UNIT I

INTRODUCTION TO WEARABLE SYSTEMS AND SENSORS

Wearable Systems - Introduction, Need for Wearable Systems, Drawbacks of Conventional Systems
for Wearable Monitoring, Applications Of Wearable Systems, Types of Wearable Systems,
Components of wearable Systems. Sensors for wearable systems -Inertia movement sensors,
Respiration activity sensor, Inductive plethysmography, Impedance plethysmography,
pneumography, Wearable ground reaction force sensor.

1.1. WEARABLE SYSTEMS -INTRODUCTION

 Wearable technology is any kind of electronic device designed to be worn on the user's
body. Such devices can take many different forms, including jewellery, accessories, medical
devices, and clothing or elements of clothing.
 The term wearable computing implies processing or communications capabilities, but in
reality, the sophistication among wearables can vary.
 The most sophisticated examples of wearable technology include artificial intelligence (Al)
hearing aids, Google Glass and Microsoft's HoloLens, and a holographic computer in the
form of a virtual reality (V R) headset. An example of a less complex form of wearable
technology is a disposable skin patch with sensors that transmit patient data wirelessly to a
control device in a healthcare facility.

1.1.1. FEATURES OF WEARABLE DEVICES

1. Activity Monitoring.
2. Bluetooth Enabled.
3. Digital Display.
4. Health Monitoring.
5. Location Tracking.
6. Smart Watches.
7. Water Resistant / Outdoor Rated.
8. Wrist

1.1.2. OBJECTIVES OF WEARABLE TECHNOLOGY

 The most common uses for wearable technology are for helping to monitor and alert the
wearer about their personal health information or for social communication purposes —like
calling, texting, social media, etc.
 Wearable systems can be broadly defined as mobile electronic devices that can be
unobtrusively embedded in the user's outfit as part of the clothing or an accessory.
 In particular, unlike conventional mobile systems, they can be operational and accessed
without or with very little hindrance to user activity.
 To this end they are able to model and recognize user activity, state, and the surrounding
situation: a property, referred to as context sensitivity. Wearable systems range from micro
sensors seamlessly integrated in textiles through consumer electronics embedded in
fashionable clothes and computerized watches to belt worn PCs with a head mounted
display.
  The wearable computing concept is part of a broader framework of ubiquitous computing
that aims at invisibly enhancing our environment with smart electronic devices.

1.2. NEED FOR WEARABLES SYSTEMS

1. Fundamentally, wearables can perform the following basic functions or unit operations
2. Sense
3. Process (Analyze)
4. Store
5. Transmit
6. Apply (Utilize)
 Of course, the specifics of each function will depend on the application domain and the
wearer, and all the processing may occur actually on the individual or at a remote location
(e.g., command and control center for first responders, fans watching the race, or viewers
enjoying the mountaineer's view from the Mount Everest base camp).

What is sensor?

 A sensor is a device that detects and responds to some type of input from the physical
environment. The specific input could be light, heat, motion, moisture, pressure, or any one
of a great number of other environmental phenomena.

Principle of sensor

 Every sensor has different principle of operation, based on the type of physical quantity it is
measuring. The idea is to create a change in the property/properties of sensor (such as
resistance, density, shape, temperature etc.) as a function of the physical quantity under
measurement.

Different types of sensors

1. Temperature Sensor
2. Proximity Sensor
3. Accelerometer
4. IR Sensor (Infrared Sensor) Pressure Sensor
5. Light Sensor
6. Ultrasonic Sensor
7. Smoke. Gas and Alcohol Sensor etc...

Wearable devices?

 Wearable technology (also called wearable gadgets) is a category of technology devices that
can be worn by a consumer and often include tracking information related to health and
fitness.

Working of Wearable devices

 Sensors can also be attached around a wearable device to allow them to monitor various
activity in the area. Most sensors can track motion, brain activity, heart activity, and muscle
activity.
 Miniature computers are also inside some wearable devices, similar to how smartphones
have miniature processors inside of them.

Need for wearable systems

  A wearable device is often used for tracking a wearer's vital signs or health and fitness
related data, location, etc.
 Medical wearables with artificial intelligence and big data are providing an added value to
healthcare with a focus on diagnosis, treatment, patient monitoring and prevention.
 To diagnose, monitor and prevent future illnesses, healthcare professionals now routinely
use wearable devices such as fitness tracker or phones. By monitoring physiological data and
behavior these devices boost self-awareness and encourage behavior change.

Smart clothing

Fig. 1.1. Smart Clothing

 Clothing that monitors the wearer's physical condition. Smart Shirts and body suits provide
biometric data, such as pulse rate, temperature, muscle stretch, heat rhythm and physical
movement, and the data are transmitted via Bluetooth to an app in real time.

1.2.1. ELEMENTS OF WEARABLES SYSTEMS

 When designing wearable systems to be used for physiological and biomechanical

parameters monitoring, it is important to integrate sensors easy to use, comfortable to
wear, and minimally obtrusive. Wearable systems include sensors for detecting physiological
signs placed on-body without discomfort, and possibly with capability of real-time and
continuous recording. The system should also be equipped with wireless communication to
transmit signals, although sometimes it is opportune to extract locally relevant variables,
which are transmitted when needed.
 Most sensors embedded into wearable systems need to be placed at specific body locations,
e.g. motion sensors used to track the movements of body segments, often in direct contact
with the skin, e.g. physiological sensors such as pulse meters or oximeters. However, it is
reasonable to embed sensors within pieces of clothing to make the wearable system as less
obtrusive as possible.
 In general, such systems should also contain some elementary processing capabilities to
perform signal pre-processing and reduce the amount of data to be transmitted. A key
technology for wearable systems is the possibility of implementing robust, cheap
microsystems enabling the combination of all the above functionalities in a single device.
 This technology combines so-called micro-electro-mechanical systems (MEMS) with
advanced electronic packaging technologies.
 The former allows complex electronic systems and mechanical structures (including sensors
and even simple motors) to be jointly manufactured in a single semiconductor chip.
1.2.2. LAYERS OF WEARABLES SYSTEMS

 A generic wearable system can be structured as a stack of different layers. The lowest layer
is represented by the body, where the skin is the first interface with the sensor layer.This
latter is comprised of three sub-layers: garment and sensors, conditioning and filtering of the
signals and local processing.
 The processing layer collects the different sensor signals, extracts specific features and
classifies the signals to provide high-level outcomes for the application layer. The application
layer can provide the feedback to the user and/or to the professional, according to the
specific applications and to the user needs.

1.2.3. IMPORTANCE OF WEARABLE SYSTEMS

 Recent developments embed signal processing in their systems, e.g. extraction of heart rate,
respiration rate and activity level. Activity classification and more advanced processing on
e.g. heart signals can be achievable exploiting miniaturization and Iow-power consumption
of the systems.
 Examples of data classification are : classification of movement patterns such as sitting,
walking or resting by using accelerometer data or ECG parameters such as ST distance
extracted from raw ECG data; another example is the estimation of the energy consumption
of the body and the combined use of a triaxial accelerometer and a wearable heart rate
sensor was exploited to accurately classify human physical activity; estimation of upper limb
posture by means of textile embedded flexible piezo resistive sensors. Examples of
integrated systems for health monitoring are two classes of sensors which can be easily
integrated into wearable systems are reported and described.
 More specifically, inertial sensors to monitor biomechanical parameters of human body and
sensors to capture physiological signs are addressed, describing the operating principles and
indicating the possible fields of application.
 For example, Internet is currently available almost everywhere in different forms, using
either cable or wireless networking technologies. With the advancement of mobile and
satellite communication technologies along with broadband communication techniques, e-
health services can be de- livered anywhere at any time.
 Especially, when wireless devices are integrated with sensors, it is possible to acquire and
monitor human signals at any environment at any time. Hence, Internet can be used as a
major tool to deliver e-health services to both developing and developed countries. E-health
services can take advantages of wireless body area network (WBAN), which can act as an
enabling technology.
 WBAN systems could offer great advancement for a ubiquitous health care, which has the
potential to improve many aspects of everyday living leading to improved quality of life of
many patients. Telemedicine and e-health services could OCIer several significant
advantages, including speedup of diagnosis, therapeutic care for emergencies, oCJering
specialist services to remote and rural locations, and supporting patients' mobility and
lifestyles.

 A WBAN monitors physiological signals from some tiny sensors with wireless transmission
capability placed either inside or around a person's body, which are used to collect
important health data of a person during a particular activity medical or sport or training-
 related activities. These nodes form a network between the sensors and a control device.
Figure I .2 shows a generic WBAN application scenario.
 Basically, a WBAN system consists of a number of tiny sensor nodes and a gateway node
used to connect them to remote locations (i.e., hospital, call center) as shown in Fig 1.2.
 For example, if dangerous gases are detected by a wearable on a first responder, the data
can be processed in the wearable and an alert issued. Simultaneously, it may be transmitted
to a remote location for confirmatory testing and the results — along with any appropriate
response (i.e., put on a gas mask) — can be communicated to the user in real-time to
potentially save a life. This same philosophy can also be used by an avid gamer who might
change his strategy depending on what "weapons" are available to him and how his
opponents are performing. Each of these scenarios requires personalized mobile
information processing, which can transform the sensory data into information and then to
knowledge that will be of value to the individual responding to the situation. While
wearables are being used in many fields, as discussed, this chapter will focus primarily on
wearable in the healthcare domain. Wearables provide an unobtrusive way to longitudinally
monitor an individual — not just during the day but, over the individual's life-time. Such an
expansive' view of the individual will be valuable in detecting changes over time and help in
early detection of problems and diseases leading to pre-emptive care and hence, a better
quality of life. Inferring the potential of wearables in other application domains should be
straightforward and can be accomplished by instantiating the fundamental principles and
concepts presented here.
 In literature, a number of different terminologies or names have been used for the gateway
device; mainly terminologies such as body control unit (BCU) or central control unit (CCU) or
personnel control unit (PCU) are used. The gateway device can be a smart phone or any
portable device that can aggregate collected sensor data and forward them to remote
stations.
 The gateway node can connect the sensor nodes to a range of communication networks.
 These-communication networks can be either a standard telecommunication network,
mobile/wireless network, a dedicated medical center/hospital LAN (local area network) or a
public WLAN (wireless local area network) hotspot, commonly known as the Wi-Fi.
 A WBAN allows a user to store collected data in his/her PDA (personal digital assistant) or-
iPod or any other portable devices and then transfer that information to a suitable'
computer when a communication link is available.
 Future applications of WBAN could introduce numerous possibilities to improve health care
and sports training facilities. In recent years, the WBAN concept has attracted the attention
of medical and ICT researchers. Standard ICT systems are already in use in medical areas
mostly related to patient record keeping and scheduling tasks.
 Fig. 1.2. A wireless body area network scheme.

