Graphene textile smart clothing for wearable cardiac monitoring

Wearable electronics is a rapidly growing field that recently started to introduce successful commercial products into the consumer electronics market. Employment of biopotential signals in wearable systems as either biofeedbacks or control commands are expected to revolutionize many technologies including point of care health monitoring systems, rehabilitation devices, human–computer/machine interfaces (HCI/HMIs), and brain–computer interfaces (BCIs). Since electrodes are regarded as a decisive part of such products, they have been studied for almost a decade now, resulting in the emergence of textile electrodes. This study reports on the synthesis and application of graphene nanotextiles for the development of wearable electrocardiography (ECG) sensors for personalized health monitoring applications. In this study, we show for the first time that the electrocardiogram was successfully obtained with graphene textiles placed on a single arm. The use of only one elastic armband, and an “all-textile-approach” facilitates seamless heart monitoring with maximum comfort to the wearer. The functionality of graphene textiles produced using dip coating and stencil printing techniques has been demonstrated by the non-invasive measurement of ECG signals, up to 98% excellent correlation with conventional pre-gelled, wet, silver/silver-chloride (Ag / AgCl) electrodes. Heart rate have been successfully determined with ECG signals obtained in different situations. The system-level integration and holistic design approach presented here will be effective for developing the latest technology in wearable heart monitoring devices

Conception, development and evaluation of polymer-based screen-printed textile electrodes for biopotential monitoring

Wearable technologies represent the new frontier of vital signs monitoring in different applications, from fitness to health. With the progressive miniaturization of the electronic components, enabling the implementation of portable and hand-held acquisition and recording devices, the research focus has shifted toward the development of effective and unobtrusive textile electrodes. This work deals with the study, development and characterization of organic-polymer-based electrodes for biopotentials. After an overview of the main materials and fabrication technologies presented so far in the scientific literature, the possibility to use these electrodes as an alternative to the Ag/AgCl disposable gelled electrodes usually adopted in clinical practice was tested. For this purpose, several textile electrode realization techniques were studied and optimized, in order to create electrodes with adequate features to detect two fundamental physiological signals: the electrocardiogram (ECG) and the electromyogram (EMG). The electrodes were obtained by depositing on the fabric the organic bio-compatible polymer poly(3,4-ethylenedioxythiophene) doped with poly(4-styrenesulfonate) (PEDOT:PSS) with three deposition procedures: dipcoating, ink-jet printing and screen printing. The physical\u2013chemical properties of the polymer solution were varied for each procedure to obtain an optimal and reproducible result. For what concerns the ECG signal, the research activity focused on screen-printed textile electrodes and their performance was first assessed by benchtop measurements and then by human trials. The first tests demonstrated that, by adding solid or liquid electrolytes the electrodes, the largest part of the characteristics required by the ANSI/AAMI EC12:2000 standard for gelled ECG electrodes can be achieved. Tests performed in different conditions showed that the skin contact impedance and the ECG morphological features are highly similar to those obtainable with disposable gelled Ag/AgCl electrodes (\u3c1 > 0.99). A trial with ten subjects revealed also the capability of the proposed electrodes to accurately capture with clinical instruments an ECG morphology with performance comparable to off-the-shelf disposable electrodes. Furthermore, the proposed textile electrodes preserve their electrical properties and functionality even after several mild washing cycles, while they suffered physical stretching. Similar tests were performed on screen-printed textile electrodes fabricated in two different sizes to test them as EMG sensors, with and without electrolytes. After a series of controlled acquisitions performed by electro-stimulating the muscles in order to analyze the waveform morphologu of the M-wave, the statistical analysis showed a high similarity in terms of rms of the noise and electrode-skin impedance between conventional and textile electrodes with the addition of solid hydrogel and saline solution. Furthermore, the M-wave recorded on the tibialis anterior muscle during the stimulation of the peroneal nerve was comparatively analyzed between conventional and textile electrodes. The comparison provided an R2 value higher than 97% in all measurement conditions. These results opened their use in smart garments for real application scenarios and for this purpose were developed a couple of smart shirts able to detect the EGC and the EMG signal. The results indicated that this approach could be adopted in the future for the development of smart garments able to comfortably detect physiological signals

The status of textile-based dry EEG electrodes

Electroencephalogram (EEG) is the biopotential recording of electrical signals generated by brain activity. It is useful for monitoring sleep quality and alertness, clinical applications, diagnosis, and treatment of patients with epilepsy, disease of Parkinson and other neurological disorders, as well as continuous monitoring of tiredness/ alertness in the field. We provide a review of textile-based EEG. Most of the developed textile-based EEGs remain on shelves only as published research results due to a limitation of flexibility, stickability, and washability, although the respective authors of the works reported that signals were obtained comparable to standard EEG. In addition, nearly all published works were not quantitatively compared and contrasted with conventional wet electrodes to prove feasibility for the actual application. This scenario would probably continue to give a publication credit, but does not add to the growth of the specific field, unless otherwise new integration approaches and new conductive polymer composites are evolved to make the application of textile-based EEG happen for bio-potential monitoring

