A comfortable health monitoring system named WEALTHY is presented. The system is based on a textile wearable interface implemented by integrating sensors, electrodes, and connections in fabric form, advanced signal processing techniques, and modern telecommunication systems. Sensors, electrodes and connections are realized with conductive and piezoresistive yarns. The sensorized knitted fabric is produced in a one step process. The purpose of this paper is to show the feasibility of a system based on fabric sensing elements. The capability of this system to acquire simultaneously several biomedical signals (i.e. electrocardiogram, respiration, activity) has been investigated and compared with a standard monitoring system. Furthermore, the paper presents two different methodologies for the acquisition of the respiratory signal with textile sensors. Results show that the information contained in the signals obtained by the integrated systems is comparable with that obtained by standard sensors. The proposed system is designed to monitor individuals affected by cardiovascular diseases, in particular during the rehabilitation phase. The system can also help professional workers who are subject to considerable physical and psychological stress and/or environmental and professional health risks.

Abstract-Textile-based sensors offer an unobtrusive method of continually monitoring physiological parameters during daily activities. Chemical analysis of body fluids, noninvasively, is a novel and exciting area of personalized wearable healthcare systems. BIOTEX was an EU-funded project that aimed to develop textile sensors to measure physiological parameters and the chemical composition of body fluids, with a particular interest in sweat. A wearable sensing system has been developed that integrates a textile-based fluid handling system for sample collection and transport with a number of sensors including sodium, conductivity, and pH sensors. Sensors for sweat rate, ECG, respiration, and blood oxygenation were also developed. For the first time, it has been possible to monitor a number of physiological parameters together with sweat composition in real time. This has been carried out via a network of wearable sensors distributed around the body of a subject user. This has huge implications for the field of sports and human performance and opens a whole new field of research in the clinical setting. F. Di Francesco is with the Dipartimento di Chimica e Chimica Industriale, Università di Pisa, Pisa 56126, Italy (e-mail: fdifra@dcci.unipi.it).D. Costanzo and M. G. Trivella are with the Istituto di Fisiologia Clinica, Consiglio Nazionale delle Ricerche, Pisa 56100, Italy (e-mail: costanzo.daniele@ libero.it; trivella@ifc.cnr.it).P. Salvo and D. E. De Rossi are with the Centro Interdipartimentale di Ricerca "E. Piaggio," Università di Pisa 56100, Italy (e-mail: psalvo@ifc.cnr.it; d.derossi@ing.unipi.it).N. Taccini and R. Paradiso are with Smartex s.r

In the last few years, the smart textile area has become increasingly widespread, leading to developments in new wearable sensing systems. Truly wearable instrumented garments capable of recording behavioral and vital signals are crucial for several fields of application. Here we report on results of a careful characterization of the performance of innovative fabric sensors and electrodes able to acquire vital biomechanical and physiological signals, respectively. The sensing function of the fabric sensors relies upon newly developed strain sensors, based on rubber-carbon-coated threads, and mainly depends on the weaving topology, and the composition and deposition process of the conducting rubber-carbon mixture. Fabric sensors are used to acquire the respitrace (RT) and movement sensors (MS). Sensing features of electrodes, instead rely upon metal-based conductive threads, which are instrumental in detecting bioelectrical signals, such as electrocardiogram (ECG) and electromyogram (EMG). Fabric sensors have been tested during some specific tasks of breathing and movement activity, and results have been compared with the responses of a commercial piezoelectric sensor and an electrogoniometer, respectively. The performance of fabric electrodes has been investigated and compared with standard clinical electrodes.

