A multi-channel opto-electronic sensor to accurately monitor heart rate against motion artefact during exercise

This study presents the use of a multi-channel opto-electronic sensor (OEPS) to effectively monitor critical physiological parameters whilst preventing motion artefact as increasingly demanded by personal healthcare. The aim of this work was to study how to capture the heart rate (HR) efficiently through a well-constructed OEPS and a 3-axis accelerometer with wireless communication. A protocol was designed to incorporate sitting, standing, walking, running and cycling. The datasets collected from these activities were processed to elaborate sport physiological effects. t-test, Bland-Altman Agreement (BAA), and correlation to evaluate the performance of the OEPS were used against Polar and Mio-Alpha HR monitors. No differences in the HR were found between OEPS, and either Polar or Mio-Alpha (both p > 0.05); a strong correlation was found between Polar and OEPS (r: 0.96, p < 0.001); the bias of BAA 0.85 bpm, the standard deviation (SD) 9.20 bpm, and the limits of agreement (LOA) from −17.18 bpm to +18.88 bpm. For the Mio-Alpha and OEPS, a strong correlation was found (r: 0.96, p < 0.001); the bias of BAA 1.63 bpm, SD 8.62 bpm, LOA from −15.27 bpm to +18.58 bpm. These results demonstrate the OEPS to be capable of carrying out real time and remote monitoring of heart rate

A comparative study of physiological monitoring with a wearable opto-electronic patch sensor (OEPS) for motion reduction

This paper presents a comparative study in physiological monitoring between a wearable opto-electronic patch sensor (OEPS) comprising a three-axis Microelectromechanical systems (MEMs) accelerometer (3MA) and commercial devices. The study aims to effectively capture critical physiological parameters, for instance, oxygen saturation, heart rate, respiration rate and heart rate variability, as extracted from the pulsatile waveforms captured by OEPS against motion artefacts when using the commercial probe. The protocol involved 16 healthy subjects and was designed to test the features of OEPS, with emphasis on the effective reduction of motion artefacts through the utilization of a 3MA as a movement reference. The results show significant agreement between the heart rates from the reference measurements and the recovered signals. Significance of standard deviation and error of mean yield values of 2.27 and 0.65 beats per minute, respectively; and a high correlation (0.97) between the results of the commercial sensor and OEPS. T, Wilcoxon and Bland-Altman with 95% limit of agreement tests were also applied in the comparison of heart rates extracted from these sensors, yielding a mean difference (MD: 0.08). The outcome of the present work incites the prospects of OEPS on physiological monitoring during physical activities

Imaging photoplethysmography: towards effective physiological measurements

Since its conception decades ago, Photoplethysmography (PPG) the non-invasive opto-electronic technique that measures arterial pulsations in-vivo has proven its worth by achieving and maintaining its rank as a compulsory standard of patient monitoring. However successful, conventional contact monitoring mode is not suitable in certain clinical and biomedical situations, e.g., in the case of skin damage, or when unconstrained movement is required. With the advance of computer and photonics technologies, there has been a resurgence of interest in PPG and one potential route to overcome the abovementioned issues has been increasingly explored, i.e., imaging photoplethysmography (iPPG). The emerging field of iPPG offers some nascent opportunities in effective and comprehensive interpretation of the physiological phenomena, indicating a promising alternative to conventional PPG. Heart and respiration rate, perfusion mapping, and pulse rate variability have been accessed using iPPG. To effectively and remotely access physiological information through this emerging technique, a number of key issues are still to be addressed. The engineering issues of iPPG, particularly the influence of motion artefacts on signal quality, are addressed in this thesis, where an engineering model based on the revised Beer-Lambert law was developed and used to describe opto-physiological phenomena relevant to iPPG. An iPPG setup consisting of both hardware and software elements was developed to investigate its reliability and reproducibility in the context of effective remote physiological assessment. Specifically, a first study was conducted for the acquisition of vital physiological signs under various exercise conditions, i.e. resting, light and heavy cardiovascular exercise, in ten healthy subjects. The physiological parameters derived from the images captured by the iPPG system exhibited functional characteristics comparable to conventional contact PPG, i.e., maximum heart rate difference was <3 bpm and a significant (p < 0.05) correlation between both measurements were also revealed. Using a method for attenuation of motion artefacts, the heart rate and respiration rate information was successfully assessed from different anatomical locations even in high-intensity physical exercise situations. This study thereby leads to a new avenue for noncontact sensing of vital signs and remote physiological assessment, showing clear and promising applications in clinical triage and sports training. A second study was conducted to remotely assess pulse rate variability (PRV), which has been considered a valuable indicator of autonomic nervous system (ANS) status. The PRV information was obtained using the iPPG setup to appraise the ANS in ten normal subjects. The performance of the iPPG system in accessing PRV was evaluated via comparison with the readings from a contact PPG sensor. Strong correlation and good agreement between these two techniques verify the effectiveness of iPPG in the remote monitoring of PRV, thereby promoting iPPG as a potential alternative to the interpretation of physiological dynamics related to the ANS. The outcomes revealed in the thesis could present the trend of a robust non-contact technique for cardiovascular monitoring and evaluation