Soft, comfortable polymer dry electrodes for high quality ECG and EEG recording

Conventional gel electrodes are widely used for biopotential measurements, despite important drawbacks such as skin irritation, long set-up time and uncomfortable removal. Recently introduced dry electrodes with rigid metal pins overcome most of these problems; however, their rigidity causes discomfort and pain. This paper presents dry electrodes offering high user comfort, since they are fabricated from EPDM rubber containing various additives for optimum conductivity, flexibility and ease of fabrication. The electrode impedance is measured on phantoms and human skin. After optimization of the polymer composition, the skin-electrode impedance is only similar to 10 times larger than that of gel electrodes. Therefore, these electrodes are directly capable of recording strong biopotential signals such as ECG while for low-amplitude signals such as EEG, the electrodes need to be coupled with an active circuit. EEG recordings using active polymer electrodes connected to a clinical EEG system show very promising results: alpha waves can be clearly observed when subjects close their eyes, and correlation and coherence analyses reveal high similarity between dry and gel electrode signals. Moreover, all subjects reported that our polymer electrodes did not cause discomfort. Hence, the polymer-based dry electrodes are promising alternatives to either rigid dry electrodes or conventional gel electrodes

Textile Concentric Ring Electrodes for ECG Recording Based on Screen-Printing Technology

[EN] Among many of the electrode designs used in electrocardiography (ECG), concentric ring electrodes (CREs) are one of the most promising due to their enhanced spatial resolution. Their development has undergone a great push due to their use in recent years; however, they are not yet widely used in clinical practice. CRE implementation in textiles will lead to a low cost, flexible, comfortable, and robust electrode capable of detecting high spatial resolution ECG signals. A textile CRE set has been designed and developed using screen-printing technology. This is a mature technology in the textile industry and, therefore, does not require heavy investments. Inks employed as conductive elements have been silver and a conducting polymer (poly (3,4-ethylenedioxythiophene) polystyrene sulfonate; PEDOT: PSS). Conducting polymers have biocompatibility advantages, they can be used with flexible substrates, and they are available for several printing technologies. CREs implemented with both inks have been compared by analyzing their electric features and their performance in detecting ECG signals. The results reveal that silver CREs present a higher average thickness and slightly lower skin-electrode impedance than PEDOT: PSS CREs. As for ECG recordings with subjects at rest, both CREs allowed the uptake of bipolar concentric ECG signals (BC-ECG) with signal-to-noise ratios similar to that of conventional ECG recordings. Regarding the saturation and alterations of ECGs captured with textile CREs caused by intentional subject movements, silver CREs presented a more stable response (fewer saturations and alterations) than those of PEDOT: PSS. Moreover, BC-ECG signals provided higher spatial resolution compared to conventional ECG. This improved spatial resolution was manifested in the identification of P1 and P2 waves of atrial activity in most of the BC-ECG signals. It can be concluded that textile silver CREs are more suitable than those of PEDOT: PSS for obtaining BC-ECG records. These developed textile electrodes bring the use of CREs closer to the clinical environment.Grant from the Ministerio de Economia y Competitividad y del Fondo Europeo de Desarrollo Regional. DPI2015-68397-R (MINECO/FEDER). This work was also supported by the Spanish Government/FEDER funds (grant number MAT2015-64139-C4-3-R (MINECO/FEDER)).Lidon-Roger, JV.; Prats-Boluda, G.; Ye Lin, Y.; Garcia Casado, FJ.; Garcia-Breijo, E. (2018). Textile Concentric Ring Electrodes for ECG Recording Based on Screen-Printing Technology. Sensors. 18(1):300-314. https://doi.org/10.3390/s18010300S30031418

Hybrid Nanostructured Textile Bioelectrode for Unobtrusive Health Monitoring

Coronary heart disease, cardiovascular diseases and strokes are the leading causes of mortality in United States of America. Timely point-of-care health diagnostics and therapeutics for person suffering from these diseases can save thousands of lives. However, lack of accessible minimally intrusive health monitoring systems makes timely diagnosis difficult and sometimes impossible. To remedy this problem, a textile based nano-bio-sensor was developed and evaluated in this research. The sensor was made of novel array of vertically standing nanostructures that are conductive nano-fibers projecting from a conductive fabric. These sensor electrodes were tested for the quality of electrical contact that they made with the skin based on the fundamental skin impedance model and electromagnetic theory. The hybrid nanostructured dry electrodes provided large surface area and better contact with skin that improved electrode sensitivity and reduced the effect of changing skin properties, which are the problems usually faced by conventional dry textile electrodes. The dry electrodes can only register strong physiological signals because of high background noise levels, thus limiting the use of existing dry electrodes to heart rate measurement and respiration. Therefore, dry electrode systems cannot be used for recording complete ECG waveform, EEG or measurement of bioimpedance. Because of their improved sensitivity these hybrid nanostructured dry electrodes can be applied to measurement of ECG and bioimpedance with very low baseline noise. These textile based electrodes can be seamlessly integrated into garments of daily use such as vests and bra. In combination with embedded wireless network device that can communicate with smart phone, laptop or GPRS, they can function as wearable wireless health diagnostic systems

