The growing use of wearable technologies increases the ability to have more information from the patient including clinical, behavioural and self-monitored data. The availability and large amounts of data that did not exist before brings an opportunity to develop new tools with intelligent analyses and decision support tools for use in clinical practice. It also opens new possibilities for the patients by providing them with more information and decision support tools specially designed for them, and empowers them in managing their own health conditions, keeping their autonomy. These new developments drive a change in healthcare delivery models and the relationship between patients and healthcare providers. It raises challenges for the healthcare systems in how to implement these new technologies and the growing amount of information in clinical practice, integrate it into the clinical workflows of the various healthcare providers. The future challenge for healthcare will be how to use the developing knowledge in a way that will bring added value to healthcare professionals, healthcare organisations and patients without increasing the workload and cost of the healthcare services. For wearable technology developers, the challenge is to develop solutions that can be easily integrated and used by healthcare professionals considering the existing constraints.

The challenge of heart rate monitoring based on wrist photoplethysmography (PPG) during heavy exercise is addressed. PPG is susceptible to motion artefacts, which have to be mitigated for accurate heart rate estimation. Motion artefacts are particularly apparent for wrist devices, for example, a smart watch, because of the high mobility of the arms. Proposed is a low complexity highly accurate heart rate estimation method for continuous heart rate monitoring using wrist PPG. The proposed method achieved 2.57% mean absolute error in a test data set where subjects ran for a maximum speed of 17 km/h.

Range-of-motion (ROM) assessment is a critical assessment tool during the rehabilitation process. The conventional approach uses the goniometer which remains the most reliable instrument but it is usually time-consuming and subject to both intra- and inter-therapist measurement errors. An automated wireless wearable sensor system for the measurement of ROM has previously been developed by the current authors. Presented is the correlation and accuracy of the automated wireless wearable sensor system against a goniometer in measuring ROM in the major joints of upper (UEs) and lower extremities (LEs) in 19 healthy subjects and 20 newly disabled inpatients through intra (same) subject comparison of ROM assessments between the sensor system against goniometer measurements by physical therapists. In healthy subjects, ROM measurements using the new sensor system were highly correlated with goniometry, with 95% of differences < 20° and 10° for most movements in major joints of UE and LE, respectively. Among inpatients undergoing rehabilitation, ROM measurements using the new sensor system were also highly correlated with goniometry, with 95% of the differences being < 20° and 25° for most movements in the major joints of UE and LE, respectively.

A passive smart tag is described that responds to dampness in diapers once a pre-defined threshold value is reached. A high-frequency (HF) system at 13.56 MHz is used as this allows operation through water or human tissues with less absorption that would occur for an ultra-HF signal. A circular spiral coil and swelling substrate facilitate a reaction to dampness that can be detected without contact to the diaper wearer. A prototype design is simulated and measured results are provided together with a demonstration of a tag integrated into a worn diaper.

The use of wearable biomedical sensors for the continuous monitoring of physiological signals will facilitate the involvement of the patients in the prevention and management of chronic diseases. The fabrication of small biomedical sensors transmitting physiological data wirelessly is possible as a result of the tremendous advances in ultra-low power electronics and radio communications. However, the widespread adoption of these devices depends very much on their ability to operate for long periods of time without the need to frequently change, recharge or even use batteries. In this context, energy harvesting (EH) is the disruptive technology that can pave the road towards the massive utilisation of wireless wearable sensors for patient self-monitoring and daily healthcare. Radio-frequency (RF) transmissions from commercial telecommunication networks represent reliable ambient energy that can be harvested as they are ubiquitous in urban and suburban areas. The state-of-the-art in RF EH for wearable biomedical sensors specifically targeting the global system of mobile 900/1800 cellular and 700 MHz digital terrestrial television networks as ambient RF energy sources are showcased. Furthermore, guidelines for the choice of the number of stages for the RF energy harvester are presented, depending on the requirements from the embedded system to power supply, which is useful for other researchers that work in the same area. The present authors' recent advances towards the development of an efficient RF energy harvester and storing system are presented and thoroughly discussed too.

Phonocardiography is a widely used method of listening to the heart sounds and indicating the presence of cardiac abnormalities. Each heart cycle consists of two major sounds – S1 and S2 – that can be used to determine the heart rate. The conventional method of acoustic signal acquisition involves placing the sound sensor at the chest where this sound is most audible. Presented is a novel algorithm for the detection of S1 and S2 heart sounds and the use of them to extract the heart rate from signals acquired by a small sensor placed at the neck. This algorithm achieves an accuracy of 90.73 and 90.69%, with respect to heart rate value provided by two commercial devices, evaluated on more than 38 h of data acquired from ten different subjects during sleep in a pilot clinical study. This is the largest dataset for acoustic heart sound classification and heart rate extraction in the literature to date. The algorithm in this study used signals from a sensor designed to monitor breathing. This shows that the same sensor and signal can be used to monitor both breathing and heart rate, making it highly useful for long-term wearable vital signs monitoring.

The global trend for increasing life expectancy is resulting in aging populations in a number of countries. This brings to bear a pressure to provide effective care for the older population with increasing constraints on available resources. Providing care for and maintaining the independence of an older person in their own home is one way that this problem can be addressed. The EU Funded Unobtrusive Smart Environments for Independent Living (USEFIL) project is an assistive technology tool being developed to enhance independent living. As part of USEFIL, a wrist wearable unit (WWU) is being developed to monitor the physical activity (PA) of the user and integrate with the USEFIL system. The WWU is a novel application of an existing technology to the assisted living problem domain. It combines existing technologies and new algorithms to extract PA parameters for activity monitoring. The parameters that are extracted include: activity level, step count and worn state. The WWU, the algorithms that have been developed and a preliminary validation are presented. The results show that activity level can be successfully extracted, that worn state can be correctly identified and that step counts in walking data can be estimated within 3% error, using the controlled dataset.

A platform to move gait analysis, which is normally restricted to a clinical environment in a well-equipped gait laboratory, into an ambulatory system, potentially in non-clinical settings is introduced. This novel system can provide functional measurements to guide therapeutic interventions for people requiring rehabilitation with limited access to such gait laboratories. BioKin system consists of three layers: a low-cost wearable wireless motion capture sensor, data collection and storage engine, and the motion analysis and visualisation platform. Moreover, a novel limb orientation estimation algorithm is implemented in the motion analysis platform. The performance of the orientation estimation algorithm is validated against the orientation results from a commercial optical motion analysis system and an instrumented treadmill. The study results demonstrate a root-mean-square error less than 4° and a correlation coefficient more than 0.95 when compared with the industry standard system. These results indicate that the proposed motion analysis platform is a potential addition to existing gait laboratories in order to facilitate gait analysis in remote locations.