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The noninvasive measurement and sensing of vital bio signs, such as respiration and cardiopulmonary parameters, has become an essential part of the evaluation of a patient's physiological condition. The demand for new technologies that facilitate remote and noninvasive techniques for such measurements continues to grow. While previous research has made strides in the continuous monitoring of vital bio signs using lasers, this paper introduces a novel technique for remote noncontact measurements based on radio frequencies. Unlike laser-based methods, this innovative approach offers the advantage of penetrating through walls and tissues, enabling the measurement of respiration and heart rate. Our method, diverging from traditional radar systems, introduces a unique sensing concept that enables the detection of micro-movements in all directions, including those parallel to the antenna surface. The main goal of this work is to present a novel, simple, and cost-effective measurement tool capable of indicating changes in a subject's condition. By leveraging the unique properties of radio frequencies, this technique allows for the noninvasive monitoring of vital bio signs without the need for physical contact or invasive procedures. Moreover, the ability to penetrate barriers such as walls and tissues opens new possibilities for remote monitoring in various settings, including home healthcare, hospital environments, and even search and rescue operations. In order to validate the effectiveness of this technique, a series of experiments were conducted using a prototype device. The results demonstrated the feasibility of accurately measuring respiration patterns and heart rate remotely, showcasing the potential for real-time monitoring of a patient's physiological parameters. Furthermore, the simplicity and low-cost nature of the proposed measurement tool make it accessible to a wide range of users, including healthcare professionals, caregivers, and individuals seeking to monitor their own health. [ABSTRACT FROM AUTHOR]

The monitoring of hemodynamic parameters, such as heart rate and blood pressure, provides valuable indications of overall cardiovascular health. It is preferable that such monitoring is non-invasive and in real time via an affordable, compact and small-scale device for maximum convenience. Numerous literature sources have exploited derivations of these parameters from photoplethysmogram (PPG) and electrical bioimpedance (EBI) signal measurements through the use of calculation algorithms of varying complexity. Compared to electrocardiogram (ECG), these measurement techniques have a merit of well-established practices of designing a wearable device that could conveniently be put on a wrist. The current paper provides a comprehensive review on the use of PPG and EBI measurement techniques in the context of hemodynamic parameter monitoring using a wearable device. A special emphasis is placed on the most basic hemodynamic parameter—heart rate—describing different algorithms of heart rate detection and monitoring. The last section provides an overview of commercially available and in-home wearable device technologies based on PPG and EBI measurements, their design challenges, and future prospects. [ABSTRACT FROM AUTHOR]

Manual wheelchair users (MWUs) are prone to a sedentary life that can negatively affect their physical and cardiovascular health, making regular assessment important to identify appropriate interventions and lifestyle modifications. One mean of assessing MWUs' physical health is the 6 min push test (6MPT), where the user propels themselves as far as they can in six minutes. However, reliance on observer input introduces subjectivity, while limited quantitative data inhibit comprehensive assessment. Incorporating sensors into the 6MPT can address these limitations. Here, ten MWUs performed the 6MPT with additional sensors: two inertial measurement units (IMUs)—one on the wheelchair and one on the wrist together with a heart rate wristwatch. The conventional measurements of distance and laps were recorded by the observer, and the IMU data were used to calculate laps, distance, speed, and cadence. The results demonstrated that the IMU can provide the metrics of the traditional 6MPT with strong significant correlations between calculated laps and observer lap counts (r = 0.947, p < 0.001) and distances (r = 0.970, p < 0.001). Moreover, heart rate during the final minute was significantly correlated with calculated distance (r = 0.762, p = 0.017). Enhanced 6MPT assessment can provide objective, quantitative, and comprehensive data for clinicians to effectively inform interventions in rehabilitation. [ABSTRACT FROM AUTHOR]

This paper introduces an innovative non-contact heart rate monitoring method based on Wi-Fi Channel State Information (CSI). This approach integrates both amplitude and phase information of the CSI signal through rotational projection, aiming to optimize the accuracy of heart rate estimation in home environments. We develop a frequency domain subcarrier selection algorithm based on Heartbeat to subcomponent ratio (HSR) and design a complete set of signal filtering and subcarrier selection processes to further enhance the accuracy of heart rate estimation. Heart rate estimation is conducted by combining the peak frequencies of multiple subcarriers. Extensive experimental validations demonstrate that our method exhibits exceptional performance under various environmental conditions. The experimental results show that our subcarrier selection method for heart rate estimation achieves an average accuracy of 96.8%, with a median error of only 0.8 bpm, representing an approximately 20% performance improvement over existing technologies. [ABSTRACT FROM AUTHOR]

The use of radar technology for non-contact measurement of vital parameters is increasingly being examined in scientific studies. Based on a systematic literature search in the PubMed, German National Library, Austrian Library Network (Union Catalog), Swiss National Library and Common Library Network databases, the accuracy of heart rate and/or respiratory rate measurements by means of radar technology was analyzed. In 37% of the included studies on the measurement of the respiratory rate and in 48% of those on the measurement of the heart rate, the maximum deviation was 5%. For a tolerated deviation of 10%, the corresponding percentages were 85% and 87%, respectively. However, the quantitative comparability of the results available in the current literature is very limited due to a variety of variables. The elimination of the problem of confounding variables and the continuation of the tendency to focus on the algorithm applied will continue to constitute a central topic of radar-based vital parameter measurement. Promising fields of application of research can be found in particular in areas that require non-contact measurements. This includes infection events, emergency medicine, disaster situations and major catastrophic incidents. [ABSTRACT FROM AUTHOR]

