A Systematic Review on Devices for Respiratory System Monitoring and Exercises

Öz

Respiratory exercises create sensory and mechanical stimulation in the thoracic region; they are manual applications that aim to increase the ventilation of the lung area under the chest wall. In the treatment of people with problems in respiratory functions, respiratory exercises are applied manually by physiotherapists within the scope of the pulmonary rehabilitation program and should be included in the home rehabilitation program. Correct performance of these exercises by the patient and follow-up by the physician are important for the effectiveness of the treatment. Within the scope of the review study, it is aimed to conduct a systematic review of the devices designed for the respiratory system, with a focus on features such as receiving patient data, supporting respiratory training, working integrated with telerehabilitation. In this direction, academic research, patents and commercial products are examined. The reviewed devices are compared according to their strengths and weaknesses. As a result of the review, it is evaluated that receiving respiratory system data and meeting respiratory training with active stimuli can increase the respiratory capacity of patients by supporting respiratory mechanics. In addition, it is evaluated that by integrating telerehabilitation application into the system designs, it can contribute to rehabilitation in the home environment for pulmonary rehabilitation.

Anahtar Kelimeler

• Pulmonary Rehabilitation
• Wearable technology
• Respiratory Capacity
• Patient- expert interface

Solunum Sistemi Takibi ve Egzersizlerine Yönelik Cihazlar Üzerine Sistematik Bir İnceleme

Öz

Solunum egzersizleri torakal bölgede duyusal ve mekanik uyarı oluşturma; göğüs duvarı altında bulunan akciğer bölgesi havalanmasını artırmayı amaçlayan manuel uygulamalar ile yapılan uygulamalardır. Solunum fonksiyonlarında problem olan kişilerin tedavisinde pulmoner rehabilitasyon programı kapsamında fizyoterapistler tarafından solunum egzersizleri manuel olarak uygulanmakta ve ev rehabilitasyon programı içerisine dahil edilmesi gerekmektedir. Bu egzersizlerin hasta tarafından doğru, yapılması ve doktor tarafından takibi; tedavinin etkinliği açısından önem arz etmektedir. Derleme çalışması kapsamında, solunum sistemine yönelik tasarlanmış cihazların; hasta verilerini almak, solunum eğitimini desteklemek, telerehabilitasyon ile entegre çalışmak vb. özellikler odağında sistematik bir incelemesinin yapılması amaçlanmaktadır. Bu doğrultuda akademik araştırmalar, patentler ve ticari ürünler incelenmektedir. İncelenen cihazlar güçlü ve zayıf yönlerine göre karşılaştırılmıştır. Derleme çalışması sonucunda solunum sistem verilerini almak ve solunum eğitimini aktif uyaranlar ile karşılamak, hastaların solunum mekaniğini destekleyerek solunum kapasitelerini artırabilmekte olduğu değerlendirilmektedir. Ayrıca sistem tasarımlarına telerehabilitasyon uygulaması entegre edilmesi ile pulmoner rehabilitasyon için ev ortamında rehabilitasyona katkı sağlanabileceği değerlendirilmektedir.

Anahtar Kelimeler

• Pulmoner Rehabilitasyon
• Giyilebilir Teknoloji
• Solunum Kapasitesi
• Hasta - Uzman Arayüzü