 Another major area of health care where the WBAN will find its application is the aged care,
where the quality of life of elderly people can be significantly improved if the health Of older
people is invasively monitored and appropriate health care is provided.

1.3. DRAWBACKS OF CONVENTIONAL SYSTEMS FOR WEARABLE MONITORING

1. The conventional approaches for personal healthcare rely primarily on traditional methods,
including bulky instruments and complicated procedures, which, in some cases, are time-
consuming and inconvenient.
2. Moreover, such traditional approaches still require large equipment, blood drawing and
conventional bench-top assay techniques.
3. Besides, invasive methods of obtaining test samples can also cause discomfort and pain to
patients. In comparison, as an emerging analytical tool, wearable sensors can attach to
different body parts to capture various biochemical and physiological parameters.
4. In many cases, health monitoring relies on physical, chemical, and biological information
transmitted through the skin.
5. Taking advantages of non-invasive sampling and high accuracy, wearable sensors can
measure the abnormal conditions of the physical or chemical components of the human
body in real-time, revealing the human body status in time.
6. People can use wearable sensors to track the basic vital signs of the human body, such as
body temperature, respiration rate, blood pressure, pulse rate and glucose level.
7. Besides, environmental conditions including allergen particles in the air, ultraviolet and
other radiation, and the concentration of air pollutants can also be acquired.
8. Tracking these indicators can greatly benefit diagnosis, postoperative rehabilitation and
adjuvant treatment of chronic diseases patients.

Advantages of Wearable Technology

 Rapid data results can help drive improvements. Having immediate data to make decisions
and drive improvements may be helpful, rather than waiting for more formal or detailed
assessments.
  Detailed data can supplement loss analysis and loss trends. Additional data can help
identify specific trends in your claims history.
 Can help build a business case for senior management. It can be challenging to help senior
management make decisions or determine if some of your funding should be spent' on
improvements. The data from wearable technology devices can help support. your business
case for that spend.
 Data from wearable sensors offers promising job risk analysis and evaluation opportunities
for safety and ergonomics practitioners. Most ergonomic assessments or evaluations
require additional time to observe and manually collect data. Having instant data can save
time and expedite ergonomic assessments or evaluations.
 Enhance employee wellness programs. More organizations are starting to promote.
wellness programs for employees. Some wearable technology devices can assist with easily
tracking wellness program data that could supplement or support your efforts.

Disadvantages of Wearable Technology

 Requires a time commitment to review and analyze data. A team or committee may need to
review the large amount of data that is generated from the devices.
 Requires financial commitments and planning. You may need senior management or finance
team approval prior to the full implementation stage. The cost of wearable technology
depends on how many employees and locations are involved.
 Devices could lead to distraction. For many employees, wearing this device for an entire shift
can be distracting, especially if the device has haptic feedback or vibration reminders.
 Data security and privacy could be compromised with legal, financial, and personal a
consequences. An information technology (IT) department will need to ensure the data
generated from the devices is secured for authorized individuals and ensure proper consent
is obtained from each individual whose data is being collected.
 Devices could lead to over-trust or under-trust. This could be challenging when reviewing all
the data to determine realistic trends. Sometimes this results in trusting or not trusting all
the reviewed data before making any decisions or improvements.

1.4. APPLICATIONS OF WEARABLE SYSTEMS

 Wearable technology is not a new category one of the most popular early incarnations of
the wearable technology was HP's calculator watch, which was introduced in the 1980s.
 In 2010, Nike+ Sportband was introduced as a device that can communicate with the sensor
hidden in the shoes to tell people the details about running.
 In 2012, the major companies in international consumer electronics sector display their
wearable devices at trade shows.
 In 2013, the Introduction of Google Project Glass that has opened the era of wearable
technology.
 The wearable technology will drive innovation just like the personal computers of the 1980s
and the current mobile computer tablets," said Mary Meeker, called the Internet Queen.
"Some people have laughed at the wearable technology, such as Google's glasses, and it is
just like that some people laugh at personal computers and internet.
 Wearable devices have not been as widely accepted as today's smart phones, but in the
entertainment, health care, security and other fields, they have begun to play their unique
role.
  Using the "wearable device" as a keyword, we search in the Web of Science database. From
the macro perspective, some studies demonstrate the design, 'implementation" and
prospects of wearable devices. Focusing on the use of wearable equipment in a particular
area, there are medical, sports, fitness and education applications.
 Nowadays, wearable devices have been used in the field of infotainment; such as Apple's
Apple watch, Google's Google glass, Sony's Smart watch, etc., and they are launched by
major electronics companies. These devices mainly meet the needs of information
communication and people's entertainment.
 The current wearable technology is also widely used in the field of security protection. Using
built-in chip technology to detect and track the user's geographical location, and the data
transmitted to the terminal equipment, the wearable devices can prevent the user from
being lost to ensure users' security outdoor.
 At present, the wearable devices mainly meet the needs of the elderly and children to
prevent them from being lost. For example, GTX of United States and the Aetrex shoe
company jointly developed positioning shoes, which are embedded GPS chip, especially for
patients with Alzheimer's disease.
 Wearable technology has a very broad prospect for development in the medical health field.
 Today, these wearable devices such as smart bracelets, watches and collars can help
healthcare professionals detect data such as blood sugar, heart rate and exercise status so
that they can keep track of metrics and assign a health management program to users to
protect sudden changes in the body caused by sudden disease. Wearable devices will bring a
revolution for the medical equipment industry.
 Google Glass is also thought to be a good way for trainees to easily acquire intraoperative
footage for self-review.
 The medical devices in the future will be more and more miniature, and be worn and even
embedded within the human body.
 In sports and training field, the United States Company Zepp has developed wearable
devices that are suitable for and can be used in the baseball, golf and tennis.
 Athletes wear a lightweight motion sensor, which can capture their movements, and Stream
sports data to the data server (or mobile client) wirelessly. Athletes and coaches can analyze
and play back the actions by looking at the corresponding data to improve their
performance.

Applications in K-12 PE Classes

 Wearable technology can be applied in K-12 physical education classes and help students to
establish health habits and help teachers adjust exercise intensity and density according to
the information such as heart rate displayed on apps.
 The following case comes from the seventh primary school Of Zhaoqing City, Guangdong
Province, and the teacher is Zhao. This class is called “durable run campus orienteering” In
the physical education class.
 This course takes full advantage of the full color LED display, tablet computer, smart
bracelet, orienteering marking device and other equipment. Tablet computer, smart
bracelet and orienteering marking device can help collect students' data and upload them to
the teacher side in real time, and then do statistical analysis. Then students' information can
be displayed through the stage LED. Students can see their own real time movement, and
teachers at any time can get to know the movement of students and grasp the situation.
 The order of class contents is: classroom routine classroom introduction (the method of
Flipped Classroom) jogging + game, warm up campus orienteering exercise.
  The teacher uses a variety of wearable devices, such as smart wristbands, orienteering
marking device, in order to achieve the training requirements for students in this class:

1) Campus orienteering exercise

 According to the problems of preview and courses' key and difficult points, the teacher
explains the professional actions and precautions of orienteering. Then, the teacher sends
the first map to the tablets of each student through Network disk.
 Students plan the personalized map that owned their group on the paper maps, and upload
the pictures they take to the tablets.
 Students start the orienteering exercise under the two maps. Students test the physical data
as soon as finishing the orienteering.
 After finishing the test, showing the students' exercise load and trajectory in some parts of
groups.

2) Rules of campus orienteering

 Getting four-student crews (each group has two tablets, two sports bracelets, two
orienteering machines).
 Students must have two different routes of campus orienteering race according to the two
maps offered by tablets.
 The personalized maps that students planned by themselves can't be the same as the routes
that teachers hand out.
 Each group must record the sports time through the orienteering machine and routes
scanning QR codes.
 Students must then complete the corresponding exercise once they arrive at every site.
 In this lesson, wearable devices greatly help teachers and students understand students'
changes in heart rate, as well as the moving trajectory in the process. It plays a great help for
the teacher's class reflection, adjustment of physical exercise. At present, the school is still
communicating with the relevant enterprises, expecting enterprises to develop wearable
devices and supporting platform more suitable for physical education class, to ensure that
the wearable devices can provide in-time feedback about students' data about heart rate,
exercise load. What is more, the wearable devices, make real-time statistics, analysis and
provide better feedback.

Oculus Rift - A Virtual Reality Headset

We usually think that three main sources of power to promote the rise of the Internet is three Gs:
the Game, the Gamble, and the Girl. Even now, three Gs is also the traffic sources and benefit
sources of many Internet giants, largely because they represent a standard for both basic and long-
term human impulse. Historically, games also change with the transition of platforms.

 Oculus Rift, designed for electronic games at first, can provide virtual reality experience
through goggles. You Visit has adapted over 1000 virtual college tours so they can be viewed
on Oculus Rift headsets. Virtual tours would allow students to go into campus spaces not
typically open to visitors. The Oculus Rift headset is also enabling students to explore
potentially dangerous situations from the safety of the classroom. One virtual education
expert has created a virtual construction worksite where engineering students can identify
unsafe areas without exposure to harm.

Cellphone-Charging Shirt
  Researchers at the University of South Carolina converted the fibers of a t-shirt into
activated carbon, turning into a wearable hybrid super-capacitator that can charge portable
electronic devices. The inventors claim that the process they used on the t-shirt is less
expensive, and greener, in comparison to conventional methods of creating electric storage
devices.

