Development of a bed-based nighttime monitoring toolset

Doctor of PhilosophyDepartment of Electrical and Computer EngineeringSteven WarrenA movement is occurring within the healthcare field towards evidence-based or preventative care-based medicine, which requires personalized monitoring solutions. For medical technologies to fit within this framework, they need to adapt. Reduced cost of operation, ease-of-use, durability, and acceptance will be critical design considerations that will determine their success. Wearable technologies have shown the capability to monitor physiological signals at a reduced cost, but they require consistent effort from the user. Innovative unobtrusive and autonomous monitoring technologies will be needed to make personalized healthcare a reality. Ballistocardiography, a nearly forgotten field, has reemerged as a promising alternative for unobtrusive physiological monitoring. Heart rate, heart rate variability, respiration rate, movement, and additional hemodynamic features can be estimated from the ballistocardiogram (BCG). This dissertation presents a bed-based nighttime monitoring toolset designed to monitor BCG, respiration, and movement data motivated by the need to quantify the sleep of children with severe disabilities and autism – a capability currently unmet by commercial systems. A review of ballistocardiography instrumentation techniques (Chapter 2) is presented to 1) build an understanding of how the forces generated by the heart are coupled to the measurement apparatus and 2) provide a background of the field. The choice of sensing modalities and acquisition hardware and software for developing the unobtrusive bed-based nighttime monitoring platform is outlined in Chapters 3 and 4. Preliminary results illustrating the system’s ability to track physiological signals are presented in Chapter 5. Analyses were conducted on overnight data acquired from three lower-functioning children with autism (Chapters 6 and 9) who reside at Heartspring, Wichita, KS, where results justified the platform’s multi-sensor architecture and demonstrated the system’s ability to track physiological signals from this sensitive population over many months. Further, this dissertation presents novel BCG signal processing techniques – a signal quality index (Chapter 7) and a preprocessing inverse filter (Chapter 8) that are applicable to any ballistocardiograph. The bed-based nighttime monitoring toolset outlined in this dissertation presents an unobtrusive, autonomous, robust physiological monitoring system that could be used in hospital-based or personalized, home-based medical applications that consist of short or long-term monitoring scenarios

Data-driven methods for analyzing ballistocardiograms in longitudinal cardiovascular monitoring

Cardiovascular disease (CVD) is the leading cause of death in the US; about 48% of American adults have one or more types of CVD. The importance of continuous monitoring of the older population, for early detection of changes in health conditions, has been shown in the literature, as the key to a successful clinical intervention. We have been investigating environmentally-embedded in-home networks of non-invasive sensing modalities. This dissertation concentrates on the signal processing techniques required for the robust extraction of morphological features from the ballistocardiographs (BCG), and machine learning approaches to utilize these features in non-invasive monitoring of cardiovascular conditions. At first, enhancements in the time domain detection of the cardiac cycle are addressed due to its importance in the estimation of heart rate variability (HRV) and sleep stages. The proposed enhancements in the energy-based algorithm for BCG beat detection have shown at least 50% improvement in the root mean square error (RMSE) of the beat to beat heart rate estimations compared to the reference estimations from the electrocardiogram (ECG) R to R intervals. These results are still subject to some errors, primarily due to the contamination of noise and motion artifacts caused by floor vibration, unconstrained subject movements, or even the respiratory activities. Aging, diseases, breathing, and sleep disorders can also affect the quality of estimation as they slightly modify the morphology of the BCG waveform.Includes bibliographical reference

Wearable and Nearable Biosensors and Systems for Healthcare

Biosensors and systems in the form of wearables and “nearables” (i.e., everyday sensorized objects with transmitting capabilities such as smartphones) are rapidly evolving for use in healthcare. Unlike conventional approaches, these technologies can enable seamless or on-demand physiological monitoring, anytime and anywhere. Such monitoring can help transform healthcare from the current reactive, one-size-fits-all, hospital-centered approach into a future proactive, personalized, decentralized structure. Wearable and nearable biosensors and systems have been made possible through integrated innovations in sensor design, electronics, data transmission, power management, and signal processing. Although much progress has been made in this field, many open challenges for the scientific community remain, especially for those applications requiring high accuracy. This book contains the 12 papers that constituted a recent Special Issue of Sensors sharing the same title. The aim of the initiative was to provide a collection of state-of-the-art investigations on wearables and nearables, in order to stimulate technological advances and the use of the technology to benefit healthcare. The topics covered by the book offer both depth and breadth pertaining to wearable and nearable technology. They include new biosensors and data transmission techniques, studies on accelerometers, signal processing, and cardiovascular monitoring, clinical applications, and validation of commercial devices

Artifact Noise Removal Techniques and Automatic Annotation on Seismocardiogram Using Two Tri-axial Accelerometers