A study on the effect of contact pressure during physical activity on photoplethysmographic heart rate measurements

Heart rate (HR) as an important physiological indicator could properly describe global subject’s physical status. Photoplethysmographic (PPG) sensors are catching on in field of wearable sensors, combining the advantages in costs, weight and size. Nevertheless, accuracy in HR readings is unreliable specifically during physical activity. Among several identified sources that affect PPG recording, contact pressure (CP) between the PPG sensor and skin greatly influences the signals. Methods: In this study, the accuracy of HR measurements of a PPG sensor at different CP was investigated when compared with a commercial ECG-based chest strap used as a test control, with the aim of determining the optimal CP to produce a reliable signal during physical activity. Seventeen subjects were enrolled for the study to perform a physical activity at three different rates repeated at three different contact pressures of the PPG-based wristband. Results: The results show that the CP of 54 mmHg provides the most accurate outcome with a Pearson correlation coefficient ranging from 0.81 to 0.95 and a mean average percentage error ranging from 3.8% to 2.4%, based on the physical activity rate. Conclusion: Authors found that changes in the CP have greater effects on PPG-HR signal quality than those deriving from the intensity of the physical activity and specifically, the individual best CP for each subject provided reliable HR measurements even for a high intensity of physical exercise with a Bland–Altman plot within ±11 bpm. Although future studies on a larger cohort of subjects are still needed, this study could contribute a profitable indication to enhance accuracy of PPG-based wearable devices

Artefact reduction in photoplethysmography

The use of optical techniques in biomedical monitoring and diagnosis is becoming increasingly widespread, primarily because of the non-invasive nature of optically derived measurements. Physiological analysis is usually achieved by characterisation of the spectral or temporal properties of the interaction between light and the anatomy. Although some optical measurements require complex instrumentation and protocols, recent technological advances have resulted in robust and compact equipment that is now used routinely in a multitude of clinical contexts. Unfortunately, these measurements are inherently sensitive to corruption from dynamic physical conditions or external sources of light, inducing signal artefact. Artefact is the primary restriction in the applicability of many optical measurements, especially for ambulatory monitoring and tele-medicine. The most widely used optical measurement is photoplethysmography, a technique that registers dynamic changes in blood volume throughout the peripheral vasculature and can be used to screen for a number of venous disorders, as well as monitoring the cardio-vascular pulse wave. Although photoplethysmographic devices are now incorporated into many patient-monitoring systems, the prevalent application is a measurement known as pulse oximetry, which utilises spectral analysis of the peripheral blood to estimate the arterial haernoglobin oxygen saturation. Pulse oximetry is well established as an early warning for hypoxia and is now mandatory under anaesthesia in many countries. The problem of artefact is prominent in these continuous monitoring techniques, where it is often impossible to control the physical conditions during use. This thesis investigates the possibility of reducing artefact corruption of photoplethysmographic signals in real time, using an electronic processing methodology that is based upon inversion of a physical artefact model. The consequences of this non-linear artefact reduction technique for subsequent signal analysis are discussed, culminating in a modified formulation for pulse oximetry that not only has reduced sensitivity to artefact but also possesses increased generality. The design and construction of a practical electronic system is then used to explore both the implementation issues and the scope of this technique. The performance of artefact reduction obtained is then quantified under realistic experimental conditions, demonstrating that this methodology is successful in removing or reducing a large proportion of artefact encountered in clinically relevant situations. It is concluded that non-linear artefact reduction can be applied to any photoplethysmographic technology, reducing interpretation inaccuracies that would otherwise be induced by signal artefact. It is also speculated that this technology could enable the use of photoplethysmographic systems in applications that are currently precluded by the inherent severity of artefact

