accelerometers and gyroscopes) that are directly applied on the body segment to be monitored. These sensors can be realized on a single chip (MEMS technology) with low cost and outstanding miniaturization. Accelerometers are widely used for the automatic discrimination of physical activity [17, 18] and the estimation of body segment inclination with respect to the absolute vertical [19]. Accelerometers alone are not indicated for the estimation of the full orientation of body segments. The body segment orientation can be estimated by using the combination of different sensors through data fusion techniques (Inertial Measurement Units, IMU). Usually, tri-axial accelerometers (inclination), tri-axial gyroscopes (angular velocity), magnetometers (heading angle) and temperature sensors (thermal drift compensation) are used together [19, 20, 21]. Main advantages of using accelerometers in motion analysis are the very low encumbrance and the low cost. Disadvantages are related to the possibility of obtaining only the inclination information in quasi-static situations (the effect of the system acceleration is a noise and the double integration of acceleration to estimate the segment absolute position is unreliable). Accelerometers are widely used in the field of wearable monitoring systems, generally used in the monitoring of daily life activities (ADL) [22, 23, 24, 17, 25]. Physical activity detection can be exploited for several fields of application, e.g. energy expenditure estimation, tremor or functional use of a body segment, assessment of motor control, load estimation using inverse dynamics techniques [26, 27] or artificial sensory feedback for control of electrical neuromuscular stimulation [28, 29, 30]. Usually, three-axial accelerometers are used. They can be assembled by mounting three single-axis accelerometers in a box with their sensitive axes in orthogonal directions or using a sensor based on one mass [31]. An accelerometer measures the acceleration and the local gravity that it experiences. Considering a calibrated tri-axial accelerometer (i.e. offset and sensitivity are compensated and the output is expressed in unit of g), the accelerometer signal (y) contains two factors: one is due to the gravity vector (g) and the other depends on the system inertial acceleration (a), both of them expressed in the accelerometer reference frame [19]: 0 1 0 1 0 1 a1 g1 y1 B C B C B C (1.1) y ¼ a g @ y 2 A ¼ @ a2 A @ g2 A y3 a3 g3 The inclination vector (z) is defined as the vertical unit vector, expressed in the accelerometer coordinate frame [4]. In static conditions, only the factor due to gravity is present and the inclination of the accelerometer with respect to the vertical is known. In dynamic conditions, the raw accelerometer signal does not provide a reliable estimation of the inclination, since the inertial acceleration is added


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to the gravity factor. This estimation error grows as the subject movements become faster (e.g. running, jumping). Many algorithms have been developed and tested to perform a reliable estimation of the subject body inclination: most of them use low pass filters with very low cut-off frequency in order to extract z [4] (i.e. introducing a considerable time delay), others implement more complex techniques which use a model-based approach mainly based on Kalman filter techniques [19]. An example of integration of these sensors in a garment was developed in the frame of the Proetex project (FP6-2004-IST-4-026987), which aimed at using textile and fibre based integrated smart wearables for emergency disaster intervention personnel. The ProeTEX motion sensing platform is used to detect long periods of user immobility and user falls to the ground and it is realized by means of two triaxial accelerometer modules. One accelerometer is placed in the higher part of the trunk (collar level) in order to detect inactivity and falls to the ground. The second sensor is placed in the wrist region and its aim is to achieve more accuracy in inactivity detection, since an operator can move his arms while his trunk is not moving. The core of the motion sensor is the processing algorithm described in [32], which allows to perform a reliable estimation of the body inclination even in the case of intense physical activity such as running or jumping. This algorithm allows a good estimation of subject activities and generated fall alarms with very high sensitivity and extremely low level of false positives.


Physiological Sign Sensors

Wearable systems are generally thought to be used for health care, therefore necessarily including sensors to monitor physiological signs. Occasionally, it is possible to adapt commercial devices to be integrated into a wearable system, but mostly dedicated and customized sensors should be designed and embedded. Here sensors for respiration activity, pulse monitoring, galvanic skin response, thermal and cardiopulmonary radiant sensors, gas sensors and sensors for detecting biochemical markers are envisaged and described.


Respiration Activity

The most challenging vital sign to accurately record during continuous monitoring is the respiratory activity due to the fact that the signals are affected by movement artifacts and filtering or feature recognition algorithms are not very effective. Monitoring of respiratory activity involves the collection of data on the amount and the rate at which air passes into and out of the lungs over a given period of time. In literature, there are several methods to do this, both directly, by measuring the amount of air exchanged during the respiration activity, and indirectly, by measuring parameters

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physically correlated to breathing, such as changes in thorax circumference and/or cross section, or trans-thoracic impedance. Direct methods are based on a spyrometer that measures directly the airflow in the lung exchanged during inspiration and expiration, but of course it cannot be integrated into a wearable system because it employs a mouthpiece, which could interfere with the freedom of movements, disrupting the normal breathing pattern during measurement, thus causing discomfort for the user. Indirect methods exploit displacements of the lung that are transmitted to the thorax wall and vice versa, and therefore measurements of chest-abdominal surface movements can be used to estimate lung volume variation. In literature, a number of devices have been used to measure rib cage and abdominal motion including mercury in rubber strain gauges [33], linear differential transducers [34], magnetometers [35], and optical techniques [36], but almost all cannot be comfortably integrated into a wearable system. For reference only, it is worthwhile citing a more sophisticated technique, called stereophotogrammetry, which makes it possible to estimate the three-dimensional coordinates of points of the thorax, estimating therefore volume variations. Nevertheless, this system presents a considerable drawback in that it is cumbersome, extremely expensive, and can only be used in research environments or in laboratory applications. Indirect techniques that can be implemented in wearable systems are respiratory inductive plethysmography (RIP) [37], impedance plethysmography [38], piezoresistive [39] and/or piezoelectric pneumography. These systems are minimally invasive and do not interfere with physical activity. In the following, these four technics are described.

Inductive Plethysmography

The inductive plethysmography method for breathing monitoring consists of two elastic conductive wires placed around the thorax and the abdomen to detect the cross sectional area changes of the rib cage and the abdomen region during the respiratory cycles. The conductive wires are insulated and generally sewn in a zigzag fashion onto each separate cloth band (see Fig. 1.1). They can be considered as a coil and are used to modulate the output frequency of a sinewave current produced by an electric oscillator circuit. As a matter of fact, the sinewave current generates a magnetic field, and the cross-sectional area changes due to the respiratory movements of the rib cage and of the abdomen determine a variation of the magnetic field flow through the coils. This change in flow causes a variation of the self-inductance of each coil that modulates the output frequency of the sinusoidal oscillator. This relationship allows for monitoring the respiratory activity by detecting the frequency change in the oscillator output signal. For accurate volumetric measurements using RIP, it is assumed that the cross-sectional area within the rib cage and the abdomen coil, respectively, reflects all of the changes occurring within the respective lung compartment, and further that the lung volume change is the sum of the volume changes of the two compartments. Under optimal situations, lung volume can be approximated with an error less than 10%.


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Fig. 1.1 The respiratory inductive plethysmography system including the rib cage and abdominal sensor bands

Impedance Plethysmography

This technique consists of injecting a high frequency and low amplitude current through a pair of electrodes placed on the thorax and measuring the trans-thoracic electrical impedance changes [40]. As a matter of fact, there is a relationship between the flow of air through the lungs and the impedance change of the thorax. The measurements can be carried out by using either two or four electrode configurations. Electrodes can be made of fabric and integrated into a garment or, even, embedded into an undershirt. It is worthwhile noting that by measuring the trans-thoracic electrical impedance it is possible to non-invasively monitor, in addition to breathing rate also tidal volume, functional residual capacity, lung water and cardiac output. In Fig. 1.2, the scheme of principle is depicted.

