During the last decades, Electrical Bioimpedance Spectroscopy (EBIS) has been applied mainly by using the frequency-sweep technique, across a range of many different applications. Traditionally, the tissue under study is considered to be time-invariant and dynamic changes of tissue activity are ignored by treating the changes as a noise source. A new trend in EBIS is simultaneous electrical stimulation with several frequencies, through the application of a multi-sine, rectangular or other waveform. This method can provide measurements fast enough to sample dynamic changes of different tissues, such as cardiac muscle. This high sampling rate comes at a price of reduction in SNR and the increase in complexity of devices. Although the frequency-sweep technique is often inadequate for monitoring the dynamic changes in a variant system, it can be used successfully in applications focused on the time-invariant or slowly-variant part of a system. However, in order to successfully use frequency-sweep EBIS for monitoring time-variant systems, it is paramount to consider the effects of aliasing and especially the folding of higher frequencies, on the desired frequency e.g. DC level. This paper discusses sub-Nyquist sampling of thoracic EBIS measurements and its application in the case of monitoring pulmonary oedema. It is concluded that by considering aliasing, and with proper implementation of smoothing filters, as well as by using random sampling, frequency-sweep EBIS can be used for assessing time-invariant or slowly-variant properties of time-variant biological systems, even in the presence of aliasing. In general, undersampling is not always a problem, but does always require proper consideration.
Homecare is a potential solution for problems associated with an aging population. This may involve several physiological measurements, and hence a flexible but affordable measurement device is needed. In this work, we have designed an ADAS1000-based four-lead electrocardiogram (ECG) and respiration monitoring system. It has been implemented using Raspberry PI as a platform for homecare applications. ADuM chips based on iCoupler technology have been used to achieve electrical isolation as required by IEC 60601 and IEC 60950 for patient safety. The result proved the potential of Raspberry PI for the design of a compact, affordable, and medically safe measurement device. Further work involves developing a more flexible software for collecting measurements from different devices (measuring, e.g., blood pressure, weight, impedance spectroscopy, blood glucose) through Bluetooth or user input and integrating them into a cloud-based homecare system.
The reduced Heart Rate Variability (HRV) is believed to be associated with several diseases such as congestive heart failure, diabetes and chronic kidney diseases (CKD). In these cases, HRV biofeedback may be a potential intervention method to increase HRV which in turn is beneficial to these patients. In this work, a real-time Android biofeedback application based on a Bluetooth enabled ECG and thoracic electrical bioimpedance (respiration) measurement device has been developed. The system performance and usability have been evaluated in a brief study with eight healthy volunteers. The result demonstrates real-time performance of system and positive effects of biofeedback training session by increased HRV and reduced heart rate. Further development of the application and training protocol is ongoing to investigate duration of training session to find an optimum length and interval of biofeedback sessions to use in potential interventions.
This paper presents needs and potentials for wearable sensors inoccupational healthcare. In addition, it presents ongoing European and Swedishprojects for developing personalized, and pervasive wearable systems for assessingrisks of developing musculoskeletal disorders and cardiovascular diseases at work.Occupational healthcare should benefit in preventing diseases and disorders byproviding the right feedback at the right time to the right person. Collected datafrom workers can provide evidence supporting the ergonomic and industrial tasksof redesigning the working environment to reduce the risks.
Bioimedical pilot projects e.g., telemedicine, homecare, animal and human trials usually involve several physiological measurements. Technical development of these projects is time consuming and in particular costly. A versatile but affordable biosignal measurement platform can help to reduce time and risk while keeping the focus on the important goal and making an efficient use of resources. In this work, an affordable and open source platform for development of physiological signals is proposed. As a first step an 8–12 leads electrocardiogram (ECG) and respiration monitoring system is developed. Chips based on iCoupler technology have been used to achieve electrical isolation as required by IEC 60601 for patient safety. The result shows the potential of this platform as a base for prototyping compact, affordable, and medically safe measurement systems. Further work involves both hardware and software development to develop modules. These modules may require development of front-ends for other biosignals or just collect data wirelessly from different devices e.g., blood pressure, weight, bioimpedance spectrum, blood glucose, e.g., through Bluetooth. All design and development documents, files and source codes will be available for non-commercial use through project website, BiosignalPI.org.
