30th Annual International IEEE EMBS Conference

Vancouver, British Columbia, Canada, August 20-24, 2008

A Survey on Wearable Biosensor Systems for Health Monitoring

Alexandros Pantelopoulos and Nikolaos Bourbakis, ATRC Center, Wright State University

Abstract— Wearable biosensor systems for health Fig.1 visualizes the concept of a possible wearable system
monitoring are an emerging trend and are expected to enable and should not be perceived as a standard system design, as
proactive personal health management and better treatment of many systems may adopt significantly varying architectures
various medical conditions. These systems, comprising various (for example bio-signals may be transmitted in analog form
types of small physiological sensors, transmission modules and and without preprocessing to the central node and
processing capabilities, promise to change the future of health
bidirectional communication between sensors and central
care, by providing low-cost wearable unobtrusive solutions for
continuous all-day and any-place health, mental and activity node may not exist).
status monitoring. Wearable systems for health monitoring need to satisfy a
This paper presents a comprehensive survey on the research great variety of criteria and constraints. These include small
and development done so far on wearable biosensor systems for weight and size, privacy of medical data, unobtrusiveness,
health-monitoring, by comparing a variety of current system ease of use, low cost, reliability and low power consumption
implementations and approaches and identifying their to name the most important ones. As a result, designing such
technological shortcomings. A set of significant features, that a system is a very challenging task since a lot of highly
best describe the functionality and the characteristics of constraining and often conflicting requirements have to be
wearable biosensor systems, has been selected to derive a
considered from the designers.
thorough study. The aim of this survey is not to criticize, but to
serve as a reference for current achievements and their This paper briefly reviews the state-of-the-art in research
maturity level and to provide direction for future research and development on wearable low-cost unobtrusive systems
improvements. for health-monitoring by identifying and comparing the
attributes of the most promising current achievements of
I. INTRODUCTION several worldwide projects. The paper concludes with a

D URING the past decade there have been numerous discussion of the current shortcomings in system design,
research and development efforts in the field of integration and functionality along with other challenging
wearable health-monitoring systems motivated by the need issues that have to be overcome in order for wearable
to monitor a person’s health status outside of the hospital systems to become more efficient and applicable as real-life
[1]-[3]. Such a system can provide real-time feedback solutions, which can potentially increase the quality of life.
information about one’s health condition, either to oneself or
to a professional physician at the hospital or even alert the
individual in case of possible imminent health threatening
conditions. Furthermore, wearable biosensor systems offer
also a great alternative to deal with increasing health care
costs and also to address the issues of managing and
monitoring chronic diseases, elderly people, postoperative
rehabilitation patients and persons with special abilities [4].
Wearable systems for health monitoring consist of several
miniature sensors, wearable or even implantable. The
sensors measure significant physiological signals like heart
rate, blood pressure, body and skin temperature, ECG etc.
These measurements are communicated usually through a
wireless link to a central node, for example a PDA or a
microcontroller board, which may then in turn transmit the
data to a clinician or display the according information on a
user interface and possibly generate alert signals. The
previous demonstrate a possible wearable medical system
scenario which can involve the following system
components: sensors, materials, smart textiles, actuators,
power supplies, wireless communication abilities, control
and processing units, interface for the user, software and
advanced algorithms for feature extraction and decision
support. In Fig.1, a system architecture that could apply to
Fig.1 An architecture of a wearable health-monitoring biosensor system.
such a scenario is presented.

978-1-4244-1815-2/08/$25.00 ©2008 IEEE. 4887

 II. REVIEW TABLE II
FEATURES’ WEIGHTS
A) Survey Features Patient’s Physician’s Manufacturer’s
Average
Several features have been chosen for the evaluation of perspective perspective perspective
the various wearable systems discussed in the current F1 10 3 5 6
survey. The choice of features was based upon the wide F2 10 3 3 5.3
range of requirements a wearable biosensor system must F3 10 1 5 5.3
meet in order for it to be used in real-life health monitoring F4 8 6 10 8
scenarios. In Table I, all the chosen features are listed along F5 8 5 7 6.7
with a brief explanation for each one. F6 10 10 10 10
F7 8 6 3 5.7
B) Survey Tables
F8 1 1 9 3.7
In Table II for each one of the selected features a weight F9 10 7 3 6.7
is assigned (1-10), which reflects the feature’s average
F10 10 10 10 10
importance, taking into consideration the perspective of the
F11 10 10 10 10
patient/wearer, the manufacturer and the possible
supervising physician. For example, the system’s complexity F12 5 2 7 4.7
and computational requirements are not that (or at all) F13 5 6 8 6.3
important to the patient as it is to the manufacturer. On the F14 10 10 10 10
contrary, ease of use is of most importance mainly to the F15 3 3 6 4
patient. F16 10 6 5 7

