Design and development of textile-based wearable sensors for real-time biomedical monitoring; a review

Abstract

The growing field of smart textiles has captivated researchers, focusing on advancing functionalities to enhance human well-being and elevate daily comfort. Wearable sensors, integral to healthcare, hold immense promise for real-time biomedical monitoring, presenting a transformative potential for disease management and enhanced patient outcomes. Within this domain, textile-based wearable sensors have emerged as a particularly promising technology, boasting advantages such as comfort, flexibility, and noninvasiveness. This article provides a meticulous overview of the design and development of textile-based wearable sensors for real-time biomedical monitoring. A comprehensive literature review explores existing wearable sensor technologies, emphasizing the advantages and limitations specific to textile-based sensors. The discussion encompasses considerations for sensor design, selection, and integration into wearable systems, delving into the evaluation of various sensor modalities, textile materials, and fabrication techniques. Signal processing techniques, essential for extracting pertinent biomedical information, and data analysis methods for real-time monitoring are scrutinized. Biocompatibility, comfort, and user acceptance factors are conscientiously considered, alongside thorough discussions on calibration procedures and accuracy assessment methods to ensure the reliability of measurements. The article further explores potential applications of textile-based sensors in real-time biomedical monitoring, encompassing vital signs monitoring, activity tracking, and disease detection. Human factors and user studies are critically examined to comprehend user acceptance, informing design improvements tailored to user needs. Lastly, the article discusses future research directions and challenges, including considerations for durability, washability, and scalability. This comprehensive review aspires to equip researchers and practitioners with invaluable insights into the nuanced realm of textile-based wearable sensors for real-time biomedical monitoring. By fostering advancements in the field, this review aims to facilitate the seamless translation of this cutting-edge technology into clinical practice.

Graphical Abstract

Graphical abstract of Textile-Based Wearable Sensors for Biomedical.

1. Introduction

The integration of nanotechnology, smart textiles, and electronics in the textile industry, particularly in healthcare, has led to significant advancements in modern times. Smart textiles, which encompass textiles capable of sensing and reacting to changes in the environment originating from chemical, mechanical, electrical, and thermal sources, are at the forefront of these developments (Cochrane et al., 2016; Ghahremani Honarvar & Latifi, 2017). The increasing demand for personalized healthcare and the need for continuous monitoring of physiological parameters have spurred significant advancements in wearable sensor technologies. Smart fabrics can interact with the body of the wearer and sense the physiology and needs to sustain the wellness of an individual (Coyle & Diamond, 2016). Wearable sensors offer a promising solution for real-time biomedical monitoring, enabling early detection and intervention in various health conditions (Barman et al., 2022). Among the diverse array of wearable sensor platforms, textile-based sensors have gained considerable attention due to their unique advantages, including comfort, flexibility, and noninvasiveness. The integration of sensor technology into textiles enables the development of wearable garments that seamlessly collect and transmit biomedical data, revolutionizing the way we monitor and manage our health (Berglin, 2013; Coyle et al., 2009).

Traditional approaches to biomedical monitoring often rely on cumbersome and intrusive devices, limiting the user’s mobility and comfort. However, textile-based wearable sensors offer an alternative paradigm by incorporating sensing elements directly into everyday fabrics, such as shirts, socks, or even undergarments (Choudhry et al., 2021). This integration provides a discreet and unobtrusive means of capturing vital physiological data, allowing individuals to engage in their daily activities without the constraints of conventional monitoring devices. The design and development of textile-based wearable sensors for real-time biomedical monitoring encompass a multidisciplinary approach, merging fields such as textiles, materials science, electronics, and data analysis. An essential consideration in this domain is the selection of suitable sensing modalities that can accurately capture and quantify relevant biomedical information (Y. Wang et al., 2021). Depending on the specific monitoring requirements, textile-based sensors can encompass a range of modalities, including but not limited to electrocardiography (ECG), electroencephalography (EEG), electromyography (EMG), respiration rate, temperature, and movement tracking (Tseghai et al., 2021). Textile-based sensors offer inherent advantages over their rigid counterparts, as they conform to the body’s contours and allow for seamless integration with clothing. They can be fabricated using a variety of techniques, such as embroidery, printing, or weaving, enabling the sensors to be seamlessly integrated into the fabric structure. Additionally, advancements in conductive textiles, flexible electronics, and wireless communication have further facilitated the development of textile-based wearable sensors (Goud et al., 2021; Khoshmanesh et al., 2021).

Real-time monitoring of biomedical signals requires sophisticated signal processing and data analysis techniques. Signal processing algorithms are employed to filter out noise, extract relevant features, and identify patterns indicative of various health conditions. Moreover, data analysis methods enable the interpretation of collected data, facilitating clinical decision-making and providing actionable insights for users and healthcare professionals (Amitrano et al., 2020; Choudhry et al., 2021; Cohen, 2019; Subasi, 2019). The integration of textile-based sensors into wearable systems is another crucial aspect of their development. These systems encompass the necessary hardware components, communication protocols, and power management systems required for seamless data transmission and prolonged operation. Integration with mobile applications or cloud-based platforms allows for remote monitoring, data storage, and analysis, enabling personalized healthcare and facilitating the timely detection of abnormalities (A. Ahmed et al., 2022; Ding et al., 2021).

Briefly, the design and development of textile-based wearable sensors for real-time biomedical monitoring hold great promise in advancing healthcare. These sensors provide a comfortable and unobtrusive means of capturing vital physiological data, allowing for continuous monitoring in various settings (Zhao et al., 2020). Through the integration of sensing elements into everyday textiles, they offer a convenient and user-friendly approach to healthcare management (Fang et al., 2022). This article aims to explore the various aspects involved in the design and development of textile-based wearable sensors, including sensor selection, fabrication techniques, signal processing, integration with wearable systems, and real-time biomedical monitoring applications. By advancing this field, researchers and practitioners can contribute to the realization of personalized, accessible, and efficient healthcare systems (A. Ahmed et al., 2022; Choudhry et al., 2021; Coccia et al., 2021; Coyle & Diamond, 2016). Additionally, the design and development of textile-based wearable sensors for real-time biomedical monitoring center on critical factors such as biocompatibility and comfort, ensuring a harmonious interface with the human body. Calibration and accuracy are paramount, demanding rigorous exploration of calibration methods to guarantee precise biomedical data. Furthermore, human factors and user studies play a pivotal role, in determining the success of these wearable by assessing user acceptance and satisfaction for seamless integration into daily life.

