System-level Design of Adaptive Wearable Sensors for Health and Wellness Monitoring

In recent years, population aging and the consequent higher incidence of noncommunicable diseases, have increased the need for long-term health monitoring. Moreover, as healthcare cost is projected to grow substantially by 2030 in OECD countries, the demand for portable, easy-to-use and low cost ultra-low power means of monitoring, diagnosis and prevention rises. Wearable sensors technology for remote health and wellness monitoring is an optimal candidate to tackle this problem and has advanced drastically in the last years. However, wearable sensors impose several design constraints. They must process data in real-time and provide highly accurate diagnosis and adapt to different cases. At the same time, to perform long-term monitoring, they must maximize battery lifetime, hence, usability. However, the need for more accurate algorithms and the need to obtain energy-efficient implementations can work against each other. For this reason, enhancing the energy-accuracy trade-off is essential. Several works in the literature have addressed the energy-accuracy trade-off problem. The general approach is to first develop offline methodologies that maximize the algorithm's accuracy, using signal processing and machine learning. Then, these methods are optimized to be implemented as online designs in resource-constrained ultra-low power platforms. However, different problems can occur in these two steps. Most methods use highly variable datasets (mainly having different subjects), others use fixed parameters tailored to specific conditions, which overall decreases the robustness of the algorithm. In traditional single-core devices, some optimizations whose goal is to lower the algorithms' complexity and computational burden, such as downsampling and features reduction, lead to a loss in precision. With the advances of ultra-low power platforms and new machine learning strategies, even more challenges arise. However, these advances allow to exploit the growing capabilities of the platforms and use innovative and more complex strategies that achieve high levels of accuracy, robustness and energy-efficiency. In this thesis, I propose a set of adaptive strategies in the context of remote health and wellness monitoring for an enhanced energy-accuracy trade-off in wearable sensors. First, I present three methodologies for multi-biosignal monitoring and pathology detection, which adapt to the specific physiological conditions by means of personalization to the subject and knowledge acquired from the signal. Second, in the context of modern heterogeneous wearable platforms, I propose a modular approach to software parallelization and hardware acceleration for biomedical applications to maximize the attainable speed-up and, therefore, minimizing energy consumption. Moreover, I propose an approach to scale computing resources and independent memory banks based on the specific characteristics of the patient in modern wearable sensors. Finally, in the context of intensive physical exercise, I propose an online design that adapts to the sudden physiological changes occurring in the signal. This method combines a lightweight algorithm with a more robust though more complex one to reduce energy consumption while maintaining a very high accuracy. Moreover, this adaptive strategy exploits the heterogeneity of modern platforms by matching the complexity of each algorithm with the capabilities of each core, which further enhances the energy-accuracy trade-off.

Adaptive wake and sleep detection for wearable systems

Walter Karlen

Sleep problems and disorders have a serious impact on human health and wellbeing. The rising costs for treating sleep-related chronic diseases in industrialized countries demands efficient prevention. Low-cost, wearable sleep / wake detection systems which give feedback on the wearer's "sleep performance" are a promising approach to reduce the risk of developing serious sleep disorders and fatigue. Not all bio-medical signals that are useful for sleep / wake discrimination can be easily recorded with wearable systems. Sensors often need to be placed in an obtrusive location on the body or cannot be efficiently embedded into a wearable frame. Furthermore, wearable systems have limited computational and energetic resources, which restrict the choice of sensors and algorithms for online processing and classification. Since wearable systems are used outside the laboratory, the recorded signals tend to be corrupted with additional noise that influences the precision of classification algorithms. In this thesis we present the research on a wearable sleep / wake classifier system that relies on cardiorespiratory (ECG and respiratory effort) and activity recordings and that works autonomously with minimal user interaction. This research included the selection of optimal signals and sensors, the development of a custom-tailored hardware demonstrator with embedded classification algorithms, and the realization of experiments in real-world environments for the customization and validation of the system. The processing and classification of the signals were based on Fourier transformations and artificial neural networks that are efficiently implementable into digital signal controllers. Literature analysis and empiric measurements revealed that cardiorespiratory signals are more promising for a wearable sleep / wake classification than clinically used signals such as brain potentials. The experiments conducted during this thesis showed that inter-subject differences within the recorded physiological signals make it difficult to design a sleep / wake classification model that can generalize to a group of subjects. This problem was addressed in two ways: First by adding features from another signal to the classifier, that is, measuring the behavioral quiescence during sleep using accelerometers. Conducted research on different feature extraction methods from accelerometer data showed that this data generalizes well for distinct subjects in the study group. In addition, research on user-adaptation methods was conducted. Behavioral sleep and wake measures, notably the measurement of reactivity and activity, were developed to build up a priori knowledge that was used to adapt the classification algorithm automatically to new situations. This thesis demonstrates the design and development of a low-cost, wearable hardware and embedded software for on-line sleep / wake discrimination. The proposed automatic user-adaptive classifier is advantageous compared to previously suggested classification methods that generalize over multiple subjects, because it can take changes in the wearer's physiology and sleep / wake behavior into account without adjustment from a human expert. The results of this thesis contribute to the development of smart, wearable, bio-physiological monitoring systems which require a high degree of autonomy and have only low computational resources available. We believe that the proposed sleep / wake classification system is a first promising step toward a context-aware system for sleep management, sleep disorder prevention, and reduction of fatigue.