Heart disease are ones of the most death causes in the world. Many studies investigated in evaluating the heart performance in order to detect cardiac diseases in the early stage. The aim of this study is to monitor the heart activities in long-term on active people to reduce the risk of heart disease. Specifically, this study investigates the motion noise removal techniques using two-accelerometer sensor system and various positions of the sensors on gentle movement and walking of subjects. The study also ends up with algorithms to detect cardiac phases and events on Seismocardiogram (SCG) based on acceleration sensors. A Wi-Fi based data acquisition system and a framework on Matlab are developed to collect and process data while the subjects are in motion. The tests include eight volunteers who have no record of heart disease. The walking and running data on the subjects are analyzed to find the minimal-noise bandwidth of the SCG signal. This bandwidth is used to design bandpass filters in the motion noise removal techniques and peak signal detection. There are three main techniques of combining data of the two sensors to mitigate the motion artifact: analog processing, digital processing and fusion processing. The analog processing comprises analog ADDER/SUBTRACTOR and bandpass filter to remove the motion before entering the data acquisition system. The digital processing processes all the data using combinations of total acceleration and z-axis only acceleration. The fusion processing automatically controls the amplification gain of the SUBTRACTOR to improve signal quality as long as a signal saturation is detected. The three techniques are tested on three placements of sensors including horizontal, vertical, and diagonal on gentle motion and walking. In general, the total acceleration and z-axis acceleration are best techniques to deal with gentle motion on all placements which improve average systolic signal-noise-ratio (SNR) around 2 times and average diastolic SNR around 3 times comparing to only one accelerometer. With walking motion, overall the ADDER and zaxis acceleration are best techniques on all placements of the sensors on the body which enhance about 7 times of average systolic SNR and about 11 times of average diastolic SNR comparing to only one accelerometer. The combination of two sensors also increases the average number of recognizable systole and diastole on walking corresponding to 71.3 % and 43.8 % comparing toiii only one sensor. Among the sensor placements, the performance of horizontal placement of the sensors is outstanding comparing with other positions on all motions. There are two detection stages to detect events in the SCG for automatic annotation. First, two algorithms including moving average threshold and interpolation are applied to locate the systolic and diastolic phases. Then, based on those identified phases, cardiac events are found in the searched intervals using two outstanding characteristics of the SCG. The two algorithms of phase detection are examined on the stationary data sets of digital processing and horizontal placement. The total acceleration of only one sensor is also calculated for comparison. With moving average threshold algorithm, the average error and missing rates of total acceleration and z-axis acceleration are 1.8 % and 2.1 % respectively which are lower than using one accelerometer (3.6 %). With interpolation algorithm, the average error and missing rates of total acceleration and z-axis acceleration are in the order of 2.3 % and 2.4 % which are still lower than one accelerometer. The average calculation time of the moving average algorithm is lower than the interpolation counterpart. The real-time mode of detection algorithms is also demonstrated on Matlab framework to prove the possibility of practical applications

Physiological and behavior monitoring systems for smart healthcare environments: a review

Healthcare optimization has become increasingly important in the current era, where numerous challenges are posed by population ageing phenomena and the demand for higher quality of the healthcare services. The implementation of Internet of Things (IoT) in the healthcare ecosystem has been one of the best solutions to address these challenges and therefore to prevent and diagnose possible health impairments in people. The remote monitoring of environmental parameters and how they can cause or mediate any disease, and the monitoring of human daily activities and physiological parameters are among the vast applications of IoT in healthcare, which has brought extensive attention of academia and industry. Assisted and smart tailored environments are possible with the implementation of such technologies that bring personal healthcare to any individual, while living in their preferred environments. In this paper we address several requirements for the development of such environments, namely the deployment of physiological signs monitoring systems, daily activity recognition techniques, as well as indoor air quality monitoring solutions. The machine learning methods that are most used in the literature for activity recognition and body motion analysis are also referred. Furthermore, the importance of physical and cognitive training of the elderly population through the implementation of exergames and immersive environments is also addressedinfo:eu-repo/semantics/publishedVersio

Non-invasive monitoring of vital signs using recliner chair and respiratory pattern analysis

In-home monitoring has the potential to help track health changes for older adults with chronic health conditions, thereby making early treatment possible when exacerbations arise. A recliner chair is often used by older adults, even for sleeping at night, for those with breathing difficulty, neck and back problems, or other pain. Here, we present a sensor system for recliner chairs that can be used to monitor heart rate and respiration rate. The system uses two accelerometers placed strategically to capture these vital signs noninvasively and without direct contact with the body, while at same time being hidden from view. The system was tested with 45 subjects, with an average age of 78.8 years for both upright and reclined configurations of the chair. We also tested the system on 6 different types of recliner models. An accuracy of 99% for heart rate and 93% for respiratory rate was obtained. An analysis of the error distribution patterns according to age, gender and recliner configurations are considered. A validation study of a commercially available sensor, Murata SCA11H, which is primarily designed for use on the bed is tested on the chair and the results are presented in this thesis. We have also developed a measure known as the "Breathing Pattern Index" that can be useful in determining the respiratory health of the occupants on the chair. Initial studies of the effectiveness of this index and algorithm are evaluated and the results are presented. This new system and index have the potential to help in identifying very early health changes and improve health outcomes for older adults.Includes bibliographical reference