2. Research overview

Wearable sensor technologies for biomedical monitoring have exploded in the past several years, with numerous devices available on the market. Many of these devices are based on textile-based sensors, which have several advantages over traditional sensors, including flexibility, comfort, ease of use, and non-invasiveness. Textile-based sensors are also capable of collecting a wide range of data, including temperature, pressure, motion, and physiological signals. Recent research has focused on developing textile-based sensors for specific biomedical applications, including monitoring heart rate, respiratory rate, and blood pressure (Cay et al., 2022; Hatamie et al., 2020; Lo Presti et al., 2019).

The wearable integrates various sensors, electrodes, and bus structures within a textile garment, allowing the patient to engage in normal daily activities without discomfort. The system includes a custom app for real-time visualization of signals and a software desktop for offline plotting and signal processing. The device design underwent a validation analysis focusing on ECG measurement and digital processing, and the results were encouraging, demonstrating the prototype’s ability to obtain reliable measurements. However, the paragraph also highlights the need to improve electrode adherence to reduce motion artifacts, which can interfere with signal processing and impact the overall performance of the device (Coccia et al., 2021). Sweatsock, when utilized by nurses and therapists during their working hours, has the potential to effectively monitor postural and dynamic variables in activities commonly linked to biomechanical strain. These activities encompass frequent patient handling, pushing and pulling, adopting awkward postures, prolonged standing, and significant sideways twisting (Coccia et al., 2021). A previous study suggested that non-metallic fibers may become increasingly popular in the future. The most prevalent wearable technologies for the arm and hand are smart watches and wristbands, which prioritize comfort and freedom of movement. The paragraph also mentions the commercial applications of wristbands, specifically in terms of orientation. It emphasizes that wearable devices generally include sensors, processing units, and power sources, highlighting the significance of meeting the criteria of natural clothing, including comfort and appearance, in wearable products (Seçkin et al., 2022).

With the increasing sophistication and complexity of wearable systems, issues such as outfit deformation during use and limited launderability have emerged as potential barriers to the widespread adoption of these smart systems. However, with growing consumer awareness and demand for lifestyle products, it is expected that wearable monitoring outfits will find broader applications among individual consumers. Particularly, considering the aging population, these clothing systems can play a crucial role in promoting the independence of disabled and elderly individuals, enabling them to carry out their daily activities while being monitored by online monitoring systems (Zahid et al., 2022).

2.1. Advantages and limitations of textile-based sensors

Textile-based sensors have gained significant attention in recent years due to their unique advantages in various applications. One of the notable advantages is their inherent compatibility with wearable electronics, as textiles are flexible, lightweight, and conformable to the human body. This allows for seamless integration of sensors into garments, enabling continuous and unobtrusive monitoring of physiological signals such as heart rate, respiration, and body movement. Moreover, textile-based sensors offer improved comfort compared to traditional rigid sensors, enhancing user compliance and long-term wearability (Hasan & Hossain, 2021; Nigusse et al., 2021). Another advantage of textile-based sensors is their ability to monitor large surface areas, providing spatially distributed sensing capabilities. This feature is particularly useful in applications such as pressure mapping for smart textiles and posture monitoring for healthcare and sports performance analysis. Additionally, textile-based sensors can be easily integrated into the fabric during the manufacturing process, offering cost-effective and scalable production (M. R. Ahmed et al., 2022).

However, textile-based sensors also have certain limitations that need to be considered. One limitation is the potential degradation of sensor performance over time due to mechanical stress, repeated washing, and environmental factors (Blachowicz et al., 2021). Another limitation is the complexity of signal processing and data interpretation (Coccia et al., 2021). Textile-based sensors often generate large amounts of data, requiring advanced algorithms for signal analysis and pattern recognition to extract meaningful information (Y. Zhang et al., 2020). Furthermore, textile-based sensors may face challenges in terms of sensitivity and specificity compared to traditional rigid sensors (Heo et al., 2020; Niu et al., 2019).

2.2. Recent research and developments

Researchers are exploring new materials and fabrication methods to improve the performance of textile-based sensors. Developments in nanotechnology have led to the creation of advanced functional textiles, including those that can detect changes in temperature, moisture, and physiological signals. Recent research has also focused on developing wearable sensors for remote monitoring of chronic diseases, such as diabetes and asthma. Several challenges must be overcome to make textile-based wearable sensors more widely used in healthcare, including regulation, standardization, and data privacy and security concerns (Adak & Mukhopadhyay, 2023; Ballaji, 2022). The concept behind wearable sensing devices is to facilitate seamless integration of the sensor technology into daily life routines. When selecting materials for sensor development, factors such as lighter weight, stretchability, and wearability are considered advantageous. These characteristics are sought not only in health monitoring applications but also in fields like biomedical research, sports performance tracking, and military applications (Zahid et al., 2022). Advancements in manufacturing techniques have led to the maturation of various printing processes, particularly the remarkable progress in three-dimensional (3D) printing, which has demonstrated great potential in advanced manufacturing. Although chitosan-based hydrogels (CS-Gels) have made significant strides in their application for flexible wearable devices, there are still substantial opportunities and challenges surrounding their preparation, functionality, and practical implementation. Presently, the detection capabilities of CS-Gels sensors are relatively limited, and there is a need to enable multi-dimensional signal monitoring to enhance their practical utility. In addition to capturing stress-strain signals, monitoring changes in physiological parameters such as temperature, humidity, and pH within the human body can effectively reflect alterations in an individual’s health status. Therefore, the development of CS-Gels sensors with fast response rates, high sensitivity, and a wide detection range for signals such as temperature, humidity, and pH holds significant potential in the field of smart wearable and implantable devices (Wu et al., 2023).

MXenes, novel inorganic nanomaterials characterized by their ultrathin atomic thickness, are composed of layered transition metal carbides and nitrides or carbonitrides, represented by the general structural formula M_n+1X_nT_x (n = 1–3). The distinctive structural properties of MXenes, including their ultrathin atomic layers and high specific surface area, coupled with their exceptional physicochemical characteristics such as high photothermal conversion efficiency and antibacterial properties, have led to their extensive utilization in the field of biomedicine. The focused analysis of their applications in various areas such as biosensors, diagnosis, therapy, antibacterial agents, and implants has been practiced (H. Li et al., 2023). Ionic liquid (IL)-based gels, also known as ionogels, have gained significant attention due to their unique advantages in terms of ionic conductivity and their ability to exist in a biphasic liquid-solid phase. Ionogels retain the nonvolatile IL within a 3D interconnected pore structure. These physical characteristics, along with the chemical properties of carefully selected ILs, have sparked interest in their antibacterial properties and biocompatibility. With diverse functionalities, ionogels designed for biomedical applications can be categorized into various active domains, including wearable strain sensors, therapeutic delivery systems, wound healing, and biochemical detection (Fan et al., 2023).

