Invited speaker: Dr Milos R. Popovic

Dr. Milos R. Popovic, Dipl. El. Eng., Ph.D., FCAE, FAIMBE, FIEEE, FCAHS, FEIC, P.Eng.

Milos R. Popovic is the Director of The KITE Research Institute at the Toronto Rehabilitation Institute – University Health Network and the Director of The Institute of Biomedical Engineering at the University of Toronto. He is an Elected Fellow of the Canadian Academy of Engineering, the American Institute for Medical and Biological Engineering, the Institute of Electrical and Electronics Engineers, the Canadian Academy of Health Sciences, and the Engineering Institute of Canada.

Dr. Popovic is the co-founder of MyndTec, NovaKonexus, the Canadian Spinal Cord Injury Rehabilitation Association, the Centre for Advancing Neurotechnological Innovation to Application (CRANIA) at the University Health Network and the University of Toronto, and the CRANIA Neuromodulation Institute at the University of Toronto. He is also the founder of the Fabric-Based Research (FIBRE) Platform and the Rehabilitation Engineering Laboratory, both located at the KITE Research Institute.

Title of Presentation: How Dry Stimulation Electrodes Embedded in Textiles Could Revolutionize Neuromodulation

Functional electrical stimulation (FES) is a technology that applies short electrical pulses to muscles in order to contract them. When these muscle contractions are carefully controlled and multiple muscle groups are activated simultaneously, the result can be complex and coordinated movements. For example, in an individual with a paralyzed arm, stimulating eight different muscle groups can restore reaching, grasping, retrieving, and releasing functions—movements that closely resemble those of a healthy person.

One of the main limitations of current FES systems is the need to attach a large number of electrodes—typically two per muscle— along with corresponding cables. In the example above, that means sixteen electrodes and significant setup time are needed to produce reaching, grasping, retrieving, and releasing functions. The tools required to prevent electrode detachment from the skin further complicate the process, making it time-consuming and impractical in many clinical environments.

In this talk, I will present a promising solution: using textiles as a platform for embedding stimulation electrodes. This approach has the potential to simplify FES delivery and make it more viable for both clinical and home-based applications.

Further presentations:

Design and Development of Smart Textile Loneliness Monitoring Systems for Older People Yi Zhou, Jessica Rees, Ashay Patel, Faith Matcham, Michela Antonelli, Anthea Tinker, Sebastien Ourselin, Wei Liu – King’s College London

This research presents the design and development of a cohesive textile-based monitoring system aimed at detecting loneliness in older adults through continuous monitoring of physiological and behavioural signals. The system integrates smart garments and smart furniture, embedding sensor modules to capture heart rate, respiration, skin temperature and motion data. A user-centered design approach was applied to ensure comfort, acceptability and ease of use for older users. The modular structure allows flexible sensor placement and facilitates maintenance and reusability. After preliminary technical evaluations, the smart textile monitoring system demonstrate outstanding capability to monitor vital signs and recognize daily activities.

Designing a Circular-Knitted Wearable for Children with Dysfunctional Breathing Using Respiratory Inductive Plethysmography Sarah Pichon, Hellen van Rees, Ben Bulsink, Melissa van Schaik, Jan-Carlos Kuhlmann – Saxion University of Applied Sciences

Dysfunctional breathing (DB) is a frequently overlooked condition characterized by disrupted, inefficient breathing patterns, often upper-chest dominant. In paediatric care, managing DB through daily breathing exercises is particularly challenging due to limited guidance and motivation at home. Advances in smart textiles offer new opportunities to support such therapies with wearable sensing systems. Among textile manufacturing methods, circular electronic knitting stands out for its ability to seamlessly and unobtrusively integrate stretchable sensors through a fully programmable, one-step process. This paper explores the integration of conductive and non-conductive yarns, demonstrating how knit structures can be programmed at a “stitch by stitch” level to combine functionality and aesthetics. To illustrate this potential, we present a case study of a Wearable Breathing Trainer: a sensorized T-shirt that applies Respiratory Inductive Plethysmography (RIP) to monitor thoracic and abdominal breathing, combined with vibrotactile stimulation to guide children during home-based breathing exercises. Four semi-structured interviews and six user evaluations were conducted with paediatric physiotherapists (PPs) to gain insights into user requirements. Additionally, the performance of the sensor was evaluated through mechanical testing of resistance changes under elongation, in vitro testing using a circumference variation device, and is currently undergoing clinical trials. This case study highlights the potential of knitted wearables for comfortable, scalable and personalized healthcare solutions.