Electrical Bioimpedance Spectroscopy (EBIS) is currently used in different tissue characterization applications. In this work we aim to use EBIS to study changes in electrical properties of the cerebral tissues after an incident of hemorrhage/ischemic stroke. To do so a case-control study was conducted using six controls and three stroke cases. The preliminary results of this study show that by using Cole-based analysis on EBIS measurements and analyzing the Cole parameters R0 and R∞, it is possible to detect changes on electrical properties of cerebral tissue after stroke.
The estimation of body fluids is a useful and common practice for assessment of disease status and therapy outcomes. Electrical bioimpedance spectroscopy (EBIS) methods are noninvasive, inexpensive and efficient alternatives for determination of body fluids. One of the main source of errors in EBIS measurements in the estimation of body fluids is capacitive coupling. In this paper an analysis of capacitive coupling in EBIS measurements was performed and the robustness of the different immittance spectra against it tested. On simulations the conductance (G) spectrum presented the smallest overall error, among all immittance spectra, in the estimation of the impedance parameters used to estimate body fluids. Afterwards the frequency range of 10–500 kHz showed to be the most robust band of the G spectrum. The accuracy of body fluid estimations from the resulting parameters that utilized G spectrum and parameters provided by the measuring device were tested on EBIS clinical measurements from growth hormone replacement therapy patients against estimations performed with dilution methods. Regarding extracellular fluid, the correlation between each EBIS method and dilution was 0.93 with limits of agreement of 1.06 ± 2.95 l for the device, 1.10 ± 2.94 l for G [10–500 kHz] and 1.04 ± 2.94 l for G [5–1000 kHz]. Regarding intracellular fluid, the correlation between dilution and the device was 0.91, same as for G [10–500 kHz] and 0.92 for G [5–1000 kHz]. Limits of agreement were 0.12 ± 4.46 l for the device, 0.09 ± 4.45 for G [10–500 kHz] and 0.04 ± 4.58 for G [5–1000 kHz]. Such close results between the EBIS methods validate the proposed approach of using G spectrum for initial Cole characterization and posterior clinical estimation of body fluids status.
In recent years, many efforts have been made to promote a healthcare paradigm shift from the traditional reactive hospital-centered healthcare approach towards a proactive, patient-oriented and self-managed approach that could improve service quality and help reduce costs while contributing to sustainability. Managing and caring for patients with chronic diseases accounts over 75% of healthcare costs in developed countries. One of the most resource demanding diseases is chronic kidney disease (CKD), which often leads to a gradual and irreparable loss of renal function, with up to 12% of the population showing signs of different stages of this disease. Peritoneal dialysis and home haemodialysis are life-saving home-based renal replacement treatments that, compared to conventional in-center hemodialysis, provide similar long-term patient survival, less restrictions of life-style, such as a more flexible diet, and better flexibility in terms of treatment options and locations. Bioimpedance has been largely used clinically for decades in nutrition for assessing body fluid distributions. Moreover, bioimpedance methods are used to assess the overhydratation state of CKD patients, allowing clinicians to estimate the amount of fluid that should be removed by ultrafiltration. In this work, the initial validation of a handheld bioimpedance system for the assessment of body fluid status that could be used to assist the patient in home-based CKD treatments is presented. The body fluid monitoring system comprises a custom-made handheld tetrapolar bioimpedance spectrometer and a textile-based electrode garment for total body fluid assessment. The system performance was evaluated against the same measurements acquired using a commercial bioimpedance spectrometer for medical use on several voluntary subjects. The analysis of the measurement results and the comparison of the fluid estimations indicated that both devices are equivalent from a measurement performance perspective, allowing for its use on ubiquitous e-healthcare dialysis solutions.
OBJECTIVE: To evaluate the frequency content of the electroencephalogram (EEG) during recovery after a severe hypoxic insult in newborn piglets. METHODS: EEG was continuously monitored in nine newborn piglets exposed to a severe hypoxic period. Power spectra in five frequency bands were calculated using Fourier transformation. Spectral edge frequency 90 (SEF90) was defined as the frequency below which 90% of the power in the EEG was located. The piglets were divided into two groups; Group 1 represented piglets with some EEG recovery and Group 2 represented piglets without any EEG recovery. RESULTS: The recovery of the EEG in Group 1 had the same time course in all frequency bands. SEF90 indicates recovery earlier than the value of total power. But SEF90 also signals activity in the EEGs that were almost completely suppressed. When SEF90 was calculated during periods of periodic EEG activity during the very early phase of recovery, the values fell within the same range as during the control period. CONCLUSION: Spectral analysis of continuous EEG in newborn piglets exposed to very severe hypoxia showed that no specific frequency band of the EEG preceded the other ones during recovery. The results of the SEF90 measure, demonstrates the need for critical analysis of the raw EEG before any reliable estimation of cerebral function can be made.
