Development of a Wearable Cardiac Monitoring System for Behavioral Neurocardiac Training: A Usability Study

BackgroundElevated blood pressure is one of the main risk factors for death globally. Behavioral neurocardiac training (BNT) is a complementary approach to blood pressure and stress management that is intended to exercise the autonomic reflexes, improve stress recovery, and l...

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Main Authors: Uddin, Akib A, Morita, Plinio P, Tallevi, Kevin, Armour, Kevin, Li, John, Nolan, Robert P, Cafazzo, Joseph A
Format: Article
Language:English
Published: JMIR Publications 2016-04-01
Series:JMIR mHealth and uHealth
Online Access:http://mhealth.jmir.org/2002/2/e45/
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spelling doaj-c7eb9af4ffc5472aa86a092b42c8efe72021-05-03T04:33:17ZengJMIR PublicationsJMIR mHealth and uHealth2291-52222016-04-0142e4510.2196/mhealth.5288Development of a Wearable Cardiac Monitoring System for Behavioral Neurocardiac Training: A Usability StudyUddin, Akib AMorita, Plinio PTallevi, KevinArmour, KevinLi, JohnNolan, Robert PCafazzo, Joseph A BackgroundElevated blood pressure is one of the main risk factors for death globally. Behavioral neurocardiac training (BNT) is a complementary approach to blood pressure and stress management that is intended to exercise the autonomic reflexes, improve stress recovery, and lower blood pressure. BNT involves cognitive-behavioral therapy with a paced breathing technique and heart rate variability biofeedback. BNT is limited to in-clinic delivery and faces an accessibility barrier because of the need for clinical oversight and the use of complex monitoring tools. ObjectiveThe objective of this project was to design, develop, and evaluate a wearable electrocardiographic (ECG) sensor system for the delivery of BNT in a home setting. MethodsThe wearable sensor system, Beat, consists of an ECG sensor and a mobile app. It was developed iteratively using the principles of test-driven Agile development and user-centered design. A usability study was conducted at Toronto General Hospital to evaluate feasibility and user experience and identify areas of improvement. ResultsThe Beat sensor was designed as a modular patch to be worn on the user’s chest and uses standard ECG electrodes. It streams a single-lead ECG wirelessly to a mobile phone using Bluetooth Low Energy. The use of small, low-power electronics, a low device profile, and a tapered enclosure allowed for a device that can be unobtrusively worn under clothing. The sensor was designed to operate with a mobile app that guides users through the BNT exercises to train them to a slow-paced breathing technique for stress recovery. The BNT app uses the ECG captured by the sensor to provide heart rate variability biofeedback in the form of a real-time heart rate waveform to complement and reinforce the impact of the training. Usability testing (n=6) indicated that the overall response to the design and user experience of the system was perceived positively. All participants indicated that the system had a positive effect on stress management and that they would use it at home. Areas of improvement were identified, which focused primarily on the delivery of training and education on BNT through the app. ConclusionsThe outcome of this project was a wearable sensor system to deliver BNT at home. The system has the potential to offer a complementary approach to blood pressure and stress management at home and reduce current accessibility barriers.http://mhealth.jmir.org/2002/2/e45/
collection DOAJ
language English
format Article
sources DOAJ
author Uddin, Akib A
Morita, Plinio P
Tallevi, Kevin
Armour, Kevin
Li, John
Nolan, Robert P
Cafazzo, Joseph A
spellingShingle Uddin, Akib A
Morita, Plinio P
Tallevi, Kevin
Armour, Kevin
Li, John
Nolan, Robert P
Cafazzo, Joseph A
Development of a Wearable Cardiac Monitoring System for Behavioral Neurocardiac Training: A Usability Study
JMIR mHealth and uHealth
author_facet Uddin, Akib A
Morita, Plinio P
Tallevi, Kevin
Armour, Kevin
Li, John
Nolan, Robert P
Cafazzo, Joseph A
author_sort Uddin, Akib A
title Development of a Wearable Cardiac Monitoring System for Behavioral Neurocardiac Training: A Usability Study
title_short Development of a Wearable Cardiac Monitoring System for Behavioral Neurocardiac Training: A Usability Study
title_full Development of a Wearable Cardiac Monitoring System for Behavioral Neurocardiac Training: A Usability Study
title_fullStr Development of a Wearable Cardiac Monitoring System for Behavioral Neurocardiac Training: A Usability Study
title_full_unstemmed Development of a Wearable Cardiac Monitoring System for Behavioral Neurocardiac Training: A Usability Study
title_sort development of a wearable cardiac monitoring system for behavioral neurocardiac training: a usability study
publisher JMIR Publications
series JMIR mHealth and uHealth
issn 2291-5222
publishDate 2016-04-01
description BackgroundElevated blood pressure is one of the main risk factors for death globally. Behavioral neurocardiac training (BNT) is a complementary approach to blood pressure and stress management that is intended to exercise the autonomic reflexes, improve stress recovery, and lower blood pressure. BNT involves cognitive-behavioral therapy with a paced breathing technique and heart rate variability biofeedback. BNT is limited to in-clinic delivery and faces an accessibility barrier because of the need for clinical oversight and the use of complex monitoring tools. ObjectiveThe objective of this project was to design, develop, and evaluate a wearable electrocardiographic (ECG) sensor system for the delivery of BNT in a home setting. MethodsThe wearable sensor system, Beat, consists of an ECG sensor and a mobile app. It was developed iteratively using the principles of test-driven Agile development and user-centered design. A usability study was conducted at Toronto General Hospital to evaluate feasibility and user experience and identify areas of improvement. ResultsThe Beat sensor was designed as a modular patch to be worn on the user’s chest and uses standard ECG electrodes. It streams a single-lead ECG wirelessly to a mobile phone using Bluetooth Low Energy. The use of small, low-power electronics, a low device profile, and a tapered enclosure allowed for a device that can be unobtrusively worn under clothing. The sensor was designed to operate with a mobile app that guides users through the BNT exercises to train them to a slow-paced breathing technique for stress recovery. The BNT app uses the ECG captured by the sensor to provide heart rate variability biofeedback in the form of a real-time heart rate waveform to complement and reinforce the impact of the training. Usability testing (n=6) indicated that the overall response to the design and user experience of the system was perceived positively. All participants indicated that the system had a positive effect on stress management and that they would use it at home. Areas of improvement were identified, which focused primarily on the delivery of training and education on BNT through the app. ConclusionsThe outcome of this project was a wearable sensor system to deliver BNT at home. The system has the potential to offer a complementary approach to blood pressure and stress management at home and reduce current accessibility barriers.
url http://mhealth.jmir.org/2002/2/e45/
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