Evaluation of dry textile electrodes for long-term electrocardiographic monitoring

Efficacy of Various Dry Electrode-Based ECG Sensors: A Review

Long-term electrocardiogram (ECG) monitoring is crucial for detecting and diagnosing cardiovascular diseases (CVDs). Monitoring cardiac health and activities using efficient, noninvasive, and cost-effective techniques such as ECG can be vital for the early detection of different CVDs. Wet electrode-based traditional ECG techniques come with unavoidable limitations of the altered quality of ECG signals caused by gel volatilization and unwanted noise followed by dermatitis. The limitation related to the wet electrodes for long-term ECG monitoring in static and dynamic postures reminds us of the urgency of a suitable substitute. Dry electrodes promise long-term ECG monitoring with the potential for significant noise reduction. This review discusses traditional and alternative techniques to record ECG in terms of meeting the efficient detection of CVDs by conducting a detailed analysis of different types of dry electrodes along with materials (substrate, support, matrix, and conductive part) used for fabrication, followed by the number of human subjects they have been used for validation. The degradation of these electrodes has also been discussed briefly. This review finds a need for more validation on a sufficient number of subjects and the issue of cost and noise hindering the commercialization of these dry electrodes.

Closed-Loop Recycling of Wearable Electronic Textiles

Wearable electronic textiles (e-textiles) are transforming personalized healthcare through innovative applications. However, integrating electronics into textiles for e-textile manufacturing exacerbates the rapidly growing issues of electronic waste (e-waste) and textile recycling due to the complicated recycling and disposal processes needed for mixed materials, including textile fibers, electronic materials, and components. Here, first closed-loop recycling for wearable e-textiles is reported by incorporating the thermal-pyrolysis of graphene-based e-textiles to convert them into graphene-like electrically conductive recycled powders. A scalable pad-dry coating technique is then used to reproduce graphene-based wearable e-textiles and demonstrate their potential healthcare applications as wearable electrodes for capturing electrocardiogram (ECG) signals and temperature sensors. Additionally, recycled graphene-based textile supercapacitor highlights their potential as sustainable energy storage devices, maintaining notable durability and retaining ≈94% capacitance after 1000 cycles with an areal capacitance of 4.92 mF cm⁻2. Such sustainable closed-loop recycling of e-textiles showcases the potential for their repurposing into multifunctional applications, promoting a circular approach that potentially prevents negative environmental impact and reduces landfill disposal.

Design, Fabrication, and Evaluation of 3D Biopotential Electrodes and Intelligent Garment System for Sports Monitoring

This study presents the development and evaluation of an innovative intelligent garment system, incorporating 3D knitted silver biopotential electrodes, designed for long-term sports monitoring. By integrating advanced textile engineering with wearable monitoring technologies, we introduce a novel approach to real-time physiological signal acquisition, focusing on enhancing athletic performance analysis and fatigue detection. Utilizing low-resistance silver fibers, our electrodes demonstrate significantly reduced skin-to-electrode impedance, facilitating improved signal quality and reliability, especially during physical activities. The garment system, embedded with these electrodes, offers a non-invasive, comfortable solution for continuous ECG and EMG monitoring, addressing the limitations of traditional Ag/AgCl electrodes, such as skin irritation and signal degradation over time. Through various experimentation, including impedance measurements and biosignal acquisition during cycling activities, we validate the system's effectiveness in capturing high-quality physiological data. Our findings illustrate the electrodes' superior performance in both dry and wet conditions. This study not only advances the field of intelligent garments and biopotential monitoring, but also provides valuable insights for the application of intelligent sports wearables in the future.

Multichannel microneedle dry electrode patches for minimally invasive transdermal recording of electrophysiological signals

The collection of multiple-channel electrophysiological signals enables a comprehensive understanding of the spatial distribution and temporal features of electrophysiological activities. This approach can help to distinguish the traits and patterns of different ailments to enhance diagnostic accuracy. Microneedle array electrodes, which can penetrate skin without pain, can lessen the impedance between the electrodes and skin; however, current microneedle methods are limited to single channels and cannot achieve multichannel collection in small areas. Here, a multichannel (32 channels) microneedle dry electrode patch device was developed via a dimensionality reduction fabrication and integration approach and supported by a self-developed circuit system to record weak electrophysiological signals, including electroencephalography (EEG), electrocardiogram (ECG), and electromyography (EMG) signals. The microneedles reduced the electrode-skin contact impedance by penetrating the nonconducting stratum corneum in a painless way. The multichannel microneedle array (MMA) enabled painless transdermal recording of multichannel electrophysiological signals from the subcutaneous space, with high temporal and spatial resolution, reaching the level of a single microneedle in terms of signal precision. The MMA demonstrated the detection of the spatial distribution of ECG, EMG and EEG signals in live rabbit models, and the microneedle electrode (MNE) achieved better signal quality in the transcutaneous detection of EEG signals than did the conventional flat dry electrode array. This work offers a promising opportunity to develop advanced tools for neural interface technology and electrophysiological recording.