Aim: To evaluate the prognostic capacity of a new method for automatic quantification of the length of suppression time in the electroencephalogram (EEG) of a group of asphyxiated newborn infants. Methods: Twenty-one full-term newborn infants who had been resuscitated for severe birth asphyxia were studied. Eight channel continuous EEG was recorded for prolonged time periods during the first days of life. Artefact detection or rejection was not applied to the signals. The signals were fed through a pretrained classifier and then segmented into burst and suppression periods. Total suppression length per hour was calculated. All surviving patients were followed with structured neurodevelopmental assessments to at least 18 months of age. Results: The patients who developed neurodevelopmental disability or died had significant suppression periods in their EEG during the first days of life while the patients who had a normal follow-up had no or negligible amount of suppression. Conclusions: This new method for automatic quantification of suppression periods in the raw, neonatal EEG discriminates infants with good from those with poor outcome.
Objective: To study whether indomethacin used in conventional dose for closure of patent ductus arteriosus affects cerebral function measured by Electroencephalograms (EEG) evaluated by quantitative measures. Study design: Seven premature neonates with haemodynamically significant persistent ductus arteriosus were recruited. EEG were recorded before, during and after an intravenous infusion of 0.2 mg/kg indomethacin over 10 min. The EEG was analysed by two methods with different degrees of complexity for the amount of low-activity periods (LAP, “suppressions”) as an indicator of affection of cerebral function. Results: Neither of the two methods identified any change in the amount of LAPs in the EEG as compared to before the indomethacin infusion. Conclusion: Indomethacin in conventional dose for closure of patent ductus arteriosus does not affect cerebral function as evaluated by quantitative EEG.
Antalet äldre i samhället ökar, och med det kostnaderna p.g.a. kroniska åldersrelaterade sjukdomstillstånd. Ett sådant tillstånd är hjärtsvikt vilket drabbar ca 2 % av västvärldens befolkning. Forskning har visat att IT-baserad hemvård för s.k. Disease Management kan resultera i minskade kostnader så väl som ökad livskvalitet hos patienterna. Inom projektet Care@Distance är avsikten att utforma ett sådant system där tyngden ligger dels på regelbundna dagliga enkla mätningar av fysiologiskt relaterade parametrar såsom vikt och blodtryck, och dels på formulär där patienten svarar på några enkla frågor om det upplevda tillståndet. Syftet är att få med både objektiv och subjektiv information som sedan kan ligga till grund för en förbättrad vård av den enskilde patienten. Systemet utformas främst för att skapa underlag för en bättre långsiktig behandling, terapi och för uppföljning av Treatment Compliance, men även för att hantera akuta situationer genom t.ex. larm till vårdgivaren. Under projektets tid har ett samarbete med DAGA-kliniken på Östra sjukhuset upprättats, genom bl.a. diskussioner om frågeformulärets utformning. Under våren 2007 har även två förstudier genomförts på kliniken, den första med inriktning mot patientdelen av systemet, och den andra mot vårdgivarsidan. Studien visar att patientdelen är lätthanterad ur patientsynpunkt samt att intresse för systemet finns. Även på vårdgivarsidan är resultaten positiva när det gäller design, funktioner och intresse, men utrymme för förbättringar finns. Fortsatta studier i form av ett längre försök i hemmet hos patienter är planerat under sommaren och hösten 2007. Under sommaren kommer även patientdelen att vidareutvecklas med ny programvara. Ett framtida projekt innefattar att utveckla en metod för att utnyttja EBI (Elektrisk Bio-Impedans). Med relativt enkla och robusta mätningar förväntas mycket användbar och relevant information om sjukdomstillståndet kunna erhållas med denna metod, men detta kräver att ny sensorteknik utvecklas för hemmiljön.
