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

Effects of poorly perfused peripheries on derived transit time parameters of the lower and upper limbs

A simple and non-intrusive approach termed the pulse transit time ratio (PTTR) has recently been shown to be a potential surrogate of the ankle-brachial index (ABI). PTTR is based on the principle of PTT, which is known to be temperature-sensitive. In this study, 23 healthy adults with normally perfused peripheries and 10 with poorly perfused peripheries were recruited. No significant change in PTTR was observed between those with cold (1.287±0.043) and normal (1.290±0.027) peripheries (p>0.05). A cold periphery may cause pulse waveform changes and indirectly affect PTT owing to poor skin microcirculation, but may have a limited effect on PTTR, which is useful as an ABI alternative. © 2008 by Walter de Gruyter

Heart Rate Estimation During Physical Exercise Using Wrist-Type Ppg Sensors

Accurate heart rate monitoring during intense physical exercise is a challenging problem due to the high levels of motion artifacts (MA) in photoplethysmography (PPG) sensors. PPG is a non-invasive optical sensor that is being used in wearable devices to measure blood flow changes using the property of light reflection and absorption, allowing the extraction of vital signals such as the heart rate (HR). However, the sensor is susceptible to MA which increases during physical activity. This occurs since the frequency range of movement and HR overlaps, difficulting correct HR estimation. For this reason, MA removal has remained an active topic under research. Several approaches have been developed in the recent past and among these, a Kalman filter (KF) based approach showed promising results for an accurate estimation and tracking using PPG sensors. However, this previous tracker was demonstrated for a particular dataset, with manually tuned parameters. Moreover, such trackers do not account for the correct method for fusing data. Such a custom approach might not perform accurately in practical scenarios, where the amount of MA and the heart rate variability (HRV) depend on numerous, unpredictable factors. Thus, an approach to automatically tune the KF based on the Expectation-Maximization (EM) algorithm, with a measurement fusion approach is developed. The applicability of such a method is demonstrated using an open-source PPG database, as well as a developed synthetic generation tool that models PPG and accelerometer (ACC) signals during predetermined physical activities

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

Remote Assessment of the Cardiovascular Function Using Camera-Based Photoplethysmography

Camera-based photoplethysmography (cbPPG) is a novel measurement technique that allows the continuous monitoring of vital signs by using common video cameras. In the last decade, the technology has attracted a lot of attention as it is easy to set up, operates remotely, and offers new diagnostic opportunities. Despite the growing interest, cbPPG is not completely established yet and is still primarily the object of research. There are a variety of reasons for this lack of development including that reliable and autonomous hardware setups are missing, that robust processing algorithms are needed, that application fields are still limited, and that it is not completely understood which physiological factors impact the captured signal. In this thesis, these issues will be addressed. A new and innovative measuring system for cbPPG was developed. In the course of three large studies conducted in clinical and non-clinical environments, the system’s great flexibility, autonomy, user-friendliness, and integrability could be successfully proven. Furthermore, it was investigated what value optical polarization filtration adds to cbPPG. The results show that a perpendicular filter setting can significantly enhance the signal quality. In addition, the performed analyses were used to draw conclusions about the origin of cbPPG signals: Blood volume changes are most likely the defining element for the signal's modulation. Besides the hardware-related topics, the software topic was addressed. A new method for the selection of regions of interest (ROIs) in cbPPG videos was developed. Choosing valid ROIs is one of the most important steps in the processing chain of cbPPG software. The new method has the advantage of being fully automated, more independent, and universally applicable. Moreover, it suppresses ballistocardiographic artifacts by utilizing a level-set-based approach. The suitability of the ROI selection method was demonstrated on a large and challenging data set. In the last part of the work, a potentially new application field for cbPPG was explored. It was investigated how cbPPG can be used to assess autonomic reactions of the nervous system at the cutaneous vasculature. The results show that changes in the vasomotor tone, i.e. vasodilation and vasoconstriction, reflect in the pulsation strength of cbPPG signals. These characteristics also shed more light on the origin problem. Similar to the polarization analyses, they support the classic blood volume theory. In conclusion, this thesis tackles relevant issues regarding the application of cbPPG. The proposed solutions pave the way for cbPPG to become an established and widely accepted technology