A Review of Wearable Multi-wavelength Photoplethysmography

Optical pulse detection photoplethysmography (PPG) provides a means of low cost and unobtrusive physiological monitoring that is popular in many wearable devices. However, the accuracy, robustness and generalizability of single-wavelength PPG sensing are sensitive to biological characteristics as well as sensor configuration and placement; this is significant given the increasing adoption of single-wavelength wrist-worn PPG devices in clinical studies and healthcare. Since different wavelengths interact with the skin to varying degrees, researchers have explored the use of multi-wavelength PPG to improve sensing accuracy, robustness and generalizability. This paper contributes a novel and comprehensive state-of-the-art review of wearable multi-wavelength PPG sensing, encompassing motion artifact reduction and estimation of physiological parameters. The paper also encompasses theoretical details about multi-wavelength PPG sensing and the effects of biological characteristics. The review findings highlight the promising developments in motion artifact reduction using multi-wavelength approaches, the effects of skin temperature on PPG sensing, the need for improved diversity in PPG sensing studies and the lack of studies that investigate the combined effects of factors. Recommendations are made for the standardization and completeness of reporting in terms of study design, sensing technology and participant characteristics

A Review of Wearable Multi-wavelength Photoplethysmography

Optical pulse detection photoplethysmography (PPG) provides a means of low cost and unobtrusive physiological monitoring that is popular in many wearable devices. However, the accuracy, robustness and generalizability of single-wavelength PPG sensing are sensitive to biological characteristics as well as sensor configuration and placement; this is significant given the increasing adoption of single-wavelength wrist-worn PPG devices in clinical studies and healthcare. Since different wavelengths interact with the skin to varying degrees, researchers have explored the use of multi-wavelength PPG to improve sensing accuracy, robustness and generalizability. This paper contributes a novel and comprehensive state-of-the-art review of wearable multi-wavelength PPG sensing, encompassing motion artifact reduction and estimation of physiological parameters. The paper also encompasses theoretical details about multi-wavelength PPG sensing and the effects of biological characteristics. The review findings highlight the promising developments in motion artifact reduction using multi-wavelength approaches, the effects of skin temperature on PPG sensing, the need for improved diversity in PPG sensing studies and the lack of studies that investigate the combined effects of factors. Recommendations are made for the standardization and completeness of reporting in terms of study design, sensing technology and participant characteristics

A Photoplethysmography System Optimised for Pervasive Cardiac Monitoring

Photoplethysmography is a non-invasive sensing technique which infers instantaneous cardiac function from an optical measurement of blood vessels. This thesis presents a photoplethysmography based sensor system that has been developed speci fically for the requirements of a pervasive healthcare monitoring system. Continuous monitoring of patients requires both the size and power consumption of the chosen sensor solution to be minimised to ensure the patients will be willing to use the device. Pervasive sensing also requires that the device be scalable for manufacturing in high volume at a build cost that healthcare providers are willing to accept. System level choice of both electronic circuits and signal processing techniques are based on their sensitivity to cardiac biosignals, robustness against noise inducing artefacts and simplicity of implementation. Numerical analysis is used to justify the implementation of a technique in hardware. Circuit prototyping and experimental data collection is used to validate a technique's application. The entire signal chain operates in the discrete-time domain which allows all of the signal processing to be implemented in firmware on an embedded processor which minimised the number of discrete components while optimising the trade-off between power and bandwidth in the analogue front-end. Synchronisation of the optical illumination and detection modules enables high dynamic range rejection of both AC and DC independent light sources without compromising the biosignal. Signal delineation is used to reduce the required communication bandwidth as it preserves both amplitude and temporal resolution of the non-stationary photoplethysmography signals allowing more complicated analytical techniques to be performed at the other end of communication channel. The complete sensing system is implemented on a single PCB using only commercial-off -the-shelf components and consumes less than 7.5mW of power. The sensor platform is validated by the successful capture of physiological data in a harsh optical sensing environment