Benchtop Performance of Novel Mixed Ionic-Electronic Conductive Electrode Form Factors for Biopotential Recordings

Background: Traditional gel-based (wet) electrodes for biopotential recordings have several shortcomings that limit their practicality for real-world measurements. Dry electrodes may improve usability, but they often suffer from reduced signal quality. We sought to evaluate the biopotential recording properties of a novel mixed ionic-electronic conductive (MIEC) material for improved performance. Methods: We fabricated four MIEC electrode form factors and compared their signal recording properties to two control electrodes, which are electrodes commonly used for biopotential recordings (Ag-AgCl and stainless steel). We used an agar synthetic skin to characterize the impedance of each electrode form factor. An electrical phantom setup allowed us to compare the recording quality of simulated biopotentials with ground-truth sources. Results: All MIEC electrode form factors yielded impedances in a similar range to the control electrodes (all <80 kΩ at 100 Hz). Three of the four MIEC samples produced similar signal-to-noise ratios and interfacial charge transfers as the control electrodes. Conclusions: The MIEC electrodes demonstrated similar and, in some cases, better signal recording characteristics than current state-of-the-art electrodes. MIEC electrodes can also be fabricated into a myriad of form factors, underscoring the great potential this novel material has across a wide range of biopotential recording applications.

Measuring Surface Electromyography with Textile Electrodes in a Smart Leg Sleeve

This paper presents the design, development, and validation of a novel e-textile leg sleeve for non-invasive Surface Electromyography (sEMG) monitoring. This wearable device incorporates e-textile sensors for sEMG signal acquisition from the lower limb muscles, specifically the anterior tibialis and lateral gastrocnemius. Validation was conducted by performing a comparative study with eleven healthy volunteers to evaluate the performance of the e-textile sleeve in acquiring sEMG signals compared to traditional Ag/AgCl electrodes. The results demonstrated strong agreement between the e-textile and conventional methods in measuring descriptive metrics of the signals, including area, power, mean, and root mean square. The paired data t-test did not reveal any statistically significant differences, and the Bland-Altman analysis indicated negligible bias between the measures recorded using the two methods. In addition, this study evaluated the wearability and comfort of the e-textile sleeve using the Comfort Rating Scale (CRS). Overall, the scores confirmed that the proposed device is highly wearable and comfortable, highlighting its suitability for everyday use in patient care.

Electrospun Rubber Nanofiber Web-Based Dry Electrodes for Biopotential Monitoring

This study aims to find base materials for dry electrode fabrication with high accuracy and without reducing electrode performance for long-term bioelectric potential monitoring after electroless silver plating. Most applications of dry electrodes that have been developed in the past few decades are restricted by low accuracy compared to commercial Ag/AgCl gel electrodes, as in our previous study of PVDF-based dry electrodes. In a recent study, however, nanoweb-based chlorinated polyisoprene (CPI) and poly(styrene-b-butadiene-b-styrene) (SBS) rubber were selected as promising candidates due to their excellent elastic properties, as well as their nanofibril nature, which may improve electrode durability and skin contact. The electroless silver plating technique was employed to coat the nanofiber web with silver, and silver nanoweb(AgNW)-based dry electrodes were fabricated. The key electrode properties (contact impedance, step response, and noise characteristics) for AgNW dry electrodes were investigated thoroughly using agar phantoms. The dry electrodes were subsequently tested on human subjects to establish their realistic performance in terms of ECG, EMG monitoring, and electrical impedance tomography (EIT) measurements. The experimental results demonstrated that the AgNW dry electrodes, particularly the SBS-AgNW dry electrodes, performed similarly to commercial Ag/AgCl gel electrodes and were outperformed in terms of long-term stability.

Recent Advances and Challenges in Textile Electrodes for Wearable Biopotential Signal Monitoring: A Comprehensive Review

The technology of wearable medical equipment has advanced to the point where it is now possible to monitor the electrocardiogram and electromyogram comfortably at home. The transition from wet Ag/AgCl electrodes to various types of gel-free dry electrodes has made it possible to continuously and accurately monitor the biopotential signals. Fabrics or textiles, which were once meant to protect the human body, have undergone significant development and are now employed as intelligent textile materials for healthcare monitoring. The conductive textile electrodes provide the benefit of being breathable and comfortable. In recent years, there has been a significant advancement in the fabrication of wearable conductive textile electrodes for monitoring biopotential signals. This review paper provides a comprehensive overview of the advances in wearable conductive textile electrodes for biopotential signal monitoring. The paper covers various aspects of the technology, including the electrode design, various manufacturing techniques utilised to fabricate wearable smart fabrics, and performance characteristics. The advantages and limitations of various types of textile electrodes are discussed, and key challenges and future research directions are identified. This will allow them to be used to their fullest potential for signal gathering during physical activities such as running, swimming, and other exercises while being linked into wireless portable health monitoring systems.

