Wearable devices, as an important component of digital health, are gradually penetrating into the clinical nursing field. This paper explores the current applications of wearable devices in the field of clinical nursing, with a focus on their significant roles in real-time monitoring of physiological parameters, disease management, functional rehabilitation exercises. Additionally, it analyzes the challenges these devices face, such as the need for standardized development, data security and privacy protection, and cost-benefit analysis. This paper also proposes measures to address these challenges, including enhancing policy formulation, promoting standardization, and fostering technological innovation, with the aim of providing valuable insights for the advancement of high-quality clinical nursing practices.
Self-powered wearable piezoelectric sensing devices demand flexibility and high voltage electrical properties to meet personalized health and safety management needs. Aiming at the characteristics of piezoceramics with high piezoelectricity and low flexibility, this study designs a high-performance piezoelectric sensor based on multi-phase barium titanate (BTO) flexible piezoceramic film, namely multi-phase BTO sensor. The substrate-less self-supported multi-phase BTO films had excellent flexibility and could be bent 180° at a thickness of 33 μm, and exhibited good bending fatigue resistance in 1 × 104 bending cycles at a thickness of 5 μm. The prepared multi-phase BTO sensor could maintain good piezoelectric stability after 1.2 × 104 piezoelectric cycle tests. Based on the flexibility, high piezoelectricity, wearability, portability and battery-free self-powered characteristics of this sensor, the developed smart mask could monitor the respiratory signals of different frequencies and amplitudes in real time. In addition, by mounting the sensor on the hand or shoulder, different gestures and arm movements could also be detected. In summary, the multi-phase BTO sensor developed in this paper is expected to develop convenient and efficient wearable sensing devices for physiological health and behavioral activity monitoring applications.
Epilepsy is a complex and widespread neurological disorder that has become a global public health issue. In recent years, significant progress has been made in the use of wearable devices for seizure monitoring, prediction, and treatment. This paper reviewed the applications of invasive and non-invasive wearable devices in seizure monitoring, such as subcutaneous EEG, ear-EEG, and multimodal sensors, highlighting their advantages in improving the accuracy of seizure recording. It also discussed the latest advances in the prediction and treatment of seizure using wearable devices.
Sleep-related breathing disorder (SRBD) is a sleep disease with high incidence and many complications. However, patients are often unaware of their sickness. Therefore, SRBD harms health seriously. At present, home SRBD monitoring equipment is a popular research topic to help people get aware of their health conditions. This article fully compares recent state-of-art research results about home SRBD monitors to clarify the advantages and limitations of various sensing techniques. Furthermore, the direction of future research and commercialization is pointed out. According to the system design, novel home SRBD monitors can be divided into two types: wearable and unconstrained. The two types of monitors have their own advantages and disadvantages. The wearable devices are simple and portable, but they are not comfortable and durable enough. Meanwhile, the unconstrained devices are more unobtrusive and comfortable, but the supporting algorithms are complex to develop. At present, researches are mainly focused on system design and performance evaluation, while high performance algorithm and large-scale clinical trial need further research. This article can help researchers understand state-of-art research progresses on SRBD monitoring quickly and comprehensively and inspire their research and innovation ideas. Additionally, this article also summarizes the existing commercial sleep respiratory monitors, so as to promote the commercialization of novel home SRBD monitors that are still under research.