A low-power long-term ambulatory ECG monitor was developed for the acquisition, storage and processing of three simultaneous leads DI, aVF and V2 with a beat-to-beat heart rate measurement in real time. It provides long-term continuous ECG recordings until 84 h. The monitor uses a QRS complex detection algorithm based on the continuous wavelet transform with splines, which automatically selects the scale for the analysis of ECG records with different sampling frequencies. It includes a lead-off detection to continuously monitor the electrode connections and a real-time system of visual and acoustic alarms to alert users of abnormal conditions in its operation. The monitor presented is based in an ADS1294 analogue front end with four channels, 24-bit analog-to-digital converters and programmable gain amplifiers, a low-power dual-core ESP32 microcontroller, a microSD memory for data storage in a range of 4 GB to 32 GB and a 1.4 in thin-film transistor liquid crystal display (LCD) variant with a resolution of 128 × 128 pixels. It has programmable sampling rates of 250, 500 and 1000 Hz; a bandwidth of 0 Hz to 50% of the selected sampling rate; a CMRR of −105 dB; an input margin of ±2.4 V; a resolution of 286 nV; and a current consumption of 50 mA for an average battery life of 84 h. The ambulatory ECG monitor was evaluated with the commercial data-acquisition system BIOPAC MP36 and its module for ECG LABEL SS2LB, simultaneously comparing the morphologies of two ECG records and obtaining a correlation of 91.78%. For the QRS detection in real time, the implemented algorithm had an error less than 5%. The developed ambulatory ECG monitor can be used for the analysis of the dynamics of the heart rate variability in long-term ECG records and for the development of one's own databases of ECG recordings of normal subjects and patients with cardiovascular and noncardiovascular diseases. [ABSTRACT FROM AUTHOR]

Cardio-mechanical monitoring techniques, such as Seismocardiography (SCG) and Gyrocardiography (GCG), have received an ever-growing interest in recent years as potential alternatives to Electrocardiography (ECG) for heart rate monitoring. Wearable SCG and GCG devices based on lightweight accelerometers and gyroscopes are particularly appealing for continuous, long-term monitoring of heart rate and its variability (HRV). Heartbeat detection in cardio-mechanical signals is usually performed with the support of a concurrent ECG lead, which, however, limits their applicability in standalone cardio-mechanical monitoring applications. The complex and variable morphology of SCG and GCG signals makes the ECG-free heartbeat detection task quite challenging; therefore, only a few methods have been proposed. Very recently, a template matching method based on normalized cross-correlation (NCC) has been demonstrated to provide very accurate detection of heartbeats and estimation of inter-beat intervals in SCG and GCG signals of pathological subjects. In this study, the accuracy of HRV indices obtained with this template matching method is evaluated by comparison with ECG. Tests were performed on two public datasets of SCG and GCG signals from healthy and pathological subjects. Linear regression, correlation, and Bland-Altman analyses were carried out to evaluate the agreement of 24 HRV indices obtained from SCG and GCG signals with those obtained from ECG signals, simultaneously acquired from the same subjects. The results of this study show that the NCC-based template matching method allowed estimating HRV indices from SCG and GCG signals of healthy subjects with acceptable accuracy. On healthy subjects, the relative errors on time-domain indices ranged from 0.25% to 15%, on frequency-domain indices ranged from 10% to 20%, and on non-linear indices were within 8%. The estimates obtained on signals from pathological subjects were affected by larger errors. Overall, GCG provided slightly better performances as compared to SCG, both on healthy and pathological subjects. These findings provide, for the first time, clear evidence that monitoring HRV via SCG and GCG sensors without concurrent ECG is feasible with the NCC-based template matching method for heartbeat detection. [ABSTRACT FROM AUTHOR]

Unobtrusive monitoring of children's heart rate (HR) and respiratory rate (RR) can be valuable for promoting the early detection of potential health issues, improving communication with healthcare providers and reducing unnecessary hospital visits. A promising solution for wireless vital sign monitoring is radar technology. This paper presents a novel approach for the simultaneous estimation of children's RR and HR utilizing ultra-wideband (UWB) radar using a deep transfer learning algorithm in a cohort of 55 children. The HR and RR are calculated by processing radar signals via spectrogram from time epochs of 10 s (25 sample length of hamming window with 90% overlap) and then transforming the resultant representation into 2-dimensional images. These images were fed into a pre-trained Visual Geometry Group-16 (VGG-16) model (trained on ImageNet dataset), with weights of five added layers fine-tuned using the proposed data. The prediction on the test data achieved a mean absolute error (MAE) of 7.3 beats per minute (BPM < 6.5% of average HR) and 2.63 breaths per minute (BPM < 7% of average RR). We also achieved a significant Pearson's correlation of 77% and 81% between true and extracted for HR and RR, respectively. HR and RR samples are extracted every 10 s. [ABSTRACT FROM AUTHOR]

Background: Heart rate is an essential diagnostic parameter indicating a patient's condition. The assessment of heart rate is also a crucial parameter in the diagnostics of various sleep disorders, including sleep apnoea, as well as sleep/wake pattern analysis. It is usually measured using an electrocardiograph (ECG)—a device monitoring the electrical activity of the heart using several electrodes attached to a patient's upper body—or photoplethysmography (PPG). Methods: The following paper investigates an alternative method for heart rate detection and monitoring that operates on tracheal audio recordings. Datasets for this research were obtained from six participants along with ECG Holter (for validation), as well as from fifty participants undergoing a full night polysomnography testing, during which both heart rate measurements and audio recordings were acquired. Results: The presented method implements a digital filtering and peak detection algorithm applied to audio recordings obtained with a wireless sensor using a contact microphone attached in the suprasternal notch. The system was validated using ECG Holter data, achieving over 92% accuracy. Furthermore, the proposed algorithm was evaluated against whole-night polysomnography-derived HR using Bland-Altman's plots and Pearson's Correlation Coefficient, reaching the average of 0.82 (0.93 maximum) with 0 BPM error tolerance and 0.89 (0.97 maximum) at ±3 BPM. Conclusions: The results prove that the proposed system serves the purpose of a precise heart rate monitoring tool that can conveniently assess HR during sleep as a part of a home-based sleep disorder diagnostics process. [ABSTRACT FROM AUTHOR]

