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IEEE JOURNAL OF BIOMEDICAL AND HEALTH INFORMATICS, VOL. 19, NO. 3, MAY 2015
AbstractA mobile device is presented for monitoring both respiration and pulse. The device is developed as a bendable/flexible
inlay that can be placed in a shirt pocket or the inside pocket of
a jacket. To achieve optimum monitoring performance, the device
combines two sensor principles, which work in a safe noncontact
way through several layers of cotton or other textiles. One sensor,
based on magnetic induction, is intended for respiratory monitoring, and the other is a reflective photoplethysmography sensor
intended for pulse detection. Because each sensor signal has some
dependence on both physiological parameters, fusing the sensor
signals allows enhanced signal coverage.
Index TermsNoncontact monitoring, pulse, respiration, sensor
fusion, wearable sensors.
I. INTRODUCTION
OME or telemonitoring systems need frequent records of
vital signs on a regular basis to assess the health status of
a patient. To maintain the patients quality of life, monitoring of
vital signs should take place as unobtrusively as possible. For
this purpose, on-body sensors can be of considerable benefit.
An ideal on-body sensor for home application should be mobile and easily wearable, so as not to restrict the patients mobility. Also, it should be easy to use without the need for skilled
personal and/or complex electrode application on multiple measurement locations. Because the device should be suitable for
long-term monitoring, direct skin contact should be avoided to
prevent skin irritation. Finally, for better acceptance by the patients, the sensor should be imperceptible, i.e., light weight, flat,
and adaptive to body motion.
The novel device presented here for monitoring respiration
and pulse meets all the aforementioned requirements of an ideal
on-body sensor. It combines two sensors, both of which work in
2168-2194 2015 IEEE. Personal use is permitted, but republication/redistribution requires IEEE permission.
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TEICHMANN et al.: BENDABLE AND WEARABLE CARDIORESPIRATORY MONITORING DEVICE FUSING TWO NONCONTACT SENSOR
Fig. 2.
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Fig. 3.
IEEE JOURNAL OF BIOMEDICAL AND HEALTH INFORMATICS, VOL. 19, NO. 3, MAY 2015
tissue is performed by three high-power LEDs (SFH4250, Osram). For optimum signal-to-noise ratio (SNR), they emit infrared light with a wavelength of 850 nm. Each LED provides
a radiant flux of up to e = 60 mW with a forward current
of If = 100 mA. For optimum connection and coupling into
tissue during different postures, the LEDs are placed in a triangular arrangement around the photodiode [see Fig. 1(b)]. The
photodiode has a photosensitive range of 730 to 1100 nm with
maximum sensitivity at = 880 nm and, hence, matches the
chosen LED type very well. The photodiode produces a current
which is proportional to the amount of incident photons. This
current is transferred by an impedance converter into a voltage
signal, which can be measured and digitized by a 24-bit A/D
converter (ADS1292, Texas Instruments).
The data captured by the A/D converter are read out by the
FlexPocks microcontroller unit via the serialperipheral interface. Hardware implemented filter stages were avoided to reduce
the physical dimensions of the device. Therefore, noise reduction and further filtering is performed by the microcontroller.
The microcontroller also provides a pulse width modulation
signal, which controls a current source to drive the LEDs. This
enables to adapt the emitted light intensity to the ambient light,
the light translucency of the textile layer, and the actual connection (i.e., air gap) between LEDs and tissue. In this way, energy
consumption of the device is reduced and saturation of the A/D
converter is prevented.
C. MI Sensor
1) Physical Principle: Human tissue is an inhomogeneous
and anisotropic electrical medium. The impedance distribution
within the thorax is modulated by physiological activity. This
modulation can be explained by volume changes, displacement
of organ boundaries, and microscopic processes.
MI monitoring is a noncontact method to measure the variation of the impedance distribution of an object. It is based on
electromagnetic coupling between a coil and an object in its
vicinity. The basic physical principle is shown in Fig. 3. The
coil is driven by an alternating current and, therefore, sends out
a primary alternating magnetic field, which penetrates a conductive medium in its vicinity and induces eddy currents into it.