Magnetic resonance imaging compatible non-invasive fibre-optic sensors based on the Bragg gratings and interferometers in the application of monitoring heart and respiration rate of the human body: A comparative study

The publication presents a comparative study of two fibre-optic sensors in the application of heart rate (HR) and respiratory rate (RR) monitoring of the human body. After consultation with clinical practitioners, two types of non-invasive measuring and analysis systems based on fibre Bragg grating (FBG) and fibre-optic interferometer (FOI) have been designed and assembled. These systems use probes (both patent pending) that have been encapsulated in the bio-compatible polydimethylsiloxane (PMDS). The main advantage of PDMS is that it is electrically non-conductive and, as well as optical fibres, has low permeability. The initial verification measurement of the system designed was performed on four subjects in a harsh magnetic resonance (MR) environment under the supervision of a senior radiology assistant. A follow-up comparative study was conducted, upon a consent of twenty volunteers, in a laboratory environment with a minimum motion load and discussed with a head doctor of the Radiodiagnostic Institute. The goal of the laboratory study was to perform measurements that would simulate as closely as possible the environment of harsh MR or the environment of long-term health care facilities, hospitals and clinics. Conventional HR and RR measurement systems based on ECG measurements and changes in the thoracic circumference were used as references. The data acquired was compared by the objective Bland-Altman (B-A) method and discussed with practitioners. The results obtained confirmed the functionality of the designed probes, both in the case of RR and HR measurements (for both types of B-A, more than 95% of the values lie within the +/- 1.96 SD range), while demonstrating higher accuracy of the interferometric probe (in case of the RR determination, 95.66% for the FOI probe and 95.53% for the FBG probe, in case of the HR determination, 96.22% for the FOI probe and 95.23% for the FBG probe).Web of Science1811art. no. 371

A wearable heart monitor at the ear using ballistocardiogram (BCG) and electrocardiogram (ECG) with a nanowatt ECG heartbeat detection circuit

Thesis (Ph. D.)--Massachusetts Institute of Technology, Dept. of Electrical Engineering and Computer Science, 2013.Cataloged from PDF version of thesis.Includes bibliographical references (p. 132-137).This work presents a wearable heart monitor at the ear that uses the ballistocardiogram (BCG) and the electrocardiogram (ECG) to extract heart rate, stroke volume, and pre-ejection period (PEP) for the application of continuous heart monitoring. Being a natural anchoring point, the ear is demonstrated as a viable location for the integrated sensing of physiological signals. The source of periodic head movements is identified as a type of BCG, which is measured using an accelerometer. The head BCG's principal peaks (J-waves) are synchronized to heartbeats. Ensemble averaging is used to obtain consistent J-wave amplitudes, which are related to stroke volume. The ECG is sensed locally near the ear using a single-lead configuration. When the BCG and the ECG are used together, an electromechanical duration called the RJ interval can be obtained. Because both head BCG and ECG have low signal-to-noise ratios, cross-correlation is used to statistically extract the RJ interval. The ear-worn device is wirelessly connected to a computer for real time data recording. A clinical test involving hemodynamic maneuvers is performed on 13 subjects. The results demonstrate a linear relationship between the J-wave amplitude and stroke volume, and a linear relationship between the RJ interval and PEP. While the clinical device uses commercial components, a custom integrated circuit for ECG heartbeat detection is designed with the goal of reducing power consumption and device size. With 58nW of power consumption, the ECG circuit replaces the traditional instrumentation amplifier, analog-to-digital converter, and signal processor with a single chip solution. The circuit demonstrates a topology that takes advantage of the ECG's characteristics to extract R-wave timings at the chest and the ear in the presence of baseline drift, muscle artifact, and signal clipping.by David Da He.Ph.D

Continuous vital monitoring during sleep and light activity using carbon-black elastomer sensors

The comfortable, continuous monitoring of vital parameters is still a challenge. The long-term measurement of respiration and cardiovascular signals is required to diagnose cardiovascular and respiratory diseases. Similarly, sleep quality assessment and the recovery period following acute treatments require long-term vital parameter datalogging. To address these requirements, we have developed “VitalCore”, a wearable continuous vital parameter monitoring device in the form of a T-shirt targeting the uninterrupted monitoring of respiration, pulse, and actigraphy. VitalCore uses polymer-based stretchable resistive bands as the primary sensor to capture breathing and pulse patterns from chest expansion. The carbon black-impregnated polymer is implemented in a U-shaped configuration and attached to the T-shirt with “interfacing” material along with the accompanying electronics. In this paper, VitalCore is bench tested and compared to gold standard respiration and pulse measurements to verify its functionality and further to assess the quality of data captured during sleep and during light exercise (walking). We show that these polymer-based sensors could identify respiratory peaks with a sensitivity of 99.44%, precision of 96.23%, and false-negative rate of 0.557% during sleep. We also show that this T-shirt configuration allows the wearer to sleep in all sleeping positions with a negligible difference of data quality. The device was also able to capture breathing during gait with 88.9%–100% accuracy in respiratory peak detection