Motivation: The advancement of preventive medicine and, subsequently, telemedicine drives the need for noninvasive and remote measurements in patients' natural environments. Heart rate (HR) measurements are particularly promising and extensively researched due to their quick assessment and comprehensive representation of patients' conditions. However, in scenarios such as endurance training or emergencies, where HR measurement was not anticipated and direct access to victims is limited, no method enables obtaining HR results that are suitable even for triage. Methods: This paper presents the possibility of remotely measuring of human HR from a series of in-flight videos using videoplethysmography (VPG) along with skin detection, human pose estimation and image stabilization methods. An unmanned aerial vehicle (UAV) equipped with a camera captured ten segments of video footage featuring volunteers engaged in free walking and running activities in natural sunlight. The human pose was determined using the OpenPose algorithm, and subsequently, skin areas on the face and forearms were identified and tracked in consecutive frames. Ultimately, HR was estimated using several VPG methods: the green channel (G), green-red difference (GR), excess green (ExG), independent component analysis (ICA), and a plane orthogonal to the skin (POS). Results: When compared to simultaneous readings from a reference ECG-based wearable recorder, the root-mean-squared error ranged from 17.7 (G) to 27.7 (POS), with errors of less than 3.5 bpm achieved for the G and GR methods. Conclusions: These results demonstrate the acceptable accuracy of touchless human pulse measurement with the accompanying UAV-mounted camera. The method bridges the gap between HR-transmitting wearables and emergency HR recorders, and it has the potential to be advantageous in training or rescue scenarios in mountain, water, disaster, or battlefield settings. [ABSTRACT FROM AUTHOR]

Background: Lung carcinoma is one of the most common malignancies worldwide. At present, unfortunately, there are no markers that would allow early identification of this tumor in the preclinical or early clinical stage. The use of sniffer dogs has been reported to show some promise in early diagnosis of this type of cancer Aim: This study aimed to evaluate the possibility of utilizing changes in the heart rate of sniffer dogs (which increases when finding a positive sample) in tumor detection. Methods: This double-blinded pilot study included two sniffer dogs. A chest strap was fastened on the dog's chests for heart rate monitoring while they were examining samples and heart rate was recorded. Test parameters (sensitivity, specificity, positive and negative predictive values) were then calculated, evaluating performances based on (i) the dog's indications according to their training and (ii) the changes in their heart rates. Results: Calculation according to the dog's indications revealed an overall sensitivity of 95.2% accompanied by a specificity of 81.8%, a PPV of 93.7%, and an NPV of 85.7%, respectively. These results were not significantly different from those evaluated by heart rate; heart rate monitoring was, however, burdened with a relatively high proportion of invalid experiments in which heart rate measurement failed. When the method of calculation was changed from rounds to individual samples, the test parameters further increased. Conclusions: This pilot study confirmed the hypothesis that heart rate increases in trained sniffer dogs when encountering samples from tumor-positive patients but remains unchanged when only negative samples are present. The reliability of results based on heart rate increase is similar to that obtained by a dog's indications and, if the limitation represented by technical issues is overcome, it could serve as a valuable verification method. [ABSTRACT FROM AUTHOR]

Cardiovascular diseases (CVDs) remain a leading cause of death globally. According to the American Heart Association, approximately 19.1 million deaths were attributed to CVDs in 2020, in particular, ischemic heart disease and stroke. Several known risk factors for CVDs include smoking, alcohol consumption, lack of regular physical activity, and diabetes. The last decade has been characterized by widespread diffusion in the use of wristband-style wearable devices which can monitor and collect heart rate data, among other information. Wearable devices allow the analysis and interpretation of physiological and activity data obtained from the wearer and can therefore be used to monitor and prevent potential CVDs. However, these data are often provided in a manner that does not allow the general user to immediately comprehend possible health risks, and often require further analytics to draw meaningful conclusions. In this paper, we propose a disentangled variational autoencoder (β-VAE) with a bidirectional long short-term memory network (BiLSTM) backend to detect in an unsupervised manner anomalies in heart rate data collected during sleep time with a wearable device from eight heterogeneous participants. Testing was performed on the mean heart rate sampled both at 30 s and 1 min intervals. We compared the performance of our model with other well-known anomaly detection algorithms, and we found that our model outperformed them in almost all considered scenarios and for all considered participants. We also suggest that wearable devices may benefit from the integration of anomaly detection algorithms, in an effort to provide users more processed and straightforward information. [ABSTRACT FROM AUTHOR]