The eddy currents excite a secondary alternating magnetic field
TEICHMANN et al.: BENDABLE AND WEARABLE CARDIORESPIRATORY MONITORING DEVICE FUSING TWO NONCONTACT SENSOR
Fig. 4.
Fig. 5. Pulse measurements with different setups of the rPPG sensor. (a) Two
LEDs, LED-to-photodiode distance 20 mm. (b) Two LEDs, LED-to-photodiode
distance 15 mm. (c) One LED, LED-to-photodiode distance 15 mm.
controller to enable operation of the device during battery charging (see Fig. 4).
An LiPO battery provides an usable voltage range from 4.2
(fully charged) to 2.7 V (discharged). Since most of the electronic components of the FlexPock need a supply voltage of
more than 3.1 V, a step-up converter (LT1946A, Linear Technology) is used, which boosts the battery output to a constant
voltage of 3.6 V and, thereby, enables the use of the entire battery
capacity. Voltage regulation to 3.3 V is performed by two linear
voltage regulators. One regulator is integrated in the PMIC and
is responsible for the voltage supply of the microcontroller and
the Bluetooth module, while the other one (LT1963ES8-3.3,
Linear Technology) provides a constant reference supply voltage for the sensor part and is free of possible voltage dips caused
by the digital components. Furthermore, this partition enables
the implementation of a standby mode: The microcontroller is
able to switch the sensors OFF and to start them as soon as the
Bluetooth connection to a display unit is established. During
full operation, i.e., Bluetooth transmission at 115 kb/s, sensors
switched ON (sampling at 100 Hz), and LEDs emitting light
at maximum intensity, the power consumption of the device is
1.32 W. In combination with the chosen battery, this results in a
battery operation period of 2.23 h.
E. Data Processing
To reduce the necessary data rate for Bluetooth transmission
and to facilitate display of the physiological parameters on different platforms, calculation of respiratory and pulse rate can be
performed by the devices microcontroller unit. For extraction of
the respiratory rate, the MI signal is used, while the pulse rate
is calculated using the filtered rPPG signal.
Noise cancellation of the MI and the rPPG sensor is performed by a moving average filter of eight elements. For better
efficiency, it is implemented in a recursive form
sM A (k) =
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(1)
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IEEE JOURNAL OF BIOMEDICAL AND HEALTH INFORMATICS, VOL. 19, NO. 3, MAY 2015
TABLE I
PARAMETERS OF THE TESTED COILS
TABLE II
SNR OF THE COIL TEST MEASUREMENTS PRESENTED IN FIG. 6
coil no.
ri
ro
1
2
3
3
5
8
25 mm
25 mm
5 mm
28 mm
30 mm
8 mm
1.44 H
2.85 H
1.82 H
1.25
1.39
1.64
SNR
coil no.1
(L = 1.44 H,
n = 3)
51.8 dB
coil no.2
(L = 2.85 H,
n = 5)
96.2 dB
coil no.3
(L = 1.82 H,
n = 8)
44.7 dB
Fig. 7.
red.
the results of coil no. 1 with those of coil no. 3 shows that the
coils radius also has a significant effect on the sensor signal:
Although coil no. 3 has a higher inductivity, coil no. 2 with the
greater coil area produces a better respiratory signal.
According to these findings, the coil for the final FlexPock
design was chosen to have an outer radius of 30 mm [which is
close to the maximum size that fits into a standard shirt pocket
(approx. 100 mm)] and five windings (providing enough space
within the coil for the components of the rPPG sensor).
B. FEM Simulation of the Induced Current Density and its
Dependence on Coil Deformation
To obtain further information on the physical performance
of MI for thoracic monitoring, simulations based on the FEM
were conducted. In this way, the impact of coil deformation as
expected for a bendable measurement device could be investigated. FEM simulations were done using the ac/dc module
of the COMSOL multiphysics software package (Comsol Inc.,
Burlington, USA).
A simplified thorax model shown in Fig. 7 was composed
of simple three-dimensional geometries. To avoid mathematical
convergence problems, the model was symmetrically arranged.