Evaluation of Novel Embroidered Textile-Electrodes Made from Hybrid Polyamide Conductive Threads for Surface EMG Sensing

Recently, there has been an increase in the number of reports on textile-based dry electrodes that can detect biopotentials without the need for electrolytic gels. However, these textile electrodes have a higher electrode skin interface impedance due to the improper contact between the skin and the electrode, diminishing the reliability and repeatability of the sensor. To facilitate improved skin-electrode contact, the effects of load and holding contact pressure were monitored for an embroidered textile electrode composed of multifilament hybrid thread for its application as a surface electromyography (sEMG) sensor. The effect of the textile's inter-electrode distance and double layering of embroidery that increases the density of the conductive threads were studied. Electrodes embroidered onto an elastic strap were wrapped around the forearm with a hook and loop fastener and tested for their performance. Time domain features such as the Root Mean Square (RMS), Average Rectified Value (ARV), and Signal to Noise Ratio (SNR) were quantitatively monitored in relation to the contact pressure and load. Experiments were performed in triplicates, and the sEMG signal characteristics were observed for various loads (0, 2, 4, and 6 kg) and holding contact pressures (5, 10, and 20 mmHg). sEMG signals recorded with textile electrodes were comparable in amplitude to those recorded using typical Ag/AgCl electrodes (28.45 dB recorded), while the signal-to-noise ratios were, 11.77, 19.60, 19.91, and 20.93 dB for the different loads, and 21.33, 23.34, and 17.45 dB for different holding pressures. The signal quality increased as the elastic strap was tightened further, but a pressure higher than 20 mmHg is not recommended because of the discomfort experienced by the subjects during data collection.

Mucosa-interfacing electronics

The surface mucosa that lines many of our organs houses myriad biometric signals and, therefore, has great potential as a sensor-tissue interface for high-fidelity and long-term biosensing. However, progress is still nascent for mucosa-interfacing electronics owing to challenges with establishing robust sensor-tissue interfaces; device localization, retention and removal; and power and data transfer. This is in sharp contrast to the rapidly advancing field of skin-interfacing electronics, which are replacing traditional hospital visits with minimally invasive, real-time, continuous and untethered biosensing. This Review aims to bridge the gap between skin-interfacing electronics and mucosa-interfacing electronics systems through a comparison of the properties and functions of the skin and internal mucosal surfaces. The major physiological signals accessible through mucosa-lined organs are surveyed and design considerations for the next generation of mucosa-interfacing electronics are outlined based on state-of-the-art developments in bio-integrated electronics. With this Review, we aim to inspire hardware solutions that can serve as a foundation for developing personalized biosensing from the mucosa, a relatively uncharted field with great scientific and clinical potential.

Fabrication of Textile-Based Dry Electrode and Analysis of Its Surface EMG Signal for Applying Smart Wear

Ag/AgCl hydrogel electrodes, which are wet electrodes, are generally used to acquire bio-signals non-invasively. Research concerning dry electrodes is ongoing due to the following limitations of wet electrodes: (1) skin irritation and disease when attached for a long time; (2) poor adhesion due to sweat; and (3) considerable cost due to disposable use. Accordingly, electrodes in film, embroidery, and knit forms were manufactured from conductive sheets and conductive yarns, which are typical textile-type dry electrode materials, using different manufacturing methods and conditions. The prepared electrodes were conducted to measure the morphology, surface resistance, skin-electrode impedance, EMG signal acquisition, and analysis. The conductive sheet type electrode exhibited a similar skin-impedance, noise, and muscle activation signal amplitude to the Ag/AgCl gel electrode due to the excellent adhesion and shape stabilization. Embroidery electrodes were manufactured based on two-dimension lock stitch (Em_LS) and three-dimension moss-stitch (Em_MS). More stable EMG signal acquisition than Em_LS was possible when manufactured with Em_MS. The knit electrode was manufactured with the typical structures of plain, purl, and interlock. Although it was possible to acquire EMG signals, considerable noise was generated as the shape and size of the electrodes were changed due to the stretch characteristics of the knit structure. Finally, the applicability of the textile-type dry electrode was confirmed by combining it with a wearable device. More stable and accurate EMG signal acquirement will be possible through more precise parameter control in the future.

Exploring textile-based electrode materials for electromyography smart garments

Introduction

In recent years, electromyography (EMG) has been increasingly studied for wearable applications. Conventional gel electrodes for electrophysiological recordings have limited use in everyday applications such as prosthetic control or muscular therapy at home. This study investigates the efficacy and feasibility of dry-contact electrode materials employed in smart textiles for EMG recordings.

Methods

Dry-contact electrode materials were selected and implemented on textile substrates. Using these electrodes, EMG was recorded from the forearm of able-bodied subjects. 25% and 50% isometric maximum voluntary contractions were captured. A comparative investigation was performed against gel electrodes, assessing the effect of material properties on signal fidelity and strength compared.

Results

When isolating for electrode surface area and pressure, 31 of the 40 materials demonstrated strong positive correlations in their mean PSD with gel electrodes (r > 95, p < 0.001). The inclusion of ionic liquids in the material composition, and using raised or flat electrodes, did not demonstrate a significant effect in signal quality.

Conclusions

For EMG dry-contact electrodes, comparing the performance against gel electrodes for the application with the selected material is important. Other factors recommended to be studied are electrodes’ durability and long-term stability.