As a low-load physiological monitoring technology, wearable devices can provide new methods for monitoring, evaluating and managing chronic diseases, which is a direction for the future development of monitoring technology. However, as a new type of monitoring technology, its clinical application mode and value are still unclear and need to be further explored. In this study, a central monitoring system based on wearable devices was built in the general ward (non-ICU ward) of PLA General Hospital, the value points of clinical application of wearable physiological monitoring technology were analyzed, and the system was combined with the treatment process and applied to clinical monitoring. The system is able to effectively collect data such as electrocardiogram, respiration, blood oxygen, pulse rate, and body position/movement to achieve real-time monitoring, prediction and early warning, and condition assessment. And since its operation from March 2018, 1 268 people (657 patients) have undergone wearable continuous physiological monitoring until January 2020, with data from a total of 1 198 people (632 cases) screened for signals through signal quality algorithms and manual interpretation were available for analysis, accounting for 94.48 % (96.19%) of the total. Through continuous physiological data analysis and manual correction, sleep apnea event, nocturnal hypoxemia, tachycardia, and ventricular premature beats were detected in 232 (36.65%), 58 (9.16%), 30 (4.74%), and 42 (6.64%) of the total patients, while the number of these abnormal events recorded in the archives was 4 (0.63%), 0 (0.00%), 24 (3.80%), and 15 (2.37%) cases. The statistical analysis of sleep apnea event outcomes revealed that patients with chronic diseases were more likely to have sleep apnea events than healthy individuals, and the incidence was higher in men (62.93%) than in women (37.07%). The results indicate that wearable physiological monitoring technology can provide a new monitoring mode for inpatients, capturing more abnormal events and provide richer information for clinical diagnosis and treatment through continuous physiological parameter analysis, and can be effectively integrated into existing medical processes. We will continue to explore the applicability of this new monitoring mode in different clinical scenarios to further enrich the clinical application of wearable technology and provide richer tools and methods for the monitoring, evaluation and management of chronic diseases.
This review article aims to explore the major challenges that the healthcare system is currently facing and propose a new paradigm shift that harnesses the potential of wearable devices and novel theoretical frameworks on health and disease. Lifestyle-induced diseases currently account for a significant portion of all healthcare spending, with this proportion projected to increase with population aging. Wearable devices have emerged as a key technology for implementing large-scale healthcare systems focused on disease prevention and management. Advancements in miniaturized sensors, system integration, the Internet of Things, artificial intelligence, 5G, and other technologies have enabled wearable devices to perform high-quality measurements comparable to medical devices. Through various physical, chemical, and biological sensors, wearable devices can continuously monitor physiological status information in a non-invasive or minimally invasive way, including electrocardiography, electroencephalography, respiration, blood oxygen, blood pressure, blood glucose, activity, and more. Furthermore, by combining concepts and methods from complex systems and nonlinear dynamics, we developed a novel theory of continuous dynamic physiological signal analysis—dynamical complexity. The results of dynamic signal analyses can provide crucial information for disease prevention, diagnosis, treatment, and management. Wearable devices can also serve as an important bridge connecting doctors and patients by tracking, storing, and sharing patient data with medical institutions, enabling remote or real-time health assessments of patients, and providing a basis for precision medicine and personalized treatment. Wearable devices have a promising future in the healthcare field and will be an important driving force for the transformation of the healthcare system, while also improving the health experience for individuals.
Patients with acute heart failure (AHF) often experience dyspnea, and monitoring and quantifying their breathing patterns can provide reference information for disease and prognosis assessment. In this study, 39 AHF patients and 24 healthy subjects were included. Nighttime chest-abdominal respiratory signals were collected using wearable devices, and the differences in nocturnal breathing patterns between the two groups were quantitatively analyzed. Compared with the healthy group, the AHF group showed a higher mean breathing rate (BR_mean) [(21.03 ± 3.84) beat/min vs. (15.95 ± 3.08) beat/min, P < 0.001], and larger R_RSBI_cv [70.96% (54.34%–104.28)% vs. 58.48% (45.34%–65.95)%, P = 0.005], greater AB_ratio_cv [(22.52 ± 7.14)% vs. (17.10 ± 6.83)%, P = 0.004], and smaller SampEn (0.67 ± 0.37 vs. 1.01 ± 0.29, P < 0.001). Additionally, the mean inspiratory time (TI_mean) and expiration time (TE_mean) were shorter, TI_cv and TE_cv were greater. Furthermore, the LBI_cv was greater, while SD1 and SD2 on the Poincare plot were larger in the AHF group, all of which showed statistically significant differences. Logistic regression calibration revealed that the TI_mean reduction was a risk factor for AHF. The BR_ mean demonstrated the strongest ability to distinguish between the two groups, with an area under the curve (AUC) of 0.846. Parameters such as breathing period, amplitude, coordination, and nonlinear parameters effectively quantify abnormal breathing patterns in AHF patients. Specifically, the reduction in TI_mean serves as a risk factor for AHF, while the BR_mean distinguishes between the two groups. These findings have the potential to provide new information for the assessment of AHF patients.
