Explore the vast range of titles available.

Introduction Tremor is the most common movement disorder, affecting 5.6% of the population with Parkinson’s disease or essential tremor over the age of 65. Conventionally, tremor diseases like Parkinson’s are treated with medication. An alternative non-invasive symptom treatment is the mechanical suppression of the oscillation movement. The purpose of this review is to identify the weaknesses of past wearable tremor-suppression orthoses for the upper limb and identify the need for further research and developments. Method A systematic literature search was conducted by performing a keyword combination search of the title, abstract and keyword sections in the four databases Web of Science, MedLine, Scopus, and ProQuest. Initially, the retrieved articles were selected by title and abstract using selection criteria. The same criteria were then applied to the full publication text. After the selection process, relevant information on the retrieved orthoses was isolated, sorted and analysed systematically. Results Forty-six papers, representing 21 orthoses, were identified and analysed according to the mechanical and ergonomic properties. The identified orthoses can be divided into 5 concepts and 16 functional prototypes, then subdivided further based upon their use of passive, semi-active, or active suppression mechanisms. Most of the orthoses concentrate on the wrist and elbow flexion and extension. They mainly rely on rigid structures and actuators while having tremor-suppression efficacies for tremorous subjects from 30 to 98% using power spectral density or other methods. Conclusion The comparison of tremor-suppression orthoses considered and mapped their various mechanical and ergonomic properties, including the degrees of freedom, weight, suppression characteristics, and efficacies. This review shows that most of the orthoses are bulky and heavy, with a non-adapted human-machine interface which can cause rejection by the user. The main challenge of the design of an effective, minimally intrusive and portable tremor-suppressing orthosis is the integration of compact, powerful, lightweight, and non-cumbersome suppression mechanisms. None of the existing prototypes combine all the desired characteristics. Future research should focus on novel suppression orthoses and mechanisms with compact dimensions and light weight in order to be less cumbersome while giving a good tremor-suppression performance.

Background Tremor is the most common movement disorder with the highest prevalence in the upper limbs. The mechanical suppression of involuntary movements is an alternative and additional treatment to medication or surgery. Here we present a new, soft, lightweight, task asjustable and passive orthosis for tremor suppression. Methods A new concept of a manual, textile-based, passive orthosis was designed with an integrated, task adjustable, air-filled structure, which can easily be inflated or deflated on-demand for a certain daily activity. The air-filled structure is placed on the dorsal side of the wrist and gets bent and compressed by movements when inflated. In a constant volume air-filled structure, air pressure increases while it is inflating, creating a counterforce to the compression caused by bending. We characterised the air-filled structure stiffness by measuring the reaction torque as a function of the angle of deflection on a test bench. Furthermore, we evaluated the efficacy of the developed passive soft orthosis by analysing the suppression of involuntary movements in the wrist of a tremor-affected patient during different activities of daily living (i.e. by calculating the power spectral densities of acceleration). Results By putting special emphasis on the comfort and wearability of the orthosis, we achieved a lightweight design (33 g). The measurements of the angular deflection and resulting reaction torques show non-linear, hysteretic, behaviour, as well as linear behaviour with a coefficient of determination (R 2 ) between 0.95 and 0.99. Furthermore, we demonstrated that the soft orthosis significantly reduces tremor power for daily living activities, such as drinking from a cup, pouring water and drawing a spiral, by 74 to 82% ( p  = 0.03); confirmed by subjective tremor-reducing perception by the patient. Conclusion The orthosis we developed is a lightweight and unobtrusive assistive technology, which suppresses involuntary movements and shows high wearability properties, with the potential to be comfortable. This air-structure technology could also be applied to other movement disorders, like spasticity, or even be integrated into future exoskeletons and exosuits for the implementation of variable stiffness in the systems.

