JMIR Publications

ABSTRACT

Background:

The recent trend of technological innovation and widescale digitization as a potential solution to challenges in healthcare, sports and emergency service operations has led to the conception of smart textile technology. In healthcare these smart textile systems present the potential to aid preventative medicine and early diagnosis through comfortable, non-invasive all-day tracking of physical and mental health while promoting proactive involvement of the patient in their medical management. In areas such as sports and emergency response, the potential to provide comprehensive and simultaneous physiological insights across multiple body systems is promising. However, it is currently unclear what type of evidence exists surrounding the use of smart textiles for the monitoring of physiological outcome measures across different settings.

Objective:

The aim of this scoping review was to systematically survey the existing body of scientific literature surrounding smart textiles in their most prevalent form, the smart shirt, for the monitoring of physiological outcome measures.

Methods:

Five electronic bibliographic databases were systematically searched (Ovid MEDLINE, EMBASE, Scopus, CINAHL, SPORTDiscus). Publications from the inception of the database to June 24, 2019 were reviewed. Non-indexed literature relevant to this review was also systematically searched. Results were then collated, summarized and reported.

Results:

Following the removal of duplicates, a total of 7,871 citations were identified. Based on title and abstract screening, 7,632 citations were excluded, with 239 retrieved and assessed for eligibility. Of these, 101 citations were included for final analysis. Included studies were categorized into four themes: 1. Prototype Design; 2. Validation; 3. Observational; 4. Reviews. Among the 101 analyzed studies, prototypes design was the most prevalent theme (50/101, 49.50%) followed by validation (29/101, 28.71%), observational studies (21/101, 20.79%) and reviews (1/101, 0.99%). Presented prototype designs ranged from those capable of monitoring one physiological metric to those capable of monitoring several simultaneously. In 29 validation studies, 16 distinct smart shirts were validated against reference technology under various conditions and work rates including rest, sub-maximal and maximal exercise. The identified observational studies used the smart shirts in clinical, healthy and occupational populations for aims such as early diagnosis and stress detection. One scoping review was identified investigating the use of smart shirts for ECG signal monitoring in cardiac patients.

Conclusions:

Although, smart shirts have been found to be valid and reliable in the monitoring of specific physiological metrics, results were variable for others, demonstrating the need for further systematic validation. Analysis of the results have also demonstrated gaps in knowledge such as a considerable lag of validation and observational studies in comparison to prototype design and limited investigation using smart shirts in pediatric, elite sports, and emergency service populations.