Recent advancements in technology have spurred the development of smart sensors using flexible materials, overcoming traditional structural barriers. The integration of flexible polymeric materials into wearable sensors allows for seamless incorporation into woven textile fabrics, maintaining fabric flexibility while withstanding mechanical deformations. These sensors, acting as antennas, enable real-time, noninvasive health monitoring, contributing to innovations in telemedicine, biomonitoring, and rehabilitation. Polymers, particularly electroactive and intrinsically conductive polymers, play a vital role in wearable devices, providing optical and electrical properties for smart monitoring. Ongoing research is focused on enhancing sensor capabilities, addressing challenges like mechanical durability, power management, and user acceptance, with the ultimate goal of providing more accurate, comfortable, and personalized health support (Zahid et al., 2022).

Geographically, North America is projected to hold the largest market share, attributed to the presence of key players, heightened consumer awareness, and widespread adoption of wearable sensors. The commercial wearable sensors market is anticipated to witness continued growth, fueled by increased utilization for health monitoring, fitness tracking, and diverse applications, alongside technological advancements and growing consumer demand for smart, interconnected devices (Mukhopadhyay et al., 2022; B. Yang et al., 2021). The characteristics of stretchability, comfort, breathability, and biocompatibility in fabric materials contribute to the success of textile-based wearable biosensors, offering a comfortable wearing experience. In healthcare, these biosensors play a crucial role in real-time, non-invasive monitoring of physiological indicators, providing valuable insights into respiratory rate, pulse, blood pressure, and more. Despite their potential, challenges persist, such as issues with target parameter selectivity and signal interference in multimodal sensors. Ensuring stability and durability, managing power and communication requirements, addressing data security and privacy concerns, and enhancing user acceptance are key areas for improvement. Overcoming these challenges is crucial for the continued evolution of textile-based wearable biosensors, which have the potential to revolutionize health monitoring, medical management, and personal health care, offering more accurate, convenient, and personalized support in the future (S. Li et al., 2023).

3. Sensor selection and design considerations

Various sensor modalities are available for textile-based wearable sensors, such as piezoresistive, capacitive, piezoelectric, and optical sensors. Consideration of factors such as sensitivity, accuracy, and power consumption is crucial while selecting an appropriate sensor modality. The sensors should have a biocompatible, flexible, and washable nature, which is compatible with wearable electronics (X. Liang et al., 2022; Wang et al., 2021). Two main biomedical wearable sensors prevail in the field of textiles. The description of these sensors is given in Figure 1.

Figure 1. Textile-based wearable sensors for biomedical.

The field of flexible wearable antenna sensors has gained significant attention from both the industry and the scientific community. As the interest continues to grow, several key issues and challenges have been identified for future research in this area: (1) There is a need to improve the accuracy and effectiveness of the techniques used to manufacture and measure flexible wearable antenna sensors. Advancements in these areas will contribute to the development of more reliable and high-performance sensors. (2) The market would benefit from the introduction of yarns and conductive fabrics that exhibit lower resistivity or higher conductivity. These advancements would enable the creation of more efficient and responsive antenna sensors. (3) The exploration of novel materials specifically designed for embroidery techniques or the introduction of innovative manufacturing techniques would expand the possibilities for creating flexible wearable antenna sensors. Such developments would enhance the flexibility, comfort, and functionality of these sensors. (4) The integration of antenna sensors into textile substrates that can be comfortably worn on the body holds great potential. This approach would allow for seamless integration of sensors into clothing or wearable accessories, enabling unobtrusive monitoring and data collection. Different types of Antenna sensors are described in Figure 2 (El Gharbi et al., 2020).

Figure 2. Types of antenna sensors.

Design and development of textile-based wearable sensors for real-time biomedical monitoring requires careful selection of sensor modalities and considerations of various factors such as sensitivity, accuracy, and power consumption. Different textile fabrication techniques like screen printing, embroidery, and knitting could be used to fabricate sensors on textiles. Integration of electronic components with the textile substrates could be achieved using various methods, including bonding, stitching, and embroidery. Care should be taken to maintain the mechanical properties and washability of the textile-based wearables while integrating the electronic components. These wearable sensors provide an innovative and noninvasive way for continuous and remote monitoring of various physiological parameters (Coccia et al., 2021).

The textile pressure sensor is a highly promising option for the next-generation sensing platform due to its seamless integration into modern garments, offering breathability and conformability. This summary introduces the principles, materials, techniques, and recent advancements in textile-based pressure sensors. However, challenges such as cost, lack of standards, reliability, sensitivity range, and service life hinder the rapid expansion of textile-based pressure sensors. Overcoming these challenges requires technology maturation, mass production, and the development of functional electronic textiles (E-textiles). Pressure sensors are crucial for electronic skin (e-skin), human-computer interaction, and physiological signal monitoring, requiring high sensitivity across a wide measurement range. Failure to provide a linear response within the effective test range can lead to reduced real-time response speed and increased power consumption (J. Zhang et al., 2022). The textile sensor unit exhibits remarkable characteristics, including exceptional sensitivity (14.4 kPa⁻¹), an impressively low detection limit (2 Pa), rapid response time (approximately 24 ms), minimal power consumption (less than 6 µW), and outstanding mechanical stability even when subjected to severe deformations. The sensor’s capabilities encompass the recognition of finger movements, hand gestures, acoustic vibrations, and real-time pulse waves. Additionally, we have successfully developed large-area sensor arrays on a single textile substrate, enabling the spatial mapping of tactile stimuli. These sensor arrays can be seamlessly integrated into fabric garments, allowing for stylish designs without compromising comfort. This development highlights the immense potential of smart textiles and wearable electronics (M. Liu et al., 2017).

4. Signal processing and data analysis

Textile-based wearable sensors are being developed for real-time biomedical monitoring, allowing for remote and continuous health assessment. These sensors can collect large amounts of data, requiring advanced signal-processing techniques for extracting relevant biomedical information. Signal processing involves the manipulation of raw sensor data to extract useful information about the wearer’s health. This involves techniques for noise reduction, feature extraction, and classification. Noise reduction algorithms are used to remove unwanted signals from the raw data, such as motion artifacts, environmental noise, or baseline wander, to improve the accuracy of the measurements. Advanced techniques such as adaptive filtering, wavelet transform, and principal component analysis can be used for effective noise suppression (D. Yang et al., 2018).

