Smart E-Textile Systems: A Review for Healthcare Applications

Smart Textiles for Personalized Sports and Healthcare

Advances in wearable electronics and information technology drive sports data collection and analysis toward real-time visualization and precision. The growing pursuit of athleticism and healthy life makes it appealing for individuals to track their real-time health and exercise data seamlessly. While numerous devices enable sports and health monitoring, maintaining comfort over long periods remains a considerable challenge, especially in high-intensity and sweaty sports scenarios. Textiles, with their breathability, deformability, and moisture-wicking abilities, ensure exceptional comfort during prolonged wear, making them ideal for wearable platforms. This review summarized the progress of research on textile-based sports monitoring devices. First, the design principles and fabrication methods of smart textiles were introduced systematically. Textiles undergo a distinctive fiber-yarn-fabric or fiber-fabric manufacturing process that allows for the regulation of performance and the integration of functional elements at every step. Then, the performance requirements for precise sports data collection of smart textiles, including main vital signs, joint movement, and data transmission, were discussed. Lastly, the applications of smart textiles in various sports scenarios are demonstrated. Additionally, the review provides an in-depth analysis of the emerging challenges, strategies, and opportunities for the research and development of sports-oriented smart textiles. Smart textiles not only maintain comfort and accuracy in sports, but also serve as inexpensive and efficient information-gathering terminals. Therefore, developing multifunctional, cost-effective textile-based systems for personalized sports and healthcare is a pressing need for the future of intelligent sports.

Development of Textile-Based Strain Sensors for Compression Measurements in Sportswear (Sports Bra)

Women sports wearer's comfort and health are greatly impacted by the breast movements and resultant sports bra compression to prevent excessive movement. However, as sports bras are only made in universal sizes, they do not offer the right kind of support that is required for a certain activity. To prevent this issue, textile-based strain sensors may be utilized to track compression throughout various activities to create activity-specific designed sports bras. Textile-based strain sensors are prepared in this study using various conductive yarns, including steel, Ag-coated polyamide, and polypropylene/steel-blended threads. Various embroidery designs, including straight, zigzag, and square-wave embroidery patterns, etc., were created on knitted fabric and characterized for strain sensing efficiencies. The experiments concluded that strain sensors prepared from polypropylene/steel thread using a 2-thread square-wave design were best performed in terms of linear conductivity, sensitivity of mechanical impact, and wide working range. This best-performed sample was also tested by integrating it into the sportswear for proposed compression measurements in different body movements.

Realizing the Potential of Commercial E-Textiles for Wearable Glucose Biosensing Application

Advancements in wearable technology have enabled noninvasive health monitoring using biosensors. This research focuses on developing a textile-based sweat glucose sensor using commercially available conductive textiles, evading the complexity of traditional fabrication methods. A comparative analysis of three low-cost conductive textiles, Adafruit 1364, 1167, and 4762, has been conducted for electrochemical glucose detection with glucose-specific enzymes such as glucose oxidase (GOx) and glucose dehydrogenase (GDH). Adafruit 1364 outperformed others in morphological, electrochemical, and wearable properties. Cyclic voltammetry shows that Adafruit 1364 and 4762 effectively detect glucose at the potential of 0.23 and 0.08 V using glucose oxidase and 0.1 and 0.08 V using glucose dehydrogenase enzymes, respectively. Furthermore, chronoamperometry has been conducted to confirm the presence of glucose at 1 μM concentration. Differential pulse voltammetry was conducted to assess the sensitivity of the Adafruit 1364 fabric electrode using glucose solutions with concentrations of 0.05, 0.15, 0.25, and 0.5 mM. The electrode immobilized with GOx showed a sensitivity of 0.005 μA μM-1 and a limit of detection (LOD) of 41.3 μM, while the electrode immobilized with GDH exhibited a sensitivity of 0.0019 μA μM-1 and an LOD of 63.1 μM. The study also highlighted the reproducibility, effect of interferents, and advantageous wearable properties of these sensors.