The thorax is represented by an ellipsoid embedded in a sphere
representing the surrounding air. The coil comprises one turn of
copper (diameter 1 mm) and an outer diameter of 60 mm. It is
driven by an alternating current of Icoil = 1 mA and a frequency
of 30 MHz. Between the coil and thoracic wall, there is an air
gap of 1 mm. Table III summarizes the geometric dimensions
and material properties of the different organs. The electrical
properties of the organs were taken from [13].
In 1968, Tarjan and McFee [4] claimed that MI recordings of
the heart show the best signal quality during maximum inspiration. The authors assumed that due to the distal displacement of
the diaphragm and the lower conductivity of the inflated lung,
TEICHMANN et al.: BENDABLE AND WEARABLE CARDIORESPIRATORY MONITORING DEVICE FUSING TWO NONCONTACT SENSOR
TABLE III
OVERVIEW OF THE GEOMETRIES AND ELECTRICAL PROPERTIES OF THE
OBJECTS APPLIED FOR FEM SIMULATION
object/tissue
environment
thorax
lungs, expired
lungs, inspired
heart
size [mm]
TABLE IV
CALCULATED REFLECTED COIL IMPEDANCES Z c o il FOR THE COIL
TRANSLATIONS SHOWN IN FIG. 9
electrical property
Translation [mm]
0
20
40
60
x-dir.
y-dir.
z-dir.
[S/m]
r [1]
270
220
55
75
90
270
85
55
75
90
270
180
140
160
90
0
0.366
0.49
0.26
0.880
1
71.88
98.851
98.851
134.97
789
Z c o i l []
|Z c o i l | []
14.41 + j26.09
15.68 + j25.96
10.29 + j26.06
7.28 + j26.09
29.805
30.328
28.018
27.087
Fig. 10. Magnetic flux density (B-field) in arrow presentation on the transversal (xy) plane during coil elongation in x-direction by factor (a) 2 and (b) 2.5.
For physical dimensions, see Fig. 7 and Table III. Overlapping regions between
heart and lungs are assigned to heart tissue.
Fig. 8. Absolute value of the induced current density on the frontal (xz) plane
positioned at the center of the heart during (a) expiration (smaller volume and
higher conductivity of the lungs) and (b) inspiration (higher volume and lower
conductivity of the lungs). For physical dimensions, see Fig. 7 and Table III.
Fig. 9. Absolute value of the induced current density on the frontal (xz) plane
positioned at the center of the heart with the coil translated by 0, 20, 40, and
60 mm. For physical dimensions, see Fig. 7 and Table III.
the heart turns more into the focus of the measurement coil. To
validate this hypothesis by means of the FEM facilities available
today, the distribution of the induced current density during lung
expiration and inspiration was simulated and are compared in
Fig. 8(a) and (b), respectively. The intersecting plane lies in the
xz plane (i.e., frontal plane) at the middle of the heart (on the
y-axis).
Both simulations show a distribution of the induced current
density which is concentric around the coil center and has its
maximum value at the hearts surface. Due to the higher conductivity of the expired lung, there are high current densities in
the direct surrounding of the heart and the transition between
the organ boundaries is not well pronounced. In contrast, during inspiration, a much more pronounced change in the current
density distribution is visible, which is caused by the higher
conductivity of the lungs.
Fig. 9 shows the effect of lateral displacement of the coil. The
displacement starts at a central position directly above the heart
and comprises three consecutive translations by 20 mm. As can
be seen, the current density with the coil shifted by 20 mm
Fig. 11. Absolute value of the induced current density on the frontal (xz)
plane positioned at the center of the heart during (a) convex and (b) concave
coil deformation. For physical dimensions, see Fig. 7 and Table III.
Fig. 12.
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IEEE JOURNAL OF BIOMEDICAL AND HEALTH INFORMATICS, VOL. 19, NO. 3, MAY 2015
Fig. 13. Measurement results on a healthy volunteer (subject 4 in Table V) with the FlexPock device placed on the left breast (inside a shirt pocket) during (a)
standing and (b) and (c) sitting posture. In (c), two additional layers of cotton were placed between skin and sensor (total of three layers). (a) Standing posture
(one layer of cotton between skin and sensor). (b) Sitting posture (one layer of cotton between skin and sensor). (c) Sitting posture (three layers of cotton between
skin and sensor).
