Wearable sensor technologies are essential to the realization of personalized medicine through continuously monitoring an individual's state of health. Sampling human sweat, which is rich in physiological information, could enable non-invasive monitoring. Previously reported sweat-based and other non-invasive biosensors either can only monitor a single analyte at a time or lack on-site signal processing circuitry and sensor calibration mechanisms for accurate analysis of the physiological state. Given the complexity of sweat secretion, simultaneous and multiplexed screening of target biomarkers is critical and requires full system integration to ensure the accuracy of measurements. Here we present a mechanically flexible and fully integrated (that is, no external analysis is needed) sensor array for multiplexed in situ perspiration analysis, which simultaneously and selectively measures sweat metabolites (such as glucose and lactate) and electrolytes (such as sodium and potassium ions), as well as the skin temperature (to calibrate the response of the sensors). Our work bridges the technological gap between signal transduction, conditioning (amplification and filtering), processing and wireless transmission in wearable biosensors by merging plastic-based sensors that interface with the skin with silicon integrated circuits consolidated on a flexible circuit board for complex signal processing. This application could not have been realized using either of these technologies alone owing to their respective inherent limitations. The wearable system is used to measure the detailed sweat profile of human subjects engaged in prolonged indoor and outdoor physical activities, and to make a real-time assessment of the physiological state of the subjects. This platform enables a wide range of personalized diagnostic and physiological monitoring applications.

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Fully integrated wearable sensor arrays for multiplexed in situ perspiration analysis

The design and development of wearable biosensor systems for health monitoring has garnered lots of attention in the scientific community and the industry during the last years. Mainly motivated by increasing healthcare costs and propelled by recent technological advances in miniature biosensing devices, smart textiles, microelectronics, and wireless communications, the continuous advance of wearable sensor-based systems will potentially transform the future of healthcare by enabling proactive personal health management and ubiquitous monitoring of a patient's health condition. These systems can comprise various types of small physiological sensors, transmission modules and processing capabilities, and can thus facilitate low-cost wearable unobtrusive solutions for continuous all-day and any-place health, mental and activity status monitoring. This paper attempts to comprehensively review the current research and development on wearable biosensor systems for health monitoring. A variety of system implementations are compared in an approach to identify the technological shortcomings of the current state-of-the-art in wearable biosensor solutions. An emphasis is given to multiparameter physiological sensing system designs, providing reliable vital signs measurements and incorporating real-time decision support for early detection of symptoms or context awareness. In order to evaluate the maturity level of the top current achievements in wearable health-monitoring systems, a set of significant features, that best describe the functionality and the characteristics of the systems, has been selected to derive a thorough study. The aim of this survey is not to criticize, but to serve as a reference for researchers and developers in this scientific area and to provide direction for future research improvements.

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A Survey on Wearable Sensor-Based Systems for Health Monitoring and Prognosis

The aim of this review paper is to summarize recent developments in the field of wearable sensors and systems that are relevant to the field of rehabilitation. The growing body of work focused on the application of wearable technology to monitor older adults and subjects with chronic conditions in the home and community settings justifies the emphasis of this review paper on summarizing clinical applications of wearable technology currently undergoing assessment rather than describing the development of new wearable sensors and systems. A short description of key enabling technologies (i.e. sensor technology, communication technology, and data analysis techniques) that have allowed researchers to implement wearable systems is followed by a detailed description of major areas of application of wearable technology. Applications described in this review paper include those that focus on health and wellness, safety, home rehabilitation, assessment of treatment efficacy, and early detection of disorders. The integration of wearable and ambient sensors is discussed in the context of achieving home monitoring of older adults and subjects with chronic conditions. Future work required to advance the field toward clinical deployment of wearable sensors and systems is discussed.

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A review of wearable sensors and systems with application in rehabilitation.

Fiber-based structures are highly desirable for wearable electronics that are expected to be light-weight, long-lasting, flexible, and conformable Many fibrous structures have been manufactured by well-established lost-effective textile processing technologies, normally at ambient conditions The advancement of nanotechnology has made it feasible to build electronic devices directly on the surface or inside of single fibers, which have typical thickness of several to tens microns However, imparting electronic functions to porous, highly deformable and three-dimensional fiber assemblies and maintaining them during wear represent great challenges from both views of fundamental understanding and practical implementation This article attempts to critically review the current state-of-arts with respect to materials, fabrication techniques, and structural design of devices as well as applications of the fiber-based wearable electronic products In addition, this review elaborates the performance requirements of the fiber-based wearable electronic products, especially regarding the correlation among materials, fiber/textile structures and electronic as well as mechanical functionalities of fiber-based electronic devices Finally, discussions will be presented regarding to limitations of current materials, fabrication techniques, devices concerning manufacturability and performance as well as scientific understanding that must be improved prior to their wide adoption

Fiber‐Based Wearable Electronics: A Review of Materials, Fabrication, Devices, and Applications

Electronic Textiles (e-textiles) are fabrics that feature electronics and interconnections woven into them, presenting physical flexibility and typical size that cannot be achieved with other existing electronic manufacturing techniques. Components and interconnections are intrinsic to the fabric and thus are less visible and not susceptible of becoming tangled or snagged by surrounding objects. E-textiles can also more easily adapt to fast changes in the computational and sensing requirements of any specific application, this one representing a useful feature for power management and context awareness. The vision behind wearable computing foresees future electronic systems to be an integral part of our everyday outfits. Such electronic devices have to meet special requirements concerning wearability. Wearable systems will be characterized by their ability to automatically recognize the activity and the behavioral status of their own user as well as of the situation around her/him, and to use this information to adjust the systems' configuration and functionality. This review focuses on recent advances in the field of Smart Textiles and pays particular attention to the materials and their manufacturing process. Each technique shows advantages and disadvantages and our aim is to highlight a possible trade-off between flexibility, ergonomics, low power consumption, integration and eventually autonomy.

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Wearable Electronics and Smart Textiles: A Critical Review

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.

A wearable health care system based on knitted integrated sensors

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.

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BIOTEX—Biosensing Textiles for Personalised Healthcare Management

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.

Performance evaluation of sensing fabrics for monitoring physiological and biomechanical variables

In this paper is reported the experience gained in the last five years, in the implementation of wearable systems for personalized health care and their evolution in time. Sensing bio clothes for vital signs monitoring and wearable systems for gesture and posture recognition are specifically illustrated, resulting from the EU funded projects: Wealthy and My Heart.

Sensing Fabrics for Monitoring Physiological and Biomechanical Variables: E-textile solutions

The implementation of truly wearable, instrumented garments which are capable of recording biomechanical variables is crucial in several fields of application, from multimedia to rehabilitatio n, from sport to artistic fields. In this paper we discuss wearable devices (a smart shirt, a leotard and a glove) which can read and record the vital signs and movements of a subject wearing the system. The sensing function of the garments is based on piezo -resistive fabric sensors, based on carbon -loaded rubbers (CLR) and different conductive materials.

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Rita Paradiso

Papers

A wearable health care system based on knitted integrated sensors

BIOTEX—Biosensing Textiles for Personalised Healthcare Management

Performance evaluation of sensing fabrics for monitoring physiological and biomechanical variables

Sensing Fabrics for Monitoring Physiological and Biomechanical Variables: E-textile solutions

Electroactive fabrics and wearable biomonitoring devices