Flexible multimaterial fibers in modern biomedical applications

Biomedical devices are indispensable in modern healthcare, significantly enhancing patients' quality of life. Recently, there has been a drastic increase in innovations for the fabrication of biomedical devices. Amongst these fabrication methods, the thermal drawing process has emerged as a versatile and scalable process for the development of advanced biomedical devices. By thermally drawing a macroscopic preform, which is meticulously designed and integrated with functional materials, hundreds of meters of multifunctional fibers are produced. These scalable flexible multifunctional fibers are embedded with functionalities such as electrochemical sensing, drug delivery, light delivery, temperature sensing, chemical sensing, pressure sensing, etc. In this review, we summarize the fabrication method of thermally drawn multifunctional fibers and highlight recent developments in thermally drawn fibers for modern biomedical application, including neural interfacing, chemical sensing, tissue engineering, cancer treatment, soft robotics and smart wearables. Finally, we discuss the existing challenges and future directions of this rapidly growing field.

Advanced Flexible Physical Sensors with Independent Detection Mechanisms of Pressure and Strain Stimuli for Overcoming Signal Interference

Flexible and wearable physical sensors have gained significant interest owing to their potential in attachable devices, electronic skin, and multipurpose sensors. The physical stimuli of these sensors typically consist of vertically and horizontally applied pressures and strains, respectively. However, owing to their similar response characteristics, interference occurs between the two types of signals detected, complicating the distinction between pressure and strain stimuli, leading to inaccurate data interpretation and reduced sensor specificity. Therefore, we developed a dual-sensing-mode physical sensor with separate response mechanisms for the two types of physical stimuli based on a unique structural design that can independently induce changes in the piezocapacitance and piezoresistance for pressure and strain stimuli, respectively. The asterisk-shaped piezoresistive pathway (electrode), designed for multifunctionality, effectively detected the intensity and direction of tensile deformation, and an elastomeric sponge structure positioned between the two electrodes detected the pressure signals via changes in capacitance. This dual-sensing-mode sensor offers clearer signal differentiation and enhanced multifunctionality compared to those of traditional single-mode sensors. Additionally, extensive experimentation demonstrated that our sensor has a good sensitivity, high linearity, and stability in detecting signals, proving its applicability for sophisticated monitoring and control tasks that require the differential detection between pressure and deformation signals.

Microwave Resonators for Wearable Sensors Design: A Systematic Review

The field of flexible electronics is undergoing an exponential evolution due to the demand of the industry for wearable devices, wireless communication devices and networks, healthcare sensing devices and the technology around the Internet of Things (IoT) framework. E-tex tiles are attracting attention from within the healthcare areas, amongst others, for providing the possibility of developing continuous patient monitoring solutions and customized devices to accommodate each patient's specific needs. This review paper summarizes multiple approaches investigated in the literature for wearable/flexible resonators working as antenna-based systems, sensors and filters with special attention paid to the integration to flexible materials, especially textiles. This review manuscript provides a general overview of the flexible resonators' advantages and drawbacks, materials, fabrication techniques and processes and applications. Finally, the main challenges and future prospects of wearable resonators are discussed.

Recent research trends in textile-based temperature sensors: a mini review

In this review, the current state of research on textile-based temperature sensors is explored by focusing on their potential use in various applications. The textile-based sensors show various advantages including flexibility, conformability and seamlessness for the wearer. Integration of the textile-based sensors into clothes or fabric-based products enables continuous and sensitive monitoring of change in temperature, which can be used for various medical and fitness applications. However, there are lacks of comprehensive review on the textile-based temperature sensors. This review introduces various types of textile-based temperature sensors, including resistive, thermoelectric and fibre-optical sensors. In addition, the challenges that need to be addressed to fully realise their potential, which include improving sensitivity and accuracy, integrating wireless communication capabilities, and developing low-cost fabrication techniques. The technological advances in textile-based temperature sensors to overcome the limitations will revolutionize wearable devices requiring function of temperature monitoring.