Other applications

 Currently other applications within healthcare are being explored, such as:
 Applications for monitoring of glucose, alcohol, and lactateor blood oxygen, breath
monitoring, heartbeat, heart rate and its variability, electromyography (EMG),
electrocardiogram (ECG) and electroencephalogram (EEG), body temperature, pressure (e.g.
in shoes), sweat rate or sweat loss, levels of uric acid and ions — e.g. for preventing fatigue
or injuries or for optimizing training patterns, including via "human-integrated electronics"

1. Forecasting changes in mood, stress, and health

2. Measuring blood alcohol content
3. Measuring athletic performance
4. Monitoring how sick the user is
5. Detecting early signs of infection
6. Long-term monitoring of patients with heart and circulatory problems that records an
electrocardiogram and is self-moistening
7. Health Risk Assessment applications, including measures of frailty and riSks of age-
dependent diseases
8. Automatic documentation of care activities
9. Days-long continuous imaging of diverse organs through a wearable bio adhesive stretchable
high-resolution ultrasound imaging patch or e.g. a wearable continuous heart ultrasound
imager (potential novel diagnostic and monitoring tools)
10. Sleep tracking
11. Cortisol monitoring for measuring stress
12. Measuring relaxation or alertness e.g. to adjust their modulation or to measure efficacy of
modulation techniques

Epidermal skin technology

 According to Science Daily, the Terasaki Institute for Biomedical Innovation invented-
wearable electronic skin for monitoring health. A next-generation of wearables, this ultra-
thin e-skin patch can be attached to the wearer's chest area along with a small wireless
transmitter by using water spray and can be worn for up to a week. It is sensitive enough to
pick up and record electro signals, such as heartbeats and muscle movements, which can be
sent to healthcare providers via the cloud so they can monitor the user's vitals remotely.
This powerful wearable is a steppingstone for monitoring chronic illnesses such as heart
failure and diabetes.

Health monitoring
  People use wearable technology to track and receive notifications for their heart rate and
blood pressure, watch their calorie intake or manage their training regimens. The COVID- 19
pandemic boosted the use of wearable technology, as consumers gained a broader
awareness of personal hygiene and taking precautions to prevent the spread of infections.
Apple, for instance, updated its Cardiogram app by introducing a new sleeping beats- per-
minute feature that monitors heart rate fluctuations for COVID- 19 patients.

Entertainment and gaming

 The gaming and entertainment industries were the first to adopt VR headsets, smart glasses
and controllers. Popular VR head-mounted displays, such as Oculus Quest, Meta Quest and
Sony PlayStation VR, are used for all types of entertainment purposes, including gaming,
watching movies and virtual traveling.

Fashion and smart clothing

 Clothing known as smart clothing, or intelligent fashion, has been gaining wide popularity
over the past few years. Smart jackets, such as Levi's jacket made with Google's Project
Jacquard technology whose threads are composed pf electrical fibers, enable the wearer to
answer calls, play music or take photos right from their sleeves. Smartwatches, wristbands,
smart shoes and smart jewellery are also popular examples of wearable technology.

Military

 These wearables include technology that tracks soldiers' vitals, VR-based simulation
exercises and sustainability technology, such as boot inserts that estimate how well the
soldiers are holding their equipment weight and how terrain factors can affect their
performance.

Sports and fitness

 Sports use wearable athletic devices that are either built into the fabric of the sports apparel
or are incorporated into sports equipment, such as bats and balls. The 'GPS and Bluetooth-
linked devices relay real-time data to coaches for analysis through connected electronic
devices such as laptops. Besides wearable athletic devices, familiar wearable technology
such as Fitbit, Apple Watch, Garmin, Samsung Galaxy Watch and Polar are used extensively
to track various areas of the player's health and performance metrics.

1.5. TYPES OF WEARABLE SYSTEMS

1.5.1. SMART WATCHES

 These days, the watches are tech-enabled. They double up as a fitness tracker, and sleep
monitor in addition to being the classic time-keeping device. Smartwatches provide us with
many other features including enabling us to make & attend phone calls and check
messages. Some watches have the feature of playing FM radio or audio & video files with a
Bluetooth headset. They generally connect to the smartphone via an app and act as a
supporting device. They are often referred to as a 'Wearable Computer' on your wrist
because of the bundle of features that can use through the touchscreen.

1.5.2. FITNESS TRACKERS

 Fitness Trackers are among the wearable technology devices wearable on the wrist. Fitness
trackers were primarily launched to perform the function of pedometer, i.e. counting the
 number of Steps but they have evolved to become an overall health monitor since then.
They perform various functions including tracking your heartbeat, monitoring your sleep,
calories burned, and other metrics. They share the data to the app on the smartphone. In to,
they make a perfect health tracker. Some devices are enabled to regularly share the
information on the metrics of the wearer to their physicians to keep them informed and help
early detection of any issue.

1.5.3. SMART JEWELLERY

 Jewellery no more acts like pieces of ornaments on your neck or hand, they have become
smart. Smart Jewellery are those wearables like necklaces, wrist bands, bracelets, or rings
that are tech-enabled to help you track your steps, track monitor your heartbeat & sleep,
and some even notify you of incoming calls.

1.5.4. GAME SIMULATORS

 The rise Of VR in gaming has given rise to many wearable devices that simulate an
environment and make the experience more realistic, engrossing, and adventurous. The
devices include VR Headsets (also called Head-Mounted Displays or HMDs) that create a
Visual simulation and bands that come with built-in sensors to detect your movements.
These bands enable you to control your movements through hand gestures.

1.5.5. SMART CLOTHING

 The advancement of technology with IoT has fostered many inventions including Smart
Clothes. Smart clothes are also popularly known as E- Textile as they come integrated with
electronic devices that measure the health metrics of the wearer. Smart clothes help
measure health-related aspects like heart rate, respiration rate, sleep, the body
temperature, and provide you with that information. Smart clothing also includes smart
shoes that examine your health, steps, fatigue, and collect other metrics to help you
improve health and prevent injury.

1.5.6. SMART GLASSES

 Ranging from simple smart glasses that are equipped with Bluetooth wireless music and
hands-free calling to the glasses that can live stream videos to take photos, to advanced
smart glasses that are AR-enabled to give you an immersive experience, these smart glasses
are the of eyewear. Smart glasses can enable the user to read text messages and reply to
them hands-free. Smart glasses by some companies are equipped with features like internet
access and browsing through voice commands.

1.5.7. HEARTBEAT TRACKERS & BLOOD PRESSURE MONITORS

 There are fitness trackers for a specific use case like monitoring the heartbeat or regularly
measuring the blood pressure. These devices help track the metrics among the people who
suffer from related diseases. The fitness trackers record and provide the measurements to
the wearer regularly. Some devices are enabled to share the data with the physician.

1.5.8. SMART EARBUDS

 New to enter the wearable technology market are earbuds. Though Bluetooth earbuds are
existing for a while now, they aren't considered among wearable technology because they
 do not collect and send data. But some companies are making earbuds smart. Smart earbuds
have a built-in gyroscope, GPS, and compass. The sensors in the earbuds relay the
information to the smartphone, which enables it to know your direction and movement.
Hence, the smart earbuds are equipped to provide directions in real-time.

1.5.9. SMART CONTACT LENS

 Smart Contact Lens is among the recent inventions made possible with IoT. The smart
contact lenses currently available in the market are helpful for medical reasons. It helps
monitor eyes for various diseases like Diabetes, Glaucoma, and cataracts. It helps in the
treatment of farsightedness. Apart from medical reasons, some companies are working on
smart contact lenses that are AR-enabled, work on solar power, and capture and Store
images and videos. Smart lenses are among the implantable devices.

1.5.10. IMPLEMENTATION SCENARIO OF WIRELESS BODY AREA NETWORK

 The control device can be placed on the body like a mobile phone as shown in Fig. 1.3(a), or
it can be placed at an accessible location. Most suitable technologies for this link are ZigBee,
Bluetooth, 610WPAN, and WMTS.
 The main task of the BCU is to transfer data to a PC or to a smart phone. Wireless
technologies used on this segment (BCU to PC or to an Internet device) could be a mobile
communication network, a satellite link, or a Wi-Fi link. When the Internet is used, the data
collected at this PC can be transferred to remote stations in remote medical centers across
the network.

Fig. 1.3. Implementation scenario of Wireless body area network (a) Single WBAN node,

(b) A WBAN node with multiple bodies, and

(c) Multiple WBAN nodes. See also Color Insert.

 As described in Fig 1.3, the collected sensor data can easily be transferred to remote stations
(i.e., medical centers) with the existing wireless and information technology infrastructures
such as satellite, mobile communication system, Internet, etc.
  Accessing the medical data of injured people through Internet is an erective solution at the
moment, which will allow medical professionals at the hospital to collect and evaluate data
while patients are being transferred to the hospital in an emergency vehicle. If Provisioned,
these data can also be accessed outside the emergency areas as they will be made available
online.
 The control device will be similar to smart phones we use in our daily life to receive and
monitor the data obtained from sensors. They will be like minicomputers, which will most
likely be connected via a wireless technology such as Bluetooth, Wi-Fi, 3G/2G networks or
the satellite (VSAT: very small aperture terminal).
 These technologies over flexible communication links that can be configured to send data
from medical sensors to remote medical centers (second wireless link in Fig I .2 and Fig 1.3),
which can be accessed by medical professions at any time. The BCU can be attached to the
body as a wristwatch or around belt.
 The first scenario sharing a single WBAN node can be used for home care where there is
need for only one body monitoring. Scenarios presented in Fig. LI .3(a),(b) can be used at a
disaster area, in emergency rooms in hospitals, and in ambulance while patients are taken to
the hospital.
 Above discussion shows that WBAN is a specialized sensor network with definite application
requirements. For the commercial deployment of WBANs, it is necessary to develop an
industrial standard by considering its different application scenarios and requirements.

1.6. COMPONENTS OF WEARABLE SYSTEMS

The main components of wearable devices are as follows

1. Control

 Wearable-specific microcontrollers are small, so as to be comfortable and discrete. On the

other hand, the distinctive shapes and colors can function as a decorative element. Several
of the boards available are hand washable (minus the power source). Read the
documentation carefully.

2. Input / Output

 In place of pins, these boards have metal eyelets which you can loop conductive thread
through to sew soft circuit connections. Some boards also have snaps — or eyelets large
enough to solder on snaps for easy removal.