Pneumography Based on Piezoresistive Sensor

Piezoresistive pneumography is carried out by means of piezoresistive sensors that monitor the cross-sectional variations of the rib cage. The piezoresistive sensor changes its electrical resistance if stretched or shortened and is sensitive to the thoracic circumference variations that occur during respiration. Piezoresistive sensors can be easily realized as simple elastic wires or by means of an innovative sensorized textile technology. It consists of a conductive mixture directly spread over the fabric. The lightness and the adherence of the fabric make the sensorized garments truly unobtrusive and uncumbersome, and hence comfortable for the subject wearing them. This mixture does not change the mechanical properties of the fabric and maintains the wearability of the garment. Figure 1.3 shows where the two conductive wires or bands could be applied.

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Fig. 1.2 Principle scheme of impedance plethysmography system which can be integrated into a wearable system

Fig. 1.3 Picture showing how two piezoresistive belts can be embedded into a garment to monitor abdominal and thoracic respiratory activity

Plethysmography Based on Piezoelectric Sensor

This method is based on a piezoelectric cable or strip which can be simply fastened around the thorax, thus monitoring the thorax circumference variations during the respiratory activity. A possible implementation can be a coaxial cable whose dielectric is a piezoelectric polymer (p(VDF-TrFE)), which can be easily sewn in a textile belt and placed around the chest. In Fig. 1.4, a possible application is reported. The sensor is sensitive to the thorax movements and produces a signal directly proportional to the thorax expansion in terms of charge variation, which was converted in an output voltage proportional to the charge by means of a charge amplifier. A suitable local processor can enable implementation of the Fast Fourier Transform in real time and extraction of the breathing rate.


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Fig. 1.4 Concept of a wearable system equipped with a piezoelectric band


Galvanic Skin Response

One of the most interesting measurements of the electrical body response is the Galvanic Skin Response (GSR), which was easily transformed from laboratory to wearable instrumentation, and has become one of the most used wearable devices especially for the high correlation that has shown with the most significant parameters in the field of neuroscience. It is a part of the whole ElectroDermal Response (EDR), which is also constituted of the measure of skin potentials. In deep, EDR is associated with sweat gland activity. Convincing evidence, indeed, was experimentally found in which a direct correlation is seen between EDR and stimulated sweat gland activity. Furthermore, when sweat gland activity is abolished, then there is an absence of EDR signals [41]. There are two major measures of the electrodermal response. The first, involving the measurement of resistance or conductance between two electrodes placed in the palmar region, was originally suggested by Fe´re´ [42]. It is possible also to detect voltages between these electrodes; these potential waveforms appear to be similar to the passive resistance changes, though its interpretation is less

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straightforward. This measurement was pioneered by Tarchanoff [43]. The first type of measurement is referred to as exosomatic, since the current on which the measurement is based is introduced from the outside. The second type, which is less commonly used, is called endosomatic, since the source of voltage is internal. Researchers also distinguish whether the measurement is of the (tonic) background level, or the time-varying (phasic) response type. An electrical equivalent model underlying EDR is represented in Fig. 1.5. This model provides only qualitative information. The active electrode is at the top (skin surface), whereas the reference electrode is considered to be at the bottom (hypodermis). R1 and R2 represent the resistance to current flow through the sweat ducts located in the epidermis and dermis, respectively. These are major current flow pathways when these ducts contain sweat, and their resistance decreases as the ducts fill. E1 and R4 represent access to the ducts through the duct wall in the dermis, whereas E2 and R3 describe the same pathway, but in the epidermis. Potentials E1 and E2 arise as a result of unequal ionic concentrations across the duct as well as selective ionic permeabilities. This potential is affected by the production of sweat, particularly if the buildup of hydrostatic pressure results in depolarization of the ductal membranes. Such a depolarization results in increased permeability to ion flow; this is manifested in the model by decreased values of R3 and R4. In particular, this is considered as an important mechanism to explain rapid-recovery signals. The potentials of E1 and E2 are normally lumen-negative. The resistance R5 is that of the corneum, whereas E3 is its potential. The phenomenon of hydration of the corneum, resulting from the diffusion of sweat from the sweat ducts into the normally dry and absorbant corneum, leads to a reduction in the value of R5. The applications of the measure lie in the area of psychophysiology and relate to studies in which a quantitative measure of

Fig. 1.5 A simplified equivalent circuit describing the electrodermal system. Components are identified in the text [44]


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Fig. 1.6 Suggested electrodes site for the measurement of skin resistance and skin potentials

sympathetic activity is desired. The importance attached to such measurements includes the statement in one recent paper that palmar sweat is one of the most salient symptoms of an anxiety state and, for some, the single most noticeable bodily reaction [45]. Other suggested locations for electrode placement can be between two fingers. In this case, electrodes can be integrated into a glove (see Fig. 1.6).


Pulse Oximetry

Pulse oximetry was introduced in 1983 as a non-invasive method for monitoring the arterial blood oxygen saturation. Recognized worldwide as the standard of care in anaesthesiology, it is widely used in intensive care, operating rooms, emergency, patient transport, general wards, birth and delivery, neonatal care, sleep laboratories, home care and in veterinary medicine. Currently, several wearable pulse oximeters are being developed to transfer this standard technique to a most effective remote home-care monitoring. Being pulse oximeter non-invasive, easy to use, readily available, and accurate, the modern wearable system developed can supply information about blood oxygen saturation, heart rate and pulse amplitude. A pulse oximeter shines light of two wavelengths through a tissue bed such as the finger or earlobe and measures the transmitted light signal. The device operates according to the following principles [46]: 1. The light absorbance of oxygenated haemoglobin and deoxygenated haemoglobin at the two wavelengths is different. To be more precise, the set of associated extinction coefficients for the absorption of light for these wavelengths is linearly independent with great enough variation for adequate sensitivity but not so large that the blood appears opaque to either of the light sources. This model assumes that only oxygenated and deoxygenated haemoglobin are present in the blood. 2. The pulsatile nature of arterial blood results in a waveform in the transmitted signal that allows the absorbance effects of arterial blood to be identified from

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those of non-pulsatile venous blood and other body tissue. By using a quotient of the two effects at different wavelengths, it is possible to obtain a measure requiring no absolute calibration with respect to overall tissue absorbance. This is a clear advantage of pulse oximeters over previous types of oximeters. 3. With adequate light, scattering in blood and tissue will illuminate sufficient arterial blood, allowing reliable detection of the pulsatile signal. The scattering effect necessitates empirical calibration of the pulse oximeter. On the other hand, this effect allows a transmittance path around bone in the finger. Systems following the principles above shown provide an empirical measure of arterial blood saturation. However, with state-of-the-art instrumentation and proper initial calibration, the correlation between the pulse oximeter measurement, SpO2, and arterial blood’s actual oxygen saturation, SaO2, is adequate-generally less than 3% discrepancy provided SaO2 is above 70% for medical applications [47]. In general, when the calibration is difficult or impossible, these systems can be redirected at considering only a led and a photodiode so that the obtained measurement is a photopletismography. Really, most pulse oximeters on the market implement photoplethysmographic measurements. The signal for the photoplethysmograph is derived from the same waveforms used to calculate SpO2. The photoplethysmograph may be used in a clinical setting in the same manner as a plethysmograph. However, the accuracy of the photoplethysmograph suffers from motion artifacts, and the patient must have adequate blood perfusion near placement of the pulse oximeter probe. Just as with the conventional plethysmogram, signal processing can derive heart rate from the photoplethysmogram waveform. Hence, most pulse oximeters also display heart rate. Similar to computing Sp02, temporal low-pass filtering abates the effect of motion artifacts on heart rate estimation. Generally, pulse oximeters are applied to a fingertip (see Fig. 1.7), but as above-mentioned they are heavily affected from motion artifact (see Fig. 1.8) so that large part of the signal has to be strongly treated or completely removed, to avoid this signal lost latest research applications aim at positioning the sensor on the forehead (see Fig. 1.9), where it has been noted that the signal shows lower artifact noise and better characteristics.