TEICHMANN et al.: BENDABLE AND WEARABLE CARDIORESPIRATORY MONITORING DEVICE FUSING TWO NONCONTACT SENSOR
TABLE V
PERFORMANCE OF THE MI AND RPPG SENSOR WITH THE DEVICE POSITIONED
ON THE LEFT BREAST (INSIDE A SHIRT POCKET) DURING (A) STANDING AND
(B) AND (C) SITTING POSTURE
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During all measurements, both sensor signals show an inverted characteristic in relation to the reference signals: i.e., the
sensor signals decrease during cardiac systole and during lung
inspiration.
IV. DISCUSSION
In (c) two additional layers of cotton were placed between skin and sensor (total of
three layers).
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IEEE JOURNAL OF BIOMEDICAL AND HEALTH INFORMATICS, VOL. 19, NO. 3, MAY 2015
less motion [14]; this could decrease the signal content obtained
by the rPPG sensor due to respiratory motion.
The fact that both sensors measure both respiration and pulse
could be used to enhance the coverage of respiratory and pulse
rate estimation, i.e., the time during which a parameter extraction is possible. The fusion of two sensors at the same
measurement location offers additional advantages: It allows
to investigate the dependence between different physiological
measures without time lag or mechanical damping caused by
different measurement locations. Such a measure could be the
time-interval between the ejection of the heart (measured by the
MI sensor via cardiac wall motion) and the corresponding arrival of the blood volume in the subcutaneous tissue (measured
by the rPPG sensor). The spatial fusion of both sensors also allows the possibility of motion artifact cancellation, since motion
artifacts will presumably couple in both sensors simultaneously
and to the same extent. However, further verification of these
ideas has to be provided in future investigation.
V. CONCLUSION
The device presented here shows excellent ability to monitor cardiorespiratory activity. Despite several layers of cotton
textile between the sensor and skin, it is still possible to obtain signals suitable for the extraction of respiratory and pulse
rate (MI sensor: SNRresp = 98.5 dB, SNRpulse = 42.2 dB; rPPG
sensor: SNRresp = 62.3 dB, SNRpulse = 27.7 dB). Combining
two noncontact sensor principles and placing them at the same
measurement location allows enhancement of both physiological information and signal quality. It has been shown that it is
likely to happen that the amount of cardiac or respiratory related
signal content of the MI and rPPG sensor changes in dependence
on body posture. Therefore, by fusing both sensor signals, the
coverage rate of the parameter extraction could be enhanced.
Furthermore, physiological measures derived by combinations
of both signals could be monitored. The spatial sensor fusion
enables the use of adaptive motion artifact cancellation techniques because both signals will be affected by the same motion
artifact. Since the device is mobile, wearable, easy to apply, easy
to operate, noncontact, unobtrusive, motion adaptive, and multimodal, it seems to be well suited for on-body sensor networks
in telemonitoring applications.
REFERENCES
[1] D. Teichmann, J. Foussier, J. Jia, S. Leonhardt, and M. Walter, Noncontact monitoring of cardiorespiratory activity by electromagnetic coupling,
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[2] R. Vas, Electronic device for physiological kinetic measurements and
detection of extraneous bodies, IEEE Trans. Biomed. Eng., vol. BME-14,
no. 1, pp. 26, Jan. 1967.
[3] D. L. Wilson and D. B. Geselowitz, Physical principles of the displacement cardiograph including a new device sensitive to variations in torso
resistivity, IEEE Trans. Biomed. Eng., vol. BME-28, no. 10, pp. 702710,
Oct. 1981.
[4] P. P. Tarjan and R. McFee, Electrodeless measurements of the effective
resistivity of the human torso and head by magnetic induction, IEEE
Trans. Biomed. Eng., vol. BME-15, no. 4, pp. 266278, Oct. 1968.
[5] M. G. Pepper, D. J. E. Taylor, and M. C. Kwok, Noninvasive detection of
ventricular wall motion by electromagnetic coupling: Part 2: Experimental, Med. Biol. Eng. Comput., vol. 29, no. 2, pp. 141148, 1991.
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