Open Access Library Journal

2024, Volume 11, e12482

ISSN Online: 2333-9721
ISSN Print: 2333-9705

A Comprehensive Review of rPPG Methods for

Heart Rate Estimation

Ali S. Salim1, Abdul Sattar M. Khidhir2

1
Department of Computer Techniques Engineering, Technical Engineering College, Northern Technical University, Mosul, Iraq
2
Department of Networks and Computer Software Techniques, Mosul Technical Institute, Northern Technical University, Mosul,
Iraq

How to cite this paper: Salim, A.S. and Abstract

Khidhir, A.S.M. (2024) A Comprehensive
Review of rPPG Methods for Heart Rate Recently, there has been an increasing interest in assessing basic health indica-
Estimation. Open Access Library Journal, 11: tions covering blood pressure, heartbeat, and breathing rate using remote pho-
e12482.
toplethysmography (rPPG) to obtain the results without direct contact with hu-
https://doi.org/10.4236/oalib.1112482
mans; rPPG has become essential to measuring vital signs while avoiding dif-
Received: October 16, 2024 ficulties in many cases, such as transmission of infection through contact with
Accepted: November 17, 2024 persons who have serious diseases or disturbing people with sensitive skin or
Published: November 20, 2024
newborn babies. This technique can also be used for other applications, such
Copyright © 2024 by author(s) and Open as monitoring people’s stress levels during indirect investigations and moni-
Access Library Inc. toring the health indications of truck drivers to send them a notification if they
This work is licensed under the Creative
suffer a health crisis. This paper discusses the methods used in remote photo-
Commons Attribution International
License (CC BY 4.0). plethysmography (rPPG) that focus on measuring the photoplethysmography
http://creativecommons.org/licenses/by/4.0/ (PPG) using an RGB camera. These techniques achieved good results correspond-
Open Access ing to the availability, cost, and ease of use.

Subject Areas
Artificial Intelligence, Image Processing

Keywords
Remote Photoplethysmography (rPPG), Heart Rate Measurement, Remote
Health Monitoring, Computer Vision, Deep Learning

1. Introduction
Heart rate (HR) is a significant physiological indicator, specifically for the rapid
notification of heart diseases and arrhythmias in the heart. The techniques of HR
monitoring can be categorized as direct and indirect contact with the human

DOI: 10.4236/oalib.1112482 Nov. 20, 2024 1 Open Access Library Journal

 A. S. Salim, A. S. M. Khidhir

body. For contact methods, measurement of electrocardiogram (ECG)-based

heart rate detection offers dependable outcomes in a lot of clinical diagnoses, as
shown in Figure 1. Ten sticky electrodes are required at designated locations on
the body to determine the heart rate. As mentioned above, it has high accuracy
and reliable results, but it restricts the patient’s moving flexibility or may cause
allergic issues with sensitive or burned skin to the patient [1]. However, photo-
plethysmography (PPG) is a commonly employed alternative method that ad-
dresses some drawbacks while providing dependable findings. In device architec-
ture, red and near-infrared light from LEDs is typically employed, as these longer
wavelengths are appropriate for assessing deep-tissue blood flow. The variation
in hemoglobin concentration during the heart’s cycle results in a minor change
in light absorption rate. The following non-invasive optical technique utilizes a
source of light and a light detector to determine the blood volume pulse (BVP)
inside superficial blood arteries during flow [2]. Beer-Lambert’s theory proposes
that the reduction of light at certain wavelengths can be determined by dispersion
and reflection as it interacts with the skin. The variation in the levels of reflected
and transmitted light is captured as a PPG signal by a photodetector, as shown in
Figure 2. This methodology is frequently included in wearable devices, including
pulse oximeters, smartwatches, and smartphones [3]. Researchers began research
on the feasibility of obtaining PPG signals from video recordings by analyzing
subtle color changes in the skin due to blood flow; they established that heart rate
could be correctly tracked using normal cameras; also, improvements in high-
definition cameras, computer vision, and deep learning methods have directed

Figure 1. ECG setup and ECG trace [4].

DOI: 10.4236/oalib.1112482 2 Open Access Library Journal

 A. S. Salim, A. S. M. Khidhir

Figure 2. (a) A wrist-mounted remote sensor pulse oximeter with a probe. (b) A pulse oximeter is a tool that non-
invasively evaluates oxygen saturation by transmitting light via the skin of a finger [2].

more research studies toward measuring heartbeats without contact with the
body. As wearable devices gained popularity, the incorporation of rPPG into
smartwatches, cellphones, and fitness trackers offers users immediate health data
without the necessity for invasive sensors. Remote tracking of health has been
gaining popular interest due to its offer of a more comfortable and unobtrusive
method for heart rate evaluation, especially for people who have sensitive or burnt
skin or require continuous vital signs measurement, as in an intensive care unit
(ICU). Therefore, methods directed to replace traditional measurement techniques
are based on the process known as rPPG [5] [6]. As mentioned above, rPPG is
helpful in cases of epidemics and infectious diseases, such as COVID-19, where it
is preferable to avoid direct contact with the patient [7]. Remote photoplethys-
mography (rPPG) uses a camera, including thermal, infrared spectrum, or RGB
cameras, to capture video of the individual and detect small color variations in
facial skin to produce the remote signal for PPG. The rPPG method operates on
an idea similar to the standard PPG method, where the rapid flow of blood within
the circulatory system alters the blood density within the blood vessels area below
the skin surface with every heartbeat, producing regular waves. The primary dis-
tinction between the two methodologies lies in the approach employed for col-
lecting the PPG signal; rPPG techniques obtain the signal by capturing the face of
the subject without contact. Conversely, traditional PPG techniques require a
physical sensor that stays in touch with the skin [8]. The principle of rPPG method
is ambient light falls on the skin; part of this light will suffer from a specular re-
flection from the skin surface, which is devoid of physiological information, and
the other parts of the light will suffer from a diffuse reflection from the blood vessels
inside the skin, changes in blood volume inside the vessels corresponding to heart-
beats result in minor differences in reflected light from the skin surface, from which
the PPG signal is derived following processing. This diffuse signal contains physi-
ological information that is captured using the camera, and the heart rate is calcu-
lated or estimated from this signal after filtering and processing it, as shown in
Figure 3 [9]. The rPPG has become one of the most widely used methods due to

