Challenges in Design and Fabrication of Flexible/Stretchable Carbon- and Textile-Based Wearable Sensors for Health Monitoring: A Critical Review

To demonstrate the wearable flexible/stretchable health-monitoring sensor, it is necessary to develop advanced functional materials and fabrication technologies. Among the various developed materials and fabrication processes for wearable sensors, carbon-based materials and textile-based configurations are considered as promising approaches due to their outstanding characteristics such as high conductivity, lightweight, high mechanical properties, wearability, and biocompatibility. Despite these advantages, in order to realize practical wearable applications, electrical and mechanical performances such as sensitivity, stability, and long-term use are still not satisfied. Accordingly, in this review, we describe recent advances in process technologies to fabricate advanced carbon-based materials and textile-based sensors, followed by their applications such as human activity and electrophysiological sensors. Furthermore, we discuss the remaining challenges for both carbon- and textile-based wearable sensors and then suggest effective strategies to realize the wearable sensors in health monitoring

Electrically Conductive Cotton Textile and Its Applications

Electronic textiles (e-textiles) have been considered as important applications in wearable electronics, which can combine the functionality of smart electronic devices with the comfort and flexibility of stylish clothing. Herein, we have successfully prepared a conductive textile via electroless deposition onto cotton textiles by using a three-step treatment process. The cotton textiles are first dipped in P4VP-SU8 solution to form a uniform layer for the subsequent absorption of silver ions. Then, the cotton textiles are immersed in silver nitrate solution in preparation for the next step electroless deposition. The sheet resistance can be as low as 0.05 Ωsq-1. Two sensors were made based on the copper coated cotton textiles. One is flexible pressure sensor, the other is ECG sensor. Both sensors performed well, proving this method is a promising candidate for applications in the fabrication of functional textile-based wearable devices

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

Smart shirt with embedded vital sign and moisture sensing

This paper presents the development of a smart shirt with embedded electrodes in two-lead configuration for heart rate measurement and a knitted moisture sensor for sweat detection. Signal conditioning for heart rate measurement is based on the Analog Devices AD8232 heart rate monitor front-end. The shirt is part of a fireman interactive Personal Protective Equipment (PPE), which monitors information on heart rate and sweat detection, among other variables. Sweat detection is used to avoid skin burns that may occur due to the combination of excessive moisture and heat. Tests have demonstrated that the measurement of heart rate using the shirt is as efficient as conventional solutions, such as heart-rate monitoring straps. Sweat detection through textile moisture sensors has also shown to be effective.FCT - Fundação para a Ciência e a Tecnologia, in the framework of project UID/CTM/00264/2013 and project PROTACTICAL - Co-Promoção Nº Projecto: 23267, sponsored by ADI

From wearable towards epidermal computing : soft wearable devices for rich interaction on the skin

