Novel Multimodal Sensing Systems for Wearable Knee Health Assessment

Wearable technologies for healthcare represent a popular research area, as they can provide quantitative metrics during rehabilitation, enable long-term, at-home monitoring of chronic conditions, and facilitate preventative—versus reactive—medical interventions. Moreover, their low cost makes them accessible to broad subject populations and enables more frequent measures of biomarkers. Such technologies are particularly useful for areas of medicine where the diagnostic or evaluation tools are expensive, not readily available, or time consuming. Orthopedics, in particular joint health assessment, is an area where wearable devices may provide clinicians and patients with more readily available quantitative data. The objective of this research is to investigate wearable, multimodal sensing technologies to facilitate joint health and rehabilitation monitoring, ultimately providing a “joint health score” based on evaluation of joint acoustics, electrical bioimpedance, inertial measures, and temperature data. This joint health score may be employed in various applications—including during rehabilitation after an acute injury and management of joint diseases, such as arthritis—providing an actionable metric for physicians based on the underlying physiological changes of the joint itself. This work specifically investigates the hardware for such a system. First, we examined microphones suited for wearable applications (e.g., miniature, inexpensive) that still provide robust measurements in terms of signal quality and consistency for repeated measurements. Second, we implemented a microcontroller-based system to sample high-throughput audio data as well as lower-rate electrical bioimpedance, inertial, and temperature data, which was incorporated into a fully untethered “brace.” Importantly, this work provides the fundamental hardware system for wearable knee joint health assessment.Ph.D

PRESENT AND FUTURE PERVASIVE HEALTHCARE METHODOLOGIES: INTELLIGENT BODY DEVICES, PROCESSING AND MODELING TO SEARCH FOR NEW CARDIOVASCULAR AND PHYSIOLOGICAL BIOMARKERS

The motivation behind this work comes from the area of pervasive computing technologies for healthcare and wearable healthcare IT systems, an emerging field of research that brings in revolutionary paradigms for computing models in the 21st century. The aim of this thesis is focused on emerging personal health technologies and pattern recognition strategies for early diagnosis and personalized treatment and rehabilitation for individuals with cardiovascular and neurophysiological diseases. Attention was paid to the development of an intelligent system for the automatic classification of cardiac valve disease for screening purposes. Promising results were reported with the possibility to implement a new screening strategy for the diagnosis of cardiac valve disease in developing countries. A novel assistive architecture for the elderly able to non-invasively assess muscle fatigue by surface electromyography using wireless platform during exercise with an ergonomic platform was presented. Finally a wearable chest belt for ECG monitoring to investigate the psycho-physiological effects of the autonomic system and a wearable technology for monitoring of knee kinematics and recognition of ambulatory activities were characterized to evaluate the reliability for clinical purposes of collected data. The potential impact in the clinical arena of this research would be extremely important, since promising data show how such emerging personal technologies and methodologies are effective in several scenarios to early screening and discovery of novel diagnostic and prognostic biomarkers

Rehabilitation Engineering

Population ageing has major consequences and implications in all areas of our daily life as well as other important aspects, such as economic growth, savings, investment and consumption, labour markets, pensions, property and care from one generation to another. Additionally, health and related care, family composition and life-style, housing and migration are also affected. Given the rapid increase in the aging of the population and the further increase that is expected in the coming years, an important problem that has to be faced is the corresponding increase in chronic illness, disabilities, and loss of functional independence endemic to the elderly (WHO 2008). For this reason, novel methods of rehabilitation and care management are urgently needed. This book covers many rehabilitation support systems and robots developed for upper limbs, lower limbs as well as visually impaired condition. Other than upper limbs, the lower limb research works are also discussed like motorized foot rest for electric powered wheelchair and standing assistance device