An elevated heart rate at admission or discharge is known to be associated with poor cardiovascular outcomes in patients with acute myocardial infarction (AMI). The association between post-discharge average office-visit heart rate and cardiovascular outcomes in patients with AMI has rarely been studied. We analyzed data for 7840 patients from the COREA-AMI registry who had their heart rates measured at least three times after hospital discharge. The office-visit heart rates were averaged and categorized into four groups by quartiles (<68, 68–74, 74–80, and >80 beats per minute). The primary end point was a composite of cardiovascular death, myocardial infarction, and ischemic stroke. During a median of 5.7 years of follow-up, major adverse cardiovascular events (MACE) affected 1357 (17.3%) patients. An average heart rate higher than 80 bpm was associated with an increased incidence of MACE compared to the reference average heart rate of 68–74 bpm. When dichotomized into <74 or ≥74 bpm, a lower average heart rate was not associated with MACE in patients with LV systolic dysfunction, in contrast to those without LV systolic dysfunction. An elevated average heart rate at office visits after AMI was associated with an increased risk of cardiovascular outcomes. Heart rate monitoring at office visits after discharge provides an important predictor related to cardiovascular events. [ABSTRACT FROM AUTHOR]

Working on elevated surfaces without prior experience can be dangerous, particularly for young people, who are significantly more at risk of developing fear and anxiety, which might lead to falls and fatalities. This critical problem has, however, received limited research attention. The present study aimed to demonstrate the associations among physiological responses, fear, and anxiety in Thai teenagers at various height levels. Sixty teenagers (30 males and 30 females) between the ages of 15 and 18 who had no labor skills were recruited to perform the task at 11 levels, starting at zero meters and increasing by one meter at each level. The measurements were examined and recorded once the task at each level was finished. The main results indicated that heart rate was partially positively associated with mean arterial pressure, fear, and anxiety (with all p values < 0.001) in all teenagers (after controlling for level and sex), as well as male and female teenagers (after controlling for level). The present study suggested monitoring heart rate data in teenagers conducting activities at heights, which can be triggered by fear and anxiety, as a strategy for preventing falls from height hazards. [ABSTRACT FROM AUTHOR]

Heart rate monitoring is especially important for aging individuals because it is associated with longevity and cardiovascular risk. Typically, this vital parameter can be measured using wearable sensors, which are widely available commercially. However, wearable sensors have some disadvantages in terms of acceptability, especially when used by elderly people. Thus, contactless solutions have increasingly attracted the scientific community in recent years. Camera-based photoplethysmography (also known as remote photoplethysmography) is an emerging method of contactless heart rate monitoring that uses a camera and a processing unit on the hardware side, and appropriate image processing methodologies on the software side. This paper describes the design and implementation of a novel pipeline for heart rate estimation using a commercial and low-cost camera as the input device. The pipeline's performance was tested and compared on a desktop PC, a laptop, and three different ARM-based embedded platforms (Raspberry Pi 4, Odroid N2+, and Jetson Nano). The results showed that the designed and implemented pipeline achieved an average accuracy of about 96.7% for heart rate estimation, with very low variance (between 1.5% and 2.5%) across processing platforms, user distances from the camera, and frame resolutions. Furthermore, benchmark analysis showed that the Odroid N2+ platform was the most convenient in terms of CPU load, RAM usage, and average execution time of the algorithmic pipeline. [ABSTRACT FROM AUTHOR]

Wearable Heart Rate monitors are used in sports to provide physiological insights into athletes' well-being and performance. Their unobtrusive nature and ability to provide reliable heart rate measurements facilitate the estimation of cardiorespiratory fitness of athletes, as quantified by maximum consumption of oxygen uptake. Previous studies have employed data-driven models which use heart rate information to estimate the cardiorespiratory fitness of athletes. This signifies the physiological relevance of heart rate and heart rate variability for the estimation of maximal oxygen uptake. In this work, the heart rate variability features that were extracted from both exercise and recovery segments were fed to three different Machine Learning models to estimate maximal oxygen uptake of 856 athletes performing Graded Exercise Testing. A total of 101 features from exercise and 30 features from recovery segments were given as input to three feature selection methods to avoid overfitting of the models and to obtain relevant features. This resulted in the increase of model's accuracy by 5.7% for exercise and 4.3% for recovery. Further, post-modelling analysis was performed to remove the deviant points in two cases, initially in both training and testing and then only in training set, using k-Nearest Neighbour. In the former case, the removal of deviant points led to a reduction of 19.3% and 18.0% in overall estimation error for exercise and recovery, respectively. In the latter case, which mimicked the real-world scenario, the average R value of the models was observed to be 0.72 and 0.70 for exercise and recovery, respectively. From the above experimental approach, the utility of heart rate variability to estimate maximal oxygen uptake of large population of athletes was validated. Additionally, the proposed work contributes to the utility of cardiorespiratory fitness assessment of athletes through wearable heart rate monitors. [ABSTRACT FROM AUTHOR]

Time-series features are the characteristics of data periodically collected over time. The calculation of time-series features helps in understanding the underlying patterns and structure of the data, as well as in visualizing the data. The manual calculation and selection of time-series feature from a large temporal dataset are time-consuming. It requires researchers to consider several signal-processing algorithms and time-series analysis methods to identify and extract meaningful features from the given time-series data. These features are the core of a machine learning-based predictive model and are designed to describe the informative characteristics of the time-series signal. For accurate stress monitoring, it is essential that these features are not only informative but also well-distinguishable and interpretable by the classification models. Recently, a lot of work has been carried out on automating the extraction and selection of times-series features. In this paper, a correlation-based time-series feature selection algorithm is proposed and evaluated on the stress-predict dataset. The algorithm calculates a list of 1578 features of heart rate and respiratory rate signals (combined) using the tsfresh library. These features are then shortlisted to the more specific time-series features using Principal Component Analysis (PCA) and Pearson, Kendall, and Spearman correlation ranking techniques. A comparative study of conventional statistical features (like, mean, standard deviation, median, and mean absolute deviation) versus correlation-based selected features is performed using linear (logistic regression), ensemble (random forest), and clustering (k-nearest neighbours) predictive models. The correlation-based selected features achieved higher classification performance with an accuracy of 98.6% as compared to the conventional statistical feature's 67.4%. The outcome of the proposed study suggests that it is vital to have better analytical features rather than conventional statistical features for accurate stress classification. [ABSTRACT FROM AUTHOR]