3. Conductive Textiles

 A material containing metals, such as silver or stainless steel, through which an electrical
current can flow is said to be conductive. Wearable systems can make use of these materials
in a variety of ways, such as:

 Thread for making circuits

 Fabric for capacitive touch sensors
 Hook-and-loop for switches

4. Sensors

 Sensors gather information about the environment, the user, or both. Examples Of the
former include light, temperature, motion (ACC); and location (GPS). Examples of the latter
 include heart rate (ECG), brain waves (EEG), and muscle tension (EMG). A few wearable
microcontrollers have basic sensors on board. Other manufacturers offer a range of external
sensor modules that connect to the main board.

5. Power

 When scoping out a wearable design one of the first things to consider is the power
requirement. Do you just want to illuminate a few LEDs, or do you want to run a,
servomotor? Boards with an integrated holder for a lithium coin battery are nice for Iow-
power projects that need to be self-contained. However, boards with a standard JST
connector (with or without a circuit to charge LiPo batteries) are more versatile.

6. Actuators

 One generic way to describe a wearable system is: In response to X, where X is the input
from a sensor, Y happens. Actuators such as LEDs, buzzers or speakers, and servomotors are
what make things happen.

Fig. 1.4. Components in wireless, wearable sensor systems

7. Networking

 To communicate with smart devices, the internet, or other wearable systems, you need
wireless connectivity. In addition to Wi-Fi and Bluetooth, wearable-friendly options include:

 BLE, which has lower power consumption than classic Bluetooth, a range of 50m,
and a data transmission rate up to I Mbps
 NFC, a radio frequency field with a range of approximately 20cm and data
transmission rate up to about 400 Kbps

Wireless Bodey Area Network (WBAN)

 A WBAN is a special purpose wireless sensor network designed to transmit data within a
very short distance. The quality of service (QoS) of a WBAN will depend on applications,
which are primarily medical applications. As discussed earlier, WBANs could be used in other
applications such as sports training; rehabilitation purposes, or military applications where
the QoS will be dictated by the nature of those applications.
 For medical applications where the source of information is physiological signals such as
heart rate, blood pressure, ECG, etc., the system generally demands low latency and high
reliability. Also, most of the physiological signal sources produce shorter data bursts at a
regular sampling frequency. Hence, a WBAN transmission data rate requirement is low to
medium for each connection.
 The range of a WBAN network should not affect the sensor node designs because the
gateway will be responsible for seamless long-distance services; hence, a modular design
approach should be taken when a long distance WBAN application design is developed.
 Similarly, the mobility feature of a WBAN will be taken care by the gateway or a router, thus
reducing the design complexity of sensor nodes. The gateway should be able to detect
movement of a WBAN or a person and connect itself to available external networks to
exchange information with the WBAN. So, the WBAN design requirements can be classified
into basic and advanced requirements. Advance design requirements will be influenced by
the design requirements of the applications that a WBAN is used. The basic WBAN design
attributes are summarized below:
 WBAN nodes should consume Iow power so that battery' could last for a very long time.
Also, WBAN nodes should use small size batteries so that light-weight nodes can be used. A
WBAN should be designed in a fail-safe manner so that failure of a node can be
automatically detected or failure of a node should not affect the operation of the network.
 A WBAN should be scalable so that health care workers can increase or decrease the
number of nodes on a patient's body without any manual intervention of IT personnel.
 To achieve the above design attributes, WBAN designers should consider the following
points in their design work:
 Wireless sensors: A transmitter circuit can be designed with a few components, which may
consume extremely Iow power when designed with an integrated circuit technology.
Appropriate sleep and wake-up cycles should be incorporated with the designed hardware
to reduce the power consumption to a minimum level.
 Reliable data communication: Reliable, error free, and robust information should be
received from sensors. A WBAN will use a wireless channel to transmit data, which is
inherently unreliable. Error checking and correction mechanisms should be incorporated so
that the unreliability of the transmission channels can be countered.
 The wireless technologies used in a medical environment should operate in the frequency
bands that are immune to interference and thus increase the coexistence of sensor node
devices with other network devices available at the same location. The wireless technology
used should have less interference effect on other medical equipment. Any network outage
should be automatically detected, and the sensor data should be delivered in a fail-safe
manner, which could be a critical requirement for a patient monitoring system.
 Wireless network security and privacy: Key software components should be defined and
developed to accommodate secure and effective wireless networking. Protocols should be
designed in such a manner that a WBAN data cannot be collected by intruders.
 A WBAN will use a wireless transmission channel, which opens up the possibility of external
intrusion while transmitting data. Data encryption techniques could be used, but designers
 should keep in their mind that undue complexities should not be introduced at the sensor
node level to avoid higher battery power and larger physical size.
 Handover mechanism: Handover mechanism should be integrated in a WBAN using the
gateway or a router. Handover features should not overload the sensor node design.
 Miniaturized antenna: Unobtrusive small antenna design should be used, which Will
operate at high frequencies. Directional or narrow beam antenna design could be
considered for specific medical applications.
 Gateway devices: A WBAN node may have a wearable or implantable node. Gateway
devices should be developed to interface with the existing wireless networks used in health
care systems. Gateway devices should implement advanced algorithms, which are more
power hungry so that sensor node design and requirements remain simple.
 Alarm option: An alarm option should be included when an outage occurs or a sensor node
fails.
 Comfort: Sensor node electronics could be designed using flexible and stretchable
technology so that sensor nodes can easily be embedded in textiles (i.e., patient's clothes). It
can be attached to the human body using a plaster to eliminate movements.

1.7. SENSORS FOR WEARABLE SYSTEMS

1.7.1. SENSORS

 When designing wearable systems to be used for physiological and biomechanical

parameters monitoring, it is important to integrate sensors easy to use, comfortable to
wear, and minimally obtrusive.
 Wearable systems include sensors for detecting physiological signs placed on-body without
discomfort, and possibly with capability of real-time and continuous recording. The system
should also be equipped with wireless communication to transmit signals, although
sometimes it is opportune to extract locally relevant variables, which are transmitted when
needed.
 Most sensors embedded into wearable systems need to be placed at specific body locations,
e.g. motion sensors used to track the movements of body segments, often in direct contact
with the skin, e.g. physiological sensors such as pulse meters or oximeters. However, it is
reasonable to embed sensors within pieces of clothing to make the wearable system as less
obtrusive as possible.
 In general, such systems should also contain some elementary processing capabilities to
perform signal pre-processing and reduce the amount of data to be transmitted.
 A key technology for wearable systems is the possibility of implementing robust, cheap
microsystems enabling the combination of all the above functionalities in a single device.
 This technology combines so-called micro-electro- mechanical systems (MEMS) with
advanced electronic packaging technologies.
 The former allows complex electronic systems and mechanical structures (including sensors
and even simple motors) to be jointly manufactured in a single semiconductor chip.
 A generic wearable system can be structured as a stack of different layers. The –lowest layer
is represented by the body, where the skin is the first interface with the sensor layer:
 This latter is comprised of three sub-layers: garment and sensors, conditioning and filtering
of the signals and local processing.
 The processing layer collects the different sensor signals, extracts specific features and
classifies the signals to provide high-level outcomes for the application layer.
  The application layer can provide the feedback to the user and/or to the professional;
according to the specific applications and to the user needs. Recent developments embed
signal processing in their systems, e.g. extraction of heart rate, respiration rate and activity
level.

1.7.2. BIOMECHANICAL SENSORS

Fig. 1.5. Biomedical Sensor

 Biomechanical sensors are thought to be used to record kinematic parameters of body

segments. Knowledge of body movement and gesture can be a means to detect movement
disturbances related to a specific pathology or helpful to contextualize physiological
information within specific physical activities.
 An increasing of heart rate, for example, could be either due to an altered cardiac behavior
or simply because the subject is running.

1.7.3. DIFFERENT SENSORS USED FOR SMART CLOTHING

 Wearable electronics refer to textiles and clothing with integrated electronic technology or
other computing devices that provide smart functionalities. These smart textiles augment
creativity, intellect, communication, memory and physical senses. This definition does not
only apply to garments but to everything that can be worn on the body. Once combined with
electronic technology, watches, caps, shirts and glasses, for instance, can all contribute to
the very wide spectrum of wearable electronics.
 Wearable technology that relies on sensors to measure how the body maneuvers offers
consumers data about themselves. With evolving sensors technology, wearables now have a
deeper measuring ability.

Accelerometer
  Accelerometers are sensors used in wearables. Their brand of acceleration, such- as gravity
and linear, demonstrates their sensing capabilities. Meanwhile, their measuring ability
enables the programming of measured data for different purposes. For instance, a user who
runs can access his or her top speed output along with acceleration. Further, accelerometers
can track sleep patterns.

Gyroscopes

 Gyroscopes are also a common wearable sensor. They differ from accelerometers by
recording only angular accelerations. In some implementations, the accelerometer is used to
measure rotational acceleration, while some systems would like to incorporate both for
filtering errors. Gyroscopes increase the precision of the data tracked and numerous types
are available, including gas bearing, mechanical and optical.

Magnetometers

 Magnetometers can be integrated to create an inertial measurement unit (IMU) with

accelerometers and gyroscopes. All of these sensors can feature three axes each, are very
similar to a compass and can improve balance. While gyroscopes and accelerometers are
usually used with them, magnetometers match them by filtering the motion orientation.

Global positioning system (GPS)

 GPS is a common sensor used on many devices _such as smartphones and smartwatches. It
is used for scanning and informing users of their location. Information is sent to a satellite to
quantify exact location and time. This serves as a transmitter and a receiver in which the
information is returned to the sensor to notify the location.

Heart rate sensors

 Various techniques and sensors are available for measuring heart rate. One method uses
capacitive sensing to idealize the electrode (sensor) and the skin as two parts of a
conventional capacitor. Photo plethysmography is a technique that uses light to track blood
flow volume changes. Fitness trackers like Fitbit rely on this approach using a photodiode.
There is a continuous green light transmitted to the skin of the wearer, which measures the
light absorption by the photodiode. This information is transferred so that pulse can be
calculated. An increase in the blood passing through the user's bloodstream, the more light
the diodes absorb.