Optisen sykemittarin suorituskyvyn arviointi

Older technologies, which might have been the golden standard in the industry for years, are rapidly becoming available to a wider audience as manufacturing methods become easier and cheaper. Companies are able to provide every consumer the same devices which have been the privilege of only the professional field. This has also been the case with fitness wearables, of which one subclass is the optical heart rate sensors. The goal of this thesis was to evaluate the performance of one such device, namely the PulseOn wrist device. The device utilizes photoplethysmography (PPG) in acquiring the heart rate signal. PPG has been used in clinical settings for oxygen saturation level determination, but the technology can also provide other figures from the cardiovascular system, such as heart rate. The measurement method is based on the detection of light, which is emitted into the skin and then interacts with the tissue. The composition of the blood vessels changes in synch with the beating of the heart, and so does the intensity of the detected light. The PulseOn device was tested in controlled laboratory conditions with 20 subjects. The measurement protocol included periods of rest and activities of varying intensities. A reference measurement was made simultaneously with a Polar heart rate belt, and also two other devices were used to record data for later assessments. The results were analysed in MATLAB, and values for heart rate reading reliability and measurement errors were calculated. For example, the correlation of the PulseOn device against the Polar belt was found to be approximately 96 %, the amount of readings that were within 10 % of the values given by the heart rate belt was 90.4 %, and the average value of the absolute errors between the two devices was 4.76 beats per minute. Even though the PulseOn device was still in its development phase at the time of the measurements, it showed satisfactory results, and that it could be used in the heart rate measurements of everyday fitness activities

Multimodal Signal Processing for Diagnosis of Cardiorespiratory Disorders

This thesis addresses the use of multimodal signal processing to develop algorithms for the automated processing of two cardiorespiratory disorders. The aim of the first application of this thesis was to reduce false alarm rate in an intensive care unit. The goal was to detect five critical arrhythmias using processing of multimodal signals including photoplethysmography, arterial blood pressure, Lead II and augmented right arm electrocardiogram (ECG). A hierarchical approach was used to process the signals as well as a custom signal processing technique for each arrhythmia type. Sleep disorders are a prevalent health issue, currently costly and inconvenient to diagnose, as they normally require an overnight hospital stay by the patient. In the second application of this project, we designed automated signal processing algorithms for the diagnosis of sleep apnoea with a main focus on the ECG signal processing. We estimated the ECG-derived respiratory (EDR) signal using different methods: QRS-complex area, principal component analysis (PCA) and kernel PCA. We proposed two algorithms (segmented PCA and approximated PCA) for EDR estimation to enable applying the PCA method to overnight recordings and rectify the computational issues and memory requirement. We compared the EDR information against the chest respiratory effort signals. The performance was evaluated using three automated machine learning algorithms of linear discriminant analysis (LDA), extreme learning machine (ELM) and support vector machine (SVM) on two databases: the MIT PhysioNet database and the St. Vincent’s database. The results showed that the QRS area method for EDR estimation combined with the LDA classifier was the highest performing method and the EDR signals contain respiratory information useful for discriminating sleep apnoea. As a final step, heart rate variability (HRV) and cardiopulmonary coupling (CPC) features were extracted and combined with the EDR features and temporal optimisation techniques were applied. The cross-validation results of the minute-by-minute apnoea classification achieved an accuracy of 89%, a sensitivity of 90%, a specificity of 88%, and an AUC of 0.95 which is comparable to the best results reported in the literature

Pulse Rate Variability for the Assessment of Cardiovascular Changes

Pulse rate variability (PRV) describes the way pulse rate changes through time and is measured from pulsatile signals such as the photoplethysmogram (PPG). It has been proposed as a surrogate for heart rate variability (HRV). Nonetheless, the relationship between these variables is not entirely clear, probably due to both physiological and technical aspects involved in the extraction of PRV. Moreover, the effects of cardiovascular changes on PRV have not been elucidated. In this thesis, four studies were performed to (1) determine the best combination of some technical aspects for the extraction of PRV from PPG signals; (2) evaluate the relationship between PRV and HRV under different cardiovascular conditions; and (3) explore the effects of cardiovascular changes on PRV. First, PRV extraction gave lower errors when (1) signals were acquired for at least 120 s with a 256 Hz sampling rate and filtered with lower low cut-off frequencies and elliptic, equiripple or Parks-McClellan filter; (2) cardiac cycles were determined using the D2max algorithm and the a fiducial points; and (3) the Fast Fourier Transform was applied to obtain frequency spectra. Secondly, the relationship between HRV and PRV was found to be affected by cold exposure and changes in blood pressure, while PRV was found to be different at different body sites. Finally, PRV was affected by haemodynamic changes, such as target flow, stroke rate and blood pressure, both in an in-vitro model and in-vivo data. Additionally, PRV was found to be a potential tool for the estimation of blood pressure, with errors as low as 1:54 ± 0:17 mmHg, 1:07 ± 0:06 mmHg and 1:22 ± 0:09 mmHg for the estimation of systolic, diastolic and mean arterial pressure. Although more studies are needed to fully understand PRV and its clinical potential, PRV should not be regarded as the same as HRV, and it could be consider as a potential valuable biomarker for cardiovascular health