Improvements are necessary in the field of electrochemical methods as the obtained signal must be compared either with a calibration curve or a standard method. A significant concern arises from the stability of wearable sensors, particularly electrochemical sensors, due to issues like passivation and biofouling of the electrode surface. These factors increase the risk of incorrect responses during operation, which is especially critical when employing enzymes or biological recognition agents for on-body measurements. Furthermore, power sources continue to pose challenges for such sensors. Ideally, an optimal power source should be compact, provide stable and sufficient energy, offer flexibility for increased comfort, and be near the sensor. Therefore, it is essential to design more robust and stable sensing mechanisms and components to enable accurate measurements, ensuring enhanced chemical and mechanical stability for long-term use. Moreover, while nanomaterials have shown promise in flexible sensors for improved sensing performance, their potential biocompatibility and toxicity must be thoroughly considered and investigated (Hatamie et al., 2020).

Feature extraction involves identifying relevant features from the sensor data and mapping them to specific physiological parameters, such as heart rate, respiration rate, or skin temperature. Techniques such as Fast Fourier Transform, linear and nonlinear regression, and peak detection can be used to extract relevant features. Classification algorithms are used to categorize the extracted features into specific disease states or physiological conditions. Supervised and unsupervised learning algorithms, such as artificial neural networks, decision trees, support vector machines, and clustering algorithms, can be used for classification. Data analysis approaches are important for real-time monitoring and health assessment, allowing clinicians to make informed decisions based on the sensor data. Simple statistical methods, such as mean and standard deviation, can be used for real-time analysis. Advanced methods, such as time-frequency analysis, entropy metrics, and spectral analysis, can be used for more sophisticated data analysis. Overall, effective signal processing and data analysis techniques are essential for the development of accurate and reliable textile-based wearable sensors for biomedical monitoring, enabling continuous and remote health assessment for a variety of applications (Majumder et al., 2017; Sonawani et al., 2023). The groundbreaking progress in the biomedical field, particularly in the realms of nanotechnology and material science, has led to significant advancements in the development of flexible smart sensors for healthcare.

4.1. Nanotechnology and materials in biomedical sensors

Recent developments in nanotechnology and material science have revolutionized the biomedical field, particularly in the design of smart sensors using flexible materials for applications such as healthcare. Nanotechnologies play a vital role in various fields, including medicine, offering the creation and control of nanoscale materials for healthcare applications. The integration of nanostructured materials with biological subjects has paved the way for innovative applications, such as biosensors using nanotubes, nanofibers, nanorods, nanoparticles (NPs), and thin films. Nanotechnologies also facilitate the development of functional materials, devices, and nanorobots, potentially addressing critical medical issues and aging-related health problems. The review emphasizes the challenges associated with the commercial-scale production of nanomaterials for biomedical applications, highlighting the need for cost-effective, scalable synthesis methods. Despite the progress, there are relatively low percentage of publications focused on nanotechnology applications in biomedical and biological engineering, indicating a need for further exploration and analysis in this area. The review aims to fill this gap by providing detailed information on recent trends and advances in nanotechnology for biomedical applications, focusing on nonbiological materials (Mabrouk et al., 2021; Singh & Patel, 2022).

5. Biocompatibility and comfort

Biocompatibility is the ability of a material to perform with an appropriate host response in a specific application without causing harm or injury to the host. Textile-based wearable sensors require biocompatible materials to ensure they do not cause irritation or harm to the skin, especially in long-term continuous wear applications. Common biocompatible materials used in textile-based sensors include cotton, silk, nylon, and polyester because they are naturally hydrophilic, porous, and do not cause skin irritation. Hydrogels are used as a conductive medium and provide excellent biocompatibility, but their low strength and high-water content limit their use in textile-based sensors. Strategies for ensuring skin contact safety and comfort include incorporating breathable materials, using soft and flexible substrates, and avoiding rough surfaces and sharp edges. Textile-based sensors should be washable, and their electrical properties should not be degraded after washing to maintain the sensor’s effectiveness. User acceptance and usability factors, such as clothing comfort and fit, are essential for the widespread adoption of textile-based wearable sensors. Overall, designing and developing textile-based wearable sensors for real-time biomedical monitoring require careful consideration of biocompatibility and comfort to ensure patient safety and user acceptance (Ates et al., 2022).

Thermal comfort has become a key issue for determining building thermal-energy performance and, in general, the well-being and productivity of occupants indoors. Human-centric measurement techniques represent the key turning point to support people-centric design and control of the built environment to guarantee well-being, energy saving, and environmental sustainability. This is the reason that motivated this review effort, framing all the sensing techniques and achieved results so far, deserving a further effort to be exhaustively exploited for indoor thermal comfort measurement. In terms of new technologies used for thermal comfort investigation, this review highlights that wearable devices may represent a promising alternative for estimating thermal comfort over time in transient conditions. The application of wearable devices is incentivized by their improved portability, as well as by new technologies and designs with low time of application, low invasiveness, and competitive costs. However, wearable devices are still prone to collect artifacts, introducing inevitably uncertainties in the collected data that lead to incorrect results. For this reason, complex data processing should be considered as still needed for their large-scale exploitation in real life (Khan et al., 2016).

The assessment of thermal comfort has become crucial in evaluating the thermal-energy performance of buildings and ensuring the well-being and productivity of occupants indoors. To achieve people-centric design and control of the built environment, human-centric measurement techniques play a pivotal role, enabling the optimization of well-being, energy efficiency, and environmental sustainability. Motivated by this objective, this review aims to comprehensively explore sensing techniques and the results achieved thus far in the field, to fully leverage them for indoor thermal comfort measurement. Regarding the use of new technologies in thermal comfort research, this review emphasizes the potential of wearable devices as a promising alternative for assessing thermal comfort in transient conditions over time. Wearable devices are attractive due to their enhanced portability, advancements in technology and design, shorter application times, lower invasiveness, and competitive costs. However, it is important to acknowledge that wearable devices are susceptible to collecting artifacts, which can introduce uncertainties and result in inaccurate data. Consequently, complex data processing is still necessary for their effective large-scale utilization in real-life scenarios (Mansi et al., 2021).

Flexible wearable sensors offer unique advantages in terms of comfort, flexibility, and direct contact with human skin and tissues, setting them apart from traditional rigid sensors. It is crucial to carefully select the appropriate manufacturing processes and flexible materials to ensure user safety and minimize environmental pollution. The use of soft and self-healing materials as substrates can significantly enhance the sensor’s service life. However, one challenge faced by flexible sensors is the limited capacity of their batteries to meet long-term power supply demands. As the market offers a wide range of wearable sensors, people’s monitoring needs are growing alongside the increasing availability of sensor types. To address these needs, the future direction of development will focus on multi-functional sensors that can cater to diverse monitoring requirements. Smart sensors with selectivity tailored to specific monitoring needs will also gain attention. However, factors such as poor sensitivity and stability, complex operating procedures, and expensive manufacturing equipment hinder the large-scale industrial production of these sensors. Interference from signal crosstalk and harsh environmental conditions can disrupt analytical data and compromise the stability of the sensor system. Enhancing sensitivity and selectivity is a vital solution to overcome these challenges. Additionally, designing cleaner circuits can minimize potential noise. Despite the obstacles in developing flexible wearable sensors for medical monitoring, there are promising signs indicating progress and innovation in this field (Yuan et al., 2022).