The market for wrist-worn devices is growing at previously unheard-of speeds. A consequence of their fast commercialization is a lack of adequate studies testing their accuracy on varied populations and pursuits. To provide an understanding of wearable sensors for sports medicine, the present study examined heart rate (HR) measurements of four popular wrist-worn devices, the (Fitbit Charge (FB), Apple Watch (AW), Tomtom runner Cardio (TT), and Samsung G2 (G2)), and compared them with gold standard measurements derived by continuous electrocardiogram examination (ECG). Eight athletes participated in a comparative study undergoing maximal stress testing on a cycle ergometer or a treadmill. We analyzed 1,286 simultaneous HR data pairs between the tested devices and the ECG. The four devices were reasonably accurate at the lowest activity level. However, at higher levels of exercise intensity the FB and G2 tended to underestimate HR values during intense physical effort, while the TT and AW devices were fairly reliable. Our results suggest that HR estimations should be considered cautiously at specific intensities. Indeed, an effective intervention is required to register accurate HR readings at high-intensity levels (above 150 bpm). It is important to consider that even though none of these devices are certified or sold as medical or safety devices, researchers must nonetheless evaluate wrist-worn wearable technology in order to fully understand how HR affects psychological and physical health, especially under conditions of more intense exercise. [ABSTRACT FROM AUTHOR]

Frequency-modulated continuous wave (FMCW) radars are currently being investigated for remote vital signs monitoring (measure of respiration and heart rates) as an innovative wireless solution for healthcare and ambient assisted living. However, static reflectors (furniture, objects, stationary body parts, etc.) within the range or range angular bin where the subject is present contribute in the Doppler signal to a direct current (DC) offset. The latter is added to the person's information, containing also a useful DC component, causing signal distortion and hence reducing the accuracy in measuring the vital sign parameters. Removing the sole contribution of the unwanted DC offset is fundamental to perform proper phase demodulation, so that accurate vital signs monitoring can be achieved. In this work, we analyzed different DC offset calibration methods to determine which one achieves the highest accuracy in measuring the physiological parameters as the transmitting frequency varies. More precisely, by using two FMCW radars, operating below 10 GHz and at millimeter wave (mmWave), we applied four DC offset calibration methods to the baseband radar signals originated by the cardiopulmonary activities. We experimentally determined the accuracy of the methods by measuring the respiration and the heart rates of different subjects in an office setting. It was found that the linear demodulation outperforms the other methods if operating below 10 GHz while the geometric fitting provides the best results at mmWave. [ABSTRACT FROM AUTHOR]

Real-time monitoring of heart rate is useful for monitoring workers. Wearable heart rate monitors worn on the upper body are less susceptible to artefacts caused by arm and wrist movements than popular wristband-type sensors using the photoplethysmography method. Therefore, they are considered suitable for stable and accurate measurement for various movements. In this study, we conducted an experiment to verify the accuracy of our developed and commercially available wearable heart rate monitor consisting of a smart shirt with bioelectrodes and a transmitter, assuming a real-world work environment with physical loads. An exercise protocol was designed to light to moderate intensity according to international standards because no standard exercise protocol for the validation simulating these works has been reported. This protocol includes worker-specific movements such as applying external vibration and lifting and lowering loads. In the experiment, we simultaneously measured the instantaneous heart rate with the above wearable device and a Holter monitor as a reference to evaluate mean absolute percentage error (MAPE). The MAPE was 0.92% or less for all exercise protocols conducted. This value indicates that the accuracy of the wearable device is high enough for use in real-world cases of physical load in light to moderate intensity tasks such as those in our experimental protocol. In addition, the experimental protocol and measurement data devised in this study can be used as a benchmark for other wearable heart rate monitors for use for similar purposes. [ABSTRACT FROM AUTHOR]

(1) Background: Cervical spinal cord injury (SCI) patients have impairment in the autonomic nervous system, reflected in the cardiovascular adaption level during the performance of upper limb (UL) activities carried out in the rehabilitation process. This adaption level could be measured from the heart rate (HR) by means of wearable technologies. Therefore, the objective was to analyze the feasibility of using Xiaomi Mi Band 5 wristband (XMB5) for HR monitoring in these patients during the performance of UL activities; (2) Methods: The HR measurements obtained from XMB5 were compared to those obtained by the professional medical equipment Nonin LifeSense II capnograph and pulse oximeter (NLII) in static and dynamic conditions. Then, four healthy people and four cervical SCI patients performed a UL training based on six experimental sessions; (3) Results: the correlation between the HR measurements from XMB5 and NLII devices was strong and positive in healthy people (r = 0.921 and r = 0.941 (p < 0.01) in the static and dynamic conditions, respectively). Then, XMB5 was used within the experimental sessions, and the HR oscillation range measured was significantly higher in healthy individuals than in patients; (4) Conclusions: The XMB5 seems to be feasible for measuring the HR in this biomedical application in SCI patients. [ABSTRACT FROM AUTHOR]

Heart rate at rest and exercise may predict cardiovascular risk. Heart rate variability is a measure of variation in time between each heartbeat, representing the balance between the parasympathetic and sympathetic nervous system and may predict adverse cardiovascular events. With advances in technology and increasing commercial interest, the scope of remote monitoring health systems has expanded. In this review, we discuss the concepts behind cardiac signal generation and recording, wearable devices, pros and cons focusing on accuracy, ease of application of commercial and medical grade diagnostic devices, which showed promising results in terms of reliability and value. Incorporation of artificial intelligence and cloud based remote monitoring have been evolving to facilitate timely data processing, improve patient convenience and ensure data security. [ABSTRACT FROM AUTHOR]

