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Reading health risks for babyboomers
Issue date:07/12/2009
ATA Journal for Asia on Textile & Apparel - Dec 2009 Issue
Source:Journal for Asia on Textile & Apparel
The lives of the "never had it so good" generation are about to get even better with the aid of the latest smart garments. Further development of smart garments is likely to be useful to fire-fighters as well, Adrian Wilson reports
Baby boomers in their 60s continue enjoying the lives with modern technologies (Picture courtesy of Ratpack Entertainment, Australia)</
Baby boomers in their 60s continue enjoying the lives with modern technologies (Picture courtesy of Ratpack Entertainment, Australia)
Wearable garments that remotely monitor the body's condition will have a tremendous role to play in healthcare in the coming years – and their widespread acceptance as an alternative to hospital or care home residency becomes closer to reality every day.

Freedom brought by smart wear

These garments will play a tremendous role in allowing people – especially the globally growing number of over 60s, the so-called 'Baby Boomer' generation – to experience a freedom that has never before been possible. At the same time, they are likely to provide tremendous relief to over-burdened care institutions.

After the World War II, between 1946 and 1964, certain regions of the world, such as Australia, Canada, the USA and the UK, experienced an unusual increase in the number of babies born. This phenomenon came to be known as the "baby boom", and all the people born during the period are known as "baby boomers".

In the USA alone, baby boomers comprise nearly 20% of the population, equal to 76.1 million people, many of whom will soon turn 65. But they are generally fitter and expected to live longer than previous generations, and as a result, it is feared that they will put an increased burden on the medical industries of their countries. In Australia, for example, the cost of a hospital bed has recently been estimated to cost A$1,117 (or about US$1,079) a day.

At the same time, traditional families are breaking down in these countries, and extended family systems vanishing. Hence, many baby boomers have a fear of becoming ill with no one to care for them and more and more are devoting a major part of their incomes to products and services that keep them healthy, make them look or feel better, slow down the effects of aging and prevent diseases.

An increased demand for preventive care products and diagnostics proves that the trend of self-care is definitely on the rise. Baby boomers are growing increasingly concerned about their diet and exercise, and already turning to the self-monitoring of indicators such as cholesterol, blood pressure and blood sugar.

This generation is optimistic about the implementation of home-based products and services that will help them manage even chronic disease states from the comfort of their homes, through advanced communication tools, self-diagnostic devices and home-monitoring appliances.

With the recent advances in healthcare technologies and improvements in communications infrastructure at home, home healthcare is expected to evolve from a sporadic practice today to a mainstream care delivery model within the next five to 10 years.

The ability to monitor such essential parameters as heart rate, skin temperature and respiration was collected by adding sensors to a substrate garment in the general vicinity of where the bio-electrical signal could be best collected, said Mark Pedley, CEO of UK company, SmartLife Technology.

"Without core patents in these sectors, the electronics – most of which improve the quality of the outputs from the collecting sensors – are of minimal intrinsic value, since much of the hardware and electronics, as well as some of the software derivations, are off-the-shelf technology. The 'application twist' is the way these technologies are applied to the garments and the interpretation and potential value of the data outcomes," he added.

As a company, SmartLife secured its core technology from the University of Manchester in the UK, aiming to lead the field in the research, development and commercialisation of flexible fabric sensor systems for the improvement of lifestyles.

"Our model creates a new freedom for those people who suffer from a range of personal conditions," he said.

There are 23 recognised ECG (electrocardiogram)-related conditions and the diagnosis of a number of them could be enhanced through consistent monitoring over a long period of time. The knowledge from such monitoring is likely to have a significant impact on the future understanding and treatment of many conditions, particularly when the monitoring covers the "normal" lifestyle of the wearer.

"SmartLife recognises the importance of being able to tailor the system to the application, and furthermore, tailor the system to the individual, ensuring that in medical situations, wearers are monitored against their own personal bio-rhythms and not against a generic group," said Mr Pedley. "The paradigm shift therefore, is for clinicians and medics, who work with this group of people, to move from snapshot, expensive, time-consuming and restrictive monitoring, to inexpensive, unrestricted and home-based monitoring, on a round the clock basis if required. The results become personalised to the patient in comparison with his or her norms, and even personalised in terms of how the information is both presented and analysed, should that be required."

Crucial attributes for market acceptance

Of equal importance is the necessity to manufacture and produce garments on equipment for commercial use throughout the world. "The crucial point, is that the successful deployment of these and similar products and medical devices depends absolutely on the acceptability of the product or device in practical use," said Mr Pedley. "In other words, the user must find it easy to use, comfortable and unintrusive."

The obvious solution is to make the device an integral part of something that the patient routinely and habitually employs anyway – replacing a standard piece of clothing with a special version.

"Providing that the use of the monitoring garment presents little more challenge than the normal one, the patient has no excuse not to use the monitoring version," said Mr Pedley. "In addition, the wearer can subject that garment to normal garment care procedures and maintain its performance without recourse to professional or expert help."

The Smartlife network


Normal garments come in sizes to suit body shapes and a monitoring garment must also accommodate a wide range of body shapes and sizes. In the SmartLife case, the size scaling is simple – along the lines of Small, Medium, Large – with few additional variants.

Another leading company in this field is California-based VivoMetrics, which has recently completed a prototype of its next generation LifeShirt, also for the remote monitoring of patients by healthcare professionals. It is said to incorporate significant advantages over current monitoring technologies and dramatically simplify the way vital signs data is collected and transmitted to remote care providers.