DOI: 10.4236/oalib.1112482 3 Open Access Library Journal

 A. S. Salim, A. S. M. Khidhir

Figure 3. Mechanism of rPPG using the dichromatic reflection model (DRM). The digital camera records both specular
and diffuse reflections from ambient light. Specular reflection includes surface information unrelated to signals from
the body, while diffuse reflection is affected by circulation. The signal of rPPG can be generated via additional pro-
cessing of signals [11].

the cheap cost of the standard camera, comfort for patients, and high accuracy of
the results. This method can be used in various contexts, including Telehealth,
which allows healthcare providers to monitor patients requiring continuous ob-
servation of health indicators remotely. Additionally, outside the medical domain,
this method can assess individuals’ stress levels during indirect investigations con-
ducted by authorities and the possibility of using it to monitor the vital indicators
of car drivers in order to alert the driver in the event of recording indicators for
an upcoming health crisis. This technique enables us to take health indicators
from a few meters away with standard cameras. Despite its many advantages,
rPPG faces some challenges; factors like motion artifacts and varying lighting con-
ditions can affect accuracy; performance can vary across different skin tones, re-
quiring additional research for equitable application; the diversity of the database
in the methods that use deep learning to extract the PPG signal affects the accu-
racy [10].
This research provides an in-depth review of rPPG monitoring utilizing com-
puter vision and deep learning approaches to determine the heart rate. According
to the work method, the review divides the heartbeat measurement into two types.
Section two lists the details related to the two types. Section three lists the Potential
applications. Section four lists the advantages and Limitations. Conclusions are in
section five.

2. Literature Review
The main signal being worked on to obtain the heartbeats is obtained in two ways.
The first method is to measure the amount of diffuse reflections light from the
skin to obtain the main signal, and then different algorithms are applied to process
the main signal to achieve the heart rate. The second method extracts the main
signal from subtle head movements generated by heartbeats and then applies

DOI: 10.4236/oalib.1112482 4 Open Access Library Journal

 A. S. Salim, A. S. M. Khidhir

different algorithms and filters to signal processing to achieve the heart rate. Be-
low is the previous study according to how the main signal is obtained.

2.1. Heartbeat Measurement Based on the Reflection of Light on

the Skin
Thermal cameras may be useful for the collection of rPPG data, enabling the ex-
traction of physiological information regarding heart pulse, blood flow, and res-
piratory rate [12]. This method tracks the region of interest (ROI), which is the
blood vessel that contains different amounts of blood according to the heartbeat.
After recording the thermal signal, the noise is removed, and the fast Fourier trans-
form (FFT) is used to calculate the heartbeat, as shown in Figure 4. The accuracy
of this approach was about 88%. The environment in which data were recorded
from the samples was typical regarding lighting and movement. However, the sys-
tem cannot work well in a realistic environment because of changes in illumina-
tion and difficulties in restricting a person’s movement. Additionally, the body’s
temperature and ambient temperature can also affect the results, and the high cost
of thermal equipment limits the widespread use of this method [4].

Figure 4. A description of no physical heart rate estimation using a thermal camera [4].

In 2008, Verkruysse et al. first studied rPPG. They used consumer-level digital
cameras for HR estimation from a distance of about 1 meter, depending on the av-
erage light from the around as a source. This method focuses on taking the initial
signal from the reflection of the light signal on the green channel for ROI, then
applying a bandpass filter with a range of frequency (0.8, 3.5) Hz to get a heart rate
range between (48, 210), then performed an FFT on the obtained signal to derive
heart rate. Two primary factors constrain the spatial clarity of the PPG data (power
and phase) and the level of accuracy of our existing methodology: firstly, movement
objects, and secondly, decreasing signal-to-noise ratio (SNR). The first issue may
be fixed by increasing the location of the volunteers. The second issue can be resolved
through the use of advanced movie cameras with enhanced frame quality and bet-
ter techniques for analyzing signals and processing [13].