Fig. 1.7 Transmission pulse oximeter measuring the transmission of light by two LEDs through the finger of a patient


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Fig. 1.8 The plethysmographic waveform of a subject at rest is periodic (a) and during exercise is not periodic (b)

Fig. 1.9 Reflectance pulse oximeter measuring the amount of light reflected back to the probe in forehead application


Radiant Thermal Sensors

The interest of the market devices for safety and security has rapidly grown over the last few years. In particular, the use of RadioFrequency (RF) technology for contact-less sensing has been promoted largely into several research projects [48, 49]. Body temperature is usually captured by means of thermal sensors placed in direct contact with skin. Skin temperature is strongly dependent on the body site and it is sensitive to local increasing of blood circulation. Reference body temperature, indeed, should be internal. Often skin contact with thermal sensors could be difficult and obtrusive, therefore radiant technology is preferred. The state of the art on radiant thermal sensors covers several high-potential commercial products. Meridian Medical Systems (http://mms-llc.com) is aiming at fabricating a radiometer as a Monolithic Microwave Integrated Circuit (MMIC) capable of detecting temperature of the heart. Although their research aims at implementing microwave radiometers for medical imaging, it seems they use a traditional approach based on MIC/MMIC. It is worthwhile mentioning that radiometer exists from a long time,

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and their approach using hybrid components is well known. Even though MMIC can reach good performance, their level of integration is limited traditionally to the analog-RF part only. Thermal stabilization and calibration circuits need to be implemented by means of external circuitry, resulting in bulky and expensive implementations inadequate for the mass-market. In fact, the system-on-chip implementation proposed in CMOS technology aims at implementing efficiently on the same die both the analog-RF and the digital calibration circuits. Only this result leads to consider that microwave radiometers can be implemented as a real system-on-a-chip device characterized by superior performance and highest level of integration. This is the real innovation expected for enabling microwave radiometry for the next-generation of mass-market wearable devices for medical imaging, and safety and security of emergency operators. Tyco Electronics (http:// tycoelectronics.com) is developing a 24 GHz UWB radar sensor in MIC technology for short-range applications. Moreover, this device is targeted at general purpose applications (i.e. military, collision avoidance short-range automotive, etc.) and therefore only marginally related with our specific target. Anyway, as an additional consideration to all the limitations of the MIC approach cited above concerning the microwave radiometer and therefore still valid also in this case, it is worth mentioning that its bandwidth is limited to 500 MHz. A possible application of microwave radiometers could be designing a dedicated system to assist the fire fighters in their work, for instance by detecting a fire behind a door or a wall. This sensor can be mounted on two textile microstrip board. The former can contain the radiometric sensor and it is placed in the front side of the fireman jacket (this to detect the fire coming from the front). The latter can contain the low data-rate radio transceiver for sending out the information collected by the sensor, and this can be placed in the back side, for instance close to the neck. The system idea is shown in Fig. 1.10. The radiometer consists of a patch antenna array, a low noise 13 GHz radiometer module and a data acquisition and process unit. It is worthwhile noting that the sensor is mounted on the same microstrip board of the antenna. The ZigBee transceiver (IEEE802. 15. 4) transmits the data to the personal server (or a remote unit as well) of a wireless body area network (WBAN). The wireless platform allows collecting the data acquired by multiple sensors to realize an extended monitoring of the vital and environmental data. Moreover, such a wireless platform allows us to implement re-configurable systems, which can be managed by remote operators taking care of the safeguard of the rescue team. Hereinafter, how a fire in front of the subject with a separation wall between fire and subject can be detected. This inter-wall fire detection is tried in indoor environment to simulate a condition as close as possible to the operative scenario. In particular, the setup shown in Fig. 1.11 has been used for the proof-of-the concept. To model the scenario sensed by a microwave radiometer, the approach described in [50] could be adopted. This approach is based on the filling factor q, a quantity defined as the ratio between the area of the fire AFIRE and the area of the antenna footprint AFOOT: q ¼ AFIRE =AFOOT


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Fig. 1.10 Block diagram of the overall system

Fig. 1.11 Basic setup used for the inter-wall fire detection experiments

By considering Fig. 1.11, the footprint area can be evaluated approximating the main beam of the antenna with a cone of angular aperture y (half power beam width) and by cutting this cone with the profile of the illuminated scene, the soil and the furnace in this case. The radiometric contrast rT is defined as the increase of the antenna temperature due to the fire with respect to the condition without any fire. Applying the radiative transfer theory, the radiometric contrast can be derived as follows: rT ¼ tW ½EF T F ES T S ðEF ES ÞEW T W q;


where tW is the transmissivity of the wall, eF, eS and eW are the emissivities of the fire, soil, and wall, respectively, and TF, TS and TW their physical temperatures. In conclusion, the innovative low-cost, system-on-a-chip microwave radiometer could represent a very promising solution for the realization of a next-generation of wearable sensors. The SoC microwave radiometer will allow an extended detection capability in the cases where traditional devices, such as IR devices, fail.

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Biochemical Markers

Last achievements in research have enabled the possibility of detecting biochemical markers through wearable instrumentation. CSEM1 researchers have developed non-invasive biosensors for the detection of stress markers (such as lactate in sweat) and wound healing (focussing on pH and infection markers detection). The high level of miniaturization allows the integration in textile garments for the non-invasive monitoring of biological markers. In the frame of the BIOTEX2 project, a miniaturized label-free system for application in wound dressing has been developed [51, 52]. Within the PROETEX project, CSEM researchers are currently realizing a wearable biosensor for real-time stress assessment of professional rescuers to improve their safety during the intervention. In both cases, the sensing principle is based on responsive hydrogels that shrink or swell in presence of the target marker to be detected. The hydrogels are sensitive to pH changes or they can be functionalized to the target molecule by incorporating specific enzymes. In the case of stress monitoring, the hydrogel is functionalized with lactate oxidase, the presence of the lactate changes the ionic concentration in the hydrogel and consequently the hydrogel volume by an osmotic effect. The volume modification of the hydrogel causes a modification of the refractive index of the structure. The sensitive hydrogel is then integrated on a waveguide grating chip. If the grating chip is interrogated with a light source it reflects the light at a specific wavelength. As the sensitive layer changes its refractive index, the wavelength of the reflected light is shifted in accordance. The detection principle is based on the measurements of the refractive index through an optical signal propagated along a wave guide. By exploiting this principle, a wearable optical bio-sensor has been designed and realized [51, 52]: it uses a sensitive layer on a waveguide grating chip, the biosensor is interrogated with a white light source (using a white led) and the reflected light is detected by a mini-spectrometer in order to measure the wavelength shift. Electrochemical sensors can be integrated into flexible (i.e. plastic, textile) substrates to develop wearable systems for the detection of biochemical markers. Some researchers are developing a portable electrochemical system based on Ion Sensitive Electrodes (ISE) integrated into a fabric substrate [53]. ISE can measure the sodium concentration in sweat and this measurement can be related to the operator dehydration that can lead to severe physiological consequences being able to go until the death. A portable electronic board connected to the sensing part has been developed. This board drives the electrochemical sensor, compensates the effect of temperature, performs analog acquisition and converts measurement data to digital value. Signal processing is implemented on board to correct raw data (gain, offset) and to convert them to ion concentrations. The system was evaluated in terms of sensitivity, selectivity and reproducibility initially in model solution and then in natural sweat, showing very promising 1 2

Centre Suisse d’Electronique et Microtechnique SA, CH. Biosensing textile for health management, FP6-IST-NMP-2-016789.


