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Ballistocardiography (BCG), a measure of body vibrations due to ejection of blood into aorta, has the potential to become a 'zero-effort' cardiovascular health monitoring technology, i.e., a technology that requires little or no engagement on part of the user for its operation. In order for any zero-effort monitoring technology to function without any input from the user, it is important that such a methodology can accurately perform identity recognition and thus continuously provide results and feedback to each user. However, most of the recent work on BCG has focused mainly on the estimation of parameters related to mechanical health and the use of BCG to identify a user has not been explored thoroughly. In this paper, we examine, using discrete cosine transform based features and multi-class linear classifier, the use of BCG heartbeats for identity recognition. We demonstrate from the BCG data of 52 healthy subjects collected using a modified floor tile that an average accuracy of 96.15% can be achieved for correct identification of each subject standing on the tile. Based on these results, we anticipate that such a BCG system, trained for a set of users, can be easily installed at different locations in the house and provide continuous and unobtrusive feedback to users for diagnostic monitoring and quantified-self.

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Effective management of neurogenic orthostatic hypotension and supine hypertension (SH-OH) due autonomic failure requires a frequent and timely adjustment of medication throughout the day to maintain the blood pressure (BP) within the normal range, i.e., an accurate depiction of BP is a key prerequisite of effective management. One of the emerging technologies that provide one's circadian and long-term physiological status with increased usability is unobtrusive zero-effort monitoring. In this paper, a zero-effort device, a floor tile, was used to develop an unobtrusive BP monitoring technique. Namely, RJ-interval, the time between the J-peak of a ballistocardiogram and the R-peak of an electrocardiogram, was used to develop a classifier that can detect changes in systolic BP (SBP) induced by the Valsalva maneuver on healthy adults (i.e., a simulated SH-OH). A t-test was used to show statistical differences between the mean RJ-intervals of decreased SBP, baseline, and increased SBP. Following the t-test, a classifier that detected a change in SBP was developed based on a naïve Bayes classifier (NBC). The t-test showed a clear statistical difference between the mean RJ-intervals of the increased SBP, baseline, and decreased SBP. The NBC-based classifier was able to detect increased SBP with 89.3% true positive rate (TPR), 100% true negative rate (TNR), and 94% accuracy and detect decreased SBP with 92.3% TPR, 100% TNR, and 95% accuracy. The analysis showed strong potential in using the developed classifier to assist monitoring of people with SH-OH; the algorithm may be used clinically to detect a long-term trend of symptoms of SH-OH.

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BACKGROUND: Remote monitoring of patients with heart failure (HF) using wearable devices can allow patient-specific adjustments to treatments and thereby potentially reduce hospitalizations. We aimed to assess HF state using wearable measurements of electrical and mechanical aspects of cardiac function in the context of exercise. METHODS AND RESULTS: Patients with compensated (outpatient) and decompensated (hospitalized) HF were fitted with a wearable ECG and seismocardiogram sensing patch. Patients stood at rest for an initial recording, performed a 6-minute walk test, and then stood at rest for 5 minutes of recovery. The protocol was performed at the time of outpatient visit or at 2 time points (admission and discharge) during an HF hospitalization. To assess patient state, we devised a method based on comparing the similarity of the structure of seismocardiogram signals after exercise compared with rest using graph mining (graph similarity score). We found that graph similarity score can assess HF patient state and correlates to clinical improvement in 45 patients (13 decompensated, 32 compensated). A significant difference was found between the groups in the graph similarity score metric (44.4±4.9 [decompensated HF] versus 35.2±10.5 [compensated HF]; P<0.001). In the 6 decompensated patients with longitudinal data, we found a significant change in graph similarity score from admission (decompensated) to discharge (compensated; 44±4.1 [admitted] versus 35±3.9 [discharged]; P<0.05). CONCLUSIONS: Wearable technologies recording cardiac function and machine learning algorithms can assess compensated and decompensated HF states by analyzing cardiac response to submaximal exercise. These techniques can be tested in the future to track the clinical status of outpatients with HF and their response to pharmacological interventions.