DOI: 10.4236/oalib.1112482 5 Open Access Library Journal

 A. S. Salim, A. S. M. Khidhir

In 2010, the author focused on blind source separation (BSS) utilizing independ-
ent component analysis (ICA). ICA is an approach for detecting independent source
data generated by a collection of signals that consist of linear combinations of the
fundamental sources, as seen in Figure 5. This new approach in healthcare signal
analysis is fast growing. ICA has been utilized to eliminate noise from electrocar-
diogram (ECG) and electroencephalogram (EEG) recordings, as well as to decrease
movement effect errors on the PPG signal [14]. The ICA method introduces an
innovative approach for indirect heart rate evaluation from video frames via blind
source separation. In this study, a laptop webcam was used for 12 participants with
varying skin colors. The trials were performed indoors, utilizing different amounts
of sunshine as the sole source of illumination. When recording a video of the skin
on the face with a webcam, the sensor of the camera detects a mix of the reflected
plethysmographic signal and various light fluctuations caused by artifacts, such as
motion variations in environmental illumination, resulting in a summation of in-
dependent random parameters that exhibit greater Gaussian characteristics than
the original parameters [15].

Figure 5. Methodology for heart pulse monitoring. (a) The ROI is dynamically identified with a face detector.
(b) From the ROI region, extracted RGB channels and counted the averaged change to obtain (c) the unfiltered
RGB signals. ICA is utilized on the normalized RGB signals for recovery (d) of three independent source signals
[15].

After recording the video, face detection was performed to identify the ROI and
count the average colors: red, green, and blue. The normalized raw signals are fur-
ther divided into three independent source signals utilizing ICA. This method sep-
arates the extracted signal and divides it into three sources. There will be one or
more sources close to the heart rate indicators, and the other source that contains
noise resulting from abnormal movement and changes in lighting is ignored, then
passed through a bandpass filter with a range of frequency (0.75, 4) Hz. According

DOI: 10.4236/oalib.1112482 6 Open Access Library Journal

 A. S. Salim, A. S. M. Khidhir

to this frequency range, the heart rate range must be between (45 and 240) beats
per minute (bpm). The recorded videos included two statuses: the first involved
no movement, and the second involved typical movement. The results were com-
pared with a blood volume pulse (BVP). This method allows the heart rate of three
people to be read simultaneously. Table 1 shows the results before and after using
ICA to demonstrate this method’s efficiency. There was a noticeable improvement
in the accuracy of this method, but it still suffered from limitations, including be-
ing affected by changes in lighting and movement [15].

Table 1. Summary details of heart pulse measurements according to proposed methodol-

ogy and reference BVP [15].

Sitting still With movement artifacts

Statistic
Before ICA After ICA Before ICA After ICA
No. of measurement pairs 372 327 372 372
Mean bias (bpm) 0.09 −0.05 8.16 0.64
Mean absolute bias (bpm) 2.79 0.91 10.81 2.44
SD of bias (bpm) 6.01 2.29 17.58 4.59
Upper limit (bpm) 11.86 4.44 42.62 9.64
Lower limit (bpm) −11.68 −4.55 −26.31 −8.35
RMSE 6.00 2.29 19.36 4.63
Correlation coefficient 0.89* 0.98* 0.15* 0.95*

*Indicates significance at p < 0.001.

In 2012, Lewandowska et al. proposed principal component analysis (PCA),

which is similar to the ICA method, but it operates on different principles. This
method also used a webcam to record video and then employed an algorithm to
detect the ROI of the face and extract the RGB signal from the ROI location on
the head. The RGB signal is based on the reflections of light on the body, and these
values vary according to the passage of blood in the veins. PCA is a process that
determines similarities in data and represents it in a format that highlights simi-
larities and differences, providing it a useful instrument for data analysis. The basic
principle of PCA is to transform the original data into a new coordinate system in
which the maximum variance by any projection lies on the first coordinate (the
first principal component), the second greatest variance on the second coordi-
nate, and so on. This method reduces the dimensionality of the data while pre-
serving as much variance as possible, making it easier to analyze. After that, a
bandpass filter is applied to the archived signal from PCA to remove unwanted
frequency. To obtain the heart rate, we count the peaks of the processed signal
over time. Comparing the above methods, ICA and PCA yielded almost similar
results, but PCA was superior to ICA in terms of simplicity, lower complexity,
and speed of calculations [16].
In 2013, Wei et al. used Laplacian eigenmap (LE) algorithms to extract signals

DOI: 10.4236/oalib.1112482 7 Open Access Library Journal

 A. S. Salim, A. S. M. Khidhir

from RGB channels obtained from participants’ faces using an ordinary webcam
to determine the HR. The LE method is distinguished from previous techniques,
such as ICA and PCA, in that it processes the signal non-linearly to achieve a more
accurate HR signal. The basic principle of LE is that it operates by embedding
high-dimensional data into a lower-dimensional space while preserving the local
geometric structure. It does this by constructing a graph representation of the
data, where each data point is a node, and edges represent relationships between
points based on proximity. The method seeks to minimize the distance between
connected points in the new space while maximizing distances between discon-
nected points. The method was conducted on 20 people using a standard webcam
to record a 30-second video at an average rate of 30 frames per second. The face
was detected using the method described in [17]. The RGB signal was extracted,
the LE algorithm was applied, and then a bandpass filter was used to delete unwanted
frequencies and calculate the peaks of the final signal to obtain the heartbeats, as
shown in Figure 6. Although the results presented showed better performance
than the previous study, which used a linear process for heart rate estimation, it
was more sensitive to noise and computational complexity [18].

Figure 6. System architecture [18].