This paper aims to study the accuracy of cardiopulmonary physiological parameters measurement under different exercise intensity in the accompanying (wearable) physiological parameter monitoring system. SensEcho, an accompanying physiological parameter monitoring system, and CORTEX METALYZER 3B, a cardiopulmonary function testing system, were used to simultaneously collect the cardiopulmonary physiological parameters of 28 healthy volunteers (17 males and 11 females) in various exercise states, such as standing, lying down and Bruce treadmill exercise. Bland-Altman analysis, correlation analysis and other methods, from the perspective of group and individual, were used to contrast and analyze the two types of equipment to measure parameters of heart rate and breathing rate. The results of group analysis showed that the heart rate and respiratory rate data box charts collected by the two devices were highly consistent. The heart rate difference was (−0.407 ± 3.380) times/min, and the respiratory rate difference was (−0.560 ± 7.047) times/min. The difference was very small. The Bland-Altman plot of the heart rate and respiratory rate in each experimental stage showed that the proportion of mean ± 2SD was 96.86% and 95.29%, respectively. The results of individual analysis showed that the correlation coefficients of the whole-process heart rate and respiratory rate data were all greater than 0.9. In conclusion, SensEcho, as an accompanying physiological parameter monitoring system, can accurately measure the human heart rate, respiration rate and other key cardiopulmonary physiological parameters under various sports conditions. It can maintain good stability under various sports conditions and meet the requirements of continuous physiological signal collection and analysis application under sports conditions.
Lower limb ankle exoskeletons have been used to improve walking efficiency and assist the elderly and patients with motor dysfunction in daily activities or rehabilitation training, while the assistance patterns may influence the wearer’s lower limb muscle activities and coordination patterns. In this paper, we aim to evaluate the effects of different ankle exoskeleton assistance patterns on wearer’s lower limb muscle activities and coordination patterns. A tethered ankle exoskeleton with nine assistance patterns that combined with differenet actuation timing values and torque magnitude levels was used to assist human walking. Lower limb muscle surface electromyography signals were collected from 7 participants walking on a treadmill at a speed of 1.25 m/s. Results showed that the soleus muscle activities were significantly reduced during assisted walking. In one assistance pattern with peak time in 49% of stride and peak torque at 0.7 N·m/kg, the soleus muscle activity was decreased by (38.5 ± 10.8)%. Compared with actuation timing, the assistance torque magnitude had a more significant influence on soleus muscle activity. In all assistance patterns, the eight lower limb muscle activities could be decomposed to five basic muscle synergies. The muscle synergies changed little under assistance with appropriate actuation timing and torque magnitude. Besides, co-contraction indexs of soleus and tibialis anterior, rectus femoris and semitendinosus under exoskeleton assistance were higher than normal walking. Our results are expected to help to understand how healthy wearers adjust their neuromuscular control mechanisms to adapt to different exoskeleton assistance patterns, and provide reference to select appropriate assistance to improve walking efficiency.
ObjectiveWearable devices refer to a class of monitoring devices that can be tightly integrated with the human body and are designed to continuously monitor individual's activity without impeding or restricting the user's normal activities in the process. With the rapid advancement of chips, sensors, and artificial intelligence technologies, such devices have been widely used for patients with cardiovascular diseases who require continuous health monitoring. These patients require continuous monitoring of a number of physiological indicators to assess disease progression, treatment efficacy, and recovery in the early stages of the disease, during the treatment, and in the recovery period. Traditional monitoring methods require patients to see a doctor on a regular basis with the help of fixed devices and analysis by doctors, which not only increases the financial burden of patients, but also consumes medical resources and time. However, wearable devices can collect data in real time and transmit it directly to doctors via the network, thus providing an efficient and cost-effective monitoring solution for patients. In this paper, we will review the applications, advantages and challenges of wearable devices in the treatment of cardiovascular diseases, as well as the outlook for their future applications.