Wearable smart textiles for long-term electrocardiography monitoring : a review

The continuous and long-term measurement and monitoring of physiological signals such as electrocardiography (ECG) are very important for the early detection and treatment of heart disorders at an early stage prior to a serious condition occurring. The increasing demand for the continuous monitoring of the ECG signal needs the rapid development of wearable electronic technology. During wearable ECG monitoring, the electrodes are the main components that affect the signal quality and comfort of the user. This review assesses the application of textile electrodes for ECG monitoring from the fundamentals to the latest developments and prospects for their future fate. The fabrication techniques of textile electrodes and their performance in terms of skin–electrode contact impedance, motion artifacts and signal quality are also reviewed and discussed. Textile electrodes can be fabricated by integrating thin metal fiber during the manufacturing stage of textile products or by coating textiles with conductive materials like metal inks, carbon mate-rials, or conductive polymers. The review also discusses how textile electrodes for ECG function via direct skin contact or via a non-contact capacitive coupling. Finally, the current intensive and promising research towards finding textile-based ECG electrodes with better comfort and signal quality in the fields of textile, material, medical and electrical engineering are presented as a perspective

Graphene-Enabled Electrodes for Electrocardiogram Monitoring

The unique parameters of Graphene (GN), notably its considerable electron mobility, high surface area and electrical conductivity are bringing extensive attention into the wearable technologies. This work presents a novel Graphene-based electrode for acquisition of electrocardiogram (ECG). The proposed electrode was fabricated by coating GN on top of metallic layer of Ag/AgCl electrode using chemical vapor deposition (CVD) technique. To investigate the performance of the fabricated GN-based electrode, two types of electrodes were fabricated with different sizes to conduct the signal qualities and the skin-electrode contact impedance measurements. Performances of the GN-enabled electrodes were compared to the conventional Ag/AgCl electrodes in terms of ECG signal quality, skin-electrode contact impedance, signal-to-noise ratio (SNR) and response time. Experimental results showed the proposed GN-based electrodes produced better ECG signals, higher SNR (improved by 8%) and lower contact impedance (improved by 78%) values than conventional ECG electrodes

Textile sensors for ECG and respiratory frequency on swimsuits

Swimming constitutes one of the most demanding sports regarding technique. Years of training are necessary to master each one of the four styles. An important improvement and help for trainers would be a swimsuit that could provide information during training. This paper presents the research undertaken to develop textile sensors that will be used in a swimsuit. This paper will address ECG and respiratory frequency sensors and respective signals. The behaviour of the proposed sensors in different conditions (dry and wet environments) will be presented and discussed. The influence of movement on the signal quality and further interpretation, both by the muscular electrical signals as well as by the displacement of the electrodes, will be addressed. Other very important issue in swimming is drag. One approach that can reduce total drag consists in using compression. However, compressed fabrics will most likely modify the textile sensors’Fundação para a Ciência e a Tecnologia (FCT) - PTDC/EEA-ELC/70803/200

Validation of polymer-based screen-printed textile electrodes for surface EMG detection

In recent years, the variety of textile electrodes developed for electrophysiological signal detection has increased rapidly. Among the applications that could benefit from this advancement, those based on surface electromyography (sEMG) are particularly relevant in rehabilitation, training and muscle function assessment. In this work, we validate the performance of polymer-based screen-printed textile electrodes for sEMG signal detection. We obtained these electrodes by depositing poly-3,4-ethylenedioxythiophene doped with poly(styrene sulfonate) (PEDOT:PSS) onto cotton fabric, and then selectively changing the physical properties of the textile substrate. The manufacturing costs are low and this process meets the requirements of textile-industry production lines. The validation of these electrodes was based on their functional and electrical characteristics, assessed for two different electrode sizes and three skin-interface conditions (dry, solid hydrogel or saline solution), and compared to those of conventional disposable gelled electrodes. Results show high similarity in terms of noise amplitude and electrode-skin impedance between the conventional and textile electrodes with the addition of solid hydrogel or saline solution. Furthermore, we compared the shape of the electrically-induced sEMG, as detected by conventional and textile electrodes from tibialis anterior. The comparison yielded an R2 value higher than 97% for all measurement conditions. Preliminary tests in dynamic conditions (walking) revealed the exploitability of the proposed electrode technology with saline application for the monitoring of sEMG for up to 35 minutes of activity. These results suggest that the proposed screen-printed textile electrodes may be an effective alternative to the conventional gelled electrodes for sEMG acquisition, thereby providing new opportunities in clinical and wellness fields