Kaynakça

1. [1] Bacak, G., & Gümüştekin, K. (2007). ÖSS’ye Hazırlanan Öğrencilerin Deneme Sınavları Ortalamaları İle Solunum Parametreleri Arasındaki İlişki. (Yüksek lisans tezi). Atatürk Üniversitesi, Sağlık Bilimleri Enstitüsü, Fizyoloji Anabilim Dalı, Erzurum.
2. [2] Yamak, D., & Yamak, B. (2019). Solunum Mekaniği. (s. 21). Ankara: Hipokrat kitabevi.
3. [3] Aboussouan, L. S. (2009). Mechanisms of exercise limitation and pulmonary rehabilitation for patients with neuromuscular disease. Chronic Respiratory Disease, 6(4), 231-249.
4. [4] Laghi, F., & Tobin, M. J. (2003). Disorders of the respiratory muscles. American journal of respiratory and critical care medicine, 168(1), 10-48.
5. [5] nytimes.com [İnternet]. USA; Breathe Better With These Nine Exercises; 2018 [Alıntılama tarihi: 22 Kasım 2022] Erişim adresi: https://www.nytimes.com/2020/07/18/at-home/coronavirus-breathing-exercises.html
6. [6] fizyoo.com [İnternet]. Türkiye; Solunum Egzersizleri Fizik Tedavi; 2018 [Alıntılama tarihi: 22 Kasım 2022] Erişim adresi: https://fizyoo.com/solunum-egzersizleri-fizik-tedavi/
7. [7] Ergene, T., Karabibik, D. (2019), Pulmoner Fizyoterapi- Rehabilitasyonun Teknikleri ve Tamamlayıcıları, (89-101) Ankara: Hipokrat Kitabevi.
8. [8] Loubet, M., Goujon, L., & Barthod, C. (2021). Recording breathing volumes with magnetic motion sensors, dedicated to COPD during the CPT session. 3rd Eurasia Conference on Biomedical Engineering, Healthcare and Sustainability.(s. 60-62).Taiwan: Tainan, Mayıs 28-30.

