Tech Review: Wearable Health Monitors

Wearable health monitoring technologies provide real-time sensing of physiological signals, with data delivered via telemetry for monitoring, recording, and transmission for detailed analysis. Such devices are of great interest in the anti-aging clinical specialty, as wearable health monitoring technologies may prove to be a cornerstone in the ability to provide health services to the aging population. Such non-invasive systems provide continuous physiological data, and may reduce healthcare costs by facilitating disease prevention and enhancing the quality of life in the case of disease management.

Great strides have been achieved in the clinical application of wearable health monitoring technologies. These systems are capable of acquiring biological parameters of aging metabolism for very early detection of diseases, such as;

• Body temperature (immune dysfunctions, infectious diseases): Scientists from the Quartermaster Research Institute of the General Logistic Department (China) report that a wearable real-time monitoring system that acquires data on multi-point body temperatures “worked steadily and reliably… to [monitor] and [evaluate] human heat and cold stresses.”
  [Shen Y, Wang T, Li C. “Study on real-time wearable monitoring system for human heat and cold stresses.” Sheng Wu Yi Xue Gong Cheng Xue Za Zhi. 2013 Feb;30(1):80-4, 94.]


• Heart rate & blood pressure (hypertension, heart disease, and stroke): Nippon Telegraph and Telephone Corporation (Japan) team reports that a wearable sensor for heart rate and blood pressure achieves “vital signs with a 1 ms resolution.”
  [Nakamura M, Nakamura J, Lopez G, Shuzo M, Yamada I. “Collaborative processing of wearable and ambient sensor system for blood pressure monitoring.” Sensors (Basel). 2011;11(7):6760-70]


• Cardiorespiratory fitness (cardiovascular status, pulmonary status): Team from Yamaguchi University (Japan) designs a cardiorespuiratory belt sensor system with a “high accuracy QRS detection algorithm …based on the combination of heart rate indicators and morphological ECG features” that measures and calculates heart rate variability .”
  [Adnane M, Jiang Z, Choi S. “Development of QRS detection algorithm designed for wearable cardiorespiratory system.” Comput Methods Programs Biomed. 2009 Jan;93(1):20-31.]


• Blood sugar (Metabolic Syndrome, pre-diabetes, and diabetes): Researchers from University Hospital of North Norway (Norway) devise a smartwatch device that monitors insulin and blood glucose.
  [Arsand E, Muzny M, Bradway M, Muzik J, Hartvigsen G. "Performance of the First Combined Smartwatch and Smartphone Diabetes Diary Application Study." J Diabetes Sci Technol. 2015 Jan 14. pii: 1932296814567708.]


• Glycated hemoglobin [HbA1c] (Metabolic Syndrome, pre-diabetes, and diabetes): Researchers leading the Edinburgh Clinical Trials (United Kingdom) assess HbA1c via “monitors and scales … which use Bluetooth wireless technology to transmit readings via modem to a remote server.”
  [Wild S, Hanley J, Lewis S, McKnight J, McCloughan L, Padfield P, Paterson M, Pinnock H, McKinstry B. “The impact of supported telemetric monitoring in people with type 2 diabetes: study protocol for a randomised controlled trial.” Trials. 2013 Jul 6;14:198. D]


• Electrocardiagram [ECG] (neurological response to stress): Team from University of Boras (Sweden) designs a sensorized garment with 1-channel ECG amplifier to record cardiogenic biopotentials that has “been functionally tested recording cardiogenic biopotential, thoracic impedance, galvanic skin response and temperature values.”
  [Seoane F, Ferreira J, Alvarez L, Buendia R, Ayllón D, Llerena C, Gil-Pita R.
  “Sensorized garments and textrode-enabled measurement instrumentation for ambulatory assessment of the autonomic nervous system response in the ATREC project.” Sensors (Basel). 2013 Jul 12;13(7):8997-9015.]