Pedometers

 Pedometers are typically found in wearables focused on physical health and can count the
user's steps while running or walking. There are two variants of ped01neters: electrical and
mechanical. The former is the most popular form today and depend on MEMS technology
for efficiency, but still operate on mechanical pedometer-based principles.
 The pendulum function is used to assess the pedometer user’s steps. A tiny metal pendulum
is used in two-ended pedometers, one with a screw. The hammer swings and hits the other
every time a user takes a step and then returns to its original location. The mechanism is
linked via spring to an electronic counting circuit. At first, there is no current, and therefore
an open circuit is closed each time the hammer hits the other side. Thus, current starts
flowing. Once the pendulum moves back to its initial point, the circuit closes again, and the
pendulum rotation starts anew. This allows the circuit to understand each step.
Pressure sensors

 Usually, pressure sensors operate from strain gauges. When pressure is applied to sensors,
the circuit causes a change in resistance. Mechanical quantities like force are observed in
many ways and are transformed into resistance-dependent electronic measurements. This
method of measuring pressure is achieved through the construction of a Wheatstone bridge,
which can track static or dynamic resistance changes. The sensing device will comprise one,
two or four arms in the configuration of the Wheatstone bridge. The number depends on
the use of the device (how many in tension and compression). The sensor mechanism allows
them to be integrated into external factors such as ball contact monitoring equipment.

Integration of sensors into wearables

 A microcontroller is a key component to enable wearable technology to operate. It is

commonly seen as a small computer, (the chip system) that allows the integration of the
internet of things (IOT) with the desired application. Most significantly, it eliminates the use
of many electronic components to execute different functions on a single chip. Due to its
ease in programming, reprogramming cost, size, and connectivity with other sensors and the
ability to handle complex functions, including graphic displays, it is best used in wearable
technology.

1.8. INERTIAL MOVEMENT SENSORS

 The inertial sensor, also known as the inertial navigation system (INS), uses an accelerometer
and gyro to determine spacecraft attitude in relation to the inertial system. The
accelerometer is used to test the motion acceleration of the carrier, which is the used to
calculate the real-time location of the carrier.
 Inertial sensors are composed of accelerometers and gyroscopes, which measure specific
force and turn rate, respectively. The so-called inertial measurement unit contains three
mutually orthogonal accelerometers and three mutually orthogonal gyroscopes. Therefore,
the acceleration and turn rate measurements are triads.
 Monitoring of parameters related to human movement has a wide range of applications. In
the medical field, motion analysis tools are widely used both in rehabilitation and in
diagnostics. In the multimedia field, motion tracking is used for the implementation of life-
like videogame interfaces and for computer animation. Standard techniques enabling
motion analysis are based on stereo- photogrammetric, magnetic and electromechanical
systems. These devices are very accurate but they operate in a restricted area and/or they
require the application of obtrusive parts on the subject body.
 On the other hand, the recent advances in technology have led to the design and
development of new tools in the field of motion detection which are comfortable for the
 user, portable and easily usable in non-structured environments. Current prototypes
realized by these emergent technologies utilize micro-transducers applied to the subject
body (as described in the current paragraph) or textile-based strain sensors.
 The first category, instead, includes devices based on inertial sensors (mainly accelerometers
and gyroscopes) that are directly applied on the body segment to be monitored.
 The sensors can be realized on a single chip (MEMS technology) with low cost and
outstanding miniaturization. Accelerometers are widely used for the automatic of physical
activity and the estimation of body segment inclination with respect to the absolute vertical.
Accelerometers alone are not indicated for the estimation of the full orientation of body
segments.
 The body segment orientation can be estimated by using the combination of different
sensors through data fusion techniques (Inertial Measurement Units, IMU). Usually, tri-axial
accelerometers (inclination), tri-axial gyroscopes (angular velocity), magnetometers (heading
angle) and temperature sensors (thermal drift compensation) are used together. Main
advantages of using accelerometers in motion analysis arc the very low encumbrance and
the Iow cost.
 Disadvantages are related to the possibility of obtaining only the inclination information in
quasi-static situations (the effect of the system acceleration is a noise and the double
integration of acceleration to estimate the segment absolute position is unreliable).
 Accelerometers are widely used in the field of wearable monitoring systems, generally used
in the monitoring of daily life activities (ADL).
 Physical activity detection can be exploited for several fields of application, e.g. energy
expenditure estimation, tremor or functional use of a body segment, assessment of motor
control, load estimation using inverse dynamics techniques or artificial sensory feedback for
control of electrical neuromuscular stimulation.
 Usually, three-axial accelerometers are used. They can be assembled by mounting three
single-axis accelerometers in a box with their sensitive axes in orthogonal directions or using
a sensor based on one mass. An accelerometer measures the acceleration and the local
gravity that it experiences. Considering a calibrated tri-axial accelerometer (i.e. offset and
sensitivity are compensated and the output is expressed in unit of g), the accelerometer
signal (y) contains two factors: one is due to the gravity vector (g) and the other depends on
the system inertial acceleration (a), both of them expressed in the accelerometer reference
frame:
 The inclination vector (z) is defined as the vertical unit vector, expressed in the
accelerometer coordinate frame. In static conditions, only the factor due to gravity is
present and the inclination of the accelerometer with respect to the vertical is known.
 In dynamic conditions, the raw accelerometer signal does not provide a reliable estimation
of the inclination, since the inertial acceleration is added to the gravity factor. This
estimation error grows as the subject movements become faster (e.g. running, jumping).
 Many algorithms have been developed and tested to perform a reliable estimation of the
subject body inclination: most of them use Iow pass filters with very low cut-off frequency in
order to extract z (i.e. introducing a considerable time delay), others implement more
complex techniques which use a model-based approach mainly based on Kalman filter
techniques.
 An example of integration of these sensors in a garment was developed in the frame o the
Proetex project (FP6-2004-IST-4-026987), which aimed at using textile and fibre b integrated
smart wearables for emergency disaster intervention personnel.
  The Proetex motion sensing platform is used to detect long periods of user immobility and
user falls to the ground and it is realized by means Of two tri- axial accelerometer modules.
One accelerometer is placed in the higher part of the trunk (collar level) in order to detect
inactivity and falls to the ground.
 The second sensor is placed in the wrist region and its aim is to achieve more accuracy in
inactivity detection, since an operator can move his arms while his trunk is not moving. The
core of the motion sensor is the processing algorithm which allows to perform a reliable
estimation of the body inclination even in the case of intense physical activity such as
running or jumping. This algorithm allows a good estimation of subject activities and
generated fall alarms with very high sensitivity and extremely Iow level of false positives.

1.9. RESPIRATION ACTIVITY SENSOR

Respiration

Respiration is the biochemical process in which the cells of an organism obtain energy by combining
oxygen and glucose, resulting in the release of carbon dioxide, water, and ATP (the currency of
energy in cells).

What happen during Human Respiration?

Usually mean the passages that transport incoming air to the lungs and to the microscopic air sacs
called alveoli where gases are exchanged.

Respiration Sensor

The respiration sensor is a sensitive girth sensor worn using an easy fitting high durability Woven
elastic band fixed with a length adjustable webbing belt.

Various method of measuring respiratory rate

1. Respiratory rate measurement using Piezoelectric Sensor (PZO).

2. Respiratory rate measurement from Laser Doppler Vibrometer (LDVi).
3. Respiration rate measurement System using Pyroelectric Sensor.
4. Impedance Pneumography method.
5. Capnometry.

Purpose of Respiratory Sensor

 It detects chest or abdominal expansion/contraction and outputs the respiration waveform.

Construction
  The sensor is latex-free, magnet-free and Velcro-free, and can be worn over clothing.

Operating Principle

1. The respiration sensor is sensitive to stretch. When strapped around a client's chest or
abdomen,
2. It will convert the expansion and contraction of the rib cage or abdominal area, to a rise and
fall of the signal on the screen.
3. For the client's comfort, the elastic strap segment stretches when the abdomen expands
during breathing.

1.9.1. PHYSIOLOGICAL SIGN SENSORS

Fig. 1.6. Placement of Sensor

Fig. 1.7. Two Sensor Placement

 Wearable systems are generally thought to be used for health care, therefore necessarily
including sensors to monitor physiological signs. Occasionally, it is possible to adapt
commercial devices to be integrated into a wearable system, but mostly dedicated and
customized sensors should be designed and embedded. Here sensors for respiration activity,
pulse monitoring, galvanic skin response, thermal and cardiopulmonary radiant sensors, gas
sensors and sensors for detecting bio- chemical markers are envisaged and described.

1.9.2. RESPIRATION ACTIVITY

  The most challenging Vital sign to accurately record during continuous monitoring is the
respiratory activity due to the fact that the signals are affected by movement artifacts and
filtering or feature recognition algorithms are not very effective.
 Monitoring of respiratory activity involves the collection of data on the amount and the rate
at which air passes into and out of the lungs over a given period of time. In literature, there
are several methods to do this, both directly, by measuring the amount of air exchanged
during the respiration activity, and indirectly, by measuring parameters physically correlated
to breathing, such as changes in thorax circumference and/or cross section, or trans-thoracic
impedance.

1.9.3. DIRECT AND INDIRECT METHODS

 Direct methods are based on a spyrometer that measures directly the airflow in the lung
exchanged during inspiration and expiration, but of course it cannot be integrated into a
wearable system because it employs a mouthpiece, which could interfere with the freedom
of movements, disrupting the normal breathing pattern during measurement, thus causing
discomfort for the user.
 Indirect methods exploit displacements of the lung that are transmitted to the thorax wall
and vice versa, and therefore measurements of chest-abdominal surface movements can be
used to estimate lung volume variation. A number of devices have been used to measure rib
cage and abdominal motion including mercury in rubber strain gauges, linear differential
transducers, magnetometers, and optical techniques, but almost all cannot be comfortably
integrated into a wearable system.
 It is worthwhile citing a more sophisticated technique, called stereo photogrammetry, which
makes it possible to estimate the three-dimensional coordinates of points of the thorax,
estimating there- fore volume variations.
 Nevertheless, this system presents a considerable drawback in that •it is cumbersome,
extremely expensive, and can only be used in research environments or in laboratory
applications.
 Indirect techniques that can be implemented in wearable systems are respiratory inductive
plethysmography (RIP), .impedance plethysmography, piezoresistive and/or piezoelectric
pneumography. These systems are minimally invasive and do not interfere with physical
activity. In the following, these four technics are described.