As a result, a variety of invasive and noninvasive wearable devices that can capture biosystematic data have been developed, and they have proven to be useful in disease diagnosis and detection. However, their effective acceptance by wearers/patients has been hampered by their performance life-span, wearability, expense, and comfort. Furthermore, its psychological impact has been identified as a contributing factor in slow recovery rates. Fortunately, with the advancement in miniature technology and the textile industry, this new fusion can be the solution to the predicaments faced by traditional wearable devices. The solution lies in bridging textile-based wearable biomedical devices with textile-based energy harvesters which can provide a continuous source of power that can be generated from the wasteful energy.

A wide range of invasive and noninvasive wearable devices capable of capturing biosystematic data have been developed, proving to be valuable in disease diagnosis and detection. However, their acceptance by wearers and patients has been hindered by factors such as limited performance lifespan, wearability issues, high cost, and discomfort. Additionally, the psychological impact of these devices has been identified as a contributing factor to slow recovery rates. Fortunately, the fusion of miniature technology and the textile industry offers a potential solution to address the challenges faced by traditional wearable devices. By combining textile-based wearable biomedical devices with textile-based energy harvesters, a continuous source of power can be generated from wasted energy, overcoming the limitations of battery life. This integration holds promise in improving the performance, wearability, and comfort of wearable devices. This advancement in textile-based wearable biomedical devices and energy harvesters has the potential to enhance user acceptance, reduce cost, and promote faster recovery rates. By leveraging the capabilities of the textile industry and the advancements in miniaturization, a new generation of wearable devices can be developed that addresses the limitations of traditional devices and offers improved functionality and user experience (Iyer et al., 2022).

6. Calibration and accuracy assessment

Textile-based wearable sensors are becoming increasingly popular for real-time biomedical monitoring. However, it is crucial to ensure their accuracy and reliability for widespread adoption. This is where calibration and accuracy assessment come into play. Calibration is the process of determining the relationship between sensor readings and the actual value of the measured quantity (Massaroni et al., 2016). Calibration of textile-based wearable sensors involves the following steps (X. Liu et al., 2022; Presti et al., 2018):

• Identification of the sensor’s response to a known stimulus or input.

• Establishment of a mathematical relationship between the sensor output and the known input.

• Determination of calibration coefficients using statistical methods.

To ensure the accuracy and reliability of measurements obtained from textile-based wearable sensors, several methods can be employed (Jang et al., 2022). These methods include (Choudhry et al., 2021; Kwak et al., 2019):

• Ensuring each sensor is calibrated before use.

• Employing signal processing techniques to remove noise.

• Continuously monitoring and calibrating sensors during use.

• Reducing interference from other sources.

Validation studies are essential to determine the accuracy and reliability of textile-based wearable sensors. These studies typically involve comparing sensor measurements with those obtained using gold-standard techniques. These gold standard techniques are well established, and their measurement accuracy and reliability are known. Several validation studies have been reported in recent years, focusing on different applications such as health and wellness monitoring, sports performance monitoring, and chronic disease management. These studies have shown that textile-based wearable sensors can provide accurate and reliable measurements. Calibration and accuracy assessment are critical to ensuring the accuracy and reliability of textile-based wearable sensors for real-time biomedical monitoring. Employing appropriate calibration techniques and ensuring continuous monitoring and calibration during use can improve measurement accuracy and reliability. Comparing sensor measurements with those obtained using gold-standard techniques can validate the performance of textile-based wearable sensors (Maselli et al., 2018). The investigation was also done on the response of a piezoresistive sensing element through laboratory tests involving calibration curve analysis and hysteresis evaluation. Additionally, it has been utilized the sensing element for monitoring the respiratory rate of six healthy volunteers. Through the calibration curve analysis, we observed that the system exhibited high sensitivity, enabling the detection of chest wall movements associated with respiration. This sensitivity is crucial for accurately capturing and monitoring respiratory activity. By using the piezoresistive sensing element, a successful monitoring of the respiratory rate has been done of the healthy volunteers. This demonstrates the potential application of the sensing element in real-time respiratory rate monitoring (Molinaro et al., 2018).

7. Integration with wearable systems

Textile-based sensors are becoming more popular due to their versatility, flexibility, and wearable comfort. Integrating these sensors with wearable systems requires careful consideration of components, communication protocols, and power management. Strategies for integrating textile-based sensors into wearable platforms include (Barua et al., 2022; He et al., 2023; Heo et al., 2018; T. Liang & Yuan, 2016; Sonawane et al., 2017):

• Incorporating sensors into clothing items such as shirts, socks, and gloves.

• Adding sensors to accessories such as headbands, wristbands, or belts.

• Using a modular approach where sensors can be added or removed depending on the user’s needs.

• Communication protocols and data transmission methods:

• Bluetooth Low Energy (BLE) is a commonly used communication protocol for wearable devices.

• Other options include Wi-Fi, Zigbee, and RFID.

• Data transmission methods should be reliable and secure to ensure accurate monitoring and interpretation of data.

By summarizing the existing knowledge on flexible and textile-based batteries and highlighting future directions, this review also aims to contribute to the advancement of fabric-based printed batteries, enabling the realization of wearable and E-textiles with improved power capabilities and longer-lasting performance (Ali et al., 2021; Khan et al., 2016).

• Textile-based sensors often require low power consumption to avoid bulky batteries or frequent recharging.

• Energy harvesting techniques, such as using solar panels, thermoelectric generators, or piezoelectric generators, can help to extend battery life or eliminate the need for batteries.

• Power management strategies should also consider optimizing the power consumption of other wearable components to maximize overall battery life.

8. Real-time biomedical monitoring applications

Textile-based wearable sensors have the potential for real-time biomedical monitoring for various applications. These sensors can be integrated into clothing or fabrics to monitor vital signs, activity tracking, and disease detection. These sensors have been used for various biomedical monitoring applications, including monitoring of cardiovascular activity, movement and posture tracking, respiratory rate monitoring, glucose monitoring, sweat analysis for disease detection, sleep monitoring, and body temperature monitoring (Lanatà et al., 2009; Mattmann et al., 2008).