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performances. A more recent technique employed for biochemical marker detection in wearable systems is based on Organic Field Effect Transistors (OFET). Researcher at University of Cagliari developed a flexible OFET able to detect pH changes in chemical solutions thanks to a functionalized floating gate [54]. The sample solution is brought into contact with a portion of the floating gate, which is properly functionalized to achieve the sensitivity to a particular chemical species. The sensing mechanism is based on the detection of the electrical charge associated with the chemical species placed over the probe area. The charge immobilized on the floating gate generates an electrical field and thus induces a phenomenon of charge separation inside the electrode, affecting the channel formation in the transistor. This mechanism can be described in terms of a shift of the effective threshold voltage of the OFET. By properly functionalizing the floating gate surface, sensitivity to different species and the detection of different reactions can be achieved, with the same sensor.


Gas Sensors

Researchers from Dublin City University (DCU) are involved in the integration of sensing platforms into wearables for the detection of environmentally harmful gases surrounding emergency personnel. Special attention is being paid to carbon monoxide (CO) and carbon dioxide (CO2). These gases are associated with fires and mining operations, and it is of the highest importance to warn and protect operators from potential harm caused by over-exposure to high concentrations of these gases. The goal is rapid detection of the status of an environment (low, medium or high hazard) and real-time communication of this information to the garment wearer. Critical in this identification of potential toxification is a reliable method of measuring CO/CO2 exposure. Commercially available sensors have been carefully selected and are being integrated into the outer garments of firefighters. The sensors provide sufficient sensitivity to reliably alert users to the presence of these harmful gases. Another important aim is to achieve wireless transmission of sensor signals to a wearable wireless base station that gathers, processes and further transmits the data. When selecting the appropriate commercially available sensors for the gas sensing application, special attention was paid to sensor size, robustness, sensitivity and power requirement. Electrochemical sensors satisfy most of these requirements, especially in terms of size and power requirements. CO is detected using an amperometric sensor in which the current between the electrodes is proportional to the concentration of the gas. On the other hand, the CO2 sensor is potentiometric. In this case, the reference and working electrodes are placed in an electrolyte that provides a reference CO2 concentration. The measured potential is based on the difference in concentration between the reference electrode and the outside air. Both types of sensors are very sensitive and give an accurate reading (in parts per million). This means that both low concentrations of these gases (which can be

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hazardous over long periods of exposure) and high concentrations (which pose an immediate danger) can be accurately detected. The signal obtained from these sensors is transmitted wirelessly to the wearable base station using Zigbee. Power is supplied to the sensors using a nickel metal hydride rechargeable battery. The CO2 sensor is placed in a specially designed pocket located on the firefighter’s boot. The pocket is designed not to obstruct the firefighter’s activities. The prototype currently used for testing is shown in Fig. 1; note the side pocket containing the CO2 sensor along with the wireless sensing module and a battery. The pocket has a waterproof membrane that protects the sensor from humidity, but allows gas to pass through. The CO sensor will be integrated in the firefighter’s outer garment (i.e. jacket). All sensed information will be fed to a wearable local base station that shares the data with a remote centralized base station. The ultimate goal is to achieve local communication between firefighters and civil workers in the operations area, as well as longer range communications between these personnel and the support team outside the operations area.


Cardiopulmonary Activity Systems

One of the most challenging points in the healthcare system is to use a single device to simultaneously gather cardiac and pulmonary information, which usually are both obtained from different systems and whose interdependences are left to the clinic experience only. An innovative cardiopulmonary wearable system that matches this dual request is based on Ultra WideBand (UWB) technology. The main advantage of this monitoring radar system is the absence of direct contact with the subject skin, dramatically reducing the typical disturbance due to motion artifact [55]. Before introducing the system concept of the system let us give a brief overview on the current state of the art. The most widespread system used to monitor the cardiac activity is the electrocardiograph (ECG), which provides information about the heart electrical activity. Another complementary technology for monitoring the cardiorespiratory activity is pulse oximetry, which measures the saturation level of the oxygen in the blood. Other systems for the monitoring of the cardiac activity are based on ultrasounds (echocardiograph or echo Doppler). Ultrasound-based systems are generally cumbersome and they can be used only by specialized operators. Anyway, all the presented measurement techniques require the direct contact with the body to carry out the measurement. Unlike the traditional techniques (electrocardiograph, echocardiograph and pulsed oximetry), radar systems allow the monitoring of the heart activity in a non-invasive and contactless way for the patient [56]. Microwave Doppler radars have been used to detect the respiration rate since 1975 [57]. These first devices were bulky and expensive, but the recent microelectronic advances led to develop CMOS fully integrated radars for non-contact cardiopulmonary monitoring [58]. Doppler radars typically transmit a continuous wave signal and receive the echo reflected by the


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target. The frequency of the reflected signal varies from that of the transmitted one by an amount proportional to the relative velocity of the target with respect to the radar. Another class of radar employed for the monitoring of vital parameters is based on pulse transmission. Pulse radars operate by sending short electromagnetic pulses and by receiving the echoes back-scattered by the target. The time delay between the transmission of the pulse and the reception of the echo is proportional to the distance of the radar from the target. Discrete prototypes of pulse radar for the detection of vital parameters are reported in literature [59, 60]. It is worthwhile mentioning that radar sensors monitor the mechanical movement of the heart wall instead of the electrical activity of the heart (such as the electrocardiograph), therefore when mechanical anomalies occur earlier than the electrical ones, this device can be used to prevent in advance possible cardiac failures. Moreover, the UWB pulses are not influenced by blankets or clothes [60]. From a circuit design point of view, UWB transceivers present a lower complexity with respect to traditional radiofrequency systems, leading to low power consumption for a long life of the battery. In fact, UWB systems do not require a stable frequency reference, which typically requires a large area on silicon die and high power consumption. Moreover, the extremely low level of transmitted power density (lower than 41. 3 dBm/MHz) of the UWB radar should reduce the risk of molecular ionization [61, 44] (see Fig. 1.14). The main block of the novel wearable wireless interface for human health care described herein is the UWB radar sensor (see Fig. 1.12). The block diagram of the proposed radar sensor for the detection of the heart and breath rates is shown in Fig. 1.13. The radar exploits a correlationbased receiver topology followed by an integrator, which averages the received pulses to have an output signal containing the information on the heart and breath tones. The operating principle of a cross-correlator radar is explained hereinafter. An electromagnetic pulse is transmitted toward the target. The echo received from the target is multiplied by a delayed replica of the transmitted pulse; the output signal of the multiplier is then integrated. It is worthwhile noting that the output signal will reach its maximum in the case of perfect time alignment

