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.
Cardiovascular disease has caused a huge burden of disease worldwide, and the rapid advancement of smart wearable devices has provided new means for early diagnosis, real-time monitoring, and event prevention of cardiovascular disease. Smart wearable devices can be classified into various categories based on detection signals and physical carrier types. Based on an overview of the composition of such devices, this article further introduces the current cutting-edge research and related market products related to smart blood pressure monitoring, electrocardiogram monitoring, and ultrasound monitoring. It also discusses the future development and challenges of such devices, aiming to provide evidence support for the research and development of smart wearable devices in the diagnosis and treatment of cardiovascular diseases in the future.
In order to improve the accuracy of blood pressure measurement in wearable devices, this paper presents a method for detecting blood pressure based on multiple parameters of pulse wave. Based on regression analysis between blood pressure and the characteristic parameters of pulse wave, such as the pulse wave transit time (PWTT), cardiac output, coefficient of pulse wave, the average slope of the ascending branch, heart rate, etc. we established a model to calculate blood pressure. For overcoming the application deficiencies caused by measuring ECG in wearable device, such as replacing electrodes and ECG lead sets which are not convenient, we calculated the PWTT with heart sound as reference (PWTTPCG). We experimentally verified the detection of blood pressure based on PWTTPCG and based on multiple parameters of pulse wave. The experiment results showed that it was feasible to calculate the PWTT from PWTTPCG. The mean measurement error of the systolic and diastolic blood pressure calculated by the model based on multiple parameters of pulse wave is 1.62 mm Hg and 1.12 mm Hg, increased by 57% and 53% compared to those of the model based on simple parameter. This method has more measurement accuracy.
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.
The dynamic electrocardiogram (ECG) collected by wearable devices is often corrupted by motion interference due to human activities. The frequency of the interference and the frequency of the ECG signal overlap with each other, which distorts and deforms the ECG signal, and then affects the accuracy of heart rate detection. In this paper, a heart rate detection method that using coarse graining technique was proposed. First, the ECG signal was preprocessed to remove the baseline drift and the high-frequency interference. Second, the motion-related high amplitude interference exceeding the preset threshold was suppressed by signal compression method. Third, the signal was coarse-grained by adaptive peak dilation and waveform reconstruction. Heart rate was calculated based on the frequency spectrum obtained from fast Fourier transformation. The performance of the method was compared with a wavelet transform based QRS feature extraction algorithm using ECG collected from 30 volunteers at rest and in different motion states. The results showed that the correlation coefficient between the calculated heart rate and the standard heart rate was 0.999, which was higher than the result of the wavelet transform method (r = 0.971). The accuracy of the proposed method was significantly higher than the wavelet transform method in all states, including resting (99.95% vs. 99.14%, P < 0.01), walking (100% vs. 97.26%, P < 0.01) and running (100% vs. 90.89%, P < 0.01). The absolute error [0 (0, 1) vs. 1 (0, 1), P < 0.05] and relative error [0 (0, 0.59) vs. 0.52 (0, 0.72), P < 0.05] of the proposed method were significantly lower than the wavelet transform method during running state. The method presented in this paper shows high accuracy and strong anti-interference ability, and is potentially used in wearable devices to realize real-time continuous heart rate monitoring in daily activities and exercise conditions.
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.
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.
With the rapid advancement of artificial intelligence (AI), its application in the rehabilitation of patients undergoing hip and knee arthroplasty has been increasingly emphasized. AI has the potential to enhance the precision and individualization of rehabilitation training, improve patient adherence, and optimize overall outcomes. This review summarizes the current progress of AI in postoperative rehabilitation following hip and knee arthroplasty, focusing on its roles in rehabilitation assessment, intelligent training, and remote rehabilitation. Furthermore, the advantages of AI in improving efficiency, accuracy, and patient engagement are highlighted, while existing challenges, including insufficient clinical evidence, high technological costs, and ethical concerns, are critically discussed. Finally, potential future directions, such as the integration of AI with virtual reality and wearable devices, are proposed. This review aims to provide valuable insights for clinical practice and future research in the rehabilitation of hip and knee arthroplasty.
According to the development status of wearable technology and the demand of intelligent health monitoring, we studied the multi-function integrated smart watches solution and its key technology. First of all, the sensor technology with high integration density, Bluetooth low energy (BLE) and mobile communication technology were integrated and used in develop practice. Secondly, for the hardware design of the system in this paper, we chose the scheme with high integration density and cost-effective computer modules and chips. Thirdly, we used real-time operating system FreeRTOS to develop the friendly graphical interface interacting with touch screen. At last, the high-performance application software which connected with BLE hardware wirelessly and synchronized data was developed based on android system. The function of this system included real-time calendar clock, telephone message, address book management, step-counting, heart rate and sleep quality monitoring and so on. Experiments showed that the collecting data accuracy of various sensors, system data transmission capacity, the overall power consumption satisfy the production standard. Moreover, the system run stably with low power consumption, which could realize intelligent health monitoring effectively.