A novel e-textile-based system called sweatshirt has been developed for remote monitoring of biomedical signals. The system consists of a textile sensing shirt, an electronic unit for data transmission, a custom-made Android App for real-time signal visualization, and web software for advanced digital signal processing. The sweatshirt allows for the acquisition of electrocardiographic, bicep electromyographic, and trunk acceleration signals. These sensors, electrodes, and bus structures are seamlessly integrated into the textile garment, ensuring user comfort without any discomfort. To complement the hardware, a comprehensive set of algorithms for signal processing has been developed, enabling clinicians to quickly obtain a comprehensive overview of a patient’s clinical status. Overall, this study showcases the successful design and development of the sweatshirt, a wearable e-textile-based system for remote monitoring of biomedical signals. The validation analysis confirms the device’s effectiveness in capturing accurate and reliable data, highlighting its potential as a valuable tool in clinical settings (Coccia et al., 2021).

Additionally, another study describes the development of a stretchable and sensitive fiber strain sensor by embedding a large amount of Ag NPs into a stretchable fiber matrix using a harmless in situ formation process. Optimization approaches were implemented to improve the sensing performance of the sensor. Despite using a mild and harmless reducing agent, the fiber strain sensor exhibited excellent electrical resistance, strain sensing range, sensitivity, and stability. The sensor was integrated into textiles for real-time gesture recognition and was demonstrated to help users maintain accurate posture during exercise. The fiber strain sensor shows potential for applications in stretchable electronics, textile electronics, and wearable electronics (Kim et al., 2021).

8.1. Monitoring vital signs, activity tracking, and disease detection

Vital signs such as heart rate, blood pressure, and oxygen saturation can be monitored in real-time using textile-based wearable sensors. Activity tracking can provide valuable insights into an individual’s physical activity levels, which can be helpful in monitoring and managing chronic diseases. Textile-based wearable sensors can also be used for early disease detection, such as detecting changes in glucose levels for diabetes patients. In clinical settings, textile-based wearable sensors can be used to continuously monitor patients’ vital signs and detect early signs of deterioration. In sports settings, textile-based wearable sensors can be used to monitor athletes’ physical activity levels and track their performance. In home healthcare settings, textile-based wearable sensors can be used to monitor patients’ vital signs and detect early signs of disease or complications. Therefore, textile-based wearable sensors have the potential to revolutionize real-time biomedical monitoring in various settings. These sensors can be used for monitoring vital signs, activity tracking, and disease detection, and provide valuable insights into an individual’s health status. With continued advancements in wearable sensor technology, we can expect to see even more innovative applications in the future (Kan & Lam, 2021).

8.2. Textile-based wearable sensors and their applications

Smart monitoring garments can be employed in the medical sector to facilitate continuous long-term observation of patients’ conditions. Capacitive sensors were employed in the field of pressure sensitivity within the scope of human touch, leveraging unique weaving techniques and a die-coating system (Takamatsu et al., 2012). Capacitive sensors show high sensitivity and accuracy, but the signals could be affected by environmental factors like humidity and stray capacitance. Piezoresistive sensors exhibit high stability, sensitivity, and repeatability, which make them ideal for biomedical monitoring applications. Piezoelectric sensors generate electrical signals when subjected to a mechanical force, which can be utilized for physiological monitoring. Optical sensors are suitable for low power consumption and non-invasive monitoring of various physiological parameters. The utilization of piezoelectric and piezoresistive sensors with various polymers has been implemented, and a summary of their characteristics and applications used in previous studies has been provided in Table 1.

Table 1. Utilization of piezoelectric and piezoresistive sensors with various polymers.

Polymer	Characteristics	Applications
Piezoelectric Sensors
Polyvinylidene fluoride (PVDF) (Lanatà et al., 2009)	Supplied with an advanced electronic control unit and wireless communication capabilities.	These sensors are designed to monitor cardiopulmonary activity.
Poly (vinylidene fluoride-co-trifluoroethylene) (Kechiche et al., 2013)	The melt-spinning process is employed for the production of filaments.	Highly responsive to strain and stress stimuli.
PVDF, high-density polyethylene (HDPE) (Nilsson et al., 2013)	Carbon black (CB) is incorporated to enhance the conductivity of composites.	Utilized for the detection of human heartbeat.
Polypyrrole/polyurethane (PPy/PU) elastomer (Balint et al., 2014)	To amplify the conductivity of the sensor, a dopant called anthraquinone-2-sulfonic acid sodium was introduced.	A waistband-like sensor designed to monitor human breath patterns.
Piezoresistive Sensors
Thermoplastic elastomer (PPyTPE) (Mattmann et al., 2008)	A silicone film was employed to securely attach the sensor thread to textiles.	Capable of detecting and recognizing 27 different upper body postures.
Polypyrrole (Munro et al., 2008)	Ferric chloride (FeCl3) as oxidant and 1,5 naphthalene sulfonic acid tetrahydrate (NDSA) as dopant was used.	An intelligent knee sleeve designed to monitor and track strain levels.
Polyaniline (PANI) (Muthukumar & Thilagavathi, 2012)	Ammonium persulphate was used for polymerization.	Strain sensor
PU/PEDOT:PSS (poly(3,4-ethylenedioxythiophene) polystyrene sulfonate (PEDOT:PSS)) (Seyedin et al., 2015; Yamaji et al., 2017)	Polymer-coated fibers and commercial Spandex yarn were combined through a wet spinning process during co-knitting.	A combination of PU/PEDOT: PSS fibers and a commercial Spandex yarn were co-knitted together.
Elastomer Sensors (Yamaji et al., 2017)	CNT (carbon nanotube) is positioned between two polymer sheets, effectively serving as an electrode.	A strain sensor designed for the rapid prototyping of human interfaces.

9. Human factors and user studies

Examination of user acceptance, comfort, and usability through human factor studies is paramount in determining the success of wearable sensors. These studies should meticulously assess factors such as comfort, ease of use, and potential barriers to adoption. User feedback becomes a crucial tool in identifying current design shortcomings and guiding future improvements. Discussions on user experiences with textile-based wearable sensors are essential to understanding how these devices are utilized and whether they effectively meet user needs across various scenarios like physical activity, showering, or sleeping. Unobtrusive and user-friendly design improvements, aligned with user preferences, should be implemented based on this feedback. Evaluating factors such as textile material, sensor placement, and sensor type according to user preferences ensures the wearable sensors seamlessly integrate into users’ lifestyles, positively contributing to their overall well-being. Human factor studies are pivotal in developing relevant, effective, and user-friendly wearable sensors for real-time biomedical monitoring, with continuous consideration of user feedback throughout the design process.

Advancements in wearable sensors and AI algorithms present significant potential for shifting from population-based to individual-based epidemiological studies, capturing personalized data on human exposure. Comprehensive research on personal exposures, considering dietary characteristics, exercise patterns, and daily habits, can greatly enhance personal health monitoring. The integration of large-scale AI-enabled personal flexible wearable sensors has the potential to elevate the intelligence of medical services and enhance the overall healthcare experience (Shan et al., 2020).

