Hexoskin Smart Shirt Can Accurately Assess Respiratory Function, May Be Tool in CF, Study Shows

Using a simple shirt — a smart one — is closer to becoming a common method to measure lung function in patients with respiratory conditions, including chronic obstructive pulmonary disease (COPD) and cystic fibrosis.

A new study conducted by researchers from Radboud University Medical Center and University of Twente, both in the Netherlands, has showed that the Hexoskin smart shirt — developed by Carré Technologies — can accurately assess lung function in healthy people.

Supported by these positive results, the team plans to further explore the potential of this smart shirt to monitor lung function in people with lung diseases, like COPD.

“Smart shirts are already available, but they tend to be used by professional or amateur sportsmen and women. We wanted to see whether a smart shirt could provide an accurate and more practical alternative for measuring lung function,” Denise Mannée, a technical physician at Radboud University Medical Centre, said in a press release.

The findings were presented by Mannée at the European Respiratory Society (ERS) International Congress 2019, held in Madrid, Spain, Sept. 28-Oct. 2, in a poster titled “Tidal volumes during tasks of daily living measured with a smart shirt.”

Evaluation of lung function is often required to be done at a clinic, using specific equipment, such as an exercise bike and face masks that need to be connected to a computer. Although these methods are very useful and accurate, they are not very practical — and cannot be used to measure respiratory function while doing everyday activities.

Hexoskin represents a user-friendly alternative that allows the remote monitoring of lung function. The smart shirt has incorporated sensors that assess lung volume as the fabric stretches with each inspiration and expiration chest movement — basically with each breath. It also has incorporated sensors that can record heart rate and movement.

All data collected by the Hexoskin can be transferred to its own analytics software, which can be used with a mobile phone or computer for health monitoring.

In this study, the team evaluated the ability of Hexoskin to measure changes in lung volume in 15 healthy volunteers tasked with everyday activities, such as lying down, sitting, standing, climbing stairs, and vacuuming.

Volunteers also were asked to use the Oxycon Mobile system by Vyaire Medical — more traditional equipment that measures breathing patterns — at the same time, for comparison. Oxycon uses a face mask and backpack-sized sensors that record inhaled and exhaled air volumes.

Analysis of the data collected with both equipment showed similar results, regardless of the activity performed. The difference between the two methods was just 0.2% on average — which only represents a few milliliters of air — when volunteers were lying down. The differences were slightly bigger during more active movements, such as vacuuming, in which the variation was 3.1% (around 40 ml).

Of note, when the team repeated the measurements on a second use, the differences were found to be larger. This suggests that every time the Hexoskin is used, it should be recalibrated.

The volunteers said the smart shirts were comfortable to use, and could be worn underneath their normal clothes.

“These results are important because they indicate that the smart shirt can be worn by patients while they go about their daily lives to accurately measure their lung function,” Mannée said.

The team believes that the smart shirt may be helpful in evaluating and monitoring changes in the lung function of people with pulmonary diseases, including asthma or cystic fibrosis, or after a lung transplant.

“Ultimately, we want to improve patients’ quality of life. If we can accurately monitor patients’ symptoms while they go about their normal activities, we might be able to spot problems and treat them sooner, and this in turn could mean less time in hospital,” Mannée said.

Using the smart shirts could help people with respiratory disorders to predict disease worsening so they can step up their treatment earlier, said Thierry Troosters, professor at the University Hospitals Leuven, in Belgium, and president of the European Respiratory Society.

“Smart shirt technology offers a promising, though relatively expensive, tool for monitoring patients’ respiratory health status during normal activities in a way that does not interfere too much with their daily live,” Troosters said. “Commbined with using a smartphone interface, such data may help to inform trained healthcare providers about the ‘status’ of their patients.”

Troosters said using this type of “artificial intelligence and deep learning algorithms” means that respiratory monitoring would be able to be done automatically. That would reduce the “burden of dealing with these data” to a minimum.

“We look forward to seeing more work into this area of respiratory research,” he concluded.