Biopotential Signal Monitoring Systems in Rehabilitation: A Review
Abstract
:1. Introduction
2. Background
2.1. EMG and Rehabilitation
2.1.1. EMG in Neurorehabilitation
2.1.2. EMG in Stroke Rehabilitation
2.1.3. EMG in Sports Rehabilitation
2.2. EMG Signal Acquisition: General Considerations
2.2.1. EMG Signal Features
2.2.2. EMG Instrumentation Characteristics
- Accuracy: this characteristic is related to the implementation of the differential amplifier, ADC and several other components connected to inherent noise; the aim is to optimize each used component to minimize noise, ensuring accuracy;
- Sensitivity: this features on the ADC resolution and consequently the overall resolution of the system; it allows the physicians to understand the limits of their reading;
- CMRR: this is the Common-Mode Rejection Ratio, and it expresses the ability of the differential amplifier to reject common-mode signals; it plays a crucial role in avoiding 50–60 Hz power line interference;
- Input impedance: the optimization of this value is relevant in differential amplifier selections and implementations related to different user skin types and electrode interfaces;
- Input range: this specification regards hardware implementation and ADC, specifying the range of the biosignal that can be picked up without saturating the amplifier. A larger input range is preferred to acquire the entire signal, but this requires an expansion of signal resolution;
- SNR: this is the Signal-to-Noise Ratio, and it is the ratio between the signal’s amplitude and the background noise.
3. Research Methodology
- RQ1: what are the most recent contributions in literature?
- RQ2: what are the commonly used medical devices?
- RQ3: how do these contributions and medical devices support physiological monitoring in rehabilitation?
- RQ4: what are the future directions and opportunities for EMG signal acquisition and analysis in a rehabiliation context?
4. Wearable Devices for Rehabilitation
5. Commercial Wearable Devices
6. Discussion
7. Conclusions
Author Contributions
Funding
Conflicts of Interest
Abbreviations
EEG | Electroencephalogram |
ECG | Electrocardiogram |
EMG | Electromyogram |
sEMG | Surface Electromyography |
IC | Integrated Circuit |
NMES | Neuromuscular Electrical Stimulation |
BCI | Brain–Computer Interface |
ADC | Analog-to-Digital Converter |
CMRR | Common-Mode Rejection Ratio |
SNR | Signal-to-Noise Ratio |
AFE | Analog Front-End |
PGA | Programmable Gain Amplifier |
LNA | Low-Noise Amplifier |
BLE | Bluetooth Low Energy |
BIA | Bioelectrical Impedence Analyzer |
CBM | Capacitive Biopotential Measurements |
SoC | System-on-Chip |
ASIC | Application Specified Integrated Circuit |
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Database | URL | Date Access |
---|---|---|
PubMed | https://pubmed.ncbi.nlm.nih.gov/ | 30 June 2021 |
MDPI | https://www.mdpi.com/ | 30 June 2021 |
Springer | https://link.springer.com/ | 30 June 2021 |
ACM Digital Library | https://dl.acm.org/ | 30 June 2021 |
Science Direct | https://www.sciencedirect.com/ | 30 June 2021 |
Authors | Signals | Channels | Platform Characteristics | Features |
---|---|---|---|---|
Tran et al., 2021 | Bio-potentials | 4 channels | Four-channel neural recording analog front-end composed by a low-noise amplifier (LNA), a programmable gain amplifier (PGA) and buffers; 4-to-1 multiplexer (MUX) and analog-to-digital converter (ADC) | Programmable gain from 45 dB to 63 dB, input-referred noise of 3.16 μVRMS within the 10 kHz bandwidth, noise efficiency factor of 2.04, power efficiency factor of 4.16, power consumption of 2.82 μW per channel powered from 1 V supply voltage |