• Electroencephalogram [EEG] (biofeedback, alertness, learning, meditation, and sleep induction): Measure level of consciousness. Netherlands scientists devise a wearable, wireless EEG sensor platform that measures 8-channels of EEG, described as “a first step towards a fully integrated, fully functional wearable wireless EEG monitoring system.”
  [Brown L, van de Molengraft J, Yazicioglu RF, Torfs T, Penders J, Van Hoof C.”A low- power, wireless, 8-channel EEG monitoring headset.” Conf Proc IEEE Eng Med Biol Soc. 2010;2010:4197-20]


• Acceleration sensor (sleep quality and sleep disorders): Combined acceleration and skin temperature data are important for sleep-wake classification.
  [Sano A, Picard RW. “Comparison of sleep-wake classification using electroencephalogram and wrist-worn multi-modal sensor data.” Conf Proc IEEE Eng Med Biol Soc. 2014 Aug;2014:930-3.]

As P. Bonato, from Harvard Medical School (Massachusetts, USA) observes: “wearable sensors and systems developed over the past decade have provided the tools to finally implement and deploy technology … in the field of patients' home monitoring. Potential applications of these technologies include the early diagnosis of diseases such as congestive heart failure, the prevention of chronic conditions such as diabetes, improved clinical management of neurodegenerative conditions such as Parkinson's disease, and the ability to promptly respond to emergency situations such as seizures in patients with epilepsy and cardiac arrest in subjects undergoing cardiovascular monitoring. “
[Bonato P. “Wearable sensors and systems. From enabling technology to clinical applications.” IEEE Eng Med Biol Mag. 2010 May-Jun;29(3):25-36.]

Wearable health monitoring technology is field-tested for utility for purposes including:

• Assess gait and balance to prevent crippling falls and life-threatening fractures [Schwenk M, Mohler J, Wendel C, D'Huyvetter K, Fain M, Taylor-Piliae R, Najafi B. "Wearable Sensor-Based In-Home Assessment of Gait, Balance, and Physical Activity for Discrimination of Frailty Status: Baseline Results of the Arizona Frailty Cohort Study." Gerontology. 2014 Dec 24.]


• Monitor and manage movement symptoms in Parkinson’s Disease [Cancela J, Pastorino M, Tzallas AT, Tsipouras MG, Rigas G, Arredondo MT, Fotiadis DI. “Wearability assessment of a wearable system for Parkinson's disease remote monitoring based on a body area network of sensors.” Sensors (Basel). 2014 Sep 16;14(9):17235-55.]


• Detect abnormal gait post-stroke
  [O'Keeffe DT, Gates DH, Bonato P. “A wearable pelvic sensor design for drop foot treatment in post-stroke patients.” Conf Proc IEEE Eng Med Biol Soc. 2007;2007:1820- 3.]


• Ascertain declines in motor activity in COPD (chronic obstructive pulmonary disease)
  [Sherrill DM, Moy ML, Reilly JJ, Bonato P. “Using hierarchical clustering methods to classify motor activities of COPD patients from wearable sensor data.” J Neuroeng Rehabil. 2005 Jun 29;2:16.]


• Monitor activities of daily living to enhance quality of life [Kantoch E, Augustyniak P, Markiewicz M, Prusak D "Monitoring activities of daily living based on wearable wireless body sensor network." Conf Proc IEEE Eng Med Biol Soc. 2014 Aug;2014:586-9.]

As progressive as wearable health monitoring devices seem, a handheld medical device that reads vital signs in seconds: the Tricorder is no longer science fiction. "Scanadu Scout" is a tiny, round device, placed on a person’s forehead, that – via its sensors, in a matter of seconds measures heart rate, temperature, blood pressure, oxygen level and provides a complete ECG reading. Data is imported to a smartphone, analyzed and tracked over time. The device is the brainchild of Walter De Brouwer, a Belgian entrepreneur who had to learn how hospitals work -- and don't work -- the hard way after his son suffered brain damage as the consequence of a fall. The Scanadu Scout is one of the ten finalists of the Qualcomm Tricorder X Prize, a contest to create an affordable, handheld device that consumers can use to diagnose their medical conditions at home. After a successful crowdfunding round via Indiegogo, the Scanadu began shipping to backers at the end of January 2015.

Hong Kong researchers astutely observe that: “The world's ageing population has led to an urgent need for long-term and patient-centered healthcare solutions. Hence, there is a growing need for wearable systems for physiologic monitoring.” [Hung K, Lee CC, Chan WM, Choy SO, Kwok P. “Development of a wearable system integrated with novel biomedical sensors for ubiquitous healthcare.” Conf Proc IEEE Eng Med Biol Soc. 2012;2012:5802-5.]

Review prepared by Ronald Klatz, M.D., D.O.