Work-related musculoskeletal disorders are a major concern globally affecting societies, companies, and individuals. To address this, a new sensor-based system is presented: the Smart Workwear System, aimed at facilitating preventive measures by supporting risk assessments, work design, and work technique training. The system has a module-based platform that enables flexibility of sensor-type utilization, depending on the specific application. A module of the Smart Workwear System that utilizes haptic feedback for work technique training is further presented and evaluated in simulated mail sorting on sixteen novice participants for its potential to reduce adverse arm movements and postures in repetitive manual handling. Upper-arm postures were recorded, using an inertial measurement unit (IMU), perceived pain/discomfort with the Borg CR10-scale, and user experience with a semi-structured interview. This study shows that the use of haptic feedback for work technique training has the potential to significantly reduce the time in adverse upper-arm postures after short periods of training. The haptic feedback was experienced positive and usable by the participants and was effective in supporting learning of how to improve postures and movements. It is concluded that this type of sensorized system, using haptic feedback training, is promising for the future, especially when organizations are introducing newly employed staff, when teaching ergonomics to employees in physically demanding jobs, and when performing ergonomics interventions.
Vibrotactile feedback training may be one possible method for interventions that target at learning better work techniques and improving postures in manual handling. This study aimed to evaluate the short term effect of real-time vibrotactile feedback on postural exposure using a smart workwear system for work postures intervention in simulated industrial order picking. Fifteen workers at an industrial manufacturing plant performed order-picking tasks, in which the vibrotactile feedback was used for postural training at work. The system recorded the trunk and upper arm postures. Questionnaires and semi-structured interviews were conducted about the users’ experience of the system. The results showed reduced time in trunk inclination >= 20 degrees, >= 30 degrees and >= 45 degrees and dominant upper arm elevation >= 30 degrees and >= 45 degrees when the workers received feedback, and for trunk inclination >= 20 degrees, >= 30 degrees and >= 45 degrees and dominant upper arm elevation >= 30 degrees, after feedback withdrawal. The workers perceived the system as useable, comfortable, and supportive for learning. The system has the potential of contributing to improved postures in order picking through an automated short-term training program.
Hidden Markov Models (HMM) and Support Vector Machines (SVM) using unsupervised and supervised training, respectively, were compared with respect to their ability to correctly classify burst and suppression in neonatal EEG. Each classifier was fed five feature signals extracted from EEG signals from six full term infants who had suffered from perinatal asphyxia. Visual inspection of the EEG by an experienced electroencephalographer was used as the gold standard when training the SVM, and for evaluating the performance of both methods. The results are presented as receiver operating characteristic (ROC) curves and quantified by the area under the curve (AUC). Our study show that the SVM and the HMM exhibit similar performance, despite their fundamental differences.
Fisher's linear discriminant (FLD), a feed-forward artificial neural network (ANN) and a support vector machine (SVM) were compared with respect to their ability to distinguish bursts from suppressions in electroencephalograms (EEG) displaying a burst-suppression pattern. Five features extracted from the EEG were used as inputs. The study was based on EEG signals from six full-term infants who had suffered from perinatal asphyxia, and the methods have been trained with reference data classified by an experienced electroencephalographer. The results are summarized as the area under the curve (AUC), derived from receiver operating characteristic (ROC) curves for the three methods. Based on this, the SVM performs slightly better than the others. Testing the three methods with combinations of increasing numbers of the five features shows that the SVM handles the increasing amount of information better than the other methods.
The overall aim of our research is to develop methods for a monitoring system to be used at neonatal intensive care units. When monitoring a baby, a range of different types of background activity needs to be considered. In this work, we have developed a scheme for automatic classification of background EEG activity in newborn babies. EEG from six full-term babies who were displaying a burst suppression pattern while suffering from the after-effects of asphyxia during birth was included along with EEG from 20 full-term healthy newborn babies. The signals from the healthy babies were divided into four behavioural states: active awake, quiet awake, active sleep and quiet sleep. By using a number of features extracted from the EEG together with Fisher’s linear discriminant classifier we have managed to achieve 100% correct classification when separating burst suppression EEG from all four healthy EEG types and 93% true positive classification when separating quiet sleep from the other types. The other three sleep stages could not be classified. When the pathological burst suppression pattern was detected, the analysis was taken one step further and the signal was segmented into burst and suppression, allowing clinically relevant parameters such as suppression length and burst suppression ratio to be calculated. The segmentation of the burst suppression EEG works well, with a probability of error around 4%.
