This study evaluates the usability of wearable head ballistocardiography (BCG) in providing accurate pulse transit time (PTT) measurements during blood pressure (BP) interventions. Head BCG is a new technique enabling measurement of proximal aortic blood ejection from sensors placed at distal sites, which envisions PTT measurement from single integrated device for cuff-less BP estimation. However, due to its low signal-to-noise ratio and sensitivity to motion artifacts, accurate beat selection is crucial to ensure the integrity of PTT calculation. In this paper, using inertial measurement unit (IMU) sensors integrated in a prototype earbud, we investigate whether the wearable head BCG signal is aligned with the ground-truth proximal reference acquired from the synchronously-recorded impedance cardiography (ICG) signal, to assess the usability of head BCG as the proximal indicator for PTT measurement at different stages of BP intervention. Wearable BCG signals showed highest reliability during resting states, with 63% of detected j-peaks aligned with ground-truth ICG signals. Beat selection via removal of IBI outliers improves the ratio of reliable peaks, at rest (68%) and during exercise (63% at intervention and 52% at plateau). Other methods, such as template matching or rejecting amplitude outliers, only improve the ratio at rest. Overall, this study reveals characteristics of distortions in the head BCG signal during intervention, as a first step toward robust solutions for PTT-based BP tracking on integrated wearable devices.

Cardiac Output (CO) is a critical indicator of health, offering insights into cardiac dysfunction, acute stress responses, and cognitive decline. Traditional CO monitoring methods, like impedance cardiography, are invasive and impractical for daily use, leading to a gap in continuous, non-invasive monitoring. Although recent advancements explored wearables on heart rate monitoring, these approaches face challenges in accurately estimating CO due to the indirect nature of the signals. To address these challenges, we introduce EarCO, a non-invasive multimodal CO monitoring system with Photoplethysmography and Ballistocardiogram signals on commodity earbuds. A novel feature fusion method is proposed to integrate raw signals and prior knowledge from both modalities, improving the system’s interpretability and accuracy. EarCO achieves an error of 1.080 L/min in the leave-one-subject-out settings with 62 subjects, making cardiovascular health monitoring accessible and practical for daily use.

Camera-based respiratory monitoring is contactless, non-invasive, unobtrusive, and easily accessible compared to conventional wearable devices. This paper presents a novel multimodal approach to estimating breathing rate based on tracking the movement and color changes of the face through an RGB camera. A machine learning model determines the final breathing rate between two separately calculated ones from breathing motion and remote photoplethysmography (rPPG) to improve the measurement performance in a broader range of breathing frequencies. Our proposed pipeline is evaluated with 140 facial video recordings from 22 healthy subjects, including 6 controlled and 2 spontaneous breathing tasks ranging from 5 to 30 BPM. The estimation accuracy achieves 1.33 BPM mean absolute error and 86.53% pass rate within 2 BPM error criteria. To the best of our knowledge, our approach outperforms previous works that use a face region alone with a single RGB camera.

Stress can potentially have detrimental effects on both physical and mental well-being, but monitoring it can be challenging, especially in free-living conditions. One approach to address this challenge is to use earbud accelerometers to capture the ballistocardiogram (BCG) response. These sensors allow for noninvasive stress monitoring by estimating physiological indicators linked to stress, such as heart rate variability (HRV). However, ear-worn devices are susceptible to motion artifacts and can exhibit significant BCG signal morphology variations. These challenges necessitate accurate algorithms to estimate HRV for everyday use. Therefore, we developed a method to measure interbeat intervals (IBI) from BCG signals collected from an earbud. To enhance IBI estimation accuracy, we employed a Bayesian method that incorporates robust apriori IBI prediction weighting and sensor fusion techniques. We have also conducted a study involving 97 participants to assess the earbuds' ability to estimate HRV metrics and classify stressful activities. Our findings demonstrate low IBI estimation error (4.16% ± 1.90%), along with lower errors in subsequent higher-order HRV metrics compared to the state-of-the-art algorithms.

Core body temperature (CBT) is one of the critical yet under-explored phenomena in the context of stress detection. Several CBT measurement methods exist, but they are often limited in continuous CBT monitoring. Furthermore, how continuous CBT can be used to model acute stress is little explored. We address these challenges by conducting an in-lab controlled study with 97 participants who participated in baseline and stress-inducing tasks while wearing prototype earbuds capable of collecting CBT. We found that accounting for changes from individual baselines in CBT results is acute stress detection with 94.88% accuracy and 94.4% F1-score, which is 29.31% and 26.07% higher in terms of accuracy and F1-score, respectively, compared to generalized features.

Consumer hearable technologies such as earbuds are increasingly embedding physiological sensors, including photoplethysmography (PPG) and inertial measurements. They create unique opportunities to passively monitor stress and deliver digital interventions such as music. However, PPG signals recorded from ear canals are often very noisy due to head movement and fit issues. This work proposes algorithms to estimate heart rate variability (HRV) features from noisy PPG signals recorded using earbuds. We have used template matching to determine the signal quality for dynamic fine filtering around the estimated heart rate. We have also improved the inter-beat interval (IBI) outlier detection and removal algorithm using the global-local context of the input PPG signal. The mean absolute error of estimating RMSSD decreased from 70.83 milliseconds (ms) to 24.88 ms, and SDNN decreased from 46.89 ms to 16.60 ms.

The accurate estimation of peripheral capillary oxygen saturation (SpO2) is vital for monitoring respiratory health, with applications spanning medical diagnostics and fitness tracking. Remote photoplethysmography (rPPG) offers a convenient and non-contact approach for SpO2estimation. However, existing methods predominantly rely on data within the normal SpO2range, hindering their effectiveness during hypoxemia. Moreover, cross-user variations poses significant challenges for practicality. To address these limitations, we propose a simple yet effective normalization-based SpO2estimation algorithm. By aligning individual Ratio-of-Ratios (RoR) data with a standard model at the matching SpO2level, we mitigate cross-user variation, accommodate different camera configurations, and account for lighting changes. Our experiments demonstrate that the proposed method achieves an rMSE of 2.8% with leave-one-subject-out cross-validation across the full SpO2range (70%-100%), significantly outperforming existing RoR-based and CNN-based SpO2estimation approaches. Notably, our methods excel in accurately identifying hypoxemia, a critical clinical requirement. We anticipate broader applicability of our approach in rPPG-based vital sign monitoring, underlining the potential for enhancing robustness and reliability in various domains.