Application

 Monitoring of respiratory rate, respiratory cycle regularity, relative amplitude of the cycle,
and others. When multiple sensors are used simultaneously it enables diaphragmatic versus
thoracic breathing assessment (e.g. for biofeedback)

1.10. INDUCTIVE PLETHYSMOGRAPHY

 Respiratory inductance plethysmography (RIP) is a method of evaluating pulmonary

ventilation by measuring the movement of the chest and abdominal wall. Accurate
measurement of pulmonary ventilation or breathing often requires the use of devices such
as masks or mouthpieces coupled to the airway opening.
 The inductive plethysmography method for breathing monitoring consists of two elastic
conductive wires placed around the thorax and the abdomen to detect the cross-sectional
area changes of the rib cage and the abdomen region during the respiratory cycles.

1.10.1. WORKING PRINCIPLE

 Fig. 1.8. The respiratory inductive plethysmography system including the rib cage and

Abdominal sensor bands

 The conductive wires are insulated and generally sewn in a zig- zag fashion onto each
separate cloth band (see Fig1.8) They can be considered as a coil and are used to modulate
the output frequency of a sinewave current produced by an electric oscillator circuit. As a
matter of fact, the sinewave current generates a magnetic field, and the cross-sectional area
changes due to the respiratory movements of the rib cage and of the abdomen determine a
variation of the magnetic field flow through the coils. This change in flow causes a variation
of the self-inductance of each coil that modulates the output frequency of the sinusoidal
oscillator.
 This relationship allows for monitoring the respiratory activity by detecting the frequency
change in the oscillator output signal. For accurate volumetric measurements using RIP, it is
assumed that the cross-sectional area within the rib cage and the abdomen coil,
respectively, reflects all of the changes occurring within the respective lung compartment,
and further that the lung volume change is the sum of the volume changes of the two
compartments. Under optimal situations, lung volume can be approximated with an error
less than 10%.

1.11. IMPEDANCE PLETHYSMOGRAPHY

Introduction

 Impedance Plethysmography (IPG), is a non-invasive medical test that measures small

changes in electrical resistance of the chest, calf or other regions of the body.
 These measurements reflect blood volume changes, and can indirectly indicate the presence
or absence Of Cardiac, Venous or Arterial pathology.
 This procedure provides an alternative to venography or arteriography, which is invasive.

Cardiac

 For the chest, the technique was developed by NASA to measure the split second impedance
changes within the chest, as the heartbeats, to calculate both Cardiac output and lung water
content.
 This technique has progressed clinically, often now called BioZ (Biologic Impedance), as
promoted by the leading manufacturer in the US and allows low cost, non-invasive
estimations of cardiac output and total peripheral resistance.
  It uses 4 pair of surface electrodes.

Arterial

 For Arteries, blood flow in any area like thigh, calf, arm or forearm can be measured by
Impedance Arteriography.
 Pulsatile flow of arteries will give characteristic Electrical Resistance that can be recorded as
a Graph.
 Along with simultaneous recording of ECG, parameters like PAT, PTT can be measured.

Venous

 For leg veins, the test measures blood volume in the lower leg due to temporary venous
obstruction.
 This is done by inflating a cuff around the thigh to sufficient pressure to cut off venous flow
but not arterial flow, causing the venous blood pressure to rise.
 When the cuff is released there is a rapid venous return and a prompt return to the resting
blood volume.
 Cuff Inflation and Deflation will alter the Electrical Resistance of respective region; that will
give a characteristic Graph.
 Delayed emptying of veins in any venous pathology will change the normal response.

Principle

 In this technique, the electrical impedance of any part of the body is measured constant
current method and variations in the impedance are recorded as a function of time.
 Since blood is a good conductor of electricity, the amount of blood -in a given body segment
is reflected inversely in the electrical impedance of the body segment.

 Pulsatile blood volume by heart that is systemic blood circulation causes proportional
decrease in the electrical impedance.
 Variation in the electrical impedance thus gives adequate information about the blood
circulation.

Fig. 1.9.
Technique

 Constant current is passed through the body segment of interest with the help of surface
electrodes.

Fig. 1.10.

 Voltage signal developed along the current path is sensed with the help of another pair of
electrodes.
 The amplitude of the signal sensed is directly proportional to the electrical impedance of the
body segment.
 Amplification and detection of this signal gives instantaneous electrical impedance Z of the
body segment.
 Difference between the instantaneous electrical impedance and initial value of electrical
impedance (Zo) gives variation in the impedance as a function of time, called the dZ (t)
waveform.
 First time derivative of the impedance (dZ/dt) is obtained to give the rate of change of
impedance.
 With the help of this dZ/dt, used in different equation, peripheral arterial — venous blood
flow & stroke volume can be measured.

Fig. 1.11. Impedance Cardiography

 Fig.1.12.ICG

Fig. 1.13. Impedance Arteriography

 Fig. 1.14.

 Stroke volume is then estimated using the Kubicek formula

 Stroke volume = k p (L/Zo)2 [ LVET (dZ/dt) max]
 Where k is a constant Which accounts for variation in body composition based on age,
gender, relative fat content, chest circumference;
 L is the inter — electrode distance;
 OP is the blood specific resistivity computed using hematocrit as [13.5 + (4.29
 Hematocrit)].

Advantages

1. Simple
2. Cheap
3. Effective
4. Portability
5. Repeatability

Applications

1. Research
2. Screening
3. Vascular Diagnosis
4. Continuous Hemodynamic Monitoring — ICU
5. Pharmacological studies — OPD
6. Adjustment of Pacemaker settings
Limitations

1. Colour Doppler
2. Echo Cardiography

Impedance plethysmography (IPG) has been touted widely for the evaluation of patients at risk
for or suspected to have lower extremity DVT. A blood pressure cuff is placed around the thigh.
Inflation of the cuff increases the blood volume in the calf, which is measured as reduced impedance
between two calf electrodes.

1.11.1. WORKING PRINCIPLE

 This technique consists of injecting a high frequency and low amplitude current through a
pair of electrodes placed on the thorax and measuring the trans-thoracic electrical
impedance changes. As a matter of fact, there is a relationship between the flow of air
through the lungs and the impedance change of the thorax.
 The measurements can be carried out by using either two or four electrode configurations.
Electrodes can be made of fabric and integrated into a garment or, even, embedded into an
undershirt. It is worthwhile noting that by measuring the trans-thoracic electrical
impedance' it is possible to non-invasively monitor, in addition to breathing rate also tidal
volume; functional residual capacity, lung water and cardiac output. In Fig., the scheme of
principle is depicted.

1.12. PNEUMOGRAPHY

 A pneumograph, also known as pneumatograph or Spirograph, is a device for recording

velocity and force of chest movements during respiration.

1.12.1. PNEUMOGRAPHY BASED ON PIEZORESISTIVE SENSOR

Fig. 1.15. Principle scheme of impedance plethysmography system which can be integrated into

a wearable system
 Fig. 1.16. Picture showing how two piezoresistive hells can be embedded into a garment to

monitor abdominal and thoracic respiratory activity

Fig. 1.17. Wireless Impedance pneumography System for Unobtrusive Sensing of Respiration

 Piezoresistive pneumography is carried out by means of piezoresistive sensors that monitor

the cross-sectional variations of the rib cage. The piezoresistive sensor changes its electrical
resistance if stretched or shortened and is sensitive to the thoracic circumference variations
that occur during respiration.
 Piezoresistive sensors can be easily realized as simple elastic wires or by means of an
innovative sensorized textile technology. It consists of a conductive mixture directly spread
over the fabric.
 The lightness and the adherence of the fabric make the sensorized garments truly
unobtrusive and uncumbersome, and hence comfortable for the subject wearing them. This
mixture does not change the mechanical properties of the fabric and maintains the
wearability of the garment. Figure 1.15 shows where the two conductive wires or bands
could be applied.

1.13. PLETHYSMOGRAPHY BASED ON PIEZOELECTRIC SENSOR

1.13.1. FUNCTION OF PLETHYSMOGRAPH SENSOR

  The Plethysmograph is an infrared photoelectric sensor used to record changes in pulsatile
blood flow. It operates by recording changes in blood volume as the arterial pulse expands
and contracts the microvasculature.

1.13.2. WORKING PRINCIPLE

 This method is based on a piezoelectric cable or strip which can be simply fastened around
the thorax, thus monitoring the thorax circumference variations during the respiratory
activity. A possible implementation can be a coaxial cable whose dielectric is a piezoelectric
polymer (p (VDF-TrFE)), which can be easily sewn in a textile belt and placed around the
chest.

Fig. 1.18. Concept of a wearable system equipped with a piezoelectric band

 In Fig.1.18, a possible application is reported. The sensor is sensitive to the thorax

movements and produces a signal directly proportional to the thorax expansion in terms of
charge variation, which was converted in an output voltage proportional to the charge by
means Of a charge amplifier. A suitable local processor can enable implementation of the
Fast Fourier Transform in real time and extraction of the breathing rate.

1.13.3. GALVANIC SKIN RESPONSE

 One of the most interesting measurements of the electrical body response is the Galvanic
Skin Response (GSR), which was easily transformed from laboratory to wearable
instrumentation, and has become one of the most used wearable devices especially for the
high correlation that has shown with the most significant parameters in the field of
neuroscience.
 It is a part of the whole Electro Dermal Response (EDR), which is also constituted of the
measure of skin potentials. In deep, EDR is associated with sweat gland activity. Convincing
evidence, indeed, was experimentally found in which a direct correlation is seen between
EDR and. stimulated sweat gland activities. Furthermore, when sweat gland activity is
abolished, then there is an absence of EDR signals.
Fig 1.19. A simplified equivalent circuit describing the electrodermal system. Components are

identified in the text

 An electrical equivalent model underlying EDR is represented in Fig 1.19. This model
Provides only qualitative information. The active electrode is at the top (skin surface),
whereas the reference electrode is considered to be at the bottom (hypodermis). RI and R2
represent the resistance to current flow through the sweat ducts located in the epidermis
and dermis, respectively. These are major current flow pathways when these ducts contain
sweat, and their resistance decreases as the ducts fill. El and R4 represent access to the
ducts through the duct wall in the dermis, whereas E2 and R3 describe the same pathway,
but in the epidermis. Potentials 'El and E2 arise as a result of unequal ionic concentrations
across the duct as well as selective ionic permeabilities.
 This potential is affected by the production of sweat, particularly if the build-up of
hydrostatic pressure results in depolarization or the ductal membranes. Such a
depolarization results in increased permeability to ion flow; this is manifested in the model
by decreased values ofR3 and Rd. In particular, this is considered as an important
mechanism to explain rapid-recovery signals. The potentials of El and E2 arc normally lumen-
negative. The resistance R5 is that of the corneum, whereas E3 is its potential.
 The phenomenon of hydration- of the corneum, resulting from the diffusion of sweat from
the sweat ducts into the normally dry and absorbant corneum, leads to a reduction in the
value of R5. The applications of the measure lie in the area of psychophysiology and relate to
studies in which a quantitative measure of sympathetic activity is desired.
 Fig. 1.20. Suggested electrodes site for the measurement of skin resistance and skin potentials

 The importance attached to such measurements includes the statement in one recent paper
that palmar sweat is one of the most salient symptoms of an anxiety state and, for some, the
single most noticeable bodily reaction. Other suggested locations for electrode placement
can be between two fingers. In this case, electrodes can be integrated into a glove (see Fig
1.20).

