A Better Way to Watch Your Step(s)

A look at what a bottom-up perspective can tell you about your body

by Toshi Quides
Reading time: 5 mins

The Digital Health revolution has been under way for some time but has accelerated rapidly over the past couple years as a pandemic forced us to internalize the realities of conducting more of our lives remotely, and gave us new reasons to keep a closer eye on our health and wellness.

Devices for tracking a patient’s medical status or the onset of life or limb threatening episodes are becoming more portable, more affordable, and subsequently more popular.  Near invisible continuous glucose monitoring (CGM) patches, pulse-oximeters and sleep monitoring built into elegant accessories like a watch, wristband, or ring, all demonstrate how seamlessly modern health sensor technology is integrating into our lives.

Many of these devices focus on bringing the patient experience out of the hospital or lab and into the home or onto the person.  Others focus on promoting a general sense of mindfulness of one’s well-being, fitness, or form as they move through the world.  In both cases, the rate at which new products with advanced sensing are being offered will have a multiplicative effect on improving our health outcomes, and the companies providing them will be in a position to offer progressively better experiences due to the insights they can then offer to their users.

The large majority of sensor systems in these fields are built either using something called an Inertial Measurement Unit (IMU) that detects accelerations and gyrations to calculate impacts, angles, and orientations, or are using optical systems that determine your status in a variety of ways, from using LEDs and light refraction to combining advanced computer vision technology with the camera on your phone.

In many of BeBop’s sensing systems, we combine smart fabric sensing with an IMU to add an additional layer of intelligence to our devices.  An IMU does an excellent job of telling our Forte Data Glove where it is in 3D space, or telling our Tempo Insole how a foot is oriented mid-stride.  Where the IMU leaves off and fabric sensing picks up, is when you need to understand multiple points of interaction in real-time (for instance, understanding how the joints of each of your fingers are moving).  Even more importantly, when the foot hits the ground, is it pronating or supinating, how is your left foot landing vs. your right foot, or whether you are striking the ground with your heel in a way that might portend an injury to your foot or leg?

IMU-only based systems will have trouble in the above cases, as will optical systems, which simply are not portable or practical enough to observe the body in everyday situations.  Even in stationary conditions, cameras only see what we show them, and thus use cases are generally limited to the initial field of vision or require arduous reorientation to provide usable data to the algorithm.   With an array of fabric sensors, BeBop provides a new kind of “camera” that continuously analyzes images of how your foot hits the ground as you move through a variety of motions and interact with different surfaces.

Beyond walking and running, there are a number of places where gait analysis and weight distribution fill in a gap with data that’s impossible to get without an “image” of your foot as it meets the ground.

Take for instance, many of the digital therapeutics and connected gym solutions that have become popular in the past couple of years.  Many of them rely on a camera on your phone or a piece of equipment, or an IMU strapped to a leg, arm, or torso.  Camera based solutions will require standing in the right place with the right amount of space to properly analyze your form.  IMU based solutions address some of the complexities, but miss things like weight and force distribution at your base which can be the difference between rehabilitating an old injury and developing a new one.

At the prevention end of the spectrum, ergonomics monitoring companies are using similar techniques to make sure workers are using proper standing, sitting, walking, and lifting form throughout the day.  With musculoskeletal injuries accounting for one of the largest sources of lost days of work, it’s not surprising that companies are trying to solve both ends of the spectrum with new technologies.

As a continuous monitoring device, the portability of an insole also makes it a uniquely ideal solution for things like fall and balance detection in eldercare settings or for those with neurological conditions where other solutions might require users to remain in a domicile.  Diabetic swelling or numbness of the feet can also lead to a number of serious conditions, so the ability to detect these episodes remotely, as well as build in recommendations to an application to increase activity, or elevate one’s feet for a while can lead to a tremendous improvement in the patient experience.

Intelligent fabric based solutions are creating a whole new generation of digital health devices due to the ability to see where other sensors can’t fit or follow, but most importantly the ability to survive in the harsh environments of human use.  The human shoe, where the foot compresses, bends, and twists thousands of times per day, or an intelligent mat one might use for exercise, sport, or rehabilitation absorbing drops, jumps, and rolls both present a daunting task for a sensor. Much of what we need to see underfoot, needs to survive all the damage our feet can dish out or it loses its utility.  The fragility of other solutions can lead to unreliable data over time or even outright failure which creates potential for higher lifetime costs, or worse, increased risk of negative outcomes for patients.

For solutions that can move with us wherever we go, provide views into interactions that remain invisible to others, and survive the everyday movements of humans, fabric presents an upgrade or complement to the technology that exists today.  As more of the physical world and our movement through it becomes quantified, device makers will be presented with the challenge of finding new insights from more parts of the body and providing better outcomes and experiences for their users.

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