Numerous review studies have explored wearable technology, but one specific study presents a review of previous research on wearable computing studies. To the best of the authors’ knowledge, there have been no comprehensive review studies on wearable wrist-worn devices (WWDs) that consider multiple aspects. The article discusses various types of WWD studies, identifies important issues, and proposes directions for future research. The next step in the research is to delve deeper into studies focused on specific domains or topics that can be addressed using wearable technology. This involves investigating and identifying problems in collaboration with domain experts to establish specific requirements for addressing those issues. By following this approach, the aim is to contribute to the advancement of wearable technology and its application in various fields (Al-Eidan et al., 2018). Deploying wearable medical and healthcare devices across diverse anatomical regions provides a comprehensive approach to continuous health monitoring and data acquisition as shown in Figure 3.

Figure 3. Medical and wearable sensors designed to be worn on different body parts.

One more study contributes to the advancement of small-form factor wearable computers by introducing methods for expanding their interaction capabilities. The proposed system, WatchSense, enables input on the back of the hand and the space above it, extending the available input space on wearable devices. This allows for interactions in various postures, while on the move, and even when the hand is holding an object. WatchSense estimates fingertip locations, identities, and touch positions, enabling new types of interactions and supporting continuous input and multitouch gestures such as pinch on the back of the hand. The system combines mid-air gestures with back-of-hand interactions, enhancing the expressiveness of input. Additionally, finger identification enables the triggering of events and mapping of controls to specific fingers. The real-time detection of fingertips, identities, and touch on the back of the hand poses challenges in computer vision due to wrist motion, oblique viewpoint, occlusions, fast motions, and fingertip ambiguity. The research presents a novel algorithm that addresses these challenges, providing a fast, accurate, and robust solution for sensing fingertip locations, identities, and touch on the back of the hand. Furthermore, it demonstrates that the back-of-hand input can not only expand the input space for smart watches but also enable input for ambient devices such as public displays (Sridhar et al., 2017). The increasing availability of computational resources, such as GPU devices, and the ease of collecting sensory signals from smartphones and wearable devices have contributed to the growth of this field. The article explores the unique implementation and design, advantages, and limitations of various deep neural network models. Additionally, it discusses benchmark datasets commonly used for performance evaluation and provides insights into their creation and collection processes (Ramanujam et al., 2021).

10. Future directions and challenges

Future research directions in textile-based wearable sensors would be the integration of more advanced sensors for specific purposes such as temperature, pressure, and chemical sensors (Hatamie et al., 2020). The evolution of wearable technologies involves the development of specialized sensors for areas like heart monitoring, sleep analysis, and stress detection. Incorporating artificial intelligence and machine learning algorithms for data analysis and interpretation is considered advantageous. The demand for wearable electronics in personalized medicine, e-skins, and health monitoring is substantial and continuously expanding. To ensure their future application in biomedical engineering and bioanalytical sciences, integrating ‘green’ characteristics such as biodegradability, self-healing, and biocompatibility into these devices is crucial. Leveraging natural materials with inherent biodegradable, sustainable, and biocompatible properties will profoundly impact the fabrication of environmentally friendly e-skins and wearable electronics. By harnessing these attributes, the advancement of eco-friendly wearable technologies can address the growing need for sustainable solutions in the biomedical engineering and bioanalytical sciences field (H. Liu et al., 2021; Y. Liu et al., 2021; Z. Zhang et al., 2019).

Anticipated trends suggest a decline in the popularity of smart wearables used as jewelry and watch necklaces, with a shift toward integration into textiles by embedding sensors and electronic circuits within the fabric. The potential rise in significance of subcutaneous applications, involving wearables implanted under the skin, could offer more detailed information, though widespread adoption may be slow due to privacy concerns and the invasive nature of the procedure. Notably, subcutaneous implants are already being utilized in mandatory health situations. Improving the integration of conductive elements into textiles without the discomfort associated with soldering is an ongoing area of focus. Flexible conductive adhesives are considered a more desirable alternative, given that soldering involves heat treatment that could potentially damage the textile surface (Seçkin et al., 2022).

The future exploration of biomedical applications for ionogels is centered on key areas of innovation: (a) Customization of cations and anions to engineer ionogels tailored for specific biomedical applications. Through meticulous component selection, ionogels can be designed to meet the unique requirements of various biomedical uses. (b) Rational design to mitigate the toxicity of imidazolium-based ionogels or create alternative biocompatible ionogels suitable for potential applications within the human body. Efforts will focus on enhancing the safety and biocompatibility of ionogels to ensure their suitability for biomedical purposes. (c) Fabrication of stimuli-responsive ionogels for drug release applications. Magnetic-responsive ionogels, for instance, can be developed by incorporating magnetic ILs, enabling controlled drug release in response to external magnetic fields. (d) Establishment of recycling procedures for ionogels to minimize their environmental impact and reduce costs. Developing efficient methods for the recovery and reuse of ionogels will contribute to sustainable and environmentally friendly practices in biomedical applications (Fan et al., 2023). Moreover, developing a prosperous design for a textile-based sensor necessitates the integration of various specialists from diverse domains, such as textile science, polymer chemistry, physics, bioengineering, software engineering, and mechatronics engineering. The synergy achieved through this multidisciplinary collaboration, combined with a thorough assessment of the desired sensor attributes, holds significant importance in the creation of a promising prototype for a groundbreaking fabric sensor (J. Zhang et al., 2022).

Wearable technologies present new opportunities by providing healthcare providers, clinical practices, care organizations, and patients with access to valuable information and knowledge. The ability to continuously gather data from various sources, including clinical and behavioral data, enables the development of analytical tools for a deeper understanding of disease development, early detection, and intervention. This knowledge and these tools have the potential to revolutionize clinical practices and empower patients to take an active role in self-care and decision-making. With the significant increase in collected data, stemming from diverse origins such as clinical parameter monitoring, self-monitoring, and behavioral data, there is a pressing need to effectively manage and utilize this data. Implementing this knowledge into best practices, integrating it into existing workflows, and sharing information with other organizations, patients, and families require the development of interactive treatment methodologies. Although these changes are still in their early stages, they will continue to evolve, driving two important processes: the shift toward integrated care and co-management with patients, and the development of new tools that bring fresh insights to clinical practice. These processes will also prompt changes in data privacy regulations and data sharing, as well as the implementation of more interoperable and standardized tools that seamlessly integrate into care systems. In parallel to these long-term processes, there is an immediate challenge of developing mature products that address the specific needs of care providers and complement the tools currently used by healthcare professionals. The ultimate challenge for all stakeholders—including healthcare providers, policy makers, and the industry - is to collaborate and find ways to implement these solutions for the benefit of all populations, prioritizing low-cost and high-quality. By doing so, we can significantly improve care delivery models and clinical practices (Lewy, 2015).

