Natural disasters occurring in inaccessible rural areas are on the rise, leading to the multiplication of first responders’ missions. However, engagement in fighting wildfires or participating in rescue missions includes risks for the well-being of the engaged first responders. Consequently, a system that monitors their actions and provides real-time and actionable information without obstructing their operational capacity is needed. The EU-funded SIXTHSENSE project aims to improve the efficiency and safety of first responders’ engagement in difficult environments by optimizing on-site team coordination and mission implementation. The project proposes an innovative wearable health monitoring system based on multimodal biosensor data that enables first responders to detect risk factors early on and allows real-time monitoring of all deployed responders. This paper is an introduction to the overall concept of the project, to the methodology and the system architecture, moreover details on Alpha version of SixthSense prototype are 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.

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%.

In the last few years, much effort has been devoted to the development of wearable sensing systems able to monitor physiological, behavioral, and environmental parameters. Less has been done on the accurate testing and assessment of this instrumentation, especially when considering devices thought to be used in harsh environments by subjects or operators performing intense physical activities. This paper presents methodology and results of the evaluation of wearable physiological sensors under these conditions. The methodology has been applied to a specific textile-based prototype, aimed at the real-time monitoring of rescuers in emergency contexts, which has been developed within a European funded project called ProeTEX. Wearable sensor measurements have been compared with the ones of suitable gold standards through Bland-Altman statistical analysis; tests were realized in controlled environments simulating typical intervention conditions, with temperatures ranging from 20 °C to 45 °C and subjects performing mild to very intense activities. This evaluation methodology demonstrated to be effective for the definition of the limits of use of wearable sensors. Furthermore, the ProeTEX prototype demonstrated to be reliable, since it produced negligible errors when used for up to 1 h in normal environmental temperature (20 °C and 35 °C) and up to 30 min in harsher environment (45 °C).

Tremor constitutes the most common motor disorder, and poses a functional problem to a large number of patients. Despite of the considerable experience in tremor management, current treatment based on drugs or surgery does not attain an effective attenuation in 25 % of patients, motivating the need for research in new therapeutic alternatives. In this context, this paper presents the concept design, development, and preliminary validation of a soft wearable robot for tremor assessment and suppression. The TREMOR neurorobot comprises a Brain Neural Computer Interface that monitors the whole neuromusculoskeletal system, aiming at characterizing both voluntary movement and tremor, and a Functional Electrical Stimulation system that compensates for tremulous movements without impeding the user perform functional tasks. First results demonstrate the performance of the TREMOR neurorobot as a novel means of assessing and attenuating pathological tremors.

Welcome to the third edition of the International Workshop on Interdisciplinary Research on E-Health Services and Systems, being held on Monday, June 20th, 2011 in Lucca, Italy, in conjunction with IEEE WoWMoM conference. It has been our great pleasure to organize this one-day workshop, dealing with a variety of research advances and challenges around e-health services and systems.

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.

The purpose of this study is to comparatively evaluate the performance of different wearable systems based on indirect breathing monitoring in terms of susceptibility to motion artifacts. These performances are compared with direct respiratory measurements using a spirometer, which is accurate, reliable, and less sensitive to movement artifacts, but cannot be integrated into truly wearable form. Experiments were carried out on four indirect methods implemented into wearable systems, inductive plethysmography, impedance plethysmography, piezoresistive pneumography, and piezoelectric pneumography, to ascertain the performance of each of them in terms of noise due to movement artifacts, as well as to study the effects of different movements or gestures during each test. A group of volunteers was asked to wear all of the breath monitoring systems simultaneously along with the face mask of the spirometer while carrying out four physical exercises in a gym under controlled conditions. Data are analyzed in the time and frequency domain to estimate the frequency respiration from each wearable system and compare it with those of the spirometer. Results confirmed that all the wearable systems are somehow affected by movement artifacts, but statistical investigation showed that for most of the physical exercises, three out of four, piezoelectric pneumography provided best performance in terms of robustness and reduced susceptibility to movement artifacts.

In this paper, several issues concerning the development of textiles endowed with electronic functions will be discussed. In particular, issues concerning materials, structures, electronic models, and the mechanical constraints due to textile technologies will be detailed. The idea starts from an already developed organic field-effect transistor that is realized on a flexible film that can be applied, after the assembly, on whatever kind of substrate, in particular, on textiles. This could pave the way to a variety of applications aimed to conjugate the favorable mechanical properties of textiles with the electronic functions of transistors. Furthermore, a possible perspective for the developments of organic sensors based on this structure are described.

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.

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.