Textile Electrodes have been widely studied for biopotentials recordings, specially for monitoring the cardiac activity. Commercially available applications, such as Adistar T-shirt and Textronics Cardioshirt, have proved a good performance for heart rate monitoring and are available worldwide. Textile technology can also be used for Electrical Bioimpedance Spectroscopy measurements enabling home and personalized health monitoring applications however solid ground research about the measurement performance of the electrodes must be done prior to the development of any textile-enabled EBI application. In this work a comparison of the measurement performance of two different types of dry-textile electrodes and manufacturers has been performed against standardized RedDot 3M Ag/AgCl electrolytic electrodes. 4-Electrode, whole body, Ankle-to-Wrist EBI measurements have been taken with the Impedimed spectrometer SFB7 from healthy subjects in the frequency range of 3kHz to 500kHz. Measurements have been taken with dry electrodes at different times to study the influence of the interaction skin-electrode interface on the EBI measurements. The analysis of the obtained complex EBI spectra shows that the measurements performed with textile electrodes produce constant and reliable EBI spectra. Certain deviation can be observed at higher frequencies and the measurements obtained with Textronics and Ag/AgCl electrodes present a better resemblance. Textile technology, if successfully integrated it, may enable the performance of EBI measurements in new scenarios allowing the rising of novel wearable monitoring applications for home and personal care as well as car safety.
Electrodes have been widely studied for biopotentials recordings, specially for monitoring the cardiac activity. Commercially available applications, such as Adistar T-shirt and Textronics Cardioshirt, have proved a good performance for heart rate monitoring and are available worldwide. Textile technology can also be used for Electrical Bioimpedance Spectroscopy measurements enabling home and personalized health monitoring applications however solid ground research about the measurement performance of the electrodes must be done prior to the development of any textile-enabled EBI application. In this work a comparison of the measurement performance of two different types of dry-textile electrodes and manufacturers has been performed against standardized RedDot 3M Ag/AgCl electrolytic electrodes. 4-Electrode, whole body, Ankle-to-Wrist EBI measurements have been taken with the Impedimed spectrometer SFB7 from healthy subjects in the frequency range of 3kHz to 500kHz. Measurements have been taken with dry electrodes at different times to study the influence of the interaction skin-electrode interface on the EBI measurements. The analysis of the obtained complex EBI spectra shows that the measurements performed with textile electrodes produce constant and reliable EBI spectra. Certain deviation can be observed at higher frequencies and the measurements obtained with Textronics and Ag/AgCl electrodes present a better resemblance. Textile technology, if successfully integrated it, may enable the performance of EBI measurements in new scenarios allowing the rising of novel wearable monitoring applications for home and personal care as well as car safety
Electrical Bioimpedance Spectroscopy (EBIS) has been widely use for assessment of total body composition and fluid distribution. (EBIS) measurements are commonly performed with electrolytic electrodes placed on the wrist and the ankle with a rather small skin–electrode contact area. The use of textile garments for EBI requires the integration of textrodes with a larger contact area surrounding the limbs in order to compensate the absence of electrolytic medium commonly present in traditional Ag/AgCl gel electrodes. Recently it has been shown that mismatch between the measurements electrodes might cause alterations on the EBIS measurements. When performing EBIS measurements with textrodes certain differences have been observed, especially at high frequencies, respect the same EBIS measurements using Ag/AgCl electrodes. In this work the influence of increasing the skinelectrode area on the estimation of body composition parameters has been study performing experimental EBIS measurement. The results indicate that an increment on the area of the skin-electrode interface did produce noticeable changes in the bioimpedance spectra as well as in the body composition parameters. This influence must be taken into consideration when designing and testing textile-enable EBIS measurement systems.
