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Related Experiment Video

Updated: May 24, 2025

Calculating Heart Rate Variability from ECG Data from Youth with Cerebral Palsy During Active Video Game Sessions
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Heart rate estimation using on-nail wearable photoplethysmography.

Nur Alia Athirah B H Mohtadzar, Ertan Balaban, Christopher Beach

    Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Annual International Conference
    |March 5, 2025
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    Summary

    New on-nail wearable sensors accurately measure heart rate (HR) using photoplethysmography (PPG) from fingernails and toenails. This technology shows potential for discrete, long-term HR monitoring, even during movement.

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    Area of Science:

    • Biomedical Engineering
    • Wearable Technology
    • Physiological Monitoring

    Background:

    • Current wearable heart rate (HR) monitoring primarily relies on photoplethysmography (PPG) sensors placed on the skin.
    • Limited research has explored PPG signal acquisition from rigid nail surfaces, such as fingernails and toenails.
    • Rigid surfaces may offer enhanced motion robustness compared to flexible skin-based sensor placements.

    Purpose of the Study:

    • To introduce and evaluate an on-nail wearable photoplethysmography (PPG) sensor for estimating heart rate (HR).
    • To assess the feasibility of HR monitoring from fingernail and toenail locations in both motion-free and motion-present conditions.
    • To compare the accuracy of the on-nail PPG sensor against commercial electrocardiogram (ECG) and pulse oximeter (PO) devices.

    Main Methods:

    • Development of an on-nail wearable PPG sensor designed for reflective mode signal acquisition.
    • Recruitment of 20 participants for data collection in both static and dynamic (motion) scenarios.
    • Comparative analysis of HR estimations from the on-nail PPG sensor against gold-standard ECG and PO measurements.

    Main Results:

    • The on-nail PPG sensor demonstrated strong correlation with ECG-derived HR, with low root mean square errors (RMSE) of 1.6 bpm (fingernail) and 2.2 bpm (toenail) in motion-free conditions.
    • During motion, RMSE increased to 5.6 bpm for fingernails and 12.8 bpm for toenails, indicating reduced accuracy but continued signal acquisition.
    • Sensor accuracy was not significantly affected by participant skin tone, suggesting broad applicability.

    Conclusions:

    • On-nail wearable PPG sensors show significant potential for accurate heart rate monitoring.
    • Nail-based PPG offers a feasible alternative for discrete, long-term HR monitoring, potentially integrated into footwear or accessories.
    • Further research could optimize sensor design and algorithms to improve motion artifact resilience for continuous monitoring applications.