In 2014, Monkaresi et al. employed an artificial intelligence methodology to

identify the pulse component from all channels (RGB components). This meth-
odology comprised the use of power spectrum analysis, k-nearest neighbours
(KNN), and linear regression analysis on each component derived from ICA to
extract signals that helped classification. KNN surpassed linear regression methods
in taking pulse signal components to determine HR. Nevertheless, applying the

DOI: 10.4236/oalib.1112482 8 Open Access Library Journal

 A. S. Salim, A. S. M. Khidhir

model across new people may produce various results or display poor perfor-
mance when additional people not included in the training dataset are introduced
to the system, potentially resulting in failures in practical applications. Addition-
ally, the research was performed in a regulated setting with defined illumination
parameters [19].
Eulerian video magnification (EVM) was originally employed to determine var-
iations in the facial region of subjects. The core idea of EVM is to amplify small,
subtle changes in a video over time while keeping the overall structure of the video
intact. It focuses on temporal changes in pixel values, which can indicate physio-
logical signals like blood flow. After recording the video, it is converted into se-
quential frames. The RGB signals are extracted for each frame. Then, the filter is
applied to remove unwanted frequencies. After that, the EVM is used to magnify
the slight change in the RGB signal for all frames. Then, the heartbeats are calcu-
lated from the final signal after applying FFT. This strategy was used for data in
which subjects were stationary. This method is impractical for heart rate moni-
toring in real-world scenarios when people may be in motion. Furthermore, its
performance may be degraded in the presence of significant noise within the sig-
nal [20].
In 2020, Laurie et al. proposed an exposure management strategy that improves
the SNR by modifying the camera shot period to maximize it with the absence of
distortion. Nonetheless, the method is weak in terms of subject flexibility, and
shows a prolonged time of execution compared to normal controls. Subjects must
remain somewhat motionless to ensure accuracy, as movement may result in color
channel overloading. The extended execution time may restrict its applicability in
real-time contexts [21].
In 2013, the authors designed a new rPPG signal filtering technique, which de-
pends on chrominance and is termed CHROM. They researched the movement
problem, leading to the development of far more advanced chrominance-based
approaches. The primary issue with rPPG is its resilience to subject movement.
The authors examined how motion affects the pulse signal and derived more ro-
bust rPPG algorithms from this analysis, achieving superiority surpassing all pre-
vious techniques in SNR and movement resilience. The main idea behind chro-
minance algorithms is to isolate and analyze the color components (like red,
green, and blue) of the video to detect subtle changes caused by blood flow. When
blood rushes to the skin’s surface, it alters the skin’s color, which can be quantified
and used to extract the heartbeat signal. The study was conducted on 117 healthy
volunteers with different skin colors. Face detection, as established by Viola and
Jones [17], was utilized to mark an ROI. Subsequently, RGB color data served as
the basis for analysis. A Bandpass filter is applied to the initial signal to remove
unwanted frequencies. After that, the CHROM method is used to analyze the sig-
nal and get a signal close to the heartbeat signal, and finally, FFT is applied to
obtain the HR result, as shown in Figure 7. The SNR was also affected by the color
of the skin type; it suffered from a decrease in people with dark skin compared to

DOI: 10.4236/oalib.1112482 9 Open Access Library Journal

 A. S. Salim, A. S. M. Khidhir

people with white skin, and this decrease is logical; the elevated melanin level
Soaks up a portion of the reflected, diffuse light that conveys signal information
PPG. CHROM showed more sensitivity to motion-induced distortions compared
to approaches based on PCA and ICA [22].

Figure 7. The common operating principle of rPPG using CHROM [23].

In 2017, the authors introduced a plane orthogonal-to-skin (POS) technique that

presents the PPG signal onto a plane orthogonal to the skin’s color for the extrac-
tion of the heart signal. The POS technique surpassed CHROM, PCA, and ICA
methodologies. This approach computes the spatial average of the RGB colors
from skin cells in each frame to determine the spatial RGB mean utilizing a stand-
ard RGB camera. Following that, it dynamically concatenates values from every
frame into a matrix and splits the RGB signals into various orthogonal bands of
frequency for sub-band heartbeat extraction. After isolating and attenuating the
various motion frequencies across distinct frequency bands, a coherent pulse sig-
nal can be synthesized by amalgamating the results of processing from the several
sub-bands to derive the heart rate [24].
In 2021, the authors employed a two-stage convolutional neural network (CNN)
methodology, wherein one CNN identifies the face and collects the rPPG signal,
while the other CNN predicts the HR from the obtained signal. The main idea
behind CNNs is to use multiple layers of filters (or convolutions) to detect pat-
terns in the input data automatically. Each layer learns to identify increasingly
complex features, from simple edges in the first layers to more complicated shapes
in deeper layers. This feature extraction process allows CNNs to effectively ana-
lyze the visual information in video frames for rPPG applications. The quantity of
research publications employing techniques based on deep learning (DL) for re-
mote heartbeat monitoring has risen yearly and will probably keep going in its
growth. End-to-end supervised learning methodologies are unquestionably effec-
tive due to their simple model optimization procedure, yet they demand substan-
tial training data, which can be challenging to obtain. This method has shown
promising results compared to previous approaches. However, the results were
mixed when applying this technique in real-world scenarios without controlling
the light source. The success of this method depends on the registered databases,

DOI: 10.4236/oalib.1112482 10 Open Access Library Journal

 A. S. Salim, A. S. M. Khidhir

their size, the diversity of samples (including different skin colors), and the variety
of registered environments. All of these factors must be considered to increase the
accuracy of this approach [25].