Fig. 1.12 Wearable Wireless UWB radar sensor interface for human health care

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Fig. 1.13 Block diagram of the UWB radar sensor

Fig. 1.14 FCC PSD mask for medical imaging and Power spectral density (PSD) of a pulse sequence with PRF equal to 1 MHz vs. frequency

between the two signals at the input of the multiplier itself. In other terms, the crosscorrelator has a frequency response equal to that of a matched filter. In particular, it can be demonstrated that the matched filter is the filter that allows obtaining the best signal-to-noise ratio at the output. Moreover, this has been confirmed by preliminary system simulations (by means of the Ptolemy simulator within Agilent ADS2005A). In detail, the CAD system analysis has shown that this topology allows us to achieve the best performance in terms of output signal-to-noise ratio (SNR) and sensitivity to small variations of the position of the heart wall with respect to other topologies, like that in which the receiver is simply turned on by the command given by the delayed replica of the transmitted pulse [61]. The principle of operation of the overall radar system shown in Fig. 1.13 is


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explained hereinafter [62]. A train of extremely short (about 200 picoseconds) Gaussian monocycle electromagnetic pulses is transmitted toward the heart. Since the heart muscle and the blood that flows inside have different characteristic impedance, a partial reflection of the energy associated with the radiated pulse occurs at the surface of separation of these two different media.



In this chapter, we gave an overview on sensors for physiological signals and biomechanical parameters, which can be easily integrated into wearable monitoring systems. The operating principle of each sensor was described as well as some applicative example was given. Generally, a wearable system has to comply with a series of requirements, e.g. minimallyinvasive, based on flexible technologies conformable to the human body, cost-effective, easy to use and customizable to the specific user. Several technologies can be easily adapted, but in several cases ad-hoc applications should be designed. Much work has to be done in this field, even if several effective sensing platforms are already available and promising for future improvements.

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Chapter 2

Energy Harvesting for Self-Powered Wearable Devices Vladimir Leonov


Introduction to Energy Harvesting in Wearable Systems

Personalized sensor networks optionally should include wearable sensors or a body area network (BAN) wirelessly connected to a home computer or a remote computer through long-distance devices, such as a personal digital assistant or a mobile phone. While long-distance data transmission can typically be performed only by using the batteries as a power supply, the sensors with a short-distance wireless link can be powered autonomously. The idea of a self-powered device is not new and is actually known for centuries. The earliest example of self-powered wearable device is the self-winding watch invented in about 1770. However, typically not much energy is harvested in a small device, so that use of a battery, primary or rechargeable, is beneficial from practical point of view. There are worldwide efforts ongoing on development of microgenerators that should eliminate the necessity of wiring and batteries in autonomous and stand-alone devices or in devices that are difficult to access. Energy harvesters are being developed for the same purpose. An energy harvester (also called an energy scavenger) is a relatively small power generator that does not require fossil fuel. Instead, it uses energy available in the ambient, such as an electromagnetic energy, vibrations, a wind, a water flow, and a thermal energy. These sources are the same as those used in power plants or power generators such as the ones for powering houses in remote locations, light towers, spacecrafts, and on transport (except those based on fossil fuels). An energy harvester is typically several-to-one centimeter-size power microplant that converts into electricity any primary energy that is available in the ambient. The reason to call them “harvesters” or “scavengers” is the new application area: they are used for powering small devices, such as sensors or sensor nodes. This way of powering them eliminates the need for cost-ineffective work, such as wiring or either

V. Leonov (*) Smart Systems and Energy Technology Imec, Kapeldreef 75, 3001 Leuven, Belgium e-mail: [emailprotected]

A. Bonfiglio and D. De Rossi (eds.), Wearable Monitoring Systems, DOI 10.1007/978-1-4419-7384-9_2, # Springer Science+Business Media, LLC 2011



V. Leonov

recharging or replacing batteries. An energy harvester could also be combined with a battery and serve a complementary source of power to improve energy autonomy of a device at limited size of the battery. Three kinds of energy sources can be used for harvesting in wearable devices. These are the mechanical energy of people’s own moving or accelerations on transport, an electromagnetic energy that is mainly light energy, and the heat flow caused by the difference in temperature between the human body and the ambient. There is a difference between truly unobtrusive energy harvesters such as photovoltaic (PV) cells and effort-driven micropower generators. The typical example for the latter is a flashlight that is to be shaken or pre-powered by using the embedded dynamo. A power of the order of Watts can be obtained in such effort-driven microgenerators. However, this way of powering BAN or wearable sensors should be rejected because of additional care required from the patient’s side. The worst-case scenario for energy harvesting is a patient who stays in his/her own bed. Then, there is practically no mechanical energy to harvest. The light intensity at home is low. The heat flow minimizes because of a blanket and low metabolic rate, especially, in elderly people. Therefore, only a part of the head and, sometimes, wrists of the person is the only relatively small zone where the energy harvester of thermal or light energy can be located on such patients. The available power is low, too, because the illumination level indoors is low and the heat transfer from the person is determined by natural convection around the head. Nevertheless, even in such case, powering of, e.g., a health-monitoring sensor by using energy harvesters is feasible. Preventive healthcare is considered as a way to potentially decrease the cost of healthcare, which is steadily on an upward trend. One of the strategies is to shift the health monitoring and management outside the expensive medical centers to family doctors and even to home. For example, the monitoring of chronic diseases while providing real-time data from and to the patient wherever he/she is and at any moment may offer significant potential for both cost reduction at the stage of monitoring and for making curative medicine cost-effective. Wireless healthcare systems, which could be an important component of so-called e-health or eHealth grids, are expected to focus on preventive care and effective provision of continuous treatment to patients, especially those living in remote locations and to elderly people. Real-time monitoring of patient’s vital signs and patient-level health data requires use of wearable sensors and mobile devices. It would be good if such devices were small, unobtrusive, and maintenance-free for their entire service life.


Principles of Energy Harvesting by Using Human Body Heat

Warmblooded animals, or homeotherms, including humans constantly generate heat as a useful side effect of metabolism. However, only a part of this heat is dissipated into the ambient as a heat flow and infrared radiation, the rest of it is rejected in a form

2 Energy Harvesting for Self-Powered Wearable Devices


of water vapor. Furthermore, only a small fraction of the heat flow can be used in a compact, wearer’s friendly and unobtrusive energy scavenger. For example, nobody would like to wear a device on his or her face. Therefore, the heat flow from the face cannot be used. The heat flow can be converted into electricity by using a thermoelectric generator (TEG), the heart of which is a thermopile. It is known from the thermodynamics that the heat flow observed on human skin cannot be effectively converted into electricity, although a human being generates more than 100 W of heat on average. Assuming that about 1–2% of this heat can be used, an electrical power of the order of milliwatts can be obtained using a person as a heat generator. If we recall that watches consume about 1,000 times less power, it is fairly good power. The human body is not a perfect heat supply for a wearable TEG. The body has high thermal resistance; therefore, the heat flow is quite limited. This is explained by the fact that warmblooded animals have reached in the process of evolution a very effective thermal management. In particular, this includes a very high thermal resistance of the body at ambient temperatures below 20–25 C, especially, if the skin temperature decreases below the sensation of thermal comfort (Monteith and Mount 1974). At typical indoor conditions, the heat flow in a person depends on the location on the body and mainly stays within the 1–10 mW/cm2. The forehead produces larger heat flow than the area covered by the clothes. Because of thermal insulation due to clothes, not much heat is dissipated from the skin and only about 3–6 mW/cm2 is observed indoors, on average. Depending on the physical activity of a person, the heat dissipation in extremities “switched” either on or off. This is to preserve the temperature of the body core at low metabolic rate, and to dissipate the excess heat when body temperature rises due to increased physical activity. The ambient air has a high thermal resistance, too. Indoors, it can be evaluated by using natural heat convection theory. The TEG placed at the interface between the objects with high thermal resistance, i.e., the body and air, must also have relatively high thermal resistance. This can be explained by using electro-thermal analogy, i.e., when voltage, current, and resistance are replaced with temperature difference, DT, heat flow, W, and thermal resistance, respectively. The corresponding thermal circuit is shown in Fig. 2.1 for the two cases: (1) a naked human being with no device, and (2) with a TEG on the skin. The human body as a heat generator and the