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GOAL: Our objective is to provide a framework for extracting signals of interest from the wearable seismocardiogram (SCG) measured during walking at normal (subject's preferred pace) and moderately fast (1.34-1.45 m/s) speeds. METHODS: We demonstrate, using empirical mode decomposition (EMD) and feature tracking algorithms, that the pre-ejection period (PEP) can be accurately estimated from a wearable patch that simultaneously measures electrocardiogram and sternal acceleration signals. We also provide a method to determine the minimum number of heartbeats required for an accurate estimate to be obtained for the PEP from the accelerometer signals during walking. RESULTS: The EMD-based denoising approach provides a statistically significant increase in the signal-to-noise ratio of wearable SCG signals and also improves estimation of PEP during walking. CONCLUSION: The algorithms described in this paper can be used to provide hemodynamic assessment from wearable SCG during walking. SIGNIFICANCE: A major limitation in the use of the SCG, a measure of local chest vibrations caused by cardiac ejection of blood in the vasculature, is that a user must remain completely still for high-quality measurements. The motion can create artifacts and practically render the signal unreadable. Addressing this limitation could allow, for the first time, SCG measurements to be obtained reliably during movement-aside from increasing the coverage throughout the day of cardiovascular monitoring, analyzing SCG signals during movement would quantify the cardiovascular system's response to stress (exercise), and thus provide a more holistic assessment of overall health.

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Impulse radio ultra-wide band (IR-UWB) radar has recently emerged as a promising candidate for non-contact monitoring of respiration and heart rate. Different studies have reported various radar based algorithms for estimation of these physiological parameters. The radar can be placed under a subject's mattress as he lays stationary on his back or it can be attached to the ceiling directly above the subject's bed. However, advertent or inadvertent movement on part of the subject and different postures can affect the radar returned signal and also the accuracy of the estimated parameters from it. The detection and analysis of these postural changes can not only lead to improvement in estimation algorithms but also towards prevention of bed sores and ulcers in patients who require periodic posture changes. In this paper, we present an algorithm that detects and quantifies different types of motion events using an under-the-mattress IR-UWB radar. The algorithm also indicates a change in posture after a macro-movement event. Based on the findings of this paper, we anticipate that IR-UWB radar can be used for extracting posture related information in non-clinical enviroments for patients who are bed-ridden.

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In this work, we extract features from an under-the-mattress impulse radio ultra-wide band (IR-UWB) radar and a microphone, placed on the side table of the bed, to classify epochs belonging to normal sleep and those that contain an apnea event in them. Sleep apnea is the most common form of sleep related breathing disorder in adults with an estimated prevalance of 5-15%. The common diagnostic process for sleep apnea, polysomnography (PSG), involves sleeping in well-equipped sleep clinics. The cost and discomfort associated with the process has spurred research towards the design of portable home-based monitoring devices. However, these include sensors which need to be attached to patients at various locations on the body. In this preliminary and on-going study, we collected 18 hours of data of 3 subjects who were previously diagnosed with sleep apnea. The data was recorded using non-contact sensors, an IR-UWB radar and a microphone, in a sleep clinic along with the time synchronized gold-standard PSG data. A simple linear classifier was used to perform binary classification between normal and apnea epochs and the performance was analyzed compared to the true results provided by the PSG. It was observed, that combining snore features from the microphone data improves the overall accuracy of the classifier.

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We introduce the Spectrum-averaged Harmonic Path (SHAPA) algorithm for estimation of heart rate (HR) and respiration rate (RR) with Impulse Radio Ultrawideband (IR-UWB) radar. Periodic movement of human torso caused by respiration and heart beat induces fundamental frequencies and their harmonics at the respiration and heart rates. IR-UWB enables capture of these spectral components and frequency domain processing enables a low cost implementation. Most existing methods of identifying the fundamental component either in frequency or time domain to estimate the HR and/or RR lead to significant error if the fundamental is distorted or cancelled by interference. The SHAPA algorithm (1) takes advantage of the HR harmonics, where there is less interference, and (2) exploits the information in previous spectra to achieve more reliable and robust estimation of the fundamental frequency in the spectrum under consideration. Example experimental results for HR estimation demonstrate how our algorithm eliminates errors caused by interference and produces 16% to 60% more valid estimates.

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