2.2. Heartbeat Measurement Based on Subtle Head Movements

Balakrishnan et al. improved another method for rPPG-based HR, which was cal-
culated from video to identify smaller head motions generated by heartbeats. Ac-
cording to Newton’s law, for every action, there is a reaction; the heartbeat pro-
duces slight movements in various parts of the human body. While this movement
is complex for the eye to perceive, advancements in computer vision have made it
possible to detect these movements [26]. This approach complements the calcu-
lation of the HR from the video through the study of tiny color variations in the
outer layer of the skin caused by the flow of blood [15] [16]. This method does not
rely on visualizing the skin to detect changes in color values resulting from the
heartbeat; instead, it focuses on head movement. The video is recorded using tra-
ditional cameras, with head movement extracted through feature tracking on the
face. The signal is then processed to isolate unwanted movements, such as those
from the person’s motion or breathing, by removing frequencies that are far from
the heartbeat frequencies, as shown in Figure 8. Then, PCA decomposes the tra-
jectories into a collection of independent sources of signals that define the primary
components of head movement. The frequency spectra are examined to select the
appropriate source for analysis and compute the duration of individual beats, and
the source with the most apparent central frequency is chosen. The mean rate of
the pulse is determined by this frequency, and the peaks of the obtained signal are
counted over time to determine the heart rate. This approach has demonstrated
high accuracy; compared with ECG as ground truth values, the average mean er-
ror for all subjects was 1.5%. The motion-based approach is particularly advanta-
geous when the person’s skin is not visible. However, the limitations of this method
include extreme changes in lighting and the person’s movement during speech, which
require advanced filtering methods to isolate the heartbeat signal from other noise
signals [26].
In 2013, the author proposed a method to extract heartbeats from the head
movement caused by the heartbeat. In this method, the focus was on tracking and
processing a few feature points instead of many points to track the movement.
This method was to record video using a camera of smartphone and then count
the frequency movement of the head from selecting and tracking a single point
from the face, then apply the ICA technique for isolating independent signals
from a collection of data that comprise linear combinations of the fundamental
sources after that used bandpass filter to remove unwanted signal and apply FFT
then count the peak of signal to extract the heart rate. The author additionally
used the PCA method to analyze the obtained signal and compare the results with
the ICA method. The results were more accurate when ICA was used during the
signal analysis. In addition, it was found that the error rate decreased when tracking

DOI: 10.4236/oalib.1112482 11 Open Access Library Journal

 A. S. Salim, A. S. M. Khidhir

Figure 8. Summary of our heartbeat prediction methodology. (a) A specific area within the
human head has been chosen, and feature locations are monitored across all video frames.
(b) The vertical component is collected from every feature element direction. (c) Each track
is later dynamically filtered to remove unnecessary frequencies. (d) PCA splits each trajec-
tory into signals from the source s1, s2, s3, s4, and s5. (e) The component showing the
clearest focused frequency is chosen. (f) Peak monitoring determines the beats of the signal
[26].

DOI: 10.4236/oalib.1112482 12 Open Access Library Journal

 A. S. Salim, A. S. M. Khidhir

a small number of features [26].

Haque et al. (2016) proposed a new approach to enhance system limitations by
selecting facial landmarks to identify the features and track their movement to
obtain the initial signal. A bandpass filter is applied to remove unwanted frequen-
cies. Finally, discrete cosine transform (DCT) instead of FFT was applied to get the
final frequency through which the heartbeats were calculated. However, the ob-
tained signal was influenced by people’s range of motion, hence significantly hin-
dering the advancement of this technology [27].
Table 2 includes various system metrics for performance, including root mean
square error (RMSE), correlation (r), and standard deviation error (σ), from prior
research.

Table 2. Performance of lab-based HR systems: σ, RMSE, and r [28].

Year Author S.D. (σ) RMSE r

2010 Poh et al. [15] (sitting still) 2.29 2.29 0.98

2010 Poh et al. [15] (with slight movement) 4.59 4.36 0.95

2014 Monkaresi et al. [19] (ICA) 25.54 35.31 0.53

2014 Monkaresi et al. [19] (ICA + KNN) 4.33 4.33 0.97

2014 Monkaresi et al. [19] (CA + KNN + Regression) 13.7 13.69 0.58

2013 de Haan et al. [22] 2.6 1.1 0.97

2014 Hsu et al. [29] - 5.48 0.88

2014 Li et al. [30] Video HR database 0.72 1.27 0.99

2014 Li et al. [30] MAHNOB-HCI database -3.3 7.62 0.81

2015 Lam et al. [31] 8.54 10.34 0.66

2016 Haque et al. [27] 3.85

2017 Qi et al. [32] 3.65 5 0.74

2019 Qi et al. [33] (still) - 7.21 0.76

2019 Qi et al. [33] (head movement) - 8.7 0.69

2019 Qi et al. [33] (active HR) - 17.88 0.47

2021 Huang et al. [25] (MAHNOB-HCI dataset) 6.31 6.42 0.84

2021 Huang et al. [25] (UBFC-rPPG dataset) 6.45 7.24 0.73

2022 Pirzada et al. [34] (various movements) 0.018 7.8 0.85

3. Potential Applications
Heart Rate Monitoring: rPPG can be employed in fitness applications and devices
to track heart rate during exercise, helping users enhance their daily activities. In
hospitals, the rPPG allows continuous heart rate monitoring of patients without
physical touch, therefore reducing the danger of infection [35].
Stress Detection: This method can measure the level of stress in individuals

DOI: 10.4236/oalib.1112482 13 Open Access Library Journal

 A. S. Salim, A. S. M. Khidhir

during indirect investigations by authorities [36].

