Chronic Obstructive Pulmonary Disease (COPD) is one of the biggest public health problems in the world. It is the fourth leading cause of chronic morbidity and mortality in the United States and it has been reported a prevalence of 251 million cases globally in 2016, year in which it was the second global main cause of death, with a total number of 2.9 millions of deaths. COPD is a chronic inflammatory lung disease that causes obstructed airflow from the lungs. A substantial number of patients suffer from exacerbations, which are defined as an acute worsening of respiratory symptoms requiring a change in treatment. There are different therapies that can be prescribed by doctors depending on the severity of the pathology, but they usually involve physical exercises to help strengthen the respiratory muscles, dietary restriction to help control the weight and the body--mass index (BMI) and oxygen therapy to increase the level of oxygen inhaled by the patient and exchanged with the blood. The main problems with COPD management are the fact that a large number of patients have the tendency not to be compliant to the therapies prescribed and that every patient need to be monitored continuously to avoid disease progression and exacerbation. The parameters that usually have to be monitored are blood pressure, nutrition, air quality, but most importantly, heart rate and oxygen levels in the blood. For this reason, we have developed the Heart and Motion (HAM) monitoring system with the goal of improving the monitoring for the patient and the physician and the compliance to the therapy. HAM is a wearable, wireless and non-invasive system composed of a smartphone application and a pulse oximeter attached to the user finger and wrist and connected via Wi-Fi to the smartphone. The smartphone has three different functions: it works as a pedometer (sensor), as a hub of data collecting and showing the pedometer data and also the heart rate and oxygen levels gathered by the pulse oximeter and as a gateway by allowing the pulse oximeter to use the smartphone mobile data through the smartphone hotspot for the internet connection. Our studies have shown that the pedometer and the pulse oximeter, in terms of distance and steps walked, heart rate and oxygen levels, are effective tools compared to already available on the market devices. Tests on multiple subjects have shown that the pedometer has an accuracy of over 99% for both the distance and steps measurements, independently from the paces of the user, while the pulse oximeter had an accuracy of over 99% for the SpO2 and around 98% for the heart rate estimations. Simulated desaturation tests have shown that the HAM pulse oximeter is also capable of detecting sudden changes of saturation levels with a delay of a few seconds with results comparable to commercially available devices. In conclusion, we have developed a non-invasive, wearable and wireless monitoring system, that provides a quality solution that could be helpful for COPD patients monitoring and for making them more compliant to the therapies prescribed.
La Chronic Obstructive Pulmonary Disease (COPD) é uno dei maggiori problemi mondiali per la sanitá pubblica. COPD é la quarta causa di morbiditá cronica a livello mondiale e di mortalitá negli Stati Uniti ed é risultato avere una prevalenza di 251 milioni di casi a livello mondiale nel 2016, anno nel quale é risultata la seconda principale causa di morte globale, con un numero totale di 2.9 milioni di morti. COPD é una malattia cronica che provoca infiammazione ai polmoni e causa un'ostruzione alle vie aeree. Un elevato numero di pazienti soffre di esacerbazioni, che sono definite come acuti peggioramenti dei sintomi respiratori che richiedono un cambiamento di terapia. Esistono diverse terapie che possono essere prescritte dai medici a seconda del livello di severitá della patologia, ma solitamente comprendono esercizi fisici per il rafforzamento dei muscoli respiratori, controllo della dieta per monitorare il peso e l'indice di massa corporea (BMI) e terapia con ossigeno per aumentare la quantitá di ossigeno inalata e che viene scambiata con il sangue. I problemi principali della gestione della COPD sono il fatto che molti pazienti hanno la tendenza ad avere poca aderenza alle terapie prescritte e che ogni paziente deve essere monitorato continuamente per evitare i progressi della malattia ed il rischio di esacerbazione. I parametri che devono essere monitorati sono la pressione sanguigna, la nutrizione, la qualitá dell'aria e, in particolar modo, la frequenza cardiaca e i livelli di ossigenazione del sangue. Per questa ragione, abbiamo sviluppato il sistema di monitoraggio Heart and Motion (HAM) con lo scopo di migliorare il monitoraggio per gli utenti e per i medici, e per monitorare l'aderenza alla terapia. HAM é un sistema non invasivo, wireless ed indossabile composta da un'applicazione smartphone ed un pulsossimetro attaccato al dito ed al