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October 07, 2019
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‘Smart shirt’ shows potential to monitor lung disease

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A “smart shirt,” which gauges the volume of air inhaled and exhaled based on how the wearer’s chest expands and contracts, may provide a simple way for physicians to monitor patients with pulmonary diseases, including COPD, a new study suggests.

“COPD comes with problems like trouble with dyspnea and coughing, which lead to problems with daily activities. Especially during an exacerbation, COPD patients can encounter problems with normal activities. We want to be able to interfere with exacerbations by closely monitoring patients at home. However, existing devices are impractical and the smart shirt would be a very interesting tool to follow patients at home,” Denise Mannée, MSc, a technical physician and PhD candidate at Radboud University Medical Center in the Netherlands, who reported the findings at the European Respiratory Society International Congress, wrote in an email to Healio Pulmonology.

For the study, Mannée and colleagues used smart shirts (Hexoskin, Carre Technologies) and a mobile app to measure tidal volumes in 15 healthy participants (mean age, 34.1 years) while they performed seven daily tasks, including lying down, sitting, bend sitting, standing, climbing stairs, walking with weights and vacuuming. Participants also simultaneously wore equipment traditionally used to monitor breathing, which included a facemask and backpack (Oxycon Mobile, Vyaire Medical). Tasks were then repeated a second time, also wearing both the shirt and traditional equipment, to generate another set of data.

A 'smart shirt,' which gauges the volume of air inhaled and exhaled based on how the fabric stretches when the wearer's chest expands and contracts, may provide a simple way for physicians to monitor patients with pulmonary diseases, including COPD, a new study suggests.
Credit: Denise Mannée

When compared with those taken with the facemask and backpack, measurements taken with the smart shirt were generally similar. When lying down, the differences between measurements taken with the two pieces of equipment were 0.2% on average. The researchers found greater differences, though, for more strenuous activities, such as vacuuming, where the difference was 3.1% on average.

“I was surprised by the accuracy of the shirt. In more demanding tasks, the difference between the shirt and the old method only differs, on average, 3%, which is a clinically irrelevant difference,” Mannée said.

However, calibrations from the first use of the smart shirt were not reliable for the second set of measurements, suggesting that the equipment would need to be recalibrated for each use.

Nevertheless, these data are promising, according to Mannée.

“We chose to start with healthy subjects to burden the patients less. With the great results we gained with healthy subjects, we expect good results with patients with COPD. Further in the future, we would like to test the shirt in a real home situation,” Mannée told Healio Pulmonology.

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“Smart shirt technology offers a promising, though relatively expensive, tool for monitoring patients’ respiratory health status during normal activities in a way that does not interfere too much with their daily lives. This is an example of data coming from wearables. Combined with using a smartphone interface, such data may help to inform trained health care providers about the ‘status’ of their patients,” Thierry Troosters, PhD, from University Hospitals Leuven, Belgium, and president-elect of the European Respiratory Society, said in a press release. “It is anticipated that by using artificial intelligence and deep learning algorithms, the burden of dealing with these data will be reduced to a minimum, and most of the monitoring will happen automatically. We look forward to seeing more work into this area of respiratory research.” – by Melissa Foster

Reference:

Mannée D, et al. Abstract PA2228. Presented at: European Respiratory Society International Congress; Sept. 28-Oct. 2, 2019; Madrid.

For more information:

Denise Mannée, MSc, can be reached at denise.manee@radboudumc.nl.

Disclosures: Mannée reports the authors received an educational grant from Chiesi and a grant from the European Fund for Regional development and that Carre Technologies provided the Hexoskin shirts.