Day and night comfort and stability on the body of four wearable devices for seizure detection: A direct user-experience

Wearable devices are progressively becoming an available tool for continuous seizure detection. Motivation to use wearables is not only driven by the accuracy and reliability of the performance but also by the form factor, comfort, and stability on the body. We collected direct feedback and device p...

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Bibliographic Details
Published in:Epilepsy & behavior 2020-11, Vol.112, p.107478-107478, Article 107478
Main Authors: Bruno, Elisa, Biondi, Andrea, Böttcher, Sebastian, Lees, Simon, Schulze-Bonhage, Andreas, Richardson, Mark P.
Format: Article
Language:English
Subjects:
Epilepsy
Epilepsy - diagnosis
Humans
London
M-health
Remote monitoring technology (RMT)
Reproducibility of Results
Seizures - diagnosis
Users
Wearable Electronic Devices
Wearables
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Summary:Wearable devices are progressively becoming an available tool for continuous seizure detection. Motivation to use wearables is not only driven by the accuracy and reliability of the performance but also by the form factor, comfort, and stability on the body. We collected direct feedback and device placement-related issues experienced by a cohort of people with epilepsy (PWE) to investigate to what extent available devices are nonintrusive, comfortable, and stable on the body. Four models of wearable devices (E4 wrist band, Everion upper arm band, IMEC upper arm band, and Epilog scalp patch electrodes) were worn by PWE who were admitted to two epilepsy monitoring units (EMUs) in London and Freiburg. Participants were periodically reviewed, and accidental displacements of the devices were annotated. Participants' experience was assessed using the Technology Acceptance Model Fast Form (TAM-FF) plus two additional questions on comfort. A thematic analysis was also performed on the free text of the questionnaire. One hundred and fifteen participants were enrolled. The devices had a good stability on the body including during seizures. Overall, all the devices were considered comfortable to be worn, including during sleep. However, devices containing wires and patches demonstrated a lesser degree of stability on the body and were judged less positively. Participants age was correlated with TAM-FF mean scores, and older participants judged the devices less favorably compared with younger participants. Removable but securely fitted, wireless, and comfortable designs were considered more appropriate for a continuous monitoring aimed at seizure detection. Some caution may be required when patch electrodes and electrodes glued to the skin or to the scalp are used, as those evaluated in the present study demonstrated a lower level of acceptability and a lower degree of stability to the body, especially at night. These factors could limit a continuous monitoring decreasing the device performance for nocturnal, unsupervised seizures which are at higher risk of lethality. •A device design incorporating comfort and ease of use is essential for acceptance and long-term adoption of the technology.•Removable but securely fitted and wireless designs are more appropriate for a monitoring aimed at seizure detection.•Devices relying on wires and patches have a higher chance to become loose and to be displaced, especially at night.•Older age may be a potential source of digital i
ISSN:1525-5050
1525-5069
DOI:10.1016/j.yebeh.2020.107478