The new LifeShirt incorporates the latest sensor technology and wireless data transmission into a lightweight and comfortable "smart garment" that eliminates the need for patients to operate multiple, discrete monitoring devices at specific times or to manually transmit vital sign data to those remotely managing their care.

The system, like that proposed by Smartlife Technology, passively and continuously collects ECG, respiratory and temperature data in context with posture and activity levels and automatically transmit that data via cellular networks or Bluetooth to healthcare providers.

Remote patient monitoring with smart garments will bring enormous savings to the US society, VivoMetrics says


The new LifeShirt is said to almost completely eliminate patient involvement in their monitoring, requiring the user to simply wear the garment.

A number of studies confirm the potential of remote patient monitoring (RPM) to improve outcomes for patients with chronic diseases and reduce the net cost of their care. It is estimated that savings resulting from RPM will reach US$200 billion over the next 25 years in the United States alone. However, an April 2009 report by Datamonitor notes that available technology will need to improve in terms of reliability and ease-of-use in order for adoption to increase.

"VivoMetrics has been a true innovator in remote monitoring technologies," said Kent Tonkin of St. Francis University's Centre of Excellence for Remote and Medically Under-served Areas (CERMUSA), a US federally funded programme that began a partnership with VivoMetrics and is dedicated to improving access to healthcare. "Solutions like LifeShirt can help us reach our goals of providing better lives and lower healthcare costs for our neighbours."

"The challenge for us is quite clear," added Howard R. Baker, VivoMetrics President and CEO. "If patients and providers aren't completely comfortable with monitoring technology, they won't use it. He continued:"The key to strong adoption and sustainability in the RPM space will be highly dependent on both patient and provider compliance. It's exciting for us to be able to draw upon over 10 years of experience acquiring quality data in a vast array of ambulatory environments. We're creating solutions that address the enormous cost of caring for a population that is growing older and experiencing increasing rates of chronic illness."

The first integrated prototypes of the new LifeShirt have been assembled and tested, and VivoMetrics expects to begin collecting clinical data before the end of 2009.

Real comfort without direct skin contact

Meanwhile, scientists at the Textile Research Institute Thuringia-Vogtland (TITV Greitz) in Germany are investigating the employment of electronic textiles that can take physiological readings without direct skin contact.

Speaking at the recent 2009 Narrow Fabrics conference taken place in Frick, Switzerland, Christian Rotsch and Dr Uwe Möhring of TITV Greitz observed that fabrics incorporating special functions in combination with electronics offer an interesting alternative to the systems traditionally used in medicine, thanks to their flexibility and a large range of applications.

While work is currently being done to integrate classical foil and textile sensors into fabrics with a view to recording vital parameters such as ECG via direct contact with the skin, an alternative is to record these vital parameters without any direct skin contact, through capacitative coupling.

This technology is of particular interest for long-term applications because it minimises or eliminates the discomfort of wearing such recording tools. TITV Greiz is collaborating with five partners to find a method for the contactless recording of EMG signals by using several textile-based and capacitative textile sensors, which not only supply values the muscular potential, but also use analytical algorithms to provide data on the individual's physical and mental stress.

In its smart textiles field, TITV Greiz is focusing on the use of textile electrodes for actuatory applications such as electromyostimulation. Here, the main challenge is to achieve long-term stability of the contact impedance between electrode and skin, since purely metallic or metal-coated filaments require an electrolyte (e.g. sweat or a coupling gel). An alternative would be the use of polymer electrolytes to optimise the contact impedance. Electrically conducting fabrics can be used to integrate the sensory or actuatory electrodes and electronic components into pieces of clothing such as bandages or body-clinging clothes.

Monitoring vital signs of firemen in real time

Health monitoring will be a key market for the emerging electronic textiles market, but the usefulness of smart textiles in other fields should not be overlooked.

A new product from New Zealand-headquartered Zephyr Technology, for example, is helping to protect firefighters and professionals in the line of duty by monitoring their vital signs in real-time.

Zephyr's BioHarness First Responder System (FRS 1000) is said to offer "unprecedented visibility of the physiological status of teams operating in challenging environments".

Deployed over existing digital radio equipment, the FRS 1000's remote real-time monitoring offers vital information which can be acted on immediately to improve health and safety, and optimise work performance at the site of a fire, incident scene or in training.

Firefighters will also greatly benefit from smart garments


Despite important advances in equipment and procedures, more than 100 US firefighters die in the line of duty every year, and many more suffer serious injury. Up until now, incident commanders have had no reliable means of assessing the status of firefighters when they are downrange or in training situations.

Brian Russell, Zephyr's CEO said: "The FRS 1000 provides critical real-time insights into the crews' physical status. These insights can assist incident commanders and firefighters in making decisions, better managing fire scenes, improving safety, and potentially saving lives."

"Zephyr Technology has been a pioneer in the use of Personal Physical Status Monitoring (PPSM) in training and high stress operational environments," added the company's Chief Technology Officer Jonathan Woodward. "The company's work with local fire departments, the NASA Ames Human Systems Integration Research Group and multiple US Special Forces contracts has been invaluable in the development and validation of our technology, and its application in the most extreme operating environments."

Founded in 2003, Zephyr Technology strategic customers now include Stanford University, NASA Ames Research Centre, US Special Operations and Motorola.
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