Towards Modular Smart Garments with Soft Electrodes for Seizure Monitoring Komal Komal, Ram Prasadh Narayanan, Frances Cleary, John Wells, Louise Bennett – South East Technological University

Epilepsy is a chronic neurological condition affecting over 50 million people globally. Integrating sensing mechanisms into smart garments offers a promising approach for unobtrusive and continuous seizure monitoring, potentially reducing the social stigma associated with conventional, visibly worn medical devices. This paper presents initial findings on (i) the electrical and mechanical characterization of embroidered electrodes and (ii) preliminary validation through EMG and EEG (eye-blink) signal acquisition. Compared to commercial gel electrodes, the embroidered electrodes exhibited higher baseline impedance across 0.1 Hz to 1 kHz, a 1-decade higher magnitude than the compared medical-grade electrode, and up to a 150% increase in surface resistance after 50 washing cycles, yet successfully capturing muscle and eye-blink signals. The broader objective is a proof-of-concept smart hybrid garment featuring 3D embroidered soft electrodes embedded within existing garment areas, with modular active electronics discreetly separated from passive electrodes, supporting a scalable, modular wearable seizure monitoring toolkit. Future work will investigate signal enhancement via textile design variations and embedded neuromorphic processing for real-time inference.

E-Textile Electrode Fabrication Techniques for sEMG and NMES Applications Sonya Patel, Vlad Porcila, Ahsan Abdullah, Conor Goodeve, Joshua Chirayath, Salvador Estrada, Joseph Brand, Adriana Ieraci, Sharon Gabison, Jane Batt, Alireza Sadeghian, Maryam Davoudpour – Humber Polytechnic

Conventional surface electromyography (sEMG) and neuromuscular electrical stimulation (NMES) procedures rely on the use of wet silver/silver chloride (Ag/AgCl) electrodes which are prone to drying out and causing discomfort over time, thereby making them unsuitable for long-term applications. To address these limitations, this study explores the design, fabrication and analysis of e-textile electrodes as a comfortable, reliable and durable alternative. A variety of fabrication techniques including embroidery, applique, 3D printing, ink-deposition printing and cut-and laminate, were used to produce different electrode types. Preliminary testing to assess electrical performance has found that e-textile electrodes have comparable results to the Ag/AgCl gold standard electrodes during sEMG analysis. Moreover, etextile electrodes have been found to evoke muscle contractions during NMES. Through further testing and analysis, this research paper aims to identify the most effective fabrication method for producing e-textile electrodes optimized for sEMG and NMES use.

In-bed Unobtrusive Heart Rate Estimation using Ballistocardiography and Sensor Fusion Algorithm Carlotta Marinai, Eleonora Melissa, Lucia Arcarisi, Francesco Bossi, Pasquale Bufano, Francesco Di Rienzo, Gianluca Rho, Michele Zanoletti, Alberto Greco, Carlo Vallati, Nicola Carbonaro, Marco Laurino, Alessandro Tognetti – University of Pisa

Unobtrusive heart rate (HR) monitoring during the night is crucial for assessing sleep quality and overall health. Ballistocardiography (BCG) has recently regained attention, particularly with accelerometer (ACC)-based systems. This study presents an optimized HR detection algorithm using the Smart Mattress Cover (SMC), a novel, non-invasive, textile-based system embedding two 3D ACCs and a pressure matrix (PM) sensor. We systematically evaluated various ACC component combinations and tested two strategies: Averaging Method using only ACCs signals, and Signal Fusion Method integrating ACCs and PM’s posture data. The most effective setup was the head-to-toe ACC component combined with Signal Fusion Method, achieving promising results with a (RMSE, MAE) of (2.02, 1.61) bpm. Our findings not only introduce a robust SMC-based HR detection method but also bridge existing gaps in literature regarding ACC specifications, positioning, and axis orientation in in-bed BCG ACC-based HR monitoring.

Feasibility of ECG Signal Acquisition in a Strong Magnetic Field using Textile Dry Electrodes Mina Laghaei, Cédric Cochrane, Xuyuan Tao, Freddy Odille, Vladan Koncar – ENSAIT, Université de Lille

Considering textile dry electrodes as a promising alternative to traditional Ag/AgCl electrodes currently used for ECG signal monitoring and aiming to preserve ECG signal quality during cardiac magnetic resonance (CMR) imaging, a reference imaging modality for diagnosing cardiac diseases, this study presents an experimental setup. The configuration uses embroidered electrodes made of non-magnetic materials, in combination with an ECG simulator and artificial reference skin, to simulate real conditions for ECG signal acquisition while accounting for the influence of impedance on signal quality. Given that the electrodes successfully recorded ECG signals in this setup, preliminary testing was conducted under strong magnetic field conditions. Notably, in line with our primary objective of evaluating the compatibility of textile electrodes in CMR environments, embroidered electrodes integrated into the garment underwent initial testing inside a 3T MRI scanner. Keywords— dry textile electrodes, ECG signal, Cardiac Magnetic Resonance (CMR)