Sleep Monitoring: rPPG can be utilized to assess heart rate and blood flow dur-
ing sleep, offering significant insights into sleep quality and possible sleep prob-
lems [37].
Chronic Disease Management: Patients with chronic diseases, like hyperten-
sion and heart disease, can be monitored remotely. This allows healthcare provid-
ers to monitor vital signs continually [38].
Virtual Consultations: During telehealth consultations, physicians can evalu-
ate patients’ heart rates in real time, thereby improving the quality of distant assess-
ments [38].
Non-Invasive Pediatric Care: rPPG is especially useful in pediatric environments,
where non-invasive techniques are favored for the monitoring of health indicators
in newborns and children [39].
Driver Monitoring: Sudden health crises contribute to an increasing number
of driving accidents and fatalities each year. In many cases, drivers may be oblivious
to these latent health risks. Therefore, in-cabin cardiac monitoring has attracted
interest from automotive manufacturers [40].

4. Advantages and Limitations

PGP allows measurements of health indicators without physical contact or inva-
sive methods, making patients comfortable; it supports remote health monitoring,
which is especially useful for telehealth applications, allowing healthcare provid-
ers to monitor patient’s conditions remotely. Employing standard video cameras,
such as those found in smartphones and webcams, reduces the need for costly med-
ical equipment, which improves the accessibility of health monitoring. Remote
photoplethysmography (rPPG) can provide continuous, real-time data on heart rate
and other health indicators, allowing for timely interventions when abnormalities
are detected. This technology can be applied in various environments such as hos-
pitals, homes, and fitness facilities, enabling variable application. Despite the fact
that this technology has many advantages, it is not devoid of limitations, including
subject movement, which can add noise, resulting in incorrect readings; these lim-
its are used in dynamic environments. Inadequate or variable illumination might
obstruct the detection of subtle variations in the color of the skin, thus affecting the
accuracy of the final results. The efficacy of rPPG may change among various skin
tones, potentially resulting in biased results in various populations. At the same time,
the integrity of the obtained signal might be affected by variables such as camera
quality, distance from the camera, and capture angle [36].

5. Conclusion
This paper offers a review of rPPG-related studies that can measure heart rate. The
paper discussed the reason for the interest in this technology and the increasing
amount of research related to it, in addition to discussing the methods used, sam-
ples, and the environment in which the experiments were conducted. The databases

DOI: 10.4236/oalib.1112482 14 Open Access Library Journal

 A. S. Salim, A. S. M. Khidhir

used in deep learning methods, in addition to the performance of each method

and the limitations that affect performance. Several things must be taken into con-
sideration during the design stage of the rPPG, including the physical distance
from the camera that records the video and the person, controlling the number of
frames during processing, the various environments and lighting conditions, the
diversity of samples that the systems are tested in terms of age, gender and skin
color. The natural movement of people during the test must also be taken into
account, as well as the extent to which movement affects the results. The makeup
on the sample’s faces must also be taken into account, as well as its effect on the
results. The methods that use deep learning must consider the previous matters
in the database used to make the results more accurate. In summary, the topic of
rPPG has achieved significant improvements in the last few years. We focused on
various facets of these studies and pointed out the critical results, applications,
challenges, and limitations that they have faced. Processing these challenges is es-
sential to obtain good results; thus, these techniques can be used in real-world
scenarios.

Conflicts of Interest
The authors declare no conflicts of interest.

References
[1] Lee, R.J., Sivakumar, S. and Lim, K.H. (2023) Review on Remote Heart Rate Meas-
urements Using Photoplethysmography. Multimedia Tools and Applications, 83,
44699-44728. https://doi.org/10.1007/s11042-023-16794-9
[2] Ghamari, M. (2018) A Review on Wearable Photoplethysmography Sensors and Their
Potential Future Applications in Health Care. International Journal of Biosensors &
Bioelectronics, 4, 195-202. https://doi.org/10.15406/ijbsbe.2018.04.00125
[3] Johnston, W. and Mendelson, Y. (2005) Extracting Heart Rate Variability from a Wear-
able Reflectance Pulse Oximeter. Proceedings of the IEEE 31st Annual Northeast Bi-
oengineering Conference, Hoboken, 2-3 April 2005, 157-158.
[4] Waqar, M. (2019) Contact-Free Heart Rate Measurement from Human Face Videos and
Its Biometric Recognition Application. Ph.D. Thesis, Aberystwyth University.
[5] Al-Naji, A., Gibson, K., Lee, S. and Chahl, J. (2017) Monitoring of Cardiorespiratory
Signal: Principles of Remote Measurements and Review of Methods. IEEE Access, 5,
15776-15790. https://doi.org/10.1109/access.2017.2735419
[6] Yan, Y., Ma, X., Yao, L. and Ouyang, J. (2015) Noncontact Measurement of Heart Rate
Using Facial Video Illuminated under Natural Light and Signal Weighted Analysis.
Bio-Medical Materials and Engineering, 26, S903-S909.
https://doi.org/10.3233/bme-151383
[7] Rohmetra, H., Raghunath, N., Narang, P., Chamola, V., Guizani, M. and Lakkaniga,
N.R. (2021) AI-Enabled Remote Monitoring of Vital Signs for COVID-19: Methods,
Prospects and Challenges. Computing, 105, 783-809.
https://doi.org/10.1007/s00607-021-00937-7
[8] Chen, X., Cheng, J., Song, R., Liu, Y., Ward, R. and Wang, Z.J. (2019) Video-Based
Heart Rate Measurement: Recent Advances and Future Prospects. IEEE Transactions
on Instrumentation and Measurement, 68, 3600-3615.