Fig. 2.1 Equivalent thermal circuits of: (a) a short-circuit natural thermal generator, and (b) the same generator with a thermal load. A relatively small surface of the skin, e.g., several square centimeters, is considered in both cases for the sake of simplicity


V. Leonov

ambient air as a heat sink represent natural thermal generator that is shunted on the skin, i.e., at the interface between the body and air (Fig. 2.1a). If a TEG is placed on the skin (Fig. 2.1b), the device behaves as a thermal load of the thermal generator. The thermal circuit of a wearable TEG placed in contact with the skin involves the thermal resistance of the body, RHG, and of the ambient air, RHS. These resistors are connected in series and represent the thermal resistance of the thermal generator. Despite the fact that the air is a heat sink, in terms of thermal circuit, its thermal resistance acts in the same way as the one of the body, i.e., of the heat generator, and must be included into the thermal generator. In other words, the thermal resistance of the body and air is the thermal resistance of the environment surrounding the TEG. The heat flow in the circuit, W, is the ratio of the temperature difference between the deep body temperature, or core temperature, Tcore and the ambient air with the temperature Tair to the thermal resistance of the circuit. The normal core temperature in humans is about 37 C with a day-to-night variation of 0.5–1 C. Animals, in general, have similar core temperatures, but in cattle it is frequently a little higher, up to 39 C. In camels and baby animals, it can further raise up to about 41 C. The highest core temperatures, up to about 45 C, have been registered in small birds. Typically, the bird temperature ranges between 38 C and 42 C. At night, however, birds have the lowest temperature, which is called nocturnal hypothermia. In general, the smaller the animal, the smaller wearable TEG is needed to produce the same power. The smallest TEG is required on a bird because of a high heat transfer coefficient from it during flight (forced air convection), which is good for the bird. It is obvious from Fig. 2.1b that the available temperature difference DT ¼ Tcore – Tair can never appear on the TEG because of high thermal resistance of the ambient air and, frequently, of the body. The ratio RTEG/(RHG + RHS + RTEG) determines the part of available temperature difference to be obtained on a TEG, i.e., DTTEG ¼ (Tskin – Trad), where Trad is the temperature of the outer surface of the TEG, which is called radiator. The thermal resistors composing the thermal generator are variable and depend on each other, and on the thermal resistance of a TEG. Therefore, Tskin and Trad in Fig. 2.1b are not the same as in Fig. 2.1a at the same ambient conditions. The increased thermal resistance of the circuit in Fig. 2.1b due to a thermal load causes also the heat flow W to decrease. Because of specific conditions of a thermopile application discussed above, there are specific requirements to both the thermopile and the TEG in most of the energy harvesters including wearable devices. First, the optimal thermal resistance of a thermopile, Rtp, required for maximum power generation must be equal to: Rtp ¼

Rpp RTEGopt ; Rpp RTEGopt


where Rpp is the parasitic thermal resistance of a TEG, and RTEGopt is the optimal thermal resistance of a TEG, at which power generation reaches its maximum. The parasitic thermal resistance, Rpp, is always observed due to: (1) air inside the TEG, (2) holding mechanical components interconnecting the cold and hot sides of

2 Energy Harvesting for Self-Powered Wearable Devices


a TEG, i.e., the elements connected thermally in parallel to the thermopile, and (3) a heat exchange due to infrared radiation. The thermal resistor Rpp is connected thermally in parallel to the thermopile between its hot and cold junctions. Actually, it may include some thermal resistance associated with parasitic heat transfer from the heat source to the radiator or to the boundary layer through convection and radiation outside the TEG. The optimal thermal resistance of a TEG can be obtained from the equation of its thermal matching with the ambient: RTEGopt ¼

ðRHG þ RHS Þ Rem ; 2ðRHG þ RHS Þ þ Rem


where RHG is the local thermal resistance of human body between the body core and the chosen location on the skin, RHS is the thermal resistance of a heat sink, i.e., the thermal resistance due to convection and radiation on the outer side of TEG, and Rem is the thermal resistance of a TEG which could occur if the TEG would be “empty,” namely, with no thermoelectric material in it. Equation (2.2) is a thermal equivalent of electrical matching of a generator with its load. The last requirement is that the thermal insulation factor N, defined as N ¼ Rem =ðRHG þ RHS Þ;


must preferably be more than one. This ratio depends on the area of radiator, the contact area with the skin, and on the thickness of a TEG. The thinner the TEG, the less power it regrettably produces due to thermal shunting of a thermopile through the air and holding components. The maximum power takes place at the optimal temperature difference between the cold and hot thermopile junctions, DTtp. The latter can be expressed as: DTtp ¼

DT ; 2ð1 þ 1=N Þ


so that at N ¼ 1, only 25% of DT can be obtained on the thermopile. If N 1, DTtp approaches a half of DT like in the other reversible heat engines. The thermal conductivity of air is significantly less than that of thermoelectric material and can therefore be neglected. In this case, one can obtain the expression for the power that can be reached in a wearable TEG, Pmax, as: Pmax ¼

Z DT DTtp ; 8 ðRHG þ RHS Þ


where Z is the thermoelectric figure-of-merit. From (2.1) to (2.5), a compact wearable TEG should be semiempty, where the thermopile must occupy only a minor part of the device volume. The rest must be filled with air or with a material showing thermal conductivity less than the thermal conductivity of air. The radiation heat exchange between the hot and cold components of a TEG must preferably be minimized through the use of materials


V. Leonov

with low emission coefficient in long-wave infrared spectral region, i.e., metals. The requirement of a “semiempty” TEG offers a good chance to body-powered power converters to be embedded in pieces of clothing. Such low-weight devices could be user-friendly and comfortable while being worn.


