The aim of this review paper is to summarize recent developments in the field of wearable sensors and systems that are relevant to the field of rehabilitation. The growing body of work focused on the application of wearable technology to monitor older adults and subjects with chronic conditions in the home and community settings justifies the emphasis of this review paper on summarizing clinical applications of wearable technology currently undergoing assessment rather than describing the development of new wearable sensors and systems.
A short description of key enabling technologies i. Applications described in this review paper include those that focus on health and wellness, safety, home rehabilitation, assessment of treatment efficacy, and early detection of disorders. The integration of wearable and ambient sensors is discussed in the context of achieving home monitoring of older adults and subjects with chronic conditions.
Future work required to advance the field toward clinical deployment of wearable sensors and systems is discussed. The US health care system faces daunting challenges. A review of self-validating sensor technology voide the improvements in health care in the last few decades, residents of industrialized countries are now living longer, but with multiple, often complex, health conditions [ 1 - 3 ].
Survival from acute trauma has also improved, but this is associated with an increase in the number of individuals with severe disabilities [ 4 ]. From an epidemiological standpoint, the cohort of "baby boomers" in the US is now reaching an age at which they will begin to severely stress the Medicare system.
Finally, recent health care reform efforts may add 32 million newly insured patients to the health care system in the next few years [ 5 ]. Cleary, answers to these questions will be complex and will require changes into A review of self-validating sensor technology voide we organize and pay for health care. However, part of the solution may lie in how and to what extent we take advantage of recent advances in information technology and related fields. Currently, there exist technologies that hold great promise to expand the capabilities of the health care system, extending its range into the community, improving diagnostics and monitoring, and maximizing the independence and participation of individuals.
This paper will discuss these technologies in depth, with a focus on remote monitoring systems based on wearable technology. We chose to focus on these technologies because recent developments in wearable sensor systems have led to a number of exciting clinical applications. Wearable sensors have diagnostic, as well as monitoring applications. Their current capabilities include physiological and biochemical sensing, as well as motion sensing [ 67 ].
It is hard to overstate the magnitude of the problems that these technologies might help solve. Physiological monitoring could help in both diagnosis and ongoing treatment of a vast number of individuals with neurological, A review of self-validating sensor technology voide and pulmonary diseases such as seizures, hypertension, dysrthymias, and asthma.
Home based motion sensing might assist in falls prevention and help maximize an individual's independence and community participation. Remote monitoring systems have the potential to mitigate problematic patient access issues. Access may get worse over time as many organizations are predicting a shortfall in primary care providers as health care reform provides insurance to millions of new patients [ 9 ].
There is a large body of literature that describes the disparities in care faced by rural residents [ 8 ]. Compared to those in urban areas, those in rural areas travel 2 to 3 times farther to see a physician, see fewer specialists, and have worse outcomes for such common conditions as diabetes, and heart attack [ 910 ].
Wearable sensors and remote monitoring systems have the potential to extend the reach of specialists in urban areas to rural areas and decrease these disparities. Wearable sensors are used to gather physiological and movement data thus enabling patient's status monitoring.
Sensors are deployed according to the clinical application of interest. Sensors to monitor vital signs e. Sensors for A review of self-validating sensor technology voide data capturing would be deployed, for instance, in applications such as monitoring the effectiveness of home-based rehabilitation interventions in stroke survivors or the use of mobility assistive devices in older adults.
Wireless communication is relied upon to transmit patient's data to a mobile phone or an access point and relay the information to a remote center via the Internet.
Clinical personnel can remotely monitor patient's status and be A review of self-validating sensor technology voide in case a medical decision has to be made. Illustration of a remote health monitoring system based on wearable sensors. Health related information is gathered via body-worn wireless sensors and transmitted to the caregiver via an information gateway such as a mobile phone.
Caregivers can use this information to implement interventions as needed. Despite the potential advantages of a remote monitoring system relying on wearable sensors like the one described above, there are significant challenges ahead before such a system can be utilized on a large scale.
These challenges include technological barriers such as limitations of currently available battery technology as well cultural barriers such as the association of a stigma with the use of medical devices for home-based clinical monitoring.
In the following section, we discuss key technologies enabling the development and deployment of wearable technologies and remote monitoring systems. The next section describes wearable and ambient sensor technologies that are essential components of systems to monitor patients in the home and community settings.
Examples of applications of these technologies largely taken from a National Science Foundation initiated study of European projects focused on rehabilitation technology [ 11 ] are then presented. Conclusions and future developments that we foresee in the field of remote monitoring of patients' status via wearable technology are discussed in the final section. Wearable systems for patients' remote monitoring consist of three main building blocks: Recent advances in sensor technology, microelectronics, telecommunication, and data analysis techniques have enabled the development and deployment of wearable systems for patients' remote monitoring.
Researchers have relied upon advances in A review of self-validating sensor technology voide above-mentioned fields to address shortcomings of ambulatory technologies e.