C) Reviewed Wearable Systems

Finally, in Table 5, all the discussed wearable systems are
In Table III all the wearable systems, which were
graded. We grade each feature on a scale of 0-10. If the
considered and evaluated are listed.
corresponding cell in the table is left empty, this means that
TABLE I there is not enough information on that characteristic. For
EVALUATION FEATURES each system, a final weighted average score is produced,
Wearability (F1) The system must have low weight and size. corresponding to the formula: (Σiwi·xi)/Σiwi where wi is the
Appropriate placement The system has to be unobtrusive and
weight of each feature (Table II) and xi is the corresponding
on the body (F2) comfortable, in order not to interfere with the
user’s movements and daily activity. score (Assigned features’ weights and corresponding system
Aesthetic issues (F3) The system should not severely affect the user’s scores are based on “aggregated opinions” of colleagues,
appearance. department’s students and doctor acquaintances to reduce
Data encryption and Encrypted transmission of measured signals and
security (F4) authentication requirement for private data the level of subjectivity in these metrics).
access.
Operational lifetime Ultra low power consumption for long-term, TABLE III
(F5) maintenance-free health monitoring. WEARABLE BIOSENSOR SYSTEMS
Real Application (F6) The developed system is applicable (and useful) Measured
Project Title or Hardware/
to real-life scenarios/health conditions. Bio-
Description Communication
Real-time Application The wearable system produces results, e.g. signals*
(F7) display of measurements, alerts, diagnosis etc, HealthGear Pulse oximeter and cell
A HR, Sa02
in (or near) real-time. (Microsoft) [5] phone / Bluetooth
Complexity and The number of operations and computational BP, T,
Computational power required by the system to achieve AMON (EU IST FP5 Wrist-worn device /
B Sa02,
Requirements (F8) desirable results. program) [6] GSM link
ECG, A
Ease of use (F9) The system incorporates a friendly, easy-to-use BSN Earpiece, Ear-worn device / HR, Sa02,
user interface. C
(Imperial College) [7] Zigbee A
Performance and test Sufficient results and performance statistics are
in real cases (F10) provided to verify the system’s functionality in A, ECG,
PDA, microcontroller
real cases. EMG,
D LiveNet, (MIT) [8] board / wires, 2.4GHz
GSR, T, R,
Reliability (F11) The system produces reliable results. radio, GPRS
Sa02, BP
Cost (F12) The amount of money required to produce and
purchase the proposed wearable system. AUDABE (Dept. of Mask, glove, chest EMG,
Interference Availability and reliability of wirelessly E Medical Physics, sensors / wires, Wi-Fi, ECG, R,
Robustness (F13) transmitted physiological measurements. Ioannina, Greece) [9] Bluetooth GSR
Fault Tolerance (F14) The system produces reliable results under any BMA classification
circumstances, such as various kinds of from W-ECG (Indian Portable ECG device /
patient’s movements. F ECG
Institute of wires
Scalability (F15) Potentiality of upgrading, enhancing and easily Technology) [10]
incorporating additional components to the Wearable ECG,
developed system. PDA, microcontroller
arrhythmia detection
G board / wires, Zigbee, ECG
Decision Support The implemented system includes some type of (Eng. + Med. Dpts,
GPRS
(F16) diagnosis/decision mechanism or an Norway) [11]
algorithm/pattern recognition system for
context aware sensing of parameters.

