Wearable knee health system employing novel physiological biomarkers

• Published in: Journal of applied physiology (1985) 2018-03, Vol.124 (3), p.537-547
• Main Authors: Inan, Omer T, Whittingslow, Daniel C, Teague, Caitlin N, Hersek, Sinan, Pouyan, Maziyar Baran, Millard-Stafford, Mindy, Kogler, Geza F, Sawka, Michael N
• Format: Article
• Language: English
• Subjects: Acoustics; Arthritis; Biomarkers; Chronic conditions; Health; Health care; Injuries; Joint diseases; Knee; Learning algorithms; Machine learning; Physical examinations; Physiology; Quality of life; Recovery time; Rehabilitation; Review; Waveforms; Wearable computers; Wearable technology
• ISSN: 8750-7587; 1522-1601
• DOI: 10.1152/japplphysiol.00366.2017

Knee injuries and chronic disorders, such as arthritis, affect millions of Americans, leading to missed workdays and reduced quality of life. Currently, after an initial diagnosis, there are few quantitative technologies available to provide sensitive subclinical feedback to patients regarding improvements or setbacks to their knee health status; instead, most assessments are qualitative, relying on patient-reported symptoms, performance during functional tests, and physical examinations. Recent advances have been made with wearable technologies for assessing the health status of the knee (and potentially other joints) with the goal of facilitating personalized rehabilitation of injuries and care for chronic conditions. This review describes our progress in developing wearable sensing technologies that enable quantitative physiological measurements and interpretation of knee health status. Our sensing system enables longitudinal quantitative measurements of knee sounds, swelling, and activity context during clinical and field situations. Importantly, we leverage machine-learning algorithms to fuse the low-level signal and feature data of the measured time series waveforms into higher level metrics of joint health. This paper summarizes the engineering validation, baseline physiological experiments, and human subject studies-both cross-sectional and longitudinal-that demonstrate the efficacy of using such systems for robust knee joint health assessment. We envision our sensor system complementing and advancing present-day practices to reduce joint reinjury risk, to optimize rehabilitation recovery time for a quicker return to activity, and to reduce health care costs.