Human skin provides a large, always available, and easy to access real-estate for interaction. Recent advances in new materials, electronics, and human-computer interaction have led to the emergence of electronic devices that reside directly on the user's skin. These conformal devices, referred to as Epidermal Devices, have mechanical properties compatible with human skin: they are very thin, often thinner than human hair; they elastically deform when the body is moving, and stretch with the user's skin. Firstly, this thesis provides a conceptual understanding of Epidermal Devices in the HCI literature. We compare and contrast them with other technical approaches that enable novel on-skin interactions. Then, through a multi-disciplinary analysis of Epidermal Devices, we identify the design goals and challenges that need to be addressed for advancing this emerging research area in HCI. Following this, our fundamental empirical research investigated how epidermal devices of different rigidity levels affect passive and active tactile perception. Generally, a correlation was found between the device rigidity and tactile sensitivity thresholds as well as roughness discrimination ability. Based on these findings, we derive design recommendations for realizing epidermal devices. Secondly, this thesis contributes novel Epidermal Devices that enable rich on-body interaction. SkinMarks contributes to the fabrication and design of novel Epidermal Devices that are highly skin-conformal and enable touch, squeeze, and bend sensing with co-located visual output. These devices can be deployed on highly challenging body locations, enabling novel interaction techniques and expanding the design space of on-body interaction. Multi-Touch Skin enables high-resolution multi-touch input on the body. We present the first non-rectangular and high-resolution multi-touch sensor overlays for use on skin and introduce a design tool that generates such sensors in custom shapes and sizes. Empirical results from two technical evaluations confirm that the sensor achieves a high signal-to-noise ratio on the body under various grounding conditions and has a high spatial accuracy even when subjected to strong deformations. Thirdly, Epidermal Devices are in contact with the skin, they offer opportunities for sensing rich physiological signals from the body. To leverage this unique property, this thesis presents rapid fabrication and computational design techniques for realizing Multi-Modal Epidermal Devices that can measure multiple physiological signals from the human body. Devices fabricated through these techniques can measure ECG (Electrocardiogram), EMG (Electromyogram), and EDA (Electro-Dermal Activity). We also contribute a computational design and optimization method based on underlying human anatomical models to create optimized device designs that provide an optimal trade-off between physiological signal acquisition capability and device size. The graphical tool allows for easily specifying design preferences and to visually analyze the generated designs in real-time, enabling designer-in-the-loop optimization. Experimental results show high quantitative agreement between the prediction of the optimizer and experimentally collected physiological data. Finally, taking a multi-disciplinary perspective, we outline the roadmap for future research in this area by highlighting the next important steps, opportunities, and challenges. Taken together, this thesis contributes towards a holistic understanding of Epidermal Devices}: it provides an empirical and conceptual understanding as well as technical insights through contributions in DIY (Do-It-Yourself), rapid fabrication, and computational design techniques.Die menschliche Haut bietet eine große, stets verfügbare und leicht zugängliche Fläche für Interaktion. Jüngste Fortschritte in den Bereichen Materialwissenschaft, Elektronik und Mensch-Computer-Interaktion (Human-Computer-Interaction, HCI) [so that you can later use the Englisch abbreviation] haben zur Entwicklung elektronischer Geräte geführt, die sich direkt auf der Haut des Benutzers befinden. Diese sogenannten Epidermisgeräte haben mechanische Eigenschaften, die mit der menschlichen Haut kompatibel sind: Sie sind sehr dünn, oft dünner als ein menschliches Haar; sie verformen sich elastisch, wenn sich der Körper bewegt, und dehnen sich mit der Haut des Benutzers. Diese Thesis bietet, erstens, ein konzeptionelles Verständnis von Epidermisgeräten in der HCI-Literatur. Wir vergleichen sie mit anderen technischen Ansätzen, die neuartige Interaktionen auf der Haut ermöglichen. Dann identifizieren wir durch eine multidisziplinäre Analyse von Epidermisgeräten die Designziele und Herausforderungen, die angegangen werden müssen, um diesen aufstrebenden Forschungsbereich voranzubringen. Im Anschluss daran untersuchten wir in unserer empirischen Grundlagenforschung, wie epidermale Geräte unterschiedlicher Steifigkeit die passive und aktive taktile Wahrnehmung beeinflussen. Im Allgemeinen wurde eine Korrelation zwischen der Steifigkeit des Geräts und den taktilen Empfindlichkeitsschwellen sowie der Fähigkeit zur Rauheitsunterscheidung festgestellt. Basierend auf diesen Ergebnissen leiten wir Designempfehlungen für die Realisierung epidermaler Geräte ab. Zweitens trägt diese Thesis zu neuartigen Epidermisgeräten bei, die eine reichhaltige Interaktion am Körper ermöglichen. SkinMarks trägt zur Herstellung und zum Design neuartiger Epidermisgeräte bei, die hochgradig an die Haut angepasst sind und Berührungs-, Quetsch- und Biegesensoren mit gleichzeitiger visueller Ausgabe ermöglichen. Diese Geräte können an sehr schwierigen Körperstellen eingesetzt werden, ermöglichen neuartige Interaktionstechniken und erweitern den Designraum für die Interaktion am Körper. Multi-Touch Skin ermöglicht hochauflösende Multi-Touch-Eingaben am Körper. Wir präsentieren die ersten nicht-rechteckigen und hochauflösenden Multi-Touch-Sensor-Overlays zur Verwendung auf der Haut und stellen ein Design-Tool vor, das solche Sensoren in benutzerdefinierten Formen und Größen erzeugt. Empirische Ergebnisse aus zwei technischen Evaluierungen bestätigen, dass der Sensor auf dem Körper unter verschiedenen Bedingungen ein hohes Signal-Rausch-Verhältnis erreicht und eine hohe räumliche Auflösung aufweist, selbst wenn er starken Verformungen ausgesetzt ist. Drittens, da Epidermisgeräte in Kontakt mit der Haut stehen, bieten sie die Möglichkeit, reichhaltige physiologische Signale des Körpers zu erfassen. Um diese einzigartige Eigenschaft zu nutzen, werden in dieser Arbeit Techniken zur schnellen Herstellung und zum computergestützten Design von multimodalen Epidermisgeräten vorgestellt, die mehrere physiologische Signale des menschlichen Körpers messen können. Die mit diesen Techniken hergestellten Geräte können EKG (Elektrokardiogramm), EMG (Elektromyogramm) und EDA (elektrodermale Aktivität) messen. Darüber hinaus stellen wir eine computergestützte Design- und Optimierungsmethode vor, die auf den zugrunde liegenden anatomischen Modellen des Menschen basiert, um optimierte Gerätedesigns zu erstellen. Diese Designs bieten einen optimalen Kompromiss zwischen der Fähigkeit zur Erfassung physiologischer Signale und der Größe des Geräts. Das grafische Tool ermöglicht die einfache Festlegung von Designpräferenzen und die visuelle Analyse der generierten Designs in Echtzeit, was eine Optimierung durch den Designer im laufenden Betrieb ermöglicht. Experimentelle Ergebnisse zeigen eine hohe quantitative Übereinstimmung zwischen den Vorhersagen des Optimierers und den experimentell erfassten physiologischen Daten. Schließlich skizzieren wir aus einer multidisziplinären Perspektive einen Fahrplan für zukünftige Forschung in diesem Bereich, indem wir die nächsten wichtigen Schritte, Möglichkeiten und Herausforderungen hervorheben. Insgesamt trägt diese Arbeit zu einem ganzheitlichen Verständnis von Epidermisgeräten bei: Sie liefert ein empirisches und konzeptionelles Verständnis sowie technische Einblicke durch Beiträge zu DIY (Do-It-Yourself), schneller Fertigung und computergestützten Entwurfstechniken

Carbon Nanotube Wearable Sensors for Health Diagnostics.

This perspective article highlights a recent surge of interest in the application of textiles containing carbon nanotube (CNT) sensors for human health monitoring. Modern life puts more and more pressure on humans, which translates into an increased number of various health disorders. Unfortunately, this effect either decreases the quality of life or shortens it prematurely. A possible solution to this problem is to employ sensors to monitor various body functions and indicate an upcoming disease likelihood at its early stage. A broad spectrum of materials is currently under investigation for this purpose, some of which already entered the market. One of the most promising materials in this field are CNTs. They are flexible and of high electrical conductivity, which can be modulated upon several forms of stimulation. The article begins with an illustration of techniques for how wearable sensors can be built from them. Then, their application potential for tracking various health parameters is presented. Finally, the article ends with a summary of this field's progress and a vision of the key directions to domesticate this concept

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