Yin et al., 2021 | Bio-potentials, impedance respiration | Single 1 channel | Oversampling and fast digital lock-in technology, ADS1294R, STM32F103RET6 for signal processing | Improve the common-mode rejection ratio (CMRR) and the signal-to-noise ratio (SNR) of the signal |
Zhao et al., 2020 | ECG/EMG | N.A. | Low-energy Bluetooth module | Wearable monitoring device, software platform for data analysis |
Biagetti et al., 2020 | Bio-potentials | 3 channels | Six electrodes, 24 bits of resolution and a sampling rate up to 3.2 kHz for each channel, Bluetooth Low Energy wireless link | Wireless sensor, real-time acquisition, maximization of the available bandwidth, reliability of the transmission |
Nakamura et al., 2020 | ECG/EMG | N.A. | Analog front-end (AFE) | Capacitive measurements |
Liu et al., 2019 | Bio-potentials | 8 channels | Powerful microcontroller unit, lithium battery, Bluetooth 3.0 data transmission and built-in 2 GB flash memory | Portable device with a graphic user interface (GUI) and an application program for displaying the signals on a computer or a smart device |
Park et al., 2018 | Bio-potentials | 128 channels | Energy-efficient integrated circuit architecture of a -modulated AFE with multi-shank neural probes connected to individual AFEs | The - AFE is characterized by a consume of each single-channel AFE of 3.05 μW from 0.5 and 1.0 V supplies in an area of 0.05 mm2 with 63.8 dB signal-to-noise-and-distortion ratio and 3.02 noise efficiency factor |
Raheem et al., 2018 | Bio-potentials | 2 channels | Programmable gain amplifier (PGA) and 10-bit (SDM-ADC) | High impedance, power consumption of 11 mW, programmable gains from 52.6 dB to 72 dB and input referred noise of 3.5 µV in the amplifier bandwidth |
Mazzetta et al., 2018 | EMG | Differential 1 channel | 32 bit ARM® Cortex®-M4, microSD, Bluetooth 4.0, 592 mWh battery, micro-USB connector, 30 × 30 × 15 mm dimensions, weight of 10 g | Power consumption, compactness and energy autonomy, wireless and comfortably wearable |
Biagetti et al., 2018 | sEMG | N.A. | Ultralight wireless sensing nodes, base station for data transmission through a 2.4 GHz radio link, communication protocol designed on top of the IEEE 802.15.4 physical layer | Low-cost wearable wireless system, user interface software for viewing, recording and analyzing data |
Kast et al., 2017 | Bio-potentials | Bipolar 64 channels | Up to eight front-end acquisition modules with synchronization module, a separated universal serial bus data-link to the computer and an ADS1299 | Raw data are analyzed and stored on a personal computer or a single-board computer |
Sarker et al., 2017 | ECG/EMG | 8 channels | 24 bit resolution/channel and 500 samples/s, IoT-based system | Compact and wearable portable bio-signal acquisition device, real-time data wireless transmission, low energy consumption |
Li et al., 2017 | ECG/EMG | N.A. | 150 mAh rechargeable Li-ion battery, packaged into a 39 × 32 × 17 mm 3D printed small box, total weight of 24.0 g, power management circuit, dual power supply for operational amplifiers | Wearable wireless non-contact system, ultra-high input impedance, feasibility of long-term biopotential monitoring |
Senepati et al., 2017 | ECG/EMG | N.A. | Band pass and band stop FIR filters, Successive Approximation Register (SAR) DAC, Spartan-3E FPGA and 0.18 μm CMOS TSMC technology | Area of 33,005 μm2 area, power consumption of 0.382 mW, suppressing of baselines wander and power line interference noise (50/60 Hz) |
Bhamra et al., 2017 | ECG/EMG | N.A. | ASIC technology in a 0.18 μm CMOS process, high-pass and low-pass cutoff frequencies being 0.5–300 Hz and 150 Hz–10 kHz, antialiasing filter, successive approximation register (SAR) analog-to-digital converter (ADC), power management | Wireless, programmable gain from 38 to 72 dB, AFE and ADC dissipation of 5.74 μW and 306 nW, measured input-referred noise of 2.98 μVrms, noise efficiency factor of 2.6, power efficiency factor of 9.46, area of the AFE of 0.0228 mm2 |
