A New World of Healthy Design–That You Wear

Jul 6, 2015, 10:32 AM, Posted by Sheree Crute

Wearable technologies have the power to make communicating with health care providers seamless and easy—opening up a new frontier for data tracking and treatment.

A man tests out a virtual reality headset. Image via Giuseppe Costantino

Gary Wellman is living the dream. Every morning, he is treated to the nearly cloudless sky that frames Arizona’s nearby Santa Rita Mountains. A retired basketball coach, 72-year-old Wellman happily shares that he “lives on a golf course in Green Valley,” and likes to keep busy. “You can’t sit around when you have arthritis and diabetes like I do.”

About a year ago, Wellman hopped out of his golf cart, stood up to reach for his clubs and found himself on the ground. He suffered from numbness in his feet, a common symptom of diabetes. After that day, Wellman says, “I began to fall a lot on the course. My doctors did all kinds of tests and came up with nothing.”

That is until Wellman’s physician suggested he participate in an experimental treatment for loss of balance conducted in the lab of Bijan Najafi, PhD, a surgeon and director of the Interdisciplinary Consortium on Advanced Motion Performance at the University of Arizona.

Health in Motion

Najafi is one of a growing number of health experts tapping the potential of, an emerging group of objects, often-wearable, that are internet-enabled to track and protect health. All of these “smart” gadgets could eventually become part of what some are calling the “Internet of Things” – a vast network of objects that seamlessly gather data and talk to each other.

We’re heading towards a day when a barely detectable system of sensors could make communicating with health care providers easy, or even let our bodies do the communicating for us. Ideally these objects will help trigger healthy decisions and inform healthy choices.

To give Wellman back his balance and mobility, Najafi’s team attached biosensors to his midsection, hips, knees, and ankles, then linked them all to a computer. During a series of workouts, Wellman would dance what he called his hula. “I moved my hips in sort of a circle. When I reached the proper position, a colored dot would appear at certain points along a grid on the computer screen.”  Ever the sportsman, Wellman worked hard to raise his skill level. “I got really proficient by the end,” he says.

Wellman is now back on the golf course and steady on his feet. “When I start to lose my balance, I can correct it with a hip motion before I fall,” he says.

Naiafi’s achievements were heralded at the recent 2015 American Institute of Architects (AIA) Design and Health Research Consortium, convened by the Robert Wood Johnson Foundation. The AIA consortium supports revolutionary, university-led research in design and health – and that’s where personal devices come in.

The balance-enhancing treatment is designed to help diabetics, cancer patients, and the frail elderly by guiding them through exercises that they might otherwise avoid because of the fear of falling.

“We created a game-based exercise using foot, ankle, and body movements,” says Najafi, who is working on a home version. The game retrains the brain by proving real-time feedback, or provides a workout with safe activities that can be challenging and engaging.

Najafi is also perfecting smart sox—stockings with biosensors that give physicians real-time data on the existence or progress of inflammation—a precursor to foot ulcers—in people with diabetes. “These patients may not feel any pain as the ulcers develop,” says Najafi, noting that the annual tab in the U.S. for foot-ulcer care is between $9 billion and $13 billion. Smart sox have the potential to prevent ulcers by showing doctor and patient where to relieve pressure before the ulcer occurs.

Beyond Fitbit

Najafi’s game-based exercises, smartsox, and other devices are being tested by health design engineers in labs cross the country. They may seem similar to the latest apps and wearable technology flooding the market, but there is one critical difference—clinical accuracy.

Many of these devices are also unique in that they can gather information without the need for the wearer’s intervention. “Research shows that after a few days, 40 percent of users no longer pay attention to health apps,” says Thomas Fisher, dean of Minnesota’s college of design.

One project, by the Center for Connected Health at Partners Healthcare and funded by RWJF, aims to change this statistic. The Center is developing an interactive “engagement engine” that will help consumers select and use trackers to develop and stick to physical activity plans. Other researchers are thinking about how to reach kids by leveraging the digital gadgets they already use, but for health.

Fisher says a potential benefit of these wearable devices and trackers is to, “help people to remain ambulatory and independent, and give health care providers the information needed to improve care and prevent illness.” His department recently won a silver medal from NASA for applications that will help protect the health of astronauts.

In the Wearable Technology Lab at the University of Minnesota , director Lucy Dunne, PhD, focuses on clothing that transmits data as the wearer moves. To test her most recent design, Crystal Compton, a design student, slipped into a comfortable black top that looks like regular fitness wear. “As I bend halfway down, elongating my spine and bringing my shoulders forward, conductive threads woven into the shirt send data on body position to a computer,” Compton explains. The shirt may be used for many things, but the current goal is to measure the movement and shape of the spine during scoliosis treatment.

Decoding Stress

Devices with sensors can do more than capture movement – they can reflect back to us how we feel. Imagine a device that could accurately report your body’s stress response at the molecular level or alert you the moment your immune system is under attack. Precisely measuring these clues to how people fare in certain environments and situations through biosensors is the work of Esther Sternberg, MD, research director at the University of Arizona Center for Integrative Medicine, one of 11 centers selected as founding members of the AIA research consortium.

Immune system proteins “can be measured through perspiration,” Sternberg says. “Our goal is to eventually measure them in real time as well as indicators of inflammation.” In her research, Sternberg and her team found that levels of specific molecules correlated with symptoms of anxiety, stress, and depression.

Dunne also has one more accomplishment in mind—saving lives. One of her latest projects is a glove designed specifically for firefighters. They look like regular industrial work gloves, but they will give the bravest a power reserved for superheroes—the ability to detect the presence or absence of objects in the dark. The sensors in the gloves will prevent them from tripping in smoke-darkened rooms, falling through holes often created as buildings give way to flames. “Linking body, environment, and technology to help people is where we are headed,” Fisher says. “The Internet of Things is moving quickly through huge advances.”

The Internet of Things is taking us towards a day when a barely detectable system of sensors could make communicating with health care providers seamless and easy—perhaps letting our bodies do the communicating for us.

Here’s a look at some of other developments in the evolution of digital health from RWJF grantees:

  • The Health Data Exploration Project  is looking at ways to use “personal health data for public good.” There has been an explosion in the amount of personal health data collected through apps, wearable self-trackers and other “Internet of Things”-type technologies. Taken together, this personal health data could provide new insights in the health of the population, and guide decisions about how to improve public health.
  • Agile Science is exploring a new way to conduct faster, more adaptable research that can help us more quickly understand how tools and technologies can help create healthier behaviors, such as getting more sleep or exercising more.
  • The Atlas of Caregiving recognizes that caring for a family member’s health is hard work, and can have health consequences for the caregivers. To come up with better ways to support caregivers, investigators will deploy wearable technologies to learn about the day-to-day lives of caregivers across different situations. The information will be used to help shape technology development, service delivery, and policy development.