Instrumentation & Measurement Magazine 24-2 - 13

Bed-Based Health Monitoring
Using Pressure Sensitive
Technology: A Review
Madison Cohen-McFarlane, Stephanie Bennett,
Bruce Wallace, Rafik Goubran, and Frank Knoefel

T

he population of older adults (>65 years old) is growing both in Canada and abroad. In 2018, there were
6.4 million older adults (aged 65 and over, with 1.6
million aged 80 or older) in Canada [1]. This population is expected to increase to between 12.3 and 16.1 million (aged 65
and over, with between 4.7 and 6.3 million aged 80 or older) by
2068 [1]. With age comes a greater reliance on healthcare services as age-related health conditions become more prevalent.
In order to reduce the expected strain on the Canadian healthcare system, researchers here and around the world have
focused on the idea of remote health monitoring.
In the current state of the novel coronavirus (2019) pandemic, remote monitoring is especially important. With the
current physical distancing recommendations, reducing hospital visits and remote appointments with a physician for one
of the most vulnerable populations, older adults, is essential
in maintaining their safety and security. The use of these tools
can also reduce the number of visits of home health providers,
again reducing virus exposure, and the workload experienced
by front line workers in this unprecedented time.
Remote health monitoring utilizes technology to track a
variety of signals from users and uses many different kinds
of sensors. From vital sign monitoring to activity detection,
this new source of information has the potential to provide
insight into not only a person's physical health but also their
mental state. In this article, we focus on the use of pressure sensors (PS) that can be used to monitor older adults at home. PS
have been applied to monitor many aspects of daily life, some
of which include monitoring the use of grab bars in the washroom [2], occupancy detection to monitor things like activities
of daily living (ADL) and mobility deterioration [3]-[5], standing platforms to monitor body sway [6], plantar pressure
monitoring for gait evaluation [7], [8], and sitting posture and
ulcer prevention in wheelchair bound individuals [9]-[11], to
name a few. This paper focuses on PS applications of in-bed
monitoring.
Bed-based PS monitoring can be done in two main ways.
The first is to use individual sensors that are strategically
placed. The use of air flow sensors in air pocket measurement

April 2021	

systems either integrated into a mattress [12] or placed below the mattress and bedframe [13] to monitor respiration and
heart rate can be considered single PS use. The application of
sensors below bed legs to monitor bed occupancy [4], [14] is
also single sensor application, although multiple sensors are
being used and combined during post-processing.
The other main application is the use of multiple PS in an
array where the PS are aligned so that they are fixed in a set
spatial pattern. The use of multiple sensors can provide spatial information to the signal that can be very important when
measuring long-term applications of pressure. For example,
PS arrays have been used to evaluate symmetry patterns of
bed exits by identifying the position of the left and right hand
[15] and the center of pressure (COP) trajectory [16]. They have
also been used to monitor internal fluid accumulation and distribution present in the ankles of individuals with congestive
heart failure (CHF) [17]. The underlying pressure sensing technology can vary in these arrays but are commonly referred to
as pressure sensitive mats (PSM). It is important to note, however, that single sensor systems may also be referred to as PSM,
especially those that are commercially available, like the Sleep
Tracking Mat marketed by Withings [13].
The following sections detail measurement applications for
bed-based pressure monitoring, the pressure sensor types that
have been used or developed, sensor configurations that have
been used, what factors need to be considered when choosing
the appropriate PS, and an overview of commercially available systems that have pressure measurement as one of their
outputs.

Remote Monitoring Pressure
Measurement Applications
Remote monitoring of health information using PS can be
considered a step towards the overall goal of smart-home monitoring. Smart-home monitoring uses technology to control
and monitor the at-home environment with the goal of making life easier. As mentioned, here we discuss remote health
monitoring specifically with PS, but a smart-home system also
has applications in home security, lighting and temperature

IEEE Instrumentation & Measurement Magazine	13
1094-6969/21/$25.00©2021IEEE



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