9. [9] Yang, C. M., Huang, W. T., Yang, T. L., Hsieh, M. C., & Liu, C. T. (2008). Textiles digital sensors for detecting breathing frequency. 5th International Summer School and Symposium on Medical Devices and Biosensors. (s. 276-279). China: Hong Kong, Haziran 1-3.
10. [10] Xiao, G., Ju, J., Lu, H., Shi, X., Wang, X., Wang, W., ... & Lu, Z. (2022). A Weavable and Scalable Cotton‐Yarn‐Based Battery Activated by Human Sweat for Textile Electronics. Advanced Science, 9 (7), 1-14.
11. [11] Zhao, C., Liu, D., Xu, G., Zhou, J., Zhang, X., Liao, C., & Wang, Y. (2022). Recent advances in fiber optic sensors for respiratory monitoring. Optical Fiber Technology, 72, 1-12.
12. [12] Yang, C. M., Yang, T. L., Wu, C. C., Hung, S. H., Liao, M. H., Su, M. J., & Hsieh, H. C. (2014). Textile-based capacitive sensor for a wireless wearable breath monitoring system. IEEE International Conference on Consumer Electronics. (s. 232-233). USA: Las Vegas, January 10-13
13. [13] Bethel, S. J., Joslin, C. T., Shepherd, B. S., Martel, J. M., & Dow, D. E. (2015). Wearable at-home recording system for sleep apnea. 17th International Conference on E-health Networking, Application & Services, (s. 149-152). USA: Boston, October 14-17.
14. [14] Chouvarda, I., Philip, N. Y., Natsiavas, P., Kilintzis, V., Sobnath, D., Kayyali, R., ... & Maglaveras, N. (2014). WELCOME—innovative integrated care platform using wearable sensing and smart cloud computing for COPD patients with comorbidities. 36th Annual International Conference of the IEEE Engineering in Medicine and Biology Society, (s. 3180-3183). USA: Chicago, August 26- 30.
15. [15] Kluge, M. G., Maltby, S., Walker, N., Bennett, N., Aidman, E., Nalivaiko, E., & Walker, F. R. (2021). Development of a modular stress management platform (Performance Edge VR) and a pilot efficacy trial of a bio-feedback enhanced training module for controlled breathing. PloS one, 16(2), 1-22.
16. [16] Puranik, K. A., & Kanthi, M. (2019). Wearable Device for Yogic Breathing. Amity International Conference on Artificial Intelligence. (s. 605-610). United Arab Emirates: Dubai, Şubat 4-6.
17. [17] Choi, K. Y., Lee, J., ElHaouij, N., Picard, R., & Ishii, H. (2021). Aspire: clippable, mobile pneumatic-haptic device for breathing rate regulation via personalizable tactile feedback. Conference on Human Factors in Computing Systems, (pp. 1- 8). Japan: Yokohama, Mayıs 8-13.
18. [18] Ando, T., Kawamura, K., Fujitani, J., Koike, T., Fujimoto, M., & Fujie, M. G. (2011). Thoracic ROM measurement system with visual bio-feedback: System design and biofeedback evaluation. Annual International Conference of the IEEE Engineering in Medicine and Biology Society, (pp. 1272-1274). USA: Boston, Ağustos 30- Eylül 3.
19. [19] Stafford, M., Lin, F., & Xu, W. (2016). Flappy breath: A smartphone-based breath exergame. IEEE First International Conference on Connected Health: Applications, Systems and Engineering Technologies. (pp. 332-333). USA: Washington, Haziran 27-29.
20. [20] Siering, L., Ludden, G. D., Mader, A., & van Rees, H. (2019). A Theoretical Framework and Conceptual Design for Engaging Children in Therapy at Home—The Design of a Wearable Breathing Trainer. Journal of Personalized Medicine, 9(2), 27.
21. [21] Zhang, Y., Wang, Z., Ge, Q., Wang, Z., Zhou, X., Han, S., ... & Wang, D. (2022). Soft Exoskeleton Mimics Human Cough for Assisting the Expectoration Capability of SCI Patients. IEEE Transactions on Neural Systems and Rehabilitation Engineering, 30, 936-946.
22. [22] Tsaknaki, V., Cotton, K., Karpashevich, P., & Sanches, P. (2021). “Feeling the Sensor Feeling you”: A Soma Design Exploration on Sensing Non-habitual Breathing. Conference on Human Factors in Computing Systems. (s. 1-16). USA: New York, Mayıs 8-13.
23. [23] Dietz, H. G. (1986). U.S. Patent No. 4,602,643. Washington, DC: U.S. Patent and Trademark Office.
24. [24] Verheem, J. B. (2004). U.S. Patent No. 10/839,998. Carlsbad, CA: U.S. Patent Application Publication
25. [25] Murphy, M. (2007). U.S. Patent No. 11/657,831. New York, NY: U.S.Patent Application Publication.
26. [26] Wasnick, M. S. (2008). U.S. Patent No. 11/639,657. Poulsbo, WA: U.S. Patent Application Publication.
27. [27] Brauers, A. (2008). W.O. International Application Number: PCT/IB2008/051797
28. [28] Amurthur, B., Bly, M. J., Libbus, I., & Manicka, Y. D. (2009). U.S. Patent No. 2008/0142004. Chicago: US. Patent Application Publication.
29. [29] Dijk, E. O., Janssen, J. H., Westerink, J. H. D. M., De Vries, J. J. G., & Dooren, M. Van. (2012). Patent No. PCT/IB2012/050984. Gronenewoudsewwg, Eindhoven: U.S. World Intellectual Property Organisation, İnternational Application Published Under the Patent Cooperation Treaty.