Design and Validation of a Handheld Probe to Measure Knee Joint Sounds

The goal of this research is to design and validate a system used to record joint sounds measurements that can be collected at home by patients. Wearable and handheld technology allows patients to monitor conditions at home, eliminating the need for time-consuming and costly medical appointments. In the United States, around 33% of adults have arthritis or other chronic joint pain conditions (CDC 2001). Due to the load placed on the knee and the reliance of the knee joint on soft tissues, knee joint conditions are the most common articular condition. The most common approach for diagnosing and monitoring knee joint disorders is physical examination, which yields poor diagnostic validity with the exception of the Lachman test for anterior cruciate ligament (ACL) injuries (Tanaka 2017). The clinical gold standard for diagnosing joint disorders is thus medical imaging, such as X-Ray or CT scanning, which poses financial challenges for patients and hospitals alike. Patients are interested in at-home joint monitoring devices. In a focus group study of osteoarthritis patients, patients described the need for objective measures of treatment success that could be taken at home (Papi 2015).Existing joint monitoring devices focus on patient-reported outcomes and physical task performances, leaving quantitative measurements of joint conditions to clinicians. This work aims to validate a knee joint health tracking device for home use that can reduce the costliness and frequency of medical appointments.Undergraduat

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

Evaluating devices for the measurement of auditory-evoked fetal movement

Determining normal and abnormal fetal function in utero in order to better predict which fetuses are at risk for adverse outcome is critical. However, the medical imaging tools that could assist with diagnosis are very expensive and rarely available in the developing world. In this study, we developed a prototype audio-motio-tachograph (AMTG), which measures fetal movements through the recording of abdominal wall deformations and tested it in Rwanda. First, we showed that AMTG detected fetal signals and that fetuses respond to complex acoustic stimuli. In order to improve the sensitivity of the device, we then measured whole abdominal wall deformations in an automated way using a lab-based 3D optical measurement system, in which fringes are projected and the deflections recorded with a camera. We found that abdominal wall deformations can be measured accurately with a non-invasive measurement apparatus. Overall, we conclude that wearable modalities provide a promising alternative assessment capacity in fetal research, especially in low income countries

Impact of Ear Occlusion on In-Ear Sounds Generated by Intra-oral Behaviors

We conducted a case study with one volunteer and a recording setup to detect sounds induced by the actions: jaw clenching, tooth grinding, reading, eating, and drinking. The setup consisted of two in-ear microphones, where the left ear was semi-occluded with a commercially available earpiece and the right ear was occluded with a mouldable silicon ear piece. Investigations in the time and frequency domains demonstrated that for behaviors such as eating, tooth grinding, and reading, sounds could be recorded with both sensors. For jaw clenching, however, occluding the ear with a mouldable piece was necessary to enable its detection. This can be attributed to the fact that the mouldable ear piece sealed the ear canal and isolated it from the environment, resulting in a detectable change in pressure. In conclusion, our work suggests that detecting behaviors such as eating, grinding, reading with a semi-occluded ear is possible, whereas, behaviors such as clenching require the complete occlusion of the ear if the activity should be easily detectable. Nevertheless, the latter approach may limit real-world applicability because it hinders the hearing capabilities.</p

Sensing with Earables: A Systematic Literature Review and Taxonomy of Phenomena

Earables have emerged as a unique platform for ubiquitous computing by augmenting ear-worn devices with state-of-the-art sensing. This new platform has spurred a wealth of new research exploring what can be detected on a wearable, small form factor. As a sensing platform, the ears are less susceptible to motion artifacts and are located in close proximity to a number of important anatomical structures including the brain, blood vessels, and facial muscles which reveal a wealth of information. They can be easily reached by the hands and the ear canal itself is affected by mouth, face, and head movements. We have conducted a systematic literature review of 271 earable publications from the ACM and IEEE libraries. These were synthesized into an open-ended taxonomy of 47 different phenomena that can be sensed in, on, or around the ear. Through analysis, we identify 13 fundamental phenomena from which all other phenomena can be derived, and discuss the different sensors and sensing principles used to detect them. We comprehensively review the phenomena in four main areas of (i) physiological monitoring and health, (ii) movement and activity, (iii) interaction, and (iv) authentication and identification. This breadth highlights the potential that earables have to offer as a ubiquitous, general-purpose platform