1.13.4. PULSE OXIMETRY

 Pulse oximetry is a test used to measure the oxygen level (oxygen saturation) of the blood. It
is an easy, painless measure of how well oxygen is being sent to parts of your body furthest
from your heart, such as the arms and legs.
 Pulse oximetry was introduced in 1983 as a non-invasive method for monitoring the arterial
blood oxygen saturation. Recognized worldwide as the standard of care in anaesthesiology,
it is widely used in intensive care, operating rooms, emergency, patient transport, general
wards, birth and delivery, neonatal care, sleep laboratories, home care and in veterinary
medicine. Currently, several wearable pulse oximeters are being developed to transfer this
standard technique to a most effective remote home-care monitoring.
 Being pulse oximeter non-invasive, easy to use, readily available, and accurate, the modern
wearable system developed can supply information about blood oxygen saturation, heart
rate and pulse amplitude. A pulse oximeter shines light of two wavelengths through a tissue
bed such as the finger or earlobe and measures the transmitted light signal.

1.13.4.1. Principle of operation

The device operates according to the following principles:

1. The light absorbance of oxygenated haemoglobin and deoxygenated haemoglobin at the

two wavelengths is different. To be more precise, the set of associated extinction
coefficients for the absorption of light for these wavelengths is linearly independent with
great enough variation for adequate sensitivity but not so large that the blood appears
opaque to either of the light sources. This model assumes that only oxygenated and
deoxygenated haemoglobin are present in the blood.
2. The pulsatile nature of arterial blood results in a waveform in the transmitted signal that
allows the absorbance effects of arterial blood to be identified from those of non-pulsatile
venous blood and other body tissue. By using a quotient of the two effects at different
wavelengths, it is possible to obtain a measure requiring no absolute calibration with respect
to overall tissue absorbance. This is a clear advantage of pulse oximeters over previous types
of oximeters.
3. With adequate light, scattering in blood and tissue will illuminate sufficient arterial blood,
allowing reliable detection of the pulsatile signal. The scattering effect necessitates empirical
calibration of the pulse oximeter. On the other hand, this effect allows a transmittance path
around bone in the finger.

Figs 1.21. Transmission pulse oximeter measuring the transmission of light b." two LEDs

through the finger of a patient

 Systems following the principles above shown provide an empirical measure of arterial
blood saturation. However, with state-of-the-art instrumentation. And proper initial
calibration, the correlation between the pulse oximeter measurement, Sp02, and arterial
blood's actual oxygen saturation, Sa02, is adequate-generally less than 3% discrepancy
provided Sa02 is above 70% for medical applications.
 In general, when the calibration is difficult or impossible, these systems can be redirected at
considering only a led and a photodiode so that the obtained measurement is a photo
plethysmography. Really, most pulse oximeters on the market implement photo
plethysmography measurements. The Signal for the photo plethysmograph is derived from
the same waveforms used to calculate Sp02. The photo- plethysmograph may be used in a
clinical setting in the same manner as a plethysmograph.

Fig. 1.22. The plethysmographic waveform of a subject at rest is periodic (a) and during

exercise is not periodic (b)

 Fig. 1.23. Reflectance pulse oximeter measuring the amount of light reflected back to the

probe in forehead application

 However, the accuracy of the photo plethysmograph- suffers from motion artifacts, and the
patient must have adequate blood perfusion near placement of the pulse oximeter probe.
Just as with the conventional plethysmogram, signal processing can derive heart rate from
the photo plethysmogram waveform. Hence, most pulse oximeters also display heart rate.
Similar to computing Sp02, temporal low-pass filtering abates the effect of motion artifacts
on heart rate estimation.
 Generally, pulse oximeters are applied to a fingertip (see Fig 1.21), but as above- mentioned
they are heavily affected from motion artifact (see Fig. I .22) so that large part of the signal
has to be strongly treated or completely removed, to avoid this signal lost latest research
applications aim at positioning the sensor on the forehead (see Fig. 1.23), where it has been
noted that the signal shows lower artifact noise and better characteristics.

1.14. WEARABLE GROUND REACTION FORCE SENSOR

The sensor measures the forces and moments generated between the foot and ground during
normal activities like walking, running and jumping. The battery powered sensor attaches to a shoe
or boot with simple strap bindings and is environmentally sealed.

1.14.1. RADIANT THERMAL SENSORS

 The interest of the market devices for safety and security has rapidly grown over the last few
years. In particular, the use of Radio Frequency (RF) technology for contact-less sensing has
been promoted largely into several research projects.
 Body temperature - is usually captured by means of thermal sensors placed in direct contact
with skin. Skin temperature is strongly dependent on the body site and it is sensitive to local
increasing of blood circulation. Reference body temperature, indeed, should be internal.
Often skin contact with thermal sensors could be difficult and obtrusive, therefore radiant
technology is preferred.
 The state of the art on radiant thermal sensors covers several high-potential commercial
products. Meridian Medical Systems is aiming at fabricating a radiometer as a Monolithic
Microwave Integrated Circuit (MMIC) capable of detecting temperature of the heart.
 Although their research aims at implementing microwave radiometers for medical imaging,
it seems they use a traditional approach based on MIC/MMIC.
 It is worthwhile mentioning that radiometer exists from a long time, and their approach
using hybrid components is well known. Even though MMIC can reach good performance,
their level of integration is limited traditionally to the analog-RF part only. Thermal
 stabilization and calibration circuits need to be implemented by means of external circuitry,
resulting in bulky and expensive implementations inadequate for the mass-market.
 In fact, the system-on-chip implementation proposed in CMOS technology aims at
implementing efficiently on the same die both the analog-RF and the digital calibration
circuits. Only this result leads to consider that microwave radiometers can be implemented
as a real device characterized by superior performance and highest level of integration. This
is the real innovation expected for enabling microwave radiometry ford next-generation of
mass-market wearable devices for medical imaging, and safety and security of emergency
operators.

1.14.2. CONSTRUCTION AND FABRICATION

 Tyco Electronics is developing a 24 GHz UWB radar sensor in MIC technology for short range
applications. Moreover, this device is targeted at general purpose applications (i.e. military,
collision avoidance short-range automotive, etc.) and therefore only marginally related with
our specific target. Anyway, as an additional consideration to all the limitations of the MIC
approach cited above concerning the microwave radiometer and therefore still valid also in
this case, it is worth mentioning that its bandwidth is limiter* to 500 MHz
 A possible application of microwave radiometers could be designing a dedicated system to
assist the fire fighters in their work, for instance by detecting a fire behind a door or a wall.
This sensor can be mounted on two textile micro strip board.
 The former can contain the radiometric sensor and it is placed in the front side of the
fireman jacket (this to detect the fire coming from the front). The latter can contain the low
data-rate radio transceiver for sending out the information collected by the sensor, and this
can be placed in the back side, for instance close to the neck. The system idea is shown in
Fig.1.24. The radiometer consists of a patch antenna array, a low noise 13 GHz radiometer
module and a data acquisition and process unit.
 It is worthwhile noting that the sensor is mounted on the same micro strip board of the
antenna. The ZigBee transceiver (IEEE802. 15. 4) transmits the data to the personal server
(or a remote unit as well) of a wireless body area network (WBAN). The wireless platform
allows collecting the data acquired by multiple sensors to realize an extended monitoring of
the vital and environmental data.

Fig. 1.24. Block diagram of the overall system

 Moreover, such a wireless platform allows us to implement re-configurable systems, which

can be managed by remote operators taking care of the safeguard of the rescue team.
Hereinafter, how a fire in front of the subject with a separation wall between fire and
 subject can be detected. This inter-wall fire detection is tried in indoor environment to
simulate a condition as close as possible to the operative scenario.
 In particular, the setup shown in Fig. 1.25 has been used for the proof-of-the concept. TO
model the scenario sensed by a microwave radiometer, the approach described could be
adopted. This approach is based on the filling factor q, a quantity defined as the ratio
between the area of the fire AFIRE and the area of the antenna footprint

Fig. 1.25. Basic setup used for the inter-wall fire detection experiments

 By considering Fig.] .25, the footprint area can be evaluated approximating the main beam
of the antenna with a cone of angular aperture y (half power beam width) and by cutting this
cone with the profile of the illuminated scene, the soil and the furnace in this case. The
radiometric contrast "T is defined as the increase of the antenna temperature due to the fire
with respect to the condition without any fire.
 Applying the radiative transfer theory', the radiometric contrast can be derived as follows:

 where Tw is the transmissivity of the wall, Ef, Es and Ew are the emissivities of the fire, soil,
and wall, respectively, and Tf, Ts and Tw their physical temperatures. In conclusion, the
innovative low-cost, system-on-a-chip microwave radiometer could represent a very
promising solution for the realization of a next-generation of wearable sensors. The SoC
microwave radiometer will allow an extended detection capability in the cases where
traditional devices, such as IR devices, fail.