A Photoplethysmography System Optimised for Pervasive Cardiac Monitoring

Photoplethysmography is a non-invasive sensing technique which infers instantaneous cardiac function from an optical measurement of blood vessels. This thesis presents a photoplethysmography based sensor system that has been developed speci fically for the requirements of a pervasive healthcare monitoring system. Continuous monitoring of patients requires both the size and power consumption of the chosen sensor solution to be minimised to ensure the patients will be willing to use the device. Pervasive sensing also requires that the device be scalable for manufacturing in high volume at a build cost that healthcare providers are willing to accept. System level choice of both electronic circuits and signal processing techniques are based on their sensitivity to cardiac biosignals, robustness against noise inducing artefacts and simplicity of implementation. Numerical analysis is used to justify the implementation of a technique in hardware. Circuit prototyping and experimental data collection is used to validate a technique's application. The entire signal chain operates in the discrete-time domain which allows all of the signal processing to be implemented in firmware on an embedded processor which minimised the number of discrete components while optimising the trade-off between power and bandwidth in the analogue front-end. Synchronisation of the optical illumination and detection modules enables high dynamic range rejection of both AC and DC independent light sources without compromising the biosignal. Signal delineation is used to reduce the required communication bandwidth as it preserves both amplitude and temporal resolution of the non-stationary photoplethysmography signals allowing more complicated analytical techniques to be performed at the other end of communication channel. The complete sensing system is implemented on a single PCB using only commercial-off -the-shelf components and consumes less than 7.5mW of power. The sensor platform is validated by the successful capture of physiological data in a harsh optical sensing environment

A Textile Sleeve for Monitoring Oxygen Saturation Using Multichannel Optical Fibre Photoplethysmography

Textile-based systems are an attractive prospect for wearable technology as they can provide monitoring of key physiological parameters in a comfortable and unobtrusive form. A novel system based on multichannel optical fibre sensor probes integrated into a textile sleeve is described. The system measures the photoplethysmogram (PPG) at two wavelengths (660 and 830 nm), which is then used to calculate oxygen saturation (SpO2). In order to achieve reliable measurement without adjusting the position of the garment, four plastic optical fibre (POF) probes are utilised to increase the likelihood that a high-quality PPG is obtained due to at least one of the probes being positioned over a blood vessel. Each probe transmits and receives light into the skin to measure the PPG and SpO2. All POFs are integrated in a stretchable textile sleeve with a circumference of 15 cm to keep the sensor in contact with the subject's wrist and to minimise motion artefacts. Tests on healthy volunteers show that the multichannel PPG sensor faithfully provides an SpO2 reading in at least one of the four sensor channels in all cases with no need for adjusting the position of the sleeve. This could not be achieved using a single sensor alone. The multichannel sensor is used to monitor the SpO2 of 10 participants with an average wrist circumference of 16.0 ± 0.6 cm. Comparing the developed sensor's SpO2 readings to a reference commercial oximeter (reflectance Masimo Radical-7) illustrates that the mean difference between the two sensors' readings is -0.03%, the upper limit of agreement (LOA) is 0.52% and the lower LOA is -0.58%. This multichannel sensor has the potential to achieve reliable, unobtrusive and comfortable textile-based monitoring of both heart rate and SpO2 during everyday life