EPFL2009

Assessment of Foot Signature Using Wearable Sensors for Clinical Gait Analysis and Real-Time Activity Recognition

Benoît Mariani

Locomotion is one of the most important abilities of humans. Actually, gait locomotion provides mobility, and symbolizes freedom and independence. However, gait can be affected by several pathologies, due to aging, neurodegenerative disease, or trauma. The evaluation and treatment of mobility diseases thus requires clinical gait assessment, which is commonly done by using either qualitative analysis based on subjective observations and questionnaires, or expensive analysis established in complex motion laboratories settings. This thesis presents a new wearable system and algorithmic methods for gait assessment in natural conditions, addressing the limitations of existing methods. The proposed system provides quantitative assessment of gait performance through simple and precise outcome measures. The system includes wireless inertial sensors worn on the foot, that record data unobtrusively over long periods of time without interfering with subject's walking. Signal processing algorithms are presented for the automatic calibration and online virtual alignment of sensor signals, the detection of temporal parameters and gait phases, and the estimation of 3D foot kinematics during gait based on fusion methods and biomechanical assumptions. The resulting 3D foot trajectory during one gait cycle is defined as Foot Signature, by analogy with hand-written signature. Spatio-temporal parameters of interest in clinical assessment are derived from foot signature, including commonly parameters, such as stride velocity and gait cycle time, as well as original parameters describing inner-stance phases of gait, foot clearance, and turning. Algorithms based on expert and machine learning methods have been also adapted and implemented in real-time to provide input features to recognize locomotion activities including level walking, stairs, and ramp locomotion. Technical validation of the presented methods against gold standard systems was carried out using experimental protocols on subjects with normal and abnormal gait. Temporal aspects and quantitative estimation of foot-flat were evaluated against pressure insoles in subjects with ankle treatments during long-term gait. Furthermore, spatial parameters and foot clearance were compared in young and elderly persons to data obtained from an optical motion capture system during forward gait trials at various speeds. Finally, turning was evaluated in children with cerebral palsy and people with Parkinson's disease against optical motion capture data captured during timed up and go and figure-of-8 tests. Overall, the results demonstrated that the presently proposed system and methods were precise and accurate, and showed agreement with reference systems as well as with clinical evaluations of subjects' mobility disease using classical scores. Currently, no other methods based on wearable sensors have been validated with such precision to measure foot signature and subsequent parameters during unconstrained walking. Finally, we have used the proposed system in a large-scale clinical application involving more than 1800 subjects from age 7 to 77. This analysis provides reference data of common and original gait parameters, as well as their relationship with walking speed, and allows comparisons between different groups of subjects with normal and abnormal gait. Since the presented methods can be used with any foot-worn inertial sensors, or even combined with other systems, we believe our work to open the door to objective and quantitative routine gait evaluations in clinical settings for supporting diagnosis. Furthermore, the present studies have high potential for further research related to rehabilitation based on real-time devices, the investigation of new parameters' significance and their association with various mobility diseases, as well as for the evaluation of clinical interventions.

EPFL2012

Timing is Everything

Karen Adam

In this thesis, timing is everything. In the first part, we mean this literally, as we tackle systems that encode information using timing alone. In the second part, we adopt the standard, metaphoric interpretation of this saying and show the importance of choosing the right time to sample a system, when efficiency is a key consideration.Time encoding machines, or, alternately, integrate-and-fire neurons, encode their inputs using spikes, the timings of which depend on the input and therefore hold information about it. These devices can be made more power efficient than their clocked counterparts and have thus been studied in the fields of signal processing, event-based vision, computational neuroscience and machine learning. However, their timing-based spiking output has so far often been considered a nuisance that one must make do with, rather than a potential advantage. In this thesis, we show that this timing-based output equips spiking devices with capabilities that are out of reach for classical encoding and processing systems.We first discover the benefits of time encoding on multi-channel encoding and recovery of a signal: with time encoding, clock alignment is easy to solve, although it poses problems in the classical sampling scenario. Then, we study the time encoding of low-dimensional signals and see that the asynchrony of spikes allows for a lower sample complexity in comparison with synchronous sampling. Thanks to this same asynchrony, time encoding of video results in an entanglement between spatial sampling density and temporal resolution---a relationship which is not present in frame-based video. Finally, we show that the all-or-none nature of the spikes allows training spiking neural networks in a layer-by-layer fashion---a feat that is impossible with clocked, artificial neural networks, due to the credit assignment problem.The second part of this thesis shows that choosing the right timing of samples can be crucial to ensure efficiency when performing nanoscale magnetic sensing. We are given a stochastic process, where each sample at time t follows a Bernoulli distribution, and which is characterized by oscillation frequencies that we are interested in recovering. We search for an optimal approach to sample this process, such that the variance of the frequencies' estimates is minimized, given constraints on the measurement time. The models we assume stem from the field of nanoscale magnetic sensing, where the number of parameters to be estimated varies with the number of spins one is trying to sense. We present an adaptive approach to choosing samples in both the single-spin and two-spin cases and compare the adaptive algorithm's performance to classical approaches to sampling.In both parts of the thesis, we move away from classical amplitude sampling and consider cases where timing takes the forefront and amplitude information is merely binary, to shows that timing can carry information and that it can control the amount of information gain.

EPFL2022