Background: Wearable sensing and information and communication technologies are key enablers driving the transformation of health care delivery toward a new model of connected health (CH) care. The advances in wearable technologies in the last decade are evidenced in a plethora of original articles, patent documentation, and focused systematic reviews. Although technological innovations continuously respond to emerging challenges and technology availability further supports the evolution of CH solutions, the widespread adoption of wearables remains hindered. Objective: This study aimed to scope the scientific literature in the field of pervasive wearable health monitoring in the time interval from January 2010 to February 2019 with respect to four important pillars: technology, safety and security, prescriptive insight, and user-related concerns. The purpose of this study was multifold: identification of (1) trends and milestones that have driven research in wearable technology in the last decade, (2) concerns and barriers from technology and user perspective, and (3) trends in the research literature addressing these issues. Methods: This study followed the scoping review methodology to identify and process the available literature. As the scope surpasses the possibilities of manual search, we relied on the natural language processing tool kit to ensure an efficient and exhaustive search of the literature corpus in three large digital libraries: Institute of Electrical and Electronics Engineers, PubMed, and Springer. The search was based on the keywords and properties to be found in articles using the search engines of the digital libraries. Results: The annual number of publications in all segments of research on wearable technology shows an increasing trend from 2010 to February 2019. The technology-related topics dominated in the number of contributions, followed by research on information delivery, safety, and security, whereas user-related concerns were the topic least addressed. The literature corpus evidences milestones in sensor technology (miniaturization and placement), communication architectures and fifth generation (5G) cellular network technology, data analytics, and evolution of cloud and edge computing architectures. The research lag in battery technology makes energy efficiency a relevant consideration in the design of both sensors and network architectures with computational offloading. The most addressed user-related concerns were (technology) acceptance and privacy, whereas research gaps indicate that more efforts should be invested into formalizing clear use cases with timely and valuable feedback and prescriptive recommendations. Conclusions: This study confirms that applications of wearable technology in the CH domain are becoming mature and established as a scientific domain. The current research should bring progress to sustainable delivery of valuable recommendations, enforcement of privacy by design, energy-efficient pervasive sensing, seamless monitoring, and low-latency 5G communications. To complement technology achievements, future work involving all stakeholders providing research evidence on improved care pathways and cost-effectiveness of the CH model is needed.

This article addresses the design, development, and evaluation of T-shirt prototypes that embed novel textile sensors for the capture of cardio and respiratory signals. The sensors are connected through textile interconnects to either an embedded custom-designed data acquisition and transmission unit or to snap fastener terminals for connection to external monitoring devices. The performance of the T-shirt prototype is evaluated in terms of signal-to-noise ratio amplitude and signal interference caused by baseline wander and motion artefacts, through laboratory tests with subjects in standing and walking conditions. Performance tests were also conducted in a hospital environment using a T-shirt prototype connected to a commercial three-channel Holter monitoring device. The textile sensors and interconnects were realized with the assistance of an industrial six-needle digital embroidery tool and their resistance to wear addressed with normalized tests of laundering and abrasion. The performance of these wearable systems is discussed, and pathways and methods for their optimization are highlighted.

Wearable systems are expected to contribute for improving traditional biopotential signals monitoring devices due to higher freedom and unobtrusiveness provided to the wearer. Textile electrodes present advantages compared with the conventional Ag/AgCl electrodes for the capturing of biopotentials, namely in terms of skin irritation due to the hydrogel and the need of a technician to place the electrodes on the correct positions. Due to the lack of hydrogel, textile electrodes present different electrical contact characteristics. The skin-electrode impedance is an important feature since it affects the captured signal quality. Although a low impedance is desired, a comfortable wearable system should not require the electrodes to be covered by the hydrogel or be moistened. A forearm sleeve provided with textile electrodes was used to study the electrode-skin impedance and the signal-to-noise ratio (SNR) of surface electromyographic (EMG) signals on a long-term use basis. The sleeve can be adjusted for different levels of tightening to control the pressure applied on the electrodes. The obtained results provide valuable information on the pressure that the textile garments of a sleeve or vest should apply on the recording electrodes, in order to assure a good electrical and mechanical contact between the electrodes and the skin and decrease the noise due to motion. It was observed that the electrode-skin impedance measurement alone is not sufficient to establish a relation with the SNR. The extraction of parameters from an electrical equivalent model of the electrode-skin interface allows to determine a relation with the model parameters and the SNR. The evaluation of these parameters during long-term monitoring will allow assessing the quality of biopotential measurements in textile electrodes.

One of the currently available treatments for aortic aneurysms is endovascular aneurysm repair (EVAR). In spite of major advances in the operating techniques, complications still occur and lifelong surveillance is recommended. In order to reduce and even eliminate the commonly used surveillance imaging exams, as well as to reduce follow-up costs, new technological solutions are being pursued. In this paper, we describe the development, including design and performance characterization, of a flexible remote pressure measurement system based on inductive-coupling for post-EVAR monitoring purposes. The telemetry system architecture and operation are described and main performance characteristics discussed. The implantable sensor details are provided and its model is presented. Simulations with the reading circuit and the sensor's model were performed and compared with measurements carried out with air and a phantom as media, in order to characterize the telemetry system and validate the models. The transfer characteristic curve (pressure versus frequency) of the monitoring system was obtained with measurements performed with the sensor inside a controlled pressure vacuum chamber. Additional experimental results which proof the system functionality were obtained within a hydraulic test bench that emulates the aorta. Several innovative aspects, when compared to the state of the art, both in the sensor and in the telemetry system were achieved.

In this article we present the design and development of T-Shirt prototypes that embed novel textile sensors for the capture of cardio and respiratory signals. The sensors are connected through textile interconnects to either an embedded custom designed data acquisition and transmission unit or to snap fastener terminals for connection to external monitoring devices. Prototypes with diverse approaches of integration are presented. The performance of the wearable systems is addressed in terms of signal-to-noise ratio amplitude and signal interference caused by baseline wander and motion artifacts, through laboratorial tests with subjects in standing and walking conditions. Performance tests were also conducted in Hospital environment using a T-Shirt prototype connected to a commercial 3-channel Holter monitoring device. The textile sensors and interconnects were realized with the assistance of an industrial 6-needle digital embroidery tool and their resistance to wear addressed with normalized tests of laundering and abrasion. The main aspects of the system´s design leading to major improvements and failure factors are discussed. Pathways and methods for the overall system´s optimization are highlighted.