polso dell'utente e connesso via Wi-Fi allo smartphone. Lo smartphone ha tre funzioni differenti: opera come pedometro (sensore), come un hub per collezionare dati e mostrare i dati del pedometro e la frequenza cardiaca ed i livelli di saturazione dell'ossigeno nel sangue ottenuti dal pulsossimetro, e come gateway, permettendo al pulsossimetro di utilizzare i dati mobili attraverso l'hotspot dello smartphone per la connessione internet. I nostri studi hanno mostrato che il pedometro ed il pulsossimetro, in termini di calcolo di passi e distanza percorsi e di frequenza cardiaca e livelli di ossigeno nel sangue, si sono rivelati strumenti con un'efficacia comparabile a quella di dispositivi attualmente in commercio. I test effettuati su molteplici soggetti hanno mostrato che il pedometro risulta avere un'accuratezza superiore al 99% per la misurazione del numero di passi e distanza percorsa, indipendentemente dall'andatura scelta, mentre il pulsossimetro ha risultato avere un'accuratezza superiore al 99% per la misurazione di SpO2 ed attorno al 98% per la stima della frequenza cardiaca. Dei test di desaturazione simulata hanno mostrato che il pulsossimetro HAM é in grado di individuare improvvise variazioni di livelli di saturazione con un ritardo di pochi secondi e con risultati comparabili a quelli di dispositivi commercialmente disponibili. In conclusione, abbiamo sviluppato un sistema di monitoraggio non invasivo, wireless ed indossabile che fornisce una soluzione di qualitá che potrebbe rivelarsi di aiuto per il monitoraggio di pazienti COPD e per facilitare ed aiutarli nell'aderenza alle terapie prescritte.
Heart and motion (HAM) : wearable wireless activity monitoring system for COPD patients
PICCININI, GIACOMO
2017/2018
Abstract
Chronic Obstructive Pulmonary Disease (COPD) is one of the biggest public health problems in the world. It is the fourth leading cause of chronic morbidity and mortality in the United States and it has been reported a prevalence of 251 million cases globally in 2016, year in which it was the second global main cause of death, with a total number of 2.9 millions of deaths. COPD is a chronic inflammatory lung disease that causes obstructed airflow from the lungs. A substantial number of patients suffer from exacerbations, which are defined as an acute worsening of respiratory symptoms requiring a change in treatment. There are different therapies that can be prescribed by doctors depending on the severity of the pathology, but they usually involve physical exercises to help strengthen the respiratory muscles, dietary restriction to help control the weight and the body--mass index (BMI) and oxygen therapy to increase the level of oxygen inhaled by the patient and exchanged with the blood. The main problems with COPD management are the fact that a large number of patients have the tendency not to be compliant to the therapies prescribed and that every patient need to be monitored continuously to avoid disease progression and exacerbation. The parameters that usually have to be monitored are blood pressure, nutrition, air quality, but most importantly, heart rate and oxygen levels in the blood. For this reason, we have developed the Heart and Motion (HAM) monitoring system with the goal of improving the monitoring for the patient and the physician and the compliance to the therapy. HAM is a wearable, wireless and non-invasive system composed of a smartphone application and a pulse oximeter attached to the user finger and wrist and connected via Wi-Fi to the smartphone. The smartphone has three different functions: it works as a pedometer (sensor), as a hub of data collecting and showing the pedometer data and also the heart rate and oxygen levels gathered by the pulse oximeter and as a gateway by allowing the pulse oximeter to use the smartphone mobile data through the smartphone hotspot for the internet connection. Our studies have shown that the pedometer and the pulse oximeter, in terms of distance and steps walked, heart rate and oxygen levels, are effective tools compared to already available on the market devices. Tests on multiple subjects have shown that the pedometer has an accuracy of over 99% for both the distance and steps measurements, independently from the paces of the user, while the pulse oximeter had an accuracy of over 99% for the SpO2 and around 98% for the heart rate estimations. Simulated desaturation tests have shown that the HAM pulse oximeter is also capable of detecting sudden changes of saturation levels with a delay of a few seconds with results comparable to commercially available devices. In conclusion, we have developed a non-invasive, wearable and wireless monitoring system, that provides a quality solution that could be helpful for COPD patients monitoring and for making them more compliant to the therapies prescribed.| File | Dimensione | Formato | |
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https://hdl.handle.net/10589/146223