DOI: 10.4236/oalib.1112482 15 Open Access Library Journal

 A. S. Salim, A. S. M. Khidhir

https://doi.org/10.1109/tim.2018.2879706
[9] van der Kooij, K.M. and Naber, M. (2019) An Open-Source Remote Heart Rate Imaging
Method with Practical Apparatus and Algorithms. Behavior Research Methods, 51,
2106-2119. https://doi.org/10.3758/s13428-019-01256-8
[10] Rouast, P.V., Adam, M.T.P., Chiong, R., Cornforth, D. and Lux, E. (2018) Remote Heart
Rate Measurement Using Low-Cost RGB Face Video: A Technical Literature Review.
Frontiers of Computer Science, 12, 858-872.
https://doi.org/10.1007/s11704-016-6243-6
[11] Cheng, C., Wong, K., Chin, J., Chan, T. and So, R.H.Y. (2021) Deep Learning Methods
for Remote Heart Rate Measurement: A Review and Future Research Agenda. Sensors,
21, Article 6296. https://doi.org/10.3390/s21186296
[12] Pavlidis, I. (2003) Continuous Physiological Monitoring. Proceedings of the 25th An-
nual International Conference of the IEEE Engineering in Medicine and Biology So-
ciety, Cancun, 17-21 September 2003, 1084-1087.
[13] Verkruysse, W., Svaasand, L.O., Stuart Nelson, J., Wieringa, F.P., Mastik, F. and van der
Steen, A.F.W. (1937) Multilaser Photoplethysmography Technique. Institute of Elec-
trical and Electronics Engineers.
[14] Yuan, Z. (2013) Concurrent Spatiotemporal Analysis of Functional Near-Infrared Spec-
troscopy Data Using Independent Component Analysis. Proceedings of the 2013 6th
International Congress on Image and Signal Processing (CISP), Hangzhou, 16-18 De-
cember 2013, 794-798. https://doi.org/10.1109/cisp.2013.6745273
[15] Poh, M., McDuff, D.J. and Picard, R.W. (2010) Non-Contact, Automated Cardiac Pulse
Measurements Using Video Imaging and Blind Source Separation. Optics Express, 18,
10762-10774. https://doi.org/10.1364/oe.18.010762
[16] Lewandowska, M. and Nowak, J. (2012) Measuring Pulse Rate with a Webcam. Journal
of Medical Imaging and Health Informatics, 2, 87-92.
https://doi.org/10.1166/jmihi.2012.1064
[17] Viola, P. and Jones, M.J. (2004) Robust Real-Time Face Detection. International Jour-
nal of Computer Vision, 57, 137-154.
https://doi.org/10.1023/b:visi.0000013087.49260.fb
[18] Wei, L., Tian, Y., Wang, Y., Ebrahimi, T. and Huang, T. (2013) Automatic Webcam-
Based Human Heart Rate Measurements Using Laplacian Eigenmap. 11th Asian Con-
ference on Computer Vision, Daejeon, 5-9 November 2012, 281-292.
https://doi.org/10.1007/978-3-642-37444-9_22
[19] Monkaresi, H., Calvo, R.A. and Yan, H. (2014) A Machine Learning Approach to Im-
prove Contactless Heart Rate Monitoring Using a Webcam. IEEE Journal of Biomed-
ical and Health Informatics, 18, 1153-1160.
https://doi.org/10.1109/jbhi.2013.2291900
[20] Wu, H., Rubinstein, M., Shih, E., Guttag, J., Durand, F. and Freeman, W. (2012) Eulerian
Video Magnification for Revealing Subtle Changes in the World. ACM Transactions
on Graphics, 31, 1-8. https://doi.org/10.1145/2185520.2185561
[21] Laurie, J., Higgins, N., Peynot, T. and Roberts, J. (2020) Dedicated Exposure Control for
Remote Photoplethysmography. IEEE Access, 8, 116642-116652.
https://doi.org/10.1109/access.2020.3003548
[22] de Haan, G. and Jeanne, V. (2013) Robust Pulse Rate from Chrominance-Based RPPG.
IEEE Transactions on Biomedical Engineering, 60, 2878-2886.
https://doi.org/10.1109/tbme.2013.2266196
[23] Wu, B.-F., Huang, P.-W., He, D.-H., Lin, C.-H. and Chen, K.-H. (2019) Remote