Simple Summary: Knowledge of internal load is essential to understand the effect of training and competition on athletes. The aim of this study was to analyse the rate of perceived exertion (RPE) scale as an indicator of intensity in amateur basketball players during a relegation play-off. The heart rate and RPE of 10 players from a Copa Catalunya team while competing over a 10-day period were analysed. There was an improvement in the relationship between the two variables from the first to the last match. The results suggest that RPE could be seen as an indicator of intensity in amateur basketball players during a relegation play-off, improving their relationship with MHR as the weeks went by, which could suggest a learning process. Knowledge of internal load is essential to understand the effect of training and competition on athletes. The aim of this study was to analyse the validity of the rate of perceived exertion (RPE) scale as an indicator of intensity in amateur female basketball players during a relegation play-off. The heart rate and RPE of 10 players (age: 21.30 ± 2.71 years, weight: 68.84 ± 11.21 kg, body fat: 20.74 ± 3.51%) from a Copa Catalunya team while competing over a 10-day period were analysed. The mean heart rate of each match was registered with the Suunto Team Pack™ heart rate monitors. The RPE values were obtained once the match ended, completing the original Borg scale. The mean RPE ranged from 15.20 ± 2.39 to 18.00 ± 1.07 AU, whereas the mean heart rate (MHR) ranged from 132.35 ± 12.37 to 147.33 ± 10.61 bpm. There was also an improvement in the statistical correlation between the two variables as the days progressed. Regression equations were calculated for the total number of registered matches and the last five matches, obtaining the following regression equations: MHR = 6.23 × RPE20 + 36.8 (R2 = 0.56) for all games and MHR = 30.95 + 6.73 × RPE (R2 = 0.73) for the last five games. The results suggest that RPE could be seen as an indicator of intensity in amateur basketball players during a relegation play-off, improving their relationship with MHR as the weeks went by, which could suggest a learning process. [ABSTRACT FROM AUTHOR]

The demand for wearable devices to simultaneously monitor heart rate (HR) and respiratory rate (RR) values has grown due to the incidence increase in cardiovascular and respiratory diseases. The use of inertial measurement unit (IMU) sensors, embedding both accelerometers and gyroscopes, may ensure a non-intrusive and low-cost monitoring. While both accelerometers and gyroscopes have been assessed independently for both HR and RR monitoring, there lacks a comprehensive comparison between them when used simultaneously. In this study, we used both accelerometers and gyroscopes embedded in a single IMU sensor for the simultaneous monitoring of HR and RR. The following main findings emerged: (i) the accelerometer outperformed the gyroscope in terms of accuracy in both HR and RR estimation; (ii) the window length used to estimate HR and RR values influences the accuracy; and (iii) increasing the length over 25 s does not provide a relevant improvement, but accuracy improves when the subject is seated or lying down, and deteriorates in the standing posture. Our study provides a comprehensive comparison between two promising systems, highlighting their potentiality for real-time cardiorespiratory monitoring. Furthermore, we give new insights into the influence of window length and posture on the systems' performance, which can be useful to spread this approach in clinical settings. [ABSTRACT FROM AUTHOR]

Respiratory and heart rates are among the most important physiological parameters used to monitor patients' health. It is important to design devices that can measure these parameters without risking or altering the subject's health. In this context, a novel sensing method to monitor simultaneously the heartbeat and respiratory rate signals of patients within an electrically safety environment was developed and tested. An optical fiber-based sensor was used in order to detect two optical phenomena. Photo-plethysmography and the relation between bending radius and attenuation of optical fiber were coupled through a single beam light traveling along this fiber. [ABSTRACT FROM AUTHOR]

Since its inception in 2013, Bluetooth Low Energy (BLE) has become the standard for short-distance wireless communication in many consumer devices, as well as special-purpose devices. In this study, we analyze the security features available in Bluetooth LE standards and evaluate the features implemented in two BLE wearable devices (a Fitbit heart rate wristband and a Polar heart rate chest wearable) and a BLE keyboard to explore which security features in the BLE standards are implemented in the devices. In this study, we used the ComProbe Bluetooth Protocol Analyzer, along with the ComProbe software to capture the BLE traffic of these three devices. We found that even though the standards provide security mechanisms, because the Bluetooth Special Interest Group does not require that manufacturers fully comply with the standards, some manufacturers fail to implement proper security mechanisms. The circumvention of security in Bluetooth devices could leak private data that could be exploited by rogue actors/hackers, thus creating security, privacy, and, possibly, safety issues for consumers and the public. We propose the design of a Bluetooth Security Facts Label (BSFL) to be included on a Bluetooth/BLE enabled device's commercial packaging and conclude that there should be better mechanisms for informing users about the security and privacy provisions of the devices they acquire and use and to educate the public on protection of their privacy when buying a connected device. [ABSTRACT FROM AUTHOR]

This paper presents an algorithm for real-time detection of the heart rate measured on a person's wrist using a wearable device with a photoplethysmographic (PPG) sensor and accelerometer. The proposed algorithm consists of an appropriately trained LSTM network and the Time-Domain Heart Rate (TDHR) algorithm for peak detection in the PPG waveform. The Long Short-Term Memory (LSTM) network uses the signals from the accelerometer to improve the shape of the PPG input signal in a time domain that is distorted by body movements. Multiple variants of the LSTM network have been evaluated, including taking their complexity and computational cost into consideration. Adding the LSTM network caused additional computational effort, but the performance results of the whole algorithm are much better, outperforming the other algorithms from the literature. [ABSTRACT FROM AUTHOR]