Parasitic capacitance modeling and measurements of conductive yarns for e-textile devices

Conductive yarns have emerged as a viable alternative to metallic wires in e-Textile devices, such as antennas, inductors, interconnects, and more, which are integral components of smart clothing applications. But the parasitic capacitance induced by their micro-structure has not been fully understood. This capacitance greatly affects device performance in high-frequency applications. We propose a lump-sum and turn-to-turn model of an air-core helical inductor constructed from conductive yarns, and systematically analyze and quantify the parasitic elements of conductive yarns. Using three commercial conductive yarns as examples, we compare the frequency response of copper-based and yarn-based inductors with identical structures to extract the parasitic capacitance. Our measurements show that the unit-length parasitic capacitance of commercial conductive yarns ranges from 1 fF/cm to 3 fF/cm, depending on the yarn's microstructure. These measurements offer significant quantitative estimation of conductive yarn parasitic elements and provide valuable design and characterization guidelines for e-Textile devices.

E-Textile by Printing an All-through Penetrating Copper Complex Ink

Wearable electronics is an emerging field in academics and industry, in which electronic devices, such as smartwatches and sensors, are printed or embedded within textiles. The electrical circuits in electronics textile (e-textile) should withstand many cycles of bending and stretching. Direct printing of conductive inks enables the patterning of electrical circuits; however, while using conventional nanoparticle-based inks, printing onto the fabric results in a thin layer of a conductor, which is not sufficiently robust and impairs the reliability required for practical applications. Here, we present a new process for fabricating robust stretchable e-textile using a thermodynamically stable, solution-based copper complex ink, which is capable of full penetrating the fabric. After printing on knitted stretchable fabrics, they were heated, and the complex underwent an intermolecular self-reduction reaction. The continuously formed metallic copper was used as a seed layer for electroless plating (EP) to form highly conductive circuits. It was found that the stretching direction has a significant role in resistivity. This new approach enables fabricating e-textiles with high stretchability and durability, as demonstrated for wearable gloves, toward printing functional e-textile.

Electronic textiles: New age of wearable technology for healthcare and fitness solutions

Sedentary lifestyles and evolving work environments have created challenges for global health and cause huge burdens on healthcare and fitness systems. Physical immobility and functional losses due to aging are two main reasons for noncommunicable disease mortality. Smart electronic textiles (e-textiles) have attracted considerable attention because of their potential uses in health monitoring, rehabilitation, and training assessment applications. Interactive textiles integrated with electronic devices and algorithms can be used to gather, process, and digitize data on human body motion in real time for purposes such as electrotherapy, improving blood circulation, and promoting wound healing. This review summarizes research advances on e-textiles designed for wearable healthcare and fitness systems. The significance of e-textiles, key applications, and future demand expectations are addressed in this review. Various health conditions and fitness problems and possible solutions involving the use of multifunctional interactive garments are discussed. A brief discussion of essential materials and basic procedures used to fabricate wearable e-textiles are included. Finally, the current challenges, possible solutions, opportunities, and future perspectives in the area of smart textiles are discussed.

SenGlove—A Modular Wearable Device to Measure Kinematic Parameters of The Human Hand

For technical or medical applications, the knowledge of the exact kinematics of the human hand is key to utilizing its capability of handling and manipulating objects and communicating with other humans or machines. The optimal relationship between the number of measurement parameters, measurement accuracy, as well as complexity, usability and cost of the measuring systems is hard to find. Biomechanic assumptions, the concepts of a biomechatronic system and the mechatronic design process, as well as commercially available components, are used to develop a sensorized glove. The proposed wearable introduced in this paper can measure 14 of 15 angular values of a simplified hand model. Additionally, five contact pressure values at the fingertips and inertial data of the whole hand with six degrees of freedom are gathered. Due to the modular design and a hand size examination based on anthropometric parameters, the concept of the wearable is applicable to a large variety of hand sizes and adaptable to different use cases. Validations show a combined root-mean-square error of 0.99° to 2.38° for the measurement of all joint angles on one finger, surpassing the human perception threshold and the current state-of-the-art in science and technology for comparable systems.