Wearable electronic products, coupled with personalized algorithms, offer tremendous possibilities. This review explores their fabrication techniques and potential applications. One area of great interest is electronic wearable textiles due to their easy and flexible integration into our daily lives across a wide range of applications. E-textiles can be categorized into five main groups: sports, medical, fashion, personal protective equipment, and military applications. These groups share common characteristics that align with the fundamental properties of textile materials, such as laundering, stretching, and flexing. Depending on the specific application, additional characteristics like abrasion resistance and UV exposure may also be important. E-textiles should demonstrate durability, viability, and energy efficiency for a prolonged life cycle, ensuring reliable functionality. The washing performance of E-textiles is crucial for their commercial success, necessitating polymer coating or encapsulation to enhance strength and durability in daily use and diverse environmental conditions. However, there is still a need for research on compact solutions in this field. Fortunately, the future looks promising for the washing performance of smart textile materials. To enable large-scale production of new-generation technologies like wearable E-textiles, academic-industry collaborations must address the challenges involved. Since single-use solutions can be costly, industrial production of these technologies becomes vital. Thus, exploring mass production methods for E-textiles remains an important research area that warrants further attention (Ismar et al., 2020). In the future, wearable sensors will be managed and monitored through smart gadgets, revolutionizing the way we address healthcare issues. These innovative devices will serve as preventive tools, helping to mitigate health problems. A visual representation of this future scenario is depicted in the detailed Figure 4, illustrating the potential of wearable sensors.

Figure 4. Future of sensors as smart gadgets in wearable textile.

10.1. Challenges related to durability, washability, and scalability

Ensuring the enduring durability of wearable sensors is paramount due to exposure to environmental factors such as moisture, temperature fluctuations, and mechanical stress. These sensors must exhibit resilience to withstand these conditions without compromising functionality or accuracy. Sustaining sensor integrity and functionality through multiple wash cycles is crucial for long-term use and user comfort. As wearable technology becomes more ubiquitous, addressing scalability issues in data collection, storage, and analysis is imperative to manage the substantial information generated by these sensors. Overcoming these challenges is pivotal for the widespread adoption and integration of wearable sensors into everyday life, unlocking their potential to revolutionize healthcare, fitness, and various industries. Some key points are outlined to overcome challenges associated with durability, washability, and scalability (Gonçalves et al.,2018; Heo et al., 2020; Xu et al., 2021);

• Development of wearable sensors that can be washed without compromising their accuracy and sensitivity.

• Creation of textiles that is more durable, breathable, and comfortable for extended period use.

• Scaling up the manufacturing process to meet the increasing demand for wearable sensors.

The implementation of wearable technologies in healthcare presents challenges for both the healthcare system and the wearable technologies industry. The healthcare system must overcome the primary hurdle of restructuring the care model and enhancing information sharing to fully leverage these technologies. Successful implementation necessitates collaborative efforts between healthcare professionals and patients, extending beyond adoption to involve both parties in the development and implementation processes, adhering to established best practices and care pathways. Advancing research and development in systems that offer supplementary information, complement existing resources, and effectively integrate them into practice will enhance the overall quality of care. This requires active engagement of physicians, recognizing patients as partners in the care process, educating them, and providing tools, data, and information. Such an approach facilitates the sharing and analysis of patient data from diverse sources, necessitating regulatory changes in data usage, privacy, and security. For the wearable technologies industry, the challenge lies in creating supporting systems that encourage widespread adoption, taking into consideration standardization, privacy, security, and existing care models. Developers must be mindful of the workloads and workflows of healthcare professionals, tailoring solutions to seamlessly integrate into the current system. To implement wearable technologies effectively, the industry should prioritize developing more affordable solutions and new business models that foster widespread adoption by healthcare organizations (Lewy, 2015).

10.2. Regulatory and ethical considerations for clinical adoption

• Ensuring adherence to relevant safety and privacy regulations such as HIPAA and GDPR.

• Maintaining ethical policies on data collection and usage such as obtaining informed consent.

• Developing protocols for clinical validation and certification of wearable sensors to ensure effectiveness and safety.

Overall, the future of textile-based wearable sensors holds great potential in monitoring health, detecting disease, and providing personalized medical care. However, there are a few obstacles to overcome before incorporating these devices into everyday healthcare practices.

11. Summary

In conclusion, the design and development of textile-based wearable sensors for real-time biomedical monitoring hold immense potential in revolutionizing healthcare. This innovative technology provides a noninvasive and unobtrusive means to monitor vital signs and other physiological parameters continuously, enabling remote health monitoring in various settings. Throughout this study, we explored the significant progress in textile-based wearable sensors, emphasizing their advantages over traditional monitoring systems. These sensors, lightweight and flexible, seamlessly integrate into everyday clothing, ensuring comfort for prolonged wear. Their compatibility with wireless communication facilitates real-time data transmission to healthcare professionals, enabling timely interventions and personalized healthcare delivery.

Textile-based wearable sensors have diverse applications in healthcare, showing promise in monitoring vital signs like heart rate, respiratory rate, and body temperature. Additionally, these sensors can monitor biomedical parameters such as muscle activity, electrocardiogram (ECG), electroencephalogram (EEG), and detect abnormal movements, sleep patterns, and falls. The versatility and accuracy of these sensors make them invaluable for early detection, diagnosis, and intervention in various medical conditions. Integrating textile-based sensors with advanced analytics and machine learning offers exciting possibilities for personalized healthcare, facilitating preventive care, disease management, and treatment optimization.

Despite these opportunities, challenges remain for widespread adoption. Ensuring sensor reliability, accuracy, power efficiency, and addressing data security, privacy concerns, and user acceptance are crucial. Continued research and development efforts are essential to overcome these challenges and advance the field.

In conclusion, textile-based wearable sensors have the potential to transform healthcare by enabling real-time, noninvasive, continuous monitoring of biomedical parameters. This technology opens avenues for personalized healthcare, early disease detection, and remote patient management. As advancements continue, we anticipate these sensors becoming integral to daily life, empowering individuals to manage their health. The future may see a shift from smart wearables like jewelry and watch necklaces to incorporation into textiles, with sensors and electronic circuits seamlessly embedded. Subcutaneous applications, involving implantation beneath the skin, may gain importance for detailed information. The article emphasizes open challenges, paving the way for future research enhancements in this dynamic field.

Disclosure statement

The authors declare no conflicts of interest.