The possibility of using a smartwatch as a rehabilitation tool to monitor patients' heart rates during exercise has gained the attention of many researchers. This study aimed to evaluate the accuracy and precision of the HR measurement performed by two wrist monitors: the Fitbit Charge 4 and the Xiaomi Mi Band 5. Thirty-one healthy volunteers were asked to perform a stress test on a treadmill. Their heart rates were recorded simultaneously by the wristbands and an electrocardiogram (ECG) at 1 min intervals. The mean absolute error percentage (MAPE), Lin's concordance correlation coefficient (LCCC), and Bland–Altman analysis were calculated to compare the precision and accuracy of heart rate measurements. The estimated validation criteria were MAPE < 10% and LCCC < 0.8. The overall MAPE and LCCC of the Fitbit were 10.19% (±11.79%) and 0.753 (95% CI: 0.717–0.785), respectively. The MAPE and LCCC of the Xiaomi were 6.89% (±9.75) and 0.903 (0.886–0.917), respectively. The precision and accuracy of both devices decreased with the increased exercise intensity. The accuracy of wearable wrist-worn heart rate monitors varies and depends on the intensity of training. Therefore, the decision to use such a device as a heart rate monitor during in-home rehabilitation should be made with caution. [ABSTRACT FROM AUTHOR]

Heart rate (HR) and heart rate variability (HRV) based physiological metrics such as Excess Post-exercise Oxygen Consumption (EPOC), Energy Expenditure (EE), and Training Impulse (TRIMP) are widely utilized in coaching to monitor and optimize an athlete's training load. Chest straps, and recently also dry electrodes integrated to special sports vests, are used to monitor HR during sports. Mechanical design, placement of electrodes, and ergonomics of the sensor affect the measured signal quality and artefacts. To evaluate the impact of the sensor mechanical design on the accuracy of the HR/HRV and further on to estimation of EPOC, EE, and TRIMP, we recorded HR and HRV from a chest strap and a vest with the same ECG sensor during supervised exercise protocol. A 3-lead clinical Holter ECG was used as a reference. Twenty-five healthy subjects (six females) participated. Mean absolute percentage error (MAPE) for HR was 0.76% with chest strap and 3.32% with vest. MAPE was 1.70% vs. 6.73% for EE, 0.38% vs. 8.99% for TRIMP and 3.90% vs. 54.15% for EPOC with chest strap and vest, respectively. Results suggest superior accuracy of chest strap over vest for HR and physiological metrics monitoring during sports. [ABSTRACT FROM AUTHOR]

Accelerations (ACC) and decelerations (DEC) are important and frequent actions in soccer. We aimed to investigate whether ACC and DEC were good indicators of the variation of training loads in elite women soccer players. Changes in the training load were monitored during two different selected weeks (considered a "low week" and a "heavy week") during the in-season. Twelve elite soccer women playing in the French first division wore a 10-Hz Global Positioning System unit recording total distance, distance within speed ranges, sprint number, ACC, DEC, and a heart rate monitor during six soccer training sessions and rated their perceived exertion (RPE). They answered the Hooper questionnaire (sleep, stress, fatigue, DOMS) to get an insight of their subjective fitness level at the start (Hooper S) and at the end of each week (Hooper E). A countermovement jump (CMJ) was also performed once a week. During the heavy week, the training load was significantly greater than the low week when considering number of ACC >2 m·s−2 (28.2 ± 11.9 vs. 56.1 ± 10.1, p < 0.001) and number of DEC < −2 m·s−2 (31.5 ± 13.4 vs. 60.9 ± 14.4, p < 0.001). The mean heart rate percentage (HR%) (p < 0.05), RPE (p < 0.001), and Hooper E (p < 0.001) were significantly greater during the heavy week. ACC and DEC showed significant correlations with most outcomes: HR%, total distance, distance per min, sprint number, Hooper index of Hooper E, DOMS E, Fatigue E, RPE, and session RPE. We concluded that, for elite women soccer players, quantifying ACC and DEC alongside other indicators seemed to be essential for a more complete training load monitoring. Indeed, it could lead to a better understanding of the reasons why athletes get fatigued and give insight into neuromuscular, rather than only energetic, fatigue. [ABSTRACT FROM AUTHOR]

Smoke inhalation poses a serious health threat to firefighters (FFs), with potential effects including respiratory and cardiac disorders. In this work, environmental and physiological data were collected from FFs, during experimental fires performed in 2015 and 2019. Extending a previous work, which allowed us to conclude that changes in heart rate (HR) were associated with alterations in the inhalation of carbon monoxide (CO), we performed a HR analysis according to different levels of CO exposure during firefighting based on data collected from three FFs. Based on HR collected and on CO occupational exposure standards (OES), we propose a classifier to identify CO exposure levels through the HR measured values. An ensemble of 100 bagged classification trees was used and the classification of CO levels obtained an overall accuracy of 91.9%. The classification can be performed in real-time and can be embedded in a decision fire-fighting support system. This classification of FF' exposure to critical CO levels, through minimally-invasive monitored HR, opens the possibility to identify hazardous situations, preventing and avoiding possible severe problems in FF' health due to inhaled pollutants. The obtained results also show the importance of future studies on the relevance and influence of the exposure and inhalation of pollutants on the FF' health, especially in what refers to hazardous levels of toxic air pollutants. [ABSTRACT FROM AUTHOR]