Calculated Characteristics of Wearable TEGs

The factor N, as follows from (2.4) to (2.5), must exceed one for satisfactory power generation. This places a barrier for the minimal thickness of a TEG at a fixed area that it occupies on the human body. The thermal resistance of the thermoelectric material and air between the two plates of a TEG is proportional to the distance between the plates (Fig. 2.2). However, decreasing the thickness of a TEG does not essentially affect the thermal resistance of thermal generator (Fig. 2.1). As a result, e.g., a thermopile weaved in clothes cannot produce satisfactory power levels. This is because N becomes much less than one. Therefore, unacceptably low DTtp is developed on the thermopile. It could have a thermal resistance of a few cm2K/W, while for reaching the power maximum it should be hundred times higher. There are two basic ways to maximize the power. The first way is to make a thin TEG, say, 3-mm-thin, and provide a very good thermal isolation between the plates of the TEG (Fig. 2.2b). This increases numerator of (2.3), the factor N, and the power. The two plates larger than the area occupied by a thermopile are required to

Fig. 2.2 A thermopile between the hot and cold plates of a thermoelectric generator (a), and the cross-section of wearable thermoelectric generators: (b) a thin TEG on the human skin (1) filled with the material (2) with a thermal conductivity much less than that of air, and (c) a thick air-filled TEG with a radiator (3). The other thermally isolating and shock-protecting components are: (4) encapsulation wall, (5) rigid supports such as pillars, and (6) a thermally isolating protection grid that allows air convection and being transparent for infrared radiation

2 Energy Harvesting for Self-Powered Wearable Devices


decrease the thermal resistance of the thermal generator (i.e., of the environment) and to get optimal temperature difference on the thermopile. Because of fragility of thermoelectric materials, the device must be enforced by using stiff supports, such as pillars or an encapsulating wall, placed in between the plates. In principle, filling of such a TEG with the material having thermal conductivity less than that of air could be advantageous for further lowering parasitic heat exchange between the plates. The device could be integrated into a piece of clothing. However, such a TEG does not reach the best power that can be obtained on a person because of a low factor N. Furthermore, accounting for technological limitations in industrial fabrication process of thermopiles, only a low voltage, much less than 1 V can be obtained in a compact device. As a result, only several thermoelectric devices connected electrically in series could guarantee an output voltage of the order of 0.5–1 V, which can be effectively used for powering electronic devices. As an alternative, the TEG could be made thicker, e.g., 1–2-cm thick. Despite complications related to integration of such units into clothes, it could reach much higher N, and therefore better power per unit area of the skin. As a result, thicker units would produce higher voltage and it becomes possible to use only one unit for powering a wearable device, of course, if the TEG produces power enough for the particular application. The second way to maximize power is to decrease the denominator in (2.3), i.e., the thermal resistance of the thermal generator. This can be done by using a fin radiator, or the one with pins. Of course, such radiator consumes some volume of the TEG. The device with a radiator cannot be therefore thin. However, in a TEG that has a thickness of 1–2 cm, the radiator helps to further increase the factor N and the power. As a numerical example, let us analyze a wearable TEG resembling a big button of 3 cm in diameter. In the calculations, we will vary the thickness of such unit and determine the dependence of maximum power on its thickness. The device resembles the one shown in Fig. 2.2b; however, the empty space between the plates is filled with air, i.e., (2) is air. Two rigid metal plates with a thickness of 1 mm will provide stiffness to the device and good thermal conductance from the human skin to the thermopile and from the latter to the ambient air. The small temperature drop related to limited thermal conductivity of the plate material is neglected. It is assumed that the unit is integrated in a piece of clothing and is located on the chest or arm of the person. We assume that the heat transfer to the ambient is described by natural convection and radiation. The heat transfer correlations are used for a vertical plate with a characteristic length of 30 cm (Incropera and DeWitt 1996) while assuming that the heat transfer from the outer surface of the device is the same as from the clothed human being. The calculations are performed for the distance between the plates from 0.5 to 8 mm, so that the thickness of the TEG varies from 2.5 to 10 mm. The other parameters are: air temperature is 22 C, the deep body temperature of a subject is 37 C, the thermal resistance of the body is 250 cm2K/W, Z ¼ 0.003 K1, the supports and encapsulation together have a thermal resistance of 400 K/W per 1 mm distance between the plates, the emission coefficient of the outer surface of the TEG is 90%, no radiation heat transfer between the polished aluminum plates, and no convection inside the TEG, i.e., it is encapsulated.


V. Leonov

b Temperature difference (0C)

Thermal resistance (K/W)

1000 1 2 100 3

10 2


6 8 Thickness(mm)












0 2


6 8 Thickness(mm)

Factor N


0 10

Fig. 2.3 Calculated dependence of thermal characteristics of optimal both the thermoelectric generator and the thermopile on the thickness of a TEG: (a) the optimal thermal resistance of an empty TEG (1), of the matched TEG (2) and of the thermopile (3), and (b) the temperature difference on a thermopile (1) and the factor N (2)

The results of modeling show that the thermal resistance of an empty TEG that scales linearly with its thickness results in a decreased thermal resistance of the thermally matched TEG if it is thin (Fig. 2.3a). The factor N becomes small and the temperature difference on the thermopile decreases to about 1 C even in the optimized TEG (Fig. 2.3b). At the thickness less than 6 mm, even a half of the theoretical power, (2.5), cannot be reached because N < 1. Ideally, a wearable device and its power supply should be small. Therefore, the power produced per unit volume of a TEG is of primary importance. Under the conditions specified above, it has a maximum in a 4–5-mm-thick device (Fig. 2.4a). The absolute power produced in a thicker device increases (Fig. 2.4b); however, the volume increases more rapidly than the power. Analysis shows that increasing the thickness from 2.5 to 6 mm causes an increase of the power because of increase in numerator of (2.3). In a thicker device, on the contrary, decreasing the denominator of (2.3) could effectively help to further increase the power. Therefore, a second device has been modeled, which resembles the TEG shown in Fig. 2.2c. In the modeled device, there is no protection grid. Then, the only difference with the first modeled device is that a part of its volume is occupied by a radiator. The results of such modeling are shown in Fig. 2.4, too. The radiator size increases up to 40% of the device volume in a 10-mm-thick TEG. It enables keeping the maximum power generation independent of the volume (Fig. 2.4a). Therefore, power generated by such TEG increases linearly at least up to 10-mm thickness. One should not expect linear increase of the power in devices thicker than 1 cm. Actually, in such devices, the other effects that have been neglected in the above modeling start to be important. Application of the radiator results in local increase of the heat flow in humans. The larger the radiator, the larger is the heat flow and the lower is the skin temperature under the TEG. The radiator temperature decreases below the temperature of the outer surface of a clothed person. Therefore, the heat transfer becomes less effective than it was assumed in the model. We can

2 Energy Harvesting for Self-Powered Wearable Devices








With radiator 20


150 100 50



6 8 Thickness(mm)


With no radiator


4 6 8 Thickness(mm)


Fig. 2.4 Calculated dependence of the power on a thickness of an optimal TEG with no radiator (circles) (Fig. 2.2b), and with the radiator of an optimal size (triangles) (Fig. 2.2c): (a) power per unit volume, (b) power produced in a TEG of 3 cm in diameter. A dashed line in (b) is the guide for an eye

conclude from Fig. 2.4 that an optimized small wearable TEG can produce about 25 mW/cm2 and about 25 mW/cm3 indoors, i.e., with no wind, no sunlight, no pieces of clothing worn on top of the TEG, and in the location on the human body, where the thermal resistance of the latter is 250 cm2K/W. The measured performance characteristics of wearable TEGs are close to their theoretical analysis performed in this section. However, if the TEG is located on an open skin surface, the radiator temperature is significantly less than the skin temperature. Consequently, the power per unit volume decreases as compared with calculations performed in this section due to higher temperature of the convection layer formed around the human body. Based on both theoretical and practical results (still to be discussed below), we conclude that a correctly designed unobtrusive TEG in the right location on the human body can produce approximately 10–30 mW/cm2 of electrical power in moderate climate, on 24-h average. The produced power depends on the thickness of a TEG and its size: the thicker the TEG, the better is power generation while the larger the TEG, the less power per unit area is produced. It also very much depends on the location on the human being therefore the latter requires particular attention.