1.14.3. BIOCHEMICAL MARKERS

 Last achievements in research have enabled the possibility of detecting biochemical markers
through wearable instrumentation. CSEM researchers have developed non-invasive
biosensors for the detection of stress markers (such as lactate in sweat) and wound healing
(focussing on pH and infection markers detection). The high level of miniaturization allows
the integration in textile garments for the non-invasive monitoring of biological markers.
 In the frame of the BIOTEX project, a miniaturized label-free system for application in
Wound dressing has been developed. Within the PROETEX project, CSEM researchers are
currently realizing a wearable biosensor for real-time stress assessment of professional
rescuers to improve their safety during the intervention.
 In both cases, the sensing principle is based on responsive hydrogels that shrink or swell in
presence of the target marker to be detected. The hydrogels are sensitive to pH changes or
they can be functionalized to the target molecule by incorporating specific enzymes. In the
 case of stress monitoring, the hydrogel is functionalized with lactate oxidase, the presence
of the lactate changes the ionic concentration in the hydrogel and consequently the
hydrogel volume by an osmotic effect.
 The volume modification of the hydrogel causes a modification of the refractive index of the
structure. The sensitive hydrogel is then integrated on a waveguide grating chip. If the
grating chip is interrogated with a light source it reflects the light at a specific wavelength. As
the sensitive layer changes its refractive index, the wave- length of the reflected light is
shifted in accordance.
 The detection principle is based on the measurements of the refractive index through an
optical signal propagated along a wave guide. By exploiting this principle, a wearable optical
bio-sensor has been designed and realized: it uses a sensitive layer OR a waveguide grating
chip, the biosensor is interrogated with a white light source (using a white led) and the
reflected light is detected by a mini-spectrometer in order to measure the wavelength shift.
 Electrochemical sensors can be .integrated into flexible (i.e. plastic, textile) substrates to
develop wearable systems for the detection of biochemical markers. Some researchers are
developing a portable electrochemical system based on Ion Sensitive Electrodes (ISE)
integrated into a fabric substrate.
 ISE can measure the sodium concentration in sweat and this measurement can be related to
the operator dehydration that can lead to severe physio- logical consequences being able to
go until the death. A portable electronic board connected to the sensing part has been
developed. This board drives the electro- chemical sensor, compensates the effect of
temperature, performs analog acquisition and converts measurement data to digital value.
 Signal processing is implemented on board to correct raw data (gain, offset) and to convert
them to ion concentrations. The system was evaluated in terms of sensitivity, selectivity and
reproducibility initially in model solution and then in natural sweat, showing very promising
performances.
 A more recent technique employed for biochemical marker detection in wearable systems is
based on Organic Field Effect Transistors (OFET). Researcher at University of Cagliari
developed a flexible OFET able to detect pH changes in chemical solutions thanks to a
functionalized floating gate.
 The sample solution is brought into contact with a portion of the floating gate, which is
properly functionalized to achieve the sensitivity to a particular chemical species. The;
sensing mechanism is based on the detection of the electrical charge associated with the
chemical species placed over the probe area.
 The charge immobilized on the floating gate generates an electrical field and thus induces a
phenomenon of charge separation inside the electrode, affecting the channel formation in
the transistor. This mechanism can be described in terms of a shift of the effective threshold
voltage of the OFET. By properly functionalizing the floating gate surface, sensitivity to
different species and the detection of different reactions can be achieved, with the same.

1.14.4. GAS SENSORS

 Researchers from Dublin City University (DCU) are involved in the integration of sensing
platforms into wearables for the detection of environmentally harmful gases surrounding
emergency personnel. Special attention is being paid to carbon monoxide (CO) and carbon
dioxide (COD. These gases are associated with fires and mining operations, and it is of the
highest importance to warn and protect operators from potential harm caused by over-
exposure to high concentrations of these gases.
  The goal is rapid detection of the status of an environment (Iow, medium or high hazard)
and real-time communication of this information to the garment wearer.
 Critical in this identification of potential toxification is a reliable method of measuring
CO/C02 exposure. Commercially available sensors have been carefully selected and are
being integrated into the outer garments of firefighters. The sensors provide sufficient
sensitivity to reliably alert users to the presence of these harmful gases.
 Another important aim is to achieve wireless transmission of sensor signals to a wearable
wireless base station that gathers, processes and further transmits the data. When selecting
the appropriate commercially available sensors for the gas sensing application, special
attention was paid to sensor size, robustness, sensitivity and power requirement.
Electrochemical sensors satisfy most of these requirements, especially in terms of size and
power requirements.
 CO is detected using an amperometric sensor in which the current between the electrodes is
proportional to the concentration of the gas. On the other hand, the C02 sensor is
Potentiometric. In this case, the reference and working electrodes are placed in an
electrolyte that provides a reference C02 concentration. The measured potential is based on
the difference in concentration between the reference electrode and the outside air.
 Both types of sensors are very sensitive and give an accurate reading (in parts per million).
This means that both Iow concentrations of these gases (which can be hazardous over long
periods of exposure) and high concentrations (which pose an immediate danger) can be
accurately detected. The signal obtained from these sensors is transmitted wirelessly to the
wearable base station using ZigBee.
 The C02 sensor is placed in a specially designed pocket located on the firefighter's boot. The
pocket is designed not to obstruct the firefighter's activities. The prototype currently used
for testing is shown and note the side pocket containing the C02 sensor along with the
Wireless sensing module and a battery. The pocket has a waterproof membrane that
protects the sensor from humidity, but allows gas to pass through. The CO sensor will be
integrated in the firefighter's outer garment (i.e. jacket).
 All sensed information will be fed to a wearable local base station that shares the data with
a remote centralized base station. The ultimate goal is to achieve local communication
between firefighters and civil workers in the operations area, as well as longer range
communications between these personnel and the support team outside the operations
area.

1.14.4.1. Cardiopulmonary Activity Systems

 One of the most challenging points in the healthcare system is to use a single device to
simultaneously gather cardiac and pulmonary information; which usually arc both obtained
from different systems and whose interdependences are left to the clinic experience only.
An innovative cardiopulmonary wearable system that matches this dual request is based on
Ultra-Wide Band (UWB) technology.
 The main advantage of this monitoring radar system is the absence of direct contact with
the subject skin, dramatically reducing the typical disturbance due to motion artifacts.
Before introducing the system concept of the system let us give a brief overview on the
current state of the art.
 The most widespread system used to monitor the cardiac activity is the electrocardiograph
(ECG), which provides information about the heart electrical activity.
 Another complementary technology for monitoring the cardiorespiratory activity is pulse
oximetry, which measures the saturation level of the oxygen in the blood.
  Other systems for the monitoring of the cardiac activity are based on ultrasounds
(echocardiograph or echo Doppler). Ultrasound-based systems are generally cumbersome
and they can be used only by specialized operators. Anyway, all the presented measurement
techniques require the direct contact with the body to carry' out-the measurement.
 Unlike the traditional techniques (electrocardiograph, echocardiograph and pulsed
oximetry), radar systems allow the monitoring of the heart activity in a non-invasive and
contactless way for the patient. Microwave Doppler radars have been used to detect the
respiration rate since 1975. These first devices were bulky and expensive, but the recent
microelectronic advances led to develop CMOS fully integrated radars for non-contact
cardiopulmonary monitoring.
 Doppler radars typically transmit a continuous wave signal and receive the echo reflected by
the target. The frequency of the reflected signal varies from that of the transmitted one by
an amount proportional to the relative velocity of the target with respect to the radar.
Another class of radar employed for the monitoring of vital parameters is based on pulse
 Pulse radars operate by sending short electromagnetic pulses and by receiving the echoes
back-scattered by the target. The time delay between the transmission of the pulse and the
reception of the echo is proportional to the distance of the radar from the target.
 It is worthwhile mentioning that radar sensors monitor the mechanical movement of the
heart wall instead of the electrical activity of the heart (such as the electrocardiograph),
therefore when mechanical anomalies occur earlier than the electrical ones, this device can
be used to prevent in advance possible cardiac failures.

1.14.4.2. UWB Radar Sensor

 Moreover, the UWB pulses are not influenced by blankets or clothes. From a circuit design
point of view, UWB transceivers present a lower complexity with respect to traditional
radiofrequency systems, leading to low power consumption for a long life of the battery. In
fact, UWB systems do not require a stable frequency reference, which typically requires a
large area on silicon die and high-power consumption.
 Moreover, the extremely low level of transmitted power density (lower than 41.3dBm/MHz)
of the UWB radar should reduce the risk of molecular ionization (see Fig. 1.28).The main
block of the novel wearable wireless interface for human health care described herein is the
UWB radar sensor (see Fig. 1.26).

Fig. 1.26. Wearable Wireless UWB radar sensor interface for human health care
 Fig. 1.27. Block diagram of the VWB radar sensor

 The block diagram of the proposed radar sensor for the detection of the heart and breath
rates is shown in Fig.127. The radar exploits a correlation- based receiver topology followed
by an integrator, which averages the received pulses to have an output signal containing the
information on the heart and breath tones. The operating principle of a cross-correlator
radar is explained hereinafter.
 An electromagnetic pulse is transmitted toward the target. The echo received from the
target is multiplied by a delayed replica of the transmitted pulse; the output signal of the
multiplier is then integrated. It is worthwhile noting that' the output signal will reach its
maximum in the case of perfect time alignment between the two signals at the input of the
multiplier itself. In other terms, the cross- correlator has a frequency response equal to that
of a matched filter.

Fig. 1.28. FCC PSD mask for medical imaging and Power spectral density (PSD) of a pulse

sequence with PRF equal to I MHz vs. frequency

 In particular, it can be demonstrated that the matched filter is the filter that allows obtaining
the best signal-to-noise ratio at the output. Moreover, this has been confirmed by
preliminary system simulations (by means of the Ptolemy simulator within Agilent
ADS2005A).
 In detail, the CAD system analysis has shown that this topology allows us to achieve the best
performance in terms of output signal-to-noise ratio (SNR) and sensitivity to small variations
of the position of the heart wall with respect to other topologies, like that in which the
receiver is simply turned on by the command given by the delayed replica of the transmitted
pulse.
 The principle of operation of the overall radar system shown in Fig.1.27 is explained
hereinafter. A train of extremely short (about 200 picoseconds) Gaussian monocycle
electromagnetic pulses is transmitted toward the heart. Since the heart muscle and the
blood that flows inside have different characteristic impedance, a partial reflection of the
energy associated with the radiated pulse occurs at the surface of separation of these two
different media.