Multihaptic wearable sensor enabled by biomimetic polymer to stoke engagement in swallowing rehabilitation therapy

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There are many disabilities in which the patient could benefit from the use of a wearable device for rehabilitation or prevention. However, the adoption of wearable sensors by patients is not strong; in this project, it is proposed that adoption could be increased by designing devices that provided reinforcing tactile cues to the wearer. This project will use haptic effects for the first time in an “epidermal” wearable device (that is, a device akin to a temporary tattoo). The haptic effects will drive engagement in simulated physical therapy. As a use case, treatment of dysphagia (or difficulty swallowing) will be the focus of this study. This condition, which afflicts approximately 3% of the US population and ≥15% of the elderly, can be associated with pain, and in many cases is devastating to the quality of life of persons with dysphagia. Moreover, uncoordinated swallowing movements can lead to the entry of food into the lungs and aspiration pneumonia, which is life-threatening. The engineering of a device worn on the neck capable of detecting swallows and other movements could augment the course of physical therapy. Ultimately, it is hoped that the knowledge created at the interface of device engineering and behavioral science will enable patients to take charge of their own rehabilitation. This project leverages the newly opened University of California San Diego (UCSD) Downtown Center, which will be the site of multiple hands-on demonstrations arising from the fundamental work on haptics; these demos will be held in conjunction with recruiting a diverse group of participants from the community for the study.The goal of this project is to increase the adoption and engagement of mobile health interventions. Specifically, by endowing epidermal wearable sensors with haptic capabilities. That is, the ability to interact with the wearer by touch. The project leverages decades of work on myriad devices that can measure a large array of physiological quantities with high accuracy. Nevertheless, the future adoption of these “epidermal” sensors by patients and consumers cannot be taken for granted. Using prevention and rehabilitation of dysphagia (loss of swallowing function) as a disease model, this project proposes a type of epidermal patch for therapy that delivers affirming tactile stimuli whenever a therapeutic movement is performed correctly. The key enabling element is a stretchable, biomimetic conductive polymer that exhibits exceptional conductivity and volumetric capacitance. This material is used in the device as three components of the device: (1) strain gauges and (2) electrodes for electromyography and for (3) haptic stimulation, at lower voltages than is possible with off-the-shelf electrodes. In a closed-loop design, the device measures a signal and immediately produces a haptic effect to encourage desired behavior in human subject experiments. The knowledge created by this work could unleash the potential of the creativity and innovation surrounding epidermal electronic devices built up over the last 15 years and could have a transformative impact on technologies for at-home therapy. Moreover, the feasibility testing with 55 participants will be performed at UCSD’s Downtown Community Center, located in a highly diverse area in San Diego. The design and engineering of devices will be conducted with the participation of dysphagic patients and those at risk of dysphagia. Testing will be held in conjunction with a hands-on exhibit of haptic materials and devices produced during this project. The impact of this work will be broadened by stratification of the subject pool by age, dysphagia status, socioeconomic status, and technological literacy.This award reflects NSF's statutory mission and has been deemed worthy of support through evaluation using the Foundation's intellectual merit and broader impacts review criteria.