Sleep apnea (SA) is a prevalent disorder diagnosed by polysomnography (PSG) based on the number of apnea–hypopnea events per hour of sleep (apnea–hypopnea index, AHI). PSG is expensive and technically complex; therefore, its use is rather limited to the initial diagnostic phase and simpler devices are required for long-term follow-up. The validity of single-parameter wearable devices for the assessment of sleep apnea severity is still debated. In this context, a wearable electrocardiogram (ECG) acquisition system (ECG belt) was developed and its suitability for the classification of sleep apnea severity was investigated using heart rate variability analysis with or without data pre-filtering. Several classification algorithms were compared and support vector machine was preferred due to its simplicity and overall performance. Whole-night ECG signals from 241 patients with a suspicion of sleep apnea were recorded using both the ECG belt and patched ECG during PSG recordings. 65% of patients had an obstructive sleep apnea and the median AHI was 21 [IQR: 7–40] h − 1 . The classification accuracy obtained from the ECG belt (accuracy: 72%, sensitivity: 70%, specificity: 74%) was comparable to the patched ECG (accuracy: 74%, sensitivity: 88%, specificity: 61%). The highest classification accuracy was obtained for the discrimination between individuals with no or mild SA vs. moderate to severe SA. In conclusion, the ECG belt provided signals comparable to patched ECG and could be used for the assessment of sleep apnea severity, especially during follow-up.

In bedridden patients, the constant load between the body and the support surface increases the risk of soft tissue injuries. Understanding body–mattress interactions is the key to developing pressure‐reducing support surfaces. Sensors at the material–body interface provide crucial information but may alter interactions by changing local mechanics. To assess such effects, a pressure sensor mat applied on top of support surfaces was compared to point pressure sensors applied on the body surface. We investigated local interface pressure at the occiput and hip on two support surfaces (foam and air‐filled mattress), using three newborn weight models (1.3 kg, 2.3 kg, and 3.3 kg) and multiple air pressures (0.2–0.8 kPa). The sensor mat led to altered material–body interactions and underestimated interface pressure. Low air pressures (0.2–0.4 kPa) reduced interface pressure below foam mattress levels. Increasing body weight was associated with higher optimal air pressure, indicating the need for weight‐specific air pressure adjustment. Exponential regression identified weight‐dependent air pressures that minimize interface pressure. Fitted curve coefficients reflected local anatomical and mechanical differences: The hip showed a higher predicted minimum interface pressure and a narrower air pressure tolerance range than the occiput. These findings demonstrate that anatomical region‐ and weight‐specific air pressure protocols are necessary to minimize interface pressure.

Background Pressure Injuries are not exclusively an adult phenomenon; various risk factors contribute to a high prevalence rate of 43% in the neonatal and pediatric intensive care population. Effective preventive measures in this population are limited. Methods We performed a pilot study to analyze the distribution and localization of support surface interface pressures in neonates in a pediatric intensive care unit (PICU). The hypothesis was that pressure redistribution by a novel air mattress would reduce pressure peaks in critical neonates. The measurements were conducted in a 27-bed level III PICU between November and December 2020. This included measuring pressure distribution and pressure peaks for five neonates positioned on either a state-of-the-art foam mattress or a new prototype air mattress. Results We confirmed that the pressure peaks were significantly reduced using the prototype air mattress, compared with the state-of-the-art foam mattress. The reduction of mean pressure values was 9–29%, while the reduction of the highest 10% of pressure values was 23–41%. Conclusions The journey to an effective, optimal, and approved product for severely ill neonates to reduce Pressure Injuries is challenging. However, a crucial step was completed by this pilot study with the first pressure measurements in a real-world setting and the successful realization of a decrease in pressure peaks obtained using a prototype air mattress.

Sleep monitoring in an unattended home setting provides important information complementing and extending the clinical polysomnography findings. The validity of a wearable textile electrocardiography (ECG)-belt has been proven in a clinical setting. For evaluation in a home setting, ECG signals and features were acquired from 12 patients (10 males and 2 females, showing an interquartile range for age of 48–59 years and for body mass indexes (BMIs) of 28.0–35.5) over 28 nights. The signal quality was assessed by artefacts detection, signal-to-noise ratio, and Poincaré plots. To assess the validity, the data were compared to previously reported data from the clinical setting. It was found that the artefact percentage was slightly reduced for the ECG-belt from 9.7% ± 14.7% in the clinical setting, to 7.5% ± 10.8% in the home setting. The signal-to-noise ratio was improved in the home setting and reached similar values to the gel electrodes in the clinical setting. Finally, it was found that for artefact percentages above 3%, Poincaré plots are instrumental to evaluate the origin of artefacts. In conclusion, the application of the ECG-belt in a home setting did not result in a reduction in signal quality compared to the ECG-belt used in the clinical setting, and thus provides new opportunities for patient pre-screening or follow-up.