Kim et al., 2016 | Bio-potentials, PPG, BIA | N.A. | CMOS technology, low-power and multimodal analog front-end (AFE) | Wearable health monitoring, low dimension and power consumption |
Mahmud et al., 2016 | ECG | N.A. | Fully integrated analog front-end (AFE), temperature sensor, accelerometer, Bluetooth Low Energy (BLE) module | Multiparameter real time monitoring, small dimensions, Android application, alerts |
Piccinini et al., 2016 | ECG/EMG | N.A. | ADS1294 Medical Analog Front End, CC3200 microcontroller, two Li-ion charged batteries | Portable solution, size physical reduction, robustness in wireless transmission, reliability in data acquisition and processing |
Lee et al., 2016 | ECG/EMG | N.A. | Mixed-signal processor system-on-chip (SoC), Bluetooth Low Energy (BLE) chip, 200 mAh battery | Wireless transmission, power efficiency, 12 h of continuous recording |
Augustyniak et al., 2016 | Bio-potentials | Single-ended 5 channels | Programmable AFE ADAS1000, 24-bit resolution analog-to-digital converter with programmable data rate up to 128 kHz | Wired and wireless body sensor networks, configurable gain for channel |
Features | Biometric | Shimmer | Biosemi | BTS Bioengineering | Biosignal Plux | BITalino | Delsys |
---|---|---|---|---|---|---|---|
Type of sensor | Wireless EMG Sensor | Shimmer3 EMG Unit | ActiveTwo | FreeEMG 1000 H2O | Electro-myography Sensor | Electro-myography Sensor | Trigno Avanti Sensor |
Size (mm × mm × mm) | 42 × 24 × 14 | 65 × 32 × 12 | 120 × 150 × 190 | Probes: 41.5 × 24.8 × 14 | 28 × 70 × 12 | 12 × 27 | 27 × 37 × 13 |
Weight | 17 g | 31 g | 1.1 kg | 13 g—battery included | 25 g | N.A. | 14 g |
# channels | 1 | 2 | 8 up to 256 | 1 | 1 | 1 | 1 differential input |
Input impedance | >100 Mohms | N.A. | >100 M @ 50 Hz | >100 GOhm | 10/7.5 GOhm/pF | ||
Input range | +/−6 mV | Approx. 800 mV @ gain = 6 | +262 mV to −262 mV | N.A. | Up to 10 mV | ±1.64 mV @ VCC = 3.3 V | 11 mV/22 mV rti |
Gain | +/−60 mV to +/−6000 mV | 1,2,3,4,6,8,12 (software configurable) | N.A. | N.A. | 1000 | 1009 | 11 mV/22 mV rti |
CMRR | >96 dB (typically 110 dB) @ 60 Hz | N.A. | >90 dB @ 50 Hz | N.A. | 100 dB | 86 dB | <−80 dB |
Consumption | N.A. | N.A. | 4 Watt @ 280 channels | N.A. | 1 mA | 0.17 mA | N.A. |
Bandwith | 0–250, 470, 950, 5000 Hz | 8.4 kHz | Up to DC—3200 Hz @ –3 dB | N.A. | 25–500 Hz | 25–482 Hz | 10–850 Hz 20–450 Hz |
Data transmission | Wireless | Bluetooth Radio – RN-42 | Fiber optic | Wireless IEEE 802.15.4 | Bluetooth Low Energy | N.A. | 2.400-2.483 GHz ISM Band, Proprietary RF Protocol - BLE V4.2 |
Resolution | N.A. | 24 bit | 24 bit | 16 bit | 12 bit | N.A. | 16 bit |
Sample rate | N.A. | 125, 250, 500, 1000, 2000, 4000, 8000 SPS | 2048 Hz–4096 Hz–8192 Hz–16,384 Hz | N.A. | N.A. | N.A. | 4370 sa/sec |
Battery type and life | Rechargeable Li-ion Polymer, Up to 8 h | 450 mAh rechargeable Li-ion battery | Battery power with >10 h @ 144 channels, >72 h @ 16 channels | Battery Li-Po, Up to 6 h | N.A. | Battery Li-Po 700 mAh | Rechargeable Li-Po Battery Up to 8 h |
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Palumbo, A.; Vizza, P.; Calabrese, B.; Ielpo, N. Biopotential Signal Monitoring Systems in Rehabilitation: A Review. Sensors 2021, 21, 7172. https://doi.org/10.3390/s21217172
Palumbo A, Vizza P, Calabrese B, Ielpo N. Biopotential Signal Monitoring Systems in Rehabilitation: A Review. Sensors. 2021; 21(21):7172. https://doi.org/10.3390/s21217172
Chicago/Turabian StylePalumbo, Arrigo, Patrizia Vizza, Barbara Calabrese, and Nicola Ielpo. 2021. "Biopotential Signal Monitoring Systems in Rehabilitation: A Review" Sensors 21, no. 21: 7172. https://doi.org/10.3390/s21217172