Human Body as a Heat Source for a Wearable Thermoelectric Power Supply

Medical studies of the properties of a human being, in particular, of heat flows and its thermal conductance are typically performed on the whole human body or on its parts such as the head, arm, hand or trunk (Hardy et al. 1970; Itoh et al. 1972). Furthermore, they are mainly conducted on naked skin surface. Clothes change the


V. Leonov

overall heat flow from the human body and its pattern. Clothes have a tremendous effect on the heat transfer from the body at ambient temperatures less than 25–28 C. All three main channels of heat rejection, namely, convection, radiation, and evaporation from the skin surface are affected by clothes. The lower the ambient temperature, the larger is the percentage of heat dissipated from open skin, i.e., from the face. The trunk has much more stable temperature at different ambient conditions (temperature, wind, and sunlight) than the head and extremities. This is because people choose appropriate clothes depending on the weather conditions. However, even indoors, at typical temperatures of 20–25 C, certain variations of the skin temperature are observed on the scale of centimeters. An example of the temperature map of the wrist and hand is shown in Fig. 2.5a. The temperature profile around the wrist is shown in Fig. 2.5b as measured at two indoor ambient temperatures. The temperature reaches maximum close to the radial and ulnar arteries. Local heat flows also change from place to place. If a TEG is attached to the body, especially the one with a radiator, the heat flow depends not only on the skin temperature, but also on the local thermal resistance of the human body. The latter is defined as a thermal resistance between the body core and the chosen location on the skin. As an example, the skin temperature has been measured in the middle of the forehead before attaching a TEG and under attached TEG. At 21.5 C, a heat flow of 9.5 mW/cm2 and a thermal resistance of 380 cm2K/W have been measured by using a thermopile with a thermal resistance of 50 cm2K/W attached to the forehead. A skin temperature of 34.7 C has been measured, but a deep brain temperature of 37.5 C has been assumed to obtain the thermal resistance. Then, a TEG with a fin radiator of 1.6 cm 1.6 cm 3.8 cm size has been attached on the same place. The contact area between the TEG and the skin was 4 cm2. The heat flow has increased to 22.5 mW/cm2, the thermal resistance of the forehead has decreased to 227 cm2K/W, and the skin temperature under the TEG dropped to 30.9 C.


b oC

Temperature, 15 35.44–36.00 34.88–35.44 14 34.31–34.88 33.75–33.31 13 33.19–33.75 32.63–33.19 12 31.50–32.63

Wearable Monitoring Systems - PDF Free Download (2024)


What is wearable devices pdf? ›

For a product to be called "wearable technology," it must wirelessly transfer information from smart sensors to a smartphone. These devices can take various forms, such as watches, glasses, Page 16 9 WEARABLE TECHNOLOGIES bracelets, or jewelry (ICTA, 2020).

Is there a wearable device to monitor vitals? ›

The Vitaliti patch continuously tracks electrocardiogram (ECG) measurement, heart rate (HR), pulse rate, respiratory rate (RR), temperature, blood pressure, and oxygen saturation.

What wearable technology is used in healthcare? ›

An Overview of the Wearable Market in Healthcare

One is medical-grade wearables such as blood pressure, glucose and heart monitors. These devices undergo clinical research and must receive U.S. Food and Drug Administration clearance to gather data that will be used to support clinical decision-making.

What is an example of a wearable medical device? ›

Wearable technology in healthcare refers to devices that patients attach to their bodies to collect health and fitness data, which they may provide to doctors, health providers, insurers and other relevant parties. Examples include fitness trackers, blood pressure monitors and biosensors.

What are the 4 wearable devices? ›

Modern wearable technology falls under a broad spectrum of usability, including smartwatches, fitness trackers such as the Fitbit Charge, VR headsets, smart jewelry, web-enabled glasses and Bluetooth headsets.

What are wearable tracking devices? ›

What are activity trackers? Activity trackers are devices that translate movement into different forms of data. Most trackers will provide estimates of steps, distance, and active minutes. The data can be viewed on a phone, tablet or PC. Depending upon the tracker, the information tracked may vary.

What is the best wearable device to monitor your heart? ›

  • Best Overall: Garmin Vivomove Sport at Amazon ($180) ...
  • Best Budget: Amazfit Band 7 at Amazon ($50) ...
  • Best for Running: COROS Pace 2 at Amazon ($199) ...
  • Best With GPS: Fitbit Charge 5 at Walmart ($129) ...
  • Best for Sleep: Fitbit Inspire 3 Health & Fitness Tracker at Amazon ($100) ...
  • Best With App: ...
  • Best for Triathletes: ...
  • Best Stylish:
Mar 1, 2024

What is the name of the machine that monitors your heartbeat? ›

What is a Holter monitor? A Holter monitor is a type of portable electrocardiogram (ECG). It records the electrical activity of the heart over 24 hours or longer while you are away from your healthcare provider's office. A standard or resting ECG is one of the simplest and fastest tests used to check the heart.

Is there a wearable EKG? ›

How do wearable ECGs differ from 12-lead ECGs? A smartwatch or wearable ECG, uses a single electrode sensor to measure the electrical activity of the heart, typically placed on the underside of the smartwatch.

What is the biggest drawback of wearable technology? ›

  • Requires a time commitment to review and analyze data. ...
  • Requires financial commitments and planning. ...
  • Devices could lead to distraction. ...
  • Data security and privacy could be compromised with legal, financial, and personal consequences. ...
  • Devices could lead to over-trust or under-trust.
Feb 24, 2023

What is the problem with wearable devices? ›

The drawbacks to wireless charging include lower efficiency, higher heat generation and slower charging. Each of these issues are related and will be improved by newer coil structures and higher coupling frequencies. Most wearable devices are extremely low-powered, meaning the impact of these drawbacks may be minimal.

What is the most common wearable technology? ›

A smartwatch is one wearable tech with the most users in the world. It is also the most popular in the market. 20.1 million smartwatches were sold in the US and 148.74 million worldwide. The number increased in 2020 as 22 million were sold in the US and 186.89 million worldwide.

What health condition needs a wearable device? ›

From continuous glucose monitors to wearables that monitor sleep quality, technology has the power to potentially personalize chronic disease care for conditions like diabetes and cardiovascular disease more than ever before.

Is there a wearable blood pressure monitor? ›

The best blood pressure that you can purchase for the US market is the YHE BP Doctor Pro, one of the few wearables available to capture your blood pressure from the wrist. Read on to see how all of the available blood pressure watch options compare.

What is one health condition that would warrant the use of a wearable device? ›

One condition that could benefit from a wearable device is people prone to seizures. A device that could record various data like a person's heart rate, respiration rate, and any abnormal movements would be extremely helpful for patients with seizures.

What is the meaning of wearable devices? ›

Wearable technology, also known as "wearables," is a category of electronic devices that can be worn as accessories, embedded in clothing, implanted in the user's body, or even tattooed on the skin.

What are wearable devices summary? ›

Wearables are electronic technology or devices incorporated into items that can be comfortably worn on a body. These wearable devices are used for tracking information on real time basis.

What are the functions of wearable devices? ›

Top Examples of Wearable Medical Technologies

Fitness Trackers: use sensors like accelerometers, heart rate monitors, and gyroscopes to monitor physical activity, such as steps taken, distance traveled, heart rate, sleep patterns, and calories burned.

What is wearable devices app? ›

Wearable applications are those that receive data from such wearable devices. Apps of this type have access to the device's hardware and operation system. These sensors collect the data and transfer it to the app programmed for the desired outcome. Today, the market of wearables is full of different solutions.


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