DOI: 10.4236/oalib.1112482 16 Open Access Library Journal

 A. S. Salim, A. S. M. Khidhir

Photoplethysmography Enhancement with Machine Leaning Methods. 2019 IEEE

International Conference on Systems, Man and Cybernetics (SMC), Bari, 6-9 October
2019, 2466-2471. https://doi.org/10.1109/smc.2019.8914554
[24] Wang, W., den Brinker, A.C., Stuijk, S. and de Haan, G. (2017) Robust Heart Rate from
Fitness Videos. Physiological Measurement, 38, 1023-1044.
https://doi.org/10.1088/1361-6579/aa6d02
[25] Huang, B., Lin, C., Chen, W., Juang, C. and Wu, X. (2021) A Novel One-Stage Frame-
work for Visual Pulse Rate Estimation Using Deep Neural Networks. Biomedical Sig-
nal Processing and Control, 66, Article ID: 102387.
https://doi.org/10.1016/j.bspc.2020.102387
[26] Balakrishnan, G., Durand, F. and Guttag, J. (2013). Detecting Pulse from Head Motions
in Video. 2013 IEEE Conference on Computer Vision and Pattern Recognition, Port-
land, 23-28 June 2013, 3430-3437. https://doi.org/10.1109/cvpr.2013.440
[27] Haque, M.A., Irani, R., Nasrollahi, K. and Moeslund, T.B. (2016) Heartbeat Rate Meas-
urement from Facial Video. IEEE Intelligent Systems, 31, 40-48.
https://doi.org/10.1109/mis.2016.20
[28] Pirzada, P., Wilde, A. and Harris-Birtill, D. (2024) Remote Photoplethysmography for
Heart Rate and Blood Oxygenation Measurement: A Review. IEEE Sensors Journal, 24,
23436-23453. https://doi.org/10.1109/jsen.2024.3405414
[29] Hsu, Y.-C., Lin, Y.-L. and Hsu, W. (2014) Learning-Based Heart Rate Detection from Re-
mote Photoplethysmography Features. 2014 IEEE International Conference on Acous-
tics, Speech and Signal Processing (ICASSP), Florence, 4-9 May 2014, 4433-4437.
https://doi.org/10.1109/icassp.2014.6854440
[30] Li, X., Chen, J., Zhao, G. and Pietikäinen, M. (2014) Remote Heart Rate Measurement
from Face Videos under Realistic Situations. 2014 IEEE Conference on Computer Vi-
sion and Pattern Recognition, Columbus, 23-28 June 2014, 4264-4271.
[31] Lam, A. and Kuno, Y. (2015) Robust Heart Rate Measurement from Video Using Select
Random Patches. 2015 IEEE International Conference on Computer Vision (ICCV),
Santiago, 7-13 December 2015, 3640-3648.
[32] Qi, H., Guo, Z., Chen, X., Shen, Z. and Jane Wang, Z. (2017) Video-Based Human Heart
Rate Measurement Using Joint Blind Source Separation. Biomedical Signal Processing
and Control, 31, 309-320. https://doi.org/10.1016/j.bspc.2016.08.020
[33] Qi, L., Yu, H., Xu, L., Mpanda, R.S. and Greenwald, S.E. (2019) Robust Heart-Rate
Estimation from Facial Videos Using Project_ICA. Physiological Measurement, 40,
Article ID: 085007. https://doi.org/10.1088/1361-6579/ab2c9f
[34] Pirzada, P., Morrison, D., Doherty, G., Dhasmana, D. and Harris-Birtill, D. (2022) Au-
tomated Remote Pulse Oximetry System (ARPOS). Sensors, 22, Article 4974.
https://doi.org/10.3390/s22134974
[35] Huang, B., Chen, W., Lin, C., Juang, C., Xing, Y., Wang, Y., et al. (2021) A Neonatal
Dataset and Benchmark for Non-Contact Neonatal Heart Rate Monitoring Based on
Spatio-Temporal Neural Networks. Engineering Applications of Artificial Intelligence,
106, Article ID: 104447. https://doi.org/10.1016/j.engappai.2021.104447
[36] McDuff, D. (2023) Camera Measurement of Physiological Vital Signs. ACM Computing
Surveys, 55, 1-40. https://doi.org/10.1145/3558518
[37] Amelard, R., Pfisterer, K.J., Clausi, D.A., Wong, A. and Jagani, S. (2018) Non-Contact
Assessment of Obstructive Sleep Apnea Cardiovascular Biomarkers Using Photople-
thysmography Imaging. Optical Diagnostics and Sensing XVIII: Toward Point-of-Care
Diagnostics, Volume 10501, Article ID: 1050113. https://doi.org/10.1117/12.2290672

DOI: 10.4236/oalib.1112482 17 Open Access Library Journal

 A. S. Salim, A. S. M. Khidhir

[38] Smith, W., Colbert, B.M., Namouz, T., Caven, D., Ewing, J.A. and Albano, A.W. (2024)
Remote Patient Monitoring Is Associated with Improved Outcomes in Hypertension:
A Large, Retrospective, Cohort Analysis. Healthcare, 12, Article 1583.
https://doi.org/10.3390/healthcare12161583
[39] Gibson, K., Al-Naji, A., Fleet, J., Steen, M., Esterman, A., Chahl, J., et al. (2019) Non-
contact Heart and Respiratory Rate Monitoring of Preterm Infants Based on a Computer
Vision System: A Method Comparison Study. Pediatric Research, 86, 738-741.
https://doi.org/10.1038/s41390-019-0506-5
[40] Nowara, E.M., Marks, T.K., Mansour, H. and Veeraraghavan, A. (2018) SparsePPG:
Towards Driver Monitoring Using Camera-Based Vital Signs Estimation in Near-In-
frared. IEEE/CVF Conference on Computer Vision and Pattern Recognition Workshops,
Salt Lake City, 18-22 June 2018, 1385-1394.

DOI: 10.4236/oalib.1112482 18 Open Access Library Journal