Develop a wireless, skin-conformable and dual-sensing wearable system in support of voice and upper airway telehealth care

PROJECT SUMMARY Voice and upper airway (VUA) disorders affect nearly 30% of the general population and 80% of occupational voice users in the United States. Patients experience symptoms of vocal fatigue, hoarse voice, chronic cough or breathing difficulties, affecting their daily communication and swallowing functions. Many of these symptoms can be modified behaviorally and with therapeutic exercises. An incalcitrant treatment challenge is to support patient compliance and their carryover of behavioral changes outside the clinic. Wearable technology is widely adopted to help track patient’s health conditions and promote adherence to treatment. Existing wearables for VUA health monitoring are, however, wired, semi-rigid and single modal sensing at best. In this project, we will leverage our expertise in wearable electronics, biomaterial engineering and computational medicine to develop a new class of VUA health wearable system. In particular, the new wearable will be wireless and conformable to the neck skin surface. A dual-modal sensing technology, which will be implemented for the very first time in VUA wearables, will be developed with neck surface accelerometry (NSA) and surface electromyography (sEMG). The combined use of NSA and sEMG will offer complementary physiological measurements that will allow for monitoring VUA symptoms with better precision and broader utility. Three specific aims (S.A.) are proposed in this project. S.A. 1. We will develop a single neck-worn wearable device that is skin-conformable, wireless and dual-sensing. A commercial NSA sensor, a multi-channel sEMG array and peripheral electronics will be assembled on a flexible, stretchable substrate. Our team has developed dry, soft sEMG electrodes, which will be customized for detecting perilaryngeal muscle activity. We will implement wireless power management and data transmission protocols. We will further modify our biocompatible and reusable adhesives for long-term wearable mounting. S.A. 2. We will evaluate the new wearable device on vocally healthy participants to optimize the configuration and placement of NSA and sEMG sensors. We will also develop efficient machine learning models to classify VUA symptoms in near real time. Results will help us refine the wearable system toward system miniaturization. S.A. 3. We will develop a companion smartphone application (app) for user-device interaction and data management. We will then evaluate the usability and utilization of the wearable system in patients with laryngeal hyperfunction who will undergo a week of remote monitoring in a free-living setting. Lastly, we will use the collected wearable data to build patient-specific algorithms for estimating clinical VUA symptom severity. Outcomes from this study will allow for iterative product improvement and translation of this technology for clinical use in a rational and accountable way. Ultimately, this wearable system will assist clinicians to remotely track patients’ VUA health status for precision treatment, and more importantly to better engage patients in self- managing their symptoms and create healthier outcomes.