Current clinical practice in diagnosing patients affected by psychiatric disorders such as bipolar disorder is based only on verbal interviews and scores from specific questionnaires, and no reliable and objective psycho-physiological markers are taken into account. In this paper, we propose to use a wearable system based on a comfortable t-shirt with integrated fabric electrodes and sensors able to acquire electrocardiogram, respirogram, and body posture information in order to detect a pattern of objective physiological parameters to support diagnosis. Moreover, we implemented a novel ad hoc methodology of advanced biosignal processing able to effectively recognize four possible clinical mood states in bipolar patients (i.e., depression, mixed state, hypomania, and euthymia) continuously monitored up to 18 h, using heart rate variability information exclusively. Mood assessment is intended as an intrasubject evaluation in which the patient's states are modeled as a Markov chain, i.e., in the time domain, each mood state refers to the previous one. As validation, eight bipolar patients were monitored collecting and analyzing more than 400 h of autonomic and cardiovascular activity. Experimental results demonstrate that our novel concept of personalized and pervasive monitoring constitutes a viable and robust clinical decision support system for bipolar disorders recognizing mood states with a total classification accuracy up to 95.81%.

BackgroundMonitoring joint angles through wearable systems enables human posture and gesture to be reconstructed as a support for physical rehabilitation both in clinics and at the patient’s home. A new generation of wearable goniometers based on knitted piezoresistive fabric (KPF) technology is presented.MethodsKPF single-and double-layer devices were designed and characterized under stretching and bending to work as strain sensors and goniometers. The theoretical working principle and the derived electromechanical model, previously proved for carbon elastomer sensors, were generalized to KPF. The devices were used to correlate angles and piezoresistive fabric behaviour, to highlight the differences in terms of performance between the single layer and the double layer sensors. A fast calibration procedure is also proposed.ResultsThe proposed device was tested both in static and dynamic conditions in comparison with standard electrogoniometers and inertial measurement units respectively. KPF goniometer capabilities in angle detection were experimentally proved and a discussion of the device measurement errors of is provided. The paper concludes with an analysis of sensor accuracy and hysteresis reduction in particular configurations.ConclusionsDouble layer KPF goniometers showed a promising performance in terms of angle measurements both in quasi-static and dynamic working mode for velocities typical of human movement. A further approach consisting of a combination of multiple sensors to increase accuracy via sensor fusion technique has been presented.

This paper presents an innovative wearable kinesthetic glove realized with knitted piezoresistive fabric (KPF) sensor technology. The glove is conceived to capture hand movement and gesture by using KPF in a double-layer configuration working as angular sensors (electrogoniometers). The sensing glove prototype is endowed by three KPF goniometers, used to track flexion and extension movement of metacarpophalangeal joint of thumb, index, and middle fingers. The glove is devoted to the continuous monitoring of patients during their daily-life activities, in particular for stroke survivors during their rehabilitation. The prototype performances have been evaluated in comparison with an optical tracking system considered as a gold standard both for relieving static and dynamic posture and gesture of the hand. The introduced prototype has shown very interesting figures of merit. The angular error, evaluated through the standard Bland Altman analysis, has been estimated in ±3° which is slightly less accurate than commercial electrogoniometers. Moreover, a new conceptual prototype design, preliminary evaluated within this study, is presented and discussed in order to solve actual limitations in terms of number and type of sensor connections, avoiding mechanical constraints given by metallic inextensible wires and improving user comfort.

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Monitoring physical activities during post-stroke rehabilitation in daily life may help physicians to optimize and tailor the training program for patients. The European research project INTERACTION (FP7-ICT-2011-7-287351) evaluated motor capabilities in stroke patients during the recovery treatment period. We developed wearable sensing platform based on the sensor fusion among inertial, knitted piezoresistive sensors and textile EMG electrodes. The device was conceived in modular form and consists of a separate shirt, trousers, glove, and shoe. Thanks to the novel fusion approach it has been possible to develop a model for the shoulder taking into account the scapulo-thoracic joint of the scapular girdle, considerably improving the estimation of the hand position in reaching activities. In order to minimize the sensor set used to monitor gait, a single inertial sensor fused with a textile goniometer proved to reconstruct the orientation of all the body segments of the leg. Finally, the sensing glove, endowed with three textile goniometers and three force sensors showed good capabilities in the reconstruction of grasping activities and evaluating the interaction of the hand with the environment, according to the project specifications. This paper reports on the design and the technical evaluation of the performance of the sensing platform, tested on healthy subjects.