Even for 1-lead electrocardiography (ECG), single-use gel conductive electrodes are employed in a clinical setting. However, gel electrodes show limited applicability for long-term monitoring due to skin irritation and detachment. In the present study, we investigated the validity of a textile ECG-belt suitable for long-term measurements in clinical use. In order to assess the signal quality and validity of the ECG-belt during sleep, 242 patients (186 males and 56 females, age 52 (interquartile range 42–60) years, body mass index 29 (interquartile range 26–33) kg·m−2) with suspected sleep apnoea underwent overnight polysomnography including standard 1-lead ECG recording. The single intervals between R-peaks (RR-intervals) were calculated from the ECG-signals. We found a mean difference for average RR-intervals of −2.9 ms, a standard error of estimate of 0.39%, as well as a Pearson r of 0.91. Furthermore, we found that the validity of the ECG-belt decreases when lying on the side, which was potentially due to the fitting of the belt. In conclusion, the validity of RR-interval measurements using the ECG-belt is high and it may be further improved for future applications by optimizing wear fitting.

The flame engulfment test according to ISO 13506 assesses the protective performance of ready-made heat and flame protective clothing when exposed to a flash fire condition using an instrumented manikin. It uses a thermal model of the human skin to predict the risk of skin burns. This evaluation method is based on a pass/fail criterion, as either a burn is predicted or not. Therefore, it provides only limited information about the transfer of heat through the protective clothing. In this study, we investigated the use of the total transferred energy as an improved characterization method of the performance of the garments. We defined an energy transmission factor as the quotient between the transferred energy on the clothed manikin divided by the transferred energy registered by the nude manikin during calibration. We analyzed the performance of seven garments and show that the energy transmission factors can be assessed with very high repeatability. When comparing the results of the right and left arms and legs, we found very high correlation coefficients of 0.96 and 0.98, respectively, showing that the thermal insulation of the garments tested was very symmetrical. This new assessment method will be proposed for the revision of ISO 13506.

Parkinson’s disease (PD) is characterized by a highly individual disease-profile as well as fluctuating symptoms. Consequently, 24-h home monitoring in a real-world environment would be an ideal solution for precise symptom diagnostics. In recent years, small lightweight sensors which have assisted in objective, reliable analysis of motor symptoms have attracted a lot of attention. While technical advances are important, patient acceptance of such new systems is just as crucial to increase long-term adherence. So far, there has been a lack of long-term evaluations of PD-patient sensor adherence and acceptance. In a pilot study of PD patients (N = 4), adherence (wearing time) and acceptance (questionnaires) of a multi-part sensor set was evaluated over a 4-week timespan. The evaluated sensor set consisted of 3 body-worn sensors and 7 at-home installed ambient sensors. After one month of continuous monitoring, the overall system usability scale (SUS)-questionnaire score was 71.5%, with an average acceptance score of 87% for the body-worn sensors and 100% for the ambient sensors. On average, sensors were worn 15 h and 4 min per day. All patients reported strong preferences of the sensor set over manual self-reporting methods. Our results coincide with measured high adherence and acceptance rate of similar short-term studies and extend them to long-term monitoring.

When developing fabrics for applications in which evaporative cooling and drying play an important role, e.g., sports or occupational applications, the drying performance of fabrics is commonly determined using fast and easy-to-perform benchmark methods. The measurement conditions in these methods, however, differ significantly from the drying conditions on the human body surface, where drying is obstructed on one side of the fabric through contact with the skin and at the same time enhanced due to contact with the heated surface (skin). The aims of this study were to understand and quantify the fabric drying process at the skin interface considering these real-use effects based on tests applying two-sided drying, one-sided drying, one-sided drying on a heated surface, and one-sided drying on a heated surface in the stretched state, and to relate these to existing standard methods. The findings showed that contact with a solid heated surface such as the skin and the stretched state of the fabric both make a significant contribution (p < 0.05) to the drying rate compared to two-sided drying in standard climatic conditions. The corresponding drying rates observed for a range of typical fabrics used in leisure and sports as a first layer next to the skin were found to be 1.6 (±0.2), 1.1 (±0.2), 7.9 (±2.1), and 10.6 (±0.8) g/m2 min for two-sided drying, one-sided drying, one-sided drying on a heated surface, and one-sided drying on a heated surface in the stretched state, respectively. These findings are of great importance for human thermal modelling, including clothing models, where the drying process significantly contributes to the heat and mass transfer in the skin–clothing–environment system.