Work has been intensified around the integration of textile and measurement technology for physiological measurements in the last years. As a result nowadays it is possible to find available commercial products for cardiovascular personal healthcare monitoring. Most of the efforts have been focused in the acquisition of EKG for cardiovascular monitoring where textile electrodes have shown satisfactory performance. Electrical Bioimpedance is another type of physiological measurement that can be used for personal healthcare monitoring where the integration and the performance of the textile electrodes has not been investigated that thoroughly. In this work, the influence of the textile electrodes on the measurements and on the estimation of the Cole (R-0,R-infinity, f(C) and a) and body composition (TBW, ICW, ECW and FFM) parameters has been especially addressed. Complex Spectroscopy 4-electrode wrist-to-ankle electrical bioimpedance measurements taken with conventional Ag/AgCl and textile-electrodes on customized bracelets have been compared and analyzed in the frequency range 3 to 500 kHz. The obtained results suggest that the use of textile electrodes do not influence remarkably on the complex spectral measurements neither in the estimation of Cole nor body composition parameter. In any case any possible effect introduced by the use of textile is smaller than the effect of preparing the skin by the using abrasive conductive paste.
Background/Objectives:Functional garments for physiological sensing purposes have been used in several disciplines, that is, sports, firefighting, military and medicine. In most of the cases, textile electrodes (textrodes) embedded in the garment are used to monitor vital signs and other physiological measurements. Electrical bioimpedance (EBI) is a non-invasive and effective technology that can be used for the detection and supervision of different health conditions.EBI technology could make use of the advantages of garment integration; however, a successful implementation of EBI technology depends on the good performance of textrodes. The main drawback of textrodes is a deficient skin-electrode interface that produces a high degree of sensitivity to signal disturbances. This sensitivity can be reduced with a suitable selection of the electrode material and an intelligent and ergonomic garment design that ensures an effective skin-electrode contact area.Subjects/Methods:In this work, textrode functional straps for total right side EBI measurements for body composition are presented, and its measurement performance is compared against the use of Ag/AgCl electrodes. Shieldex sensor fabric and a tetra-polar electrode configuration using the ImpediMed spectrometer SFB7 in the frequency range of 3-500 kHz were used to obtain and analyse the impedance spectra and Cole and body composition parameters.Results:The results obtained show stable and reliable measurements; the slight differences obtained with the functional garment do not significantly affect the computation of Cole and body composition parameters.Conclusions:The use of a larger sensor area, a high conductive material and an appropriate design can compensate, to some degree, for the charge transfer deficiency of the skin-electrode interface.
One of the most common measurement artifacts present in Electrical Bioimpedance Spectroscopy measurements (EBIS) comes from the capacitive leakage effect resulting from parasitic stray capacitances. This artifact produces a deviation in the measured impedance spectrum that is most noticeable at higher frequencies. The artifact taints the spectroscopy measurement increasing the difficulty of producing reliable EBIS measurements at high frequencies. In this work, an approach for removing such capacitive influence from the spectral measurement is presented making use of a novel method to estimate the value of the parasitic capacitance equivalent that causes the measurement artifact. The proposed method has been tested and validated theoretically and experimentally and it gives a more accurate estimation of the value of the parasitic capacitance than the previous methods. Once a reliable value of parasitic capacitance has been estimated the capacitive influence can be easily compensated in the EBIS measured data. Thus enabling analysis of EBIS data at higher frequencies, i.e. in the range of 300-500 kHz like measurements intended for cerebral monitoring, where the characteristic frequency is remarkably higher than EBIS measurements i.e. within the range 30 to 50 kHz, intended for body composition assessment.
Traditionally, measurements of electrical bioimpedance for medical diagnostic purposes have used only low frequencies, usually below 100 kHz. The analysis focused only on the resistive part of the impedance; very often at low frequencies the reactive part of the impedance is negligible. Recent studies of the electrical bioimpedance spectrum, both real and imaginary parts, have indicated new potential applications e.g. detection of meningitis, skin cancer assessment and brain cellular edema detection. An important functional unit in a wideband impedance spectrometer is the current source used to inject the current into the tissue under study. A current source must provide an output current virtually constant over the frequency range of interest and independent of the load at the output. Several designs have been proposed over the years but the performance of them all degraded markedly near bellow 1 MHz e.g. Ackmann in 1993, Bragos et al in 1994 and Bertemes-Filho et al in 2000. The development of electronic technology has made available devices that allow us to obtain a current source with large output impedance, larger than 100 k Omega, above I MHz and based in a simple single Op-Amp circuit topology. Simulation results and experimental measurements are compared and the most important parameters of the VCCS are analytically studied and experimentally tested, including the dependency to changes in the circuit elements and the incidence of the Op-Amp parameters on the current source features.