Highly Washable and Conductive Cotton E-textiles Based on Electrochemically Exfoliated Graphene

In this study, cotton e-textiles were obtained using two types of graphene oxide. The first type of graphene oxide was synthesized using the Hummers' method. The second type was obtained by the electrochemical exfoliation of graphite in an ammonium salt solution. It was shown that e-textiles based on electrochemically exfoliated graphene have a higher electrical conductivity (2 kΩ/sq) than e-textiles based on graphene oxide obtained by the Hummers' method (585 kΩ/sq). In addition, textiles based on electrochemically exfoliated graphene exhibit better washing and mechanical stress stability. The electrical resistance of the e-textiles increased only 1.86 times after 10 cycles of washing, compared with 48 times for the Hummers' method graphene oxide textiles. The X-ray photoelectron spectra of the two types of graphene oxides showed similarity in their functional compositions after reduction. Studies of individual graphene flakes by atomic force microscopy showed that graphene oxide of the second type had a smaller lateral size. Raman spectroscopy showed a higher degree of sp² structure regeneration after reduction for the second type of graphene. These properties and the tendency to form agglomerated particles determine the mechanochemical stability and high electrical conductivity of e-textiles based on electrochemically exfoliated graphene.

Wearables for Engagement Detection in Learning Environments: A Review

Appropriate teaching-learning strategies lead to student engagement during learning activities. Scientific progress and modern technology have made it possible to measure engagement in educational settings by reading and analyzing student physiological signals through sensors attached to wearables. This work is a review of current student engagement detection initiatives in the educational domain. The review highlights existing commercial and non-commercial wearables for student engagement monitoring and identifies key physiological signals involved in engagement detection. Our findings reveal that common physiological signals used to measure student engagement include heart rate, skin temperature, respiratory rate, oxygen saturation, blood pressure, and electrocardiogram (ECG) data. Similarly, stress and surprise are key features of student engagement.

Smart Textile Sock System for Athletes’ Self-Correction during Functional Tasks: Formative Usability Evaluation

(1) Background: The development of a lightweight, easy-to-use system that measures the foot’s plantar pressure is becoming an increasingly important area of research in physiotherapy. For further development of the smart sock system, a formative usability study was conducted, where the smart textile sock sensor system was used for self-correction during functional tasks; (2) Methods: Five athletes from the football school participated in the formative usability study. Athletes performed pre-defined functional tasks for self-correction when interacting with the smart textile sock system. Formative usability evaluation methods: effectiveness (task success rate, error rate), efficiency (time-based), satisfaction evaluated by System Usability Scale (SUS); (3) Results: Formative usability indicators: task completeness effectiveness ranged from 40% to 100% in the first- and second-stage tasks. Completed task efficiency time: Stage 1, from 4.2 s (SD 1.3) to 88.8 s (SD 19.8); Stage 2, from 7.2 s (SD 1.9) to 9.6 s (SD 2.1). Satisfaction was assessed by the SUS system user group with 76 points (SD 7.42), which indicates “good” satisfaction; (4) Conclusions: formative usability indicators showed the need for technical improvements to the smart textile sock pressure sensor system. The SUS results indicate “good” satisfaction with the smart textile sock pressure sensor system and its application.

Advances in the Robustness of Wearable Electronic Textiles: Strategies, Stability, Washability and Perspective

Flexible electronic textiles are the future of wearable technology with a diverse application potential inspired by the Internet of Things (IoT) to improve all aspects of wearer life by replacing traditional bulky, rigid, and uncomfortable wearable electronics. The inherently prominent characteristics exhibited by textile substrates make them ideal candidates for designing user-friendly wearable electronic textiles for high-end variant applications. Textile substrates (fiber, yarn, fabric, and garment) combined with nanostructured electroactive materials provide a universal pathway for the researcher to construct advanced wearable electronics compatible with the human body and other circumstances. However, e-textiles are found to be vulnerable to physical deformation induced during repeated wash and wear. Thus, e-textiles need to be robust enough to withstand such challenges involved in designing a reliable product and require more attention for substantial advancement in stability and washability. As a step toward reliable devices, we present this comprehensive review of the state-of-the-art advances in substrate geometries, modification, fabrication, and standardized washing strategies to predict a roadmap toward sustainability. Furthermore, current challenges, opportunities, and future aspects of durable e-textiles development are envisioned to provide a conclusive pathway for researchers to conduct advanced studies.