30. [30] Gavish, B. ve Doron, Y. (2013). U.S. Patent No. 13/926,840. Gereda, IL: U.S. Patent Application Publication.
31. [31] Al Thalab, F. S. (2014). U.S. Patent No. 8,663,126. Washington, DC: U.S. Patent and Trademark Office.
32. [32] Persidsky, A. M., & Ahlund, R. A. (2015). U.S. Patent No. 14/706,939. San Francisco: U.S. Patent Application Publication.
33. [33] Roy, J. F., Fournier, P. A., Robillard, C., Corriveau, R., Dubeau, S., Gagne-turcotte, A., & Khouya, D. (2016). CA Patent No. 14/955,749. Ottawa: Canadien Intellectual Property Office.
34. [34] Dwarika, J. (2017). U.S. Patent No. 15/147,293. Rochester, N.Y.: U.S. Patent Application Publication.
35. [35] techcrunch.com [İnternet]. San Francisco (CA): Josh Constine; [Alıntılama tarihi: 22 Kasım 2022]. Erişim adresi: https://techcrunch.com/2014/06/17/spire-breath-taker/
36. [36] thegadgetflow.com [İnternet]. New York (USA): Genevieve Healey; 2022 [Alıntılama tarihi: 22 Kasım 2022]. Erişim adresi: https://thegadgetflow.com/portfolio/oxa-breathing-wearable-uses-live-biofeedback-to-both-reduce-stress-improve-sleep/
37. [37] prana.co [İnternet]. USA; Prana; 2022 [Alıntılama tarihi: 22 Kasım 2022] Erişim adresi: https://prana.co/pages/how-it-works
38. [38] equivital.com [İnternet]. Cambridge (UK): Eq lifemonitor; 2022 [Alıntılama tarihi: 22 Kasım 2022]. Erişim adresi: https://equivital.com/products/eq02-lifemonitor/.
39. [39] zephyranywhere.com [İnternet]. Colorado (ABD): Zephyr; 2022 [Alıntılama tarihi: 22 Kasım 2022]. Erişim adresi: https://www.zephyranywhere.com/system/overview
40. [40] hexoskin.com [İnternet]. Montréal (Canada): Hexoskin; 2013 [Alıntılama tarihi: 22 Kasım 2022]. Erişim adresi: https://www.hexoskin.com/.
41. [41] Respirate.com [İnternet]. New Jersey (ABD): Resperate; c 2017-2023 [güncelleme 2023 4 Eylül; Alıntılama tarihi: 22 Kasım 2022]. Erişim adresi: https://www.resperate.com/how-it-works/.
42. [42] Bulo.breathing.co.kr [İnternet]. Seoul (South Korea): Bulo; 2022 [Alıntılama tarihi: 22 Kasım 2022]. Erişim adresi: https://www.kickstarter.com/projects/breathings/bulo-increase-performance-with-curated-breathing-exercises/.
43. [43] theawellbeing.com [İnternet]. London (UK): Melo; 2022 [Alıntılama tarihi: 22 Kasım 2022]. Erişim adresi: https://me.currentbody.com/products/melo-handheld-anxiety-and-meditiation-breathing-device/.
44. [44] Moonbird.life [İnternet]. London (UK): Moonbird; 2022 [Alıntılama tarihi: 22 Kasım 2022]. Erişim adresi: https://www.moonbird.life/.
45. [45] Vanegas, E., Igual, R. and Plaza, I. (2020). Sensing systems for respiration monitoring: A technical systematic review, Sensors, 20(18), p. 5446. Erişim: https://doi.org/10.3390/s20185446.
46. [46] Cao, D., Zhang, Z., Liang, H., Liu, X., She, Y., Li, Y., ... & Yu, M. (2018). Application of a wearable physiological monitoring system in pulmonary respiratory rehabilitation research. 11th International Congress on Image and Signal Processing, BioMedical Engineering and Informatics, (pp. 1-6).China: Beijing, 13-15 Ekim.
47. [47] Zhu, Q., Kong, X. L., & Xie, Y. Y. (2012). The influence of biofeedback on respiratory training effect. In 2012 International Conference on Systems and Informatics (ICSAI2012) (pp. 1067-1071). China: Yantai, 19-20 Mayıs.
48. [48] Karpashevich, P. et al. (2022). Touching our breathing through shape-change: Monster, organic other, or Twisted Mirror, ACM Transactions on Computer-Human Interaction, 29(3), s. 1–40. Erişim: https://doi.org/10.1145/3490498.
49. [49] Kaimakamis, E., Perantoni, E., Serasli, E., Kilintzis, V., Chouvarda, I., Cheimariotis, G. A., ... & Maglaveras, N. (2019). Applying translational medicine by using the welcome remote monitoring system on patients with COPD and comorbidities. EMBS International Conference on Biomedical & Health Informatics (BHI) (s. 1-4). USA: Chicago, Mayıs 19-22.
50. [50] Bermejo-Gil, B. M., Pérez-Robledo, F., Llamas-Ramos, R., Silva, L. A., Sales-Mendes, A., Leithardt, V. R. Q., & Llamas-Ramos, I. (2021). RespiraConNosotros: a viable home-based telerehabilitation system for respiratory patients. Sensors, 21(10), 3318.
51. [51] Kilintzis, V. et al. (2022). CoCross: An ICT platform enabling monitoring recording and fusion of clinical information chest sounds and imaging of covid-19 ICU patients, Healthcare, 10 (2), s. 276 Erişim: https://doi.org/10.3390/healthcare10020276.
52. [52] Derdiyok, F. B. (2023). Segmental solunuma yönelik giyilebilir bir telerehabilitasyon sisteminin kavramsal tasarımı (Yüksek Lisans Tezi, Sakarya Uygulamalı Bilimler Üniversitesi).