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 PDA, Textile & TABLE IV
ECG, R,
MyHeart (EU IST FP6 electronic sensors on GRADING OF SYSTEMS ACCORDING TO SELECTED FEATURES.
H other vital
program) [12] clothes / conductive A B C D E F G H I J K L
signs, A
yarns, GSM, Bluetooth
Low-Power Wireless F1 5 4 4 3 5 3 4 8 6 4 5 9
Medical Sensor Ultra-low power sensor F2 4 6 7 6 8 9 5 9
I Platform (ECE Dept. prototype / 2.4 GHz A, T, GSR
Un. Of Colorado at radio F3 5 2 3 2 9 8 3 2 9
Boulder, USA) [13] F4 5 5 6 6
Wireless physiological
signal measuring PDA, microcontroller HS, ECG, F5 3 3 4 4 7 8 4 3
J
system (Nat. Cheng board / wires, Bluetooth T F6 9 9 8 9 9 9 9 9 7 8 7 9
Kung University) [14]
F7 9 9 9 9 9 8 9 9 7 8 5 9
WBAN system for
ambulatory monitor. Zigbee nodes with F8 8 7 8 7 6 9 6 8 5 8 8
ECG,
K (University of custom sensor platforms
EMG, A F9 8 7 6 6 6 4 6 8 5
Alabama in / Zigbee
Huntsville, USA) [15] F10 7 7 6 5 8 4 8 5
Ultra-Wearable,
F11 7 4 6 5 8 5
wireless, low power Insulated bioelectrodes,
L ECG monitoring custom sensor node / 2.4 ECG F12 9 6 7 5 8 6
(Univ. of California, GHz radio 6 5 4
F13
Irvine, CA) [16]
Wearable multi-sensor F14 8 1 5 7
system for emotion- Glove with sensor unit, F15 7 1 2 8 7 8 5 9 7 8 8
GSR, T,
M related data chest belt / ISM band
HR F16 8 8 6 8 9 9 8 7
(Fraunhofer Institute, radio
Rostock) [17]
Zigbee nodes with
CodeBlue (Harvard Sa02, M N O P Q R S T U V W X Y
N custom sensor platforms
University) [18] ECG, A
/ Zigbee F1 5 7 8 5 8 7 8 8 6 8 9 6 9
Zigbee-based nodes on ECG, T,
BASUMA (University F2 5 7 7 7 8 8 8 8 8 7 9
O chest belt or ear clip / R, BP,
of Potsdam) [19]
Zigbee Sa02 F3 2 7 7 3 6 6 7 6 6 8 3 6
Wireless medical Pulse oximeter,
Sa02, HR, F4 6 6
P wearable device (EU piezoelectric sensor /
R, A
IST FP5 progr.) [20] Bluetooth, UMTS F5 4 4 5 7 5 9 5 8
W-BSN using MICS
MICS-based implantable F6 8 8 9 8 9 9 9 9 9 9 9 7 8
Q (Univ. of Newcastle, HR, T
prototype sensor / MICS
AUS)[21] F7 9 8 9 8 7 9 9 9 9 9 9 8 9
Textile & electronic
ECG, F8 8 8 7 8 8 8 7 8 8 8 6 7 7
WEALTHY (EU IST sensors on jacket /
R EMG, R,
FP5 program) [22] conductive yarns, GPRS, F9 5 5 5 6 8 7 6 8 9 8 8
T, A
Bluetooth
MagIC (Centro di Vest with textile sensors, F10 2 3 5 8 8 6 7 8 8 8 8
S Bioingegneria, IT) custom electronioc ECG, R, T F11 8 5 8 8 6 7 7 8 7 6
[23] board, PDA / Bluetooth
PDA, knitted dry F12 7 7 6 7 5
MERMOTH (EU IST ECG, R,
T electrodes / conductive F13 5 4 5
FP6 program) [24] T, A
yarns, RF link
Miniature low-power F14 6 8 6 7 7 5
Human++ (IMEC) ECG,
U BAN nodes, energy F15 9 9 9 6 6 4 4 6 9 3 2 1 1
[25] EEG,EMG
scavenging / Zigbee
Shirt with conductive F16 4 7 7 5 6 6
SmartShirt (Sensatex) fiber sensors, PDA / ECG, BP,
V
[26] conductive yarns, R
Bluetooth or Zigbee
Sensors embedded in
Lifeshirt
W vest, PDA / ECG, R, A
(Vivometrics) [27]
Bluetooth,wires
SenseWear Armband Wrist-worn device / RF T, GSR, A
X
(Bodymedia) [28] link HF
WristCare (Vivago) Wrist-worn device /
Y T, GSR, A
[29] Bluetooth, GPRS

* HR=Heart Rate, Sao2=Oxygen Saturation, ECG=Electrocardiogram,

BP=Blood Pressure, A=Activity, R=Respiration, EMG=Electromyogram,
EEG=Electroencephalogram, T=temperature (skin or body), GSR=Galvanic
Skin Response, HS=Heart Sounds, HF=Heat Flux

Fig. 2 Average Grading for every system.

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