Simple Summary: The increase in the heart rate and various heart parameters play an important role in assessing the fitness of sport horses. The fitness of a horse, that particular horse's competition routine, and the resulting lower stress affect various cardiac parameters. The aim of this study was to examine the effect of the phases of competition (warm-up, resting period, show jumping course riding, cool-down) and the difficulty of a course (100, 120, 130 cm) on the heart rate and selected heart rate variability parameters of show jumping horses. The heart rate was monitored with a "Polar Equine heart rate monitor" before, during, and after a show jumping course was completed. Neither analysis of the average heart rate nor that of the maximum heart rate were able to detect a statistically proven difference among competition levels. In contrast, according to heart rate variability measures, such as maximum RR intervals, SD1, RMSSD, pNN50, and %VLF picked up differences in workload level. It has been confirmed that lower-class show jumping (up to 120 cm height) is not a strenuous exercise for horses. Heart rate is one of the gold standards used to assess the workload level and fitness of horses. However, when slight differences need to be detected, it is not sensitive enough. Therefore, the aim of this study was to test the effect of competition level and phase of exercise on the heart rate and heart rate variability parameters in show jumpers. Fourteen horses were examined competing on three different levels: 100 cm (n = 4), 120 cm (n = 6), and 130 cm (n = 4). The length of work (min); average and maximum heart rate; average, maximum and minimum RR intervals (ms); SD1 and SD2 (ms); RMSSD (ms) and pNN50 (%); VLF, LF, HF (%) were analyzed. The measurement was divided into four phases: warm-up, resting period, show jumping course riding, and cool-down. The level of the course had no significant effect on average and maximum heart rates throughout the entire exercise. The maximum RR interval, RMSSD, pNN50, SD1, and %VLF values were significantly different (p < 0.05) in horses competing at 100 cm height from those competing in the 120 cm group. The SD1 value was sensitive for the level of competition, while the SD2 parameter was sensitive for detecting exercise phases. In conclusion, heart rate variability parameters are more sensitive for detecting smaller differences in workload than heart rate alone in lower-level show jumpers. [ABSTRACT FROM AUTHOR]

In capturing high-quality photoplethysmographic signals, it is crucial to ensure that appropriate illumination intensities are used. The purpose of the study was to deliver controlled illumination intensities for a multi-wavelength opto-electronic patch sensor that has four separate arrays each consisting of four light-emitting diodes (LEDs), the wavelength of the light generated by each array being different. The study achieved the following: (1) a linear constant current source LED driver incorporating series negative feedback using an integrated operational amplifier circuit; (2) the fitting of a linear regression equation to provide rapid determination of the LEDs driver voltage; and (3) an algorithm for the automatic adjustment of the output voltage to ensure suitable LED illumination. The data from a single centrally-located photo detector, which is capable of capturing all four channels of back-light in a time-multiplexed manner, were used to monitor heart rate and blood oxygen saturation. This paper provides circuitry for driving the LEDs and describes an adaptive algorithm implemented on a microcontroller unit that monitors the quality of the photo detector signals received in order to control each of the individual currents being supplied to the LED arrays. The study demonstrated that the operation of the new circuitry in its ability to adapt LED illumination to the strength of the signal received and the performance of the adaptive system was compared with that of a non-adaptive approach. [ABSTRACT FROM AUTHOR]

Photoplethysmography (PPG)-based continuous heart rate monitoring is essential in a number of domains, e.g., for healthcare or fitness applications. Recently, methods based on time-frequency spectra emerged to address the challenges of motion artefact compensation. However, existing approaches are highly parametrised and optimised for specific scenarios of small, public datasets. We address this fragmentation by contributing research into the robustness and generalisation capabilities of PPG-based heart rate estimation approaches. First, we introduce a novel large-scale dataset (called PPG-DaLiA), including a wide range of activities performed under close to real-life conditions. Second, we extend a state-of-the-art algorithm, significantly improving its performance on several datasets. Third, we introduce deep learning to this domain, and investigate various convolutional neural network architectures. Our end-to-end learning approach takes the time-frequency spectra of synchronised PPG- and accelerometer-signals as input, and provides the estimated heart rate as output. Finally, we compare the novel deep learning approach to classical methods, performing evaluation on four public datasets. We show that on large datasets the deep learning model significantly outperforms other methods: The mean absolute error could be reduced by 31 % on the new dataset PPG-DaLiA, and by 21 % on the dataset WESAD. [ABSTRACT FROM AUTHOR]

Anorexia nervosa (AN) is associated with a wide range of disturbances of the autonomic nervous system. The aim of the present study was to monitor the heart rate (HR) and the heart rate variability (HRV) during light physical activity in a group of adolescent girls with AN and in age-matched controls using a wearable, minimally obtrusive device. For the study, we enrolled a sample of 23 adolescents with AN and 17 controls. After performing a 12-lead electrocardiogram and echocardiography, we used a wearable device to record a one-lead electrocardiogram for 5 min at baseline for 5 min during light physical exercise (Task) and for 5 min during recovery. From the recording, we extracted HR and HRV indices. Among subjects with AN, the HR increased at task and decreased at recovery, whereas among controls it did not change between the test phases. HRV features showed a different trend between the two groups, with an increased low-to-high frequency ratio (LF/HF) in the AN group due to increased LF and decreased HF, differently from controls that, otherwise, slightly increased their standard deviation of NN intervals (SDNN) and the root mean square of successive differences (RMSSD). The response in the AN group during the task as compared to that of healthy adolescents suggests a possible sympathetic activation or parasympathetic withdrawal, differently from controls. This result could be related to the low energy availability associated to the excessive loss of fat and lean mass in subjects with AN, that could drive to autonomic imbalance even during light physical activity. [ABSTRACT FROM AUTHOR]