Highlighting Unseen Activity Through 48-Hour Continuous Measurement in Subacute Stroke Rehabilitation: Preliminary Cohort Study.

BACKGROUND: Motor impairments not only lead to a significant reduction in patient activity levels but also trigger a further deterioration in motor function due to deconditioning, which is an issue that is particularly pronounced during hospitalization. This deconditioning can be countered by sustaining appropriate activity levels. Activities that occur outside of scheduled programs, often overlooked, are critical in this context. Wearable technology, such as smart clothing, provides a means to monitor these activities. OBJECTIVE: This study aimed to observe activity levels in patients who had strokes during the subacute phase, focusing on both scheduled training sessions and other nontraining times in an inpatient rehabilitation environment. A smart clothing system is used to simultaneously measure heart rate and acceleration, offering insights into both the amount and intensity of the physical activity. METHODS: In this preliminary cohort study, 11 individuals undergoing subacute stroke rehabilitation were enrolled. The 48-hour continuous measurement system, deployed at admission and reassessed 4 weeks later, monitored accelerometry data for physical activity (quantified with a moving SD of acceleration [MSDA]) and heart rate for intensity (quantified with percent heart rate reserve). The measurements were performed using a wearable activity monitoring system, the hitoe (NTT Corporation and Toray Industries, Inc) system comprising a measuring garment (wear or strap) with integrated electrodes, a data transmitter, and a smartphone. The Functional Independence Measure was used to assess the patients' daily activity levels. This study explored factors such as differences in activity during training and nontraining periods, correlations with activities of daily living (ADLs) and age, and changes observed after 4 weeks. RESULTS: A significant increase was found in the daily total MSDA after the 4-week program, with the average percent heart rate reserve remaining consistent. Physical activity during training positively correlated with ADL levels both at admission (ρ=0.86, P<.001) and 4 weeks post admission (ρ=0.96, P<.001), whereas the correlation between age and MSDA was not significant during training periods at admission (ρ=-0.41, P=.21) or 4 weeks post admission (ρ=-0.25, P=.45). Conversely, nontraining activity showed a negative correlation with age, with significant negative correlations with age at admission (ρ=-0.82, P=.002) and 4 weeks post admission (ρ=-0.73, P=.01). CONCLUSIONS: Inpatient rehabilitation activity levels were positively correlated with ADL levels. Further analysis revealed a strong positive correlation between scheduled training activities and ADL levels, whereas nontraining activities showed no such correlation. Instead, a negative correlation between nontraining activities and age was observed. These observations suggest the importance of providing activity opportunities for older patients, while it may also suggest the need for adjusting the activity amount to accommodate the potentially limited fitness levels of this demographic. Future studies with larger patient groups are warranted to validate and further elucidate these findings.

Smart Graphene Textiles for Biopotential Monitoring: Laser-Tailored Electrochemical Property Enhancement.

While most of the research in graphene-based materials seeks high electroactive surface area and ion intercalation, here, we show an alternative electrochemical behavior that leverages graphene's potential in biosensing. We report a novel approach to fabricate graphene/polymer nanocomposites with near-record conductivity levels of 45 Ω sq-1 and enhanced biocompatibility. This is realized by laser processing of graphene oxide in a sandwich structure with a thin (100 µm) polyethylene terephthalate film on a textile substrate. Such hybrid materials exhibit high conductivity, low polarization, and stability. In addition, the nanocomposites are highly biocompatible, as evidenced by their low cytotoxicity and good skin adhesion. These results demonstrate the potential of graphene/polymer nanocomposites for smart clothing applications.

Implementation difficulties and solutions for a smart-clothes assisted home nursing care program for older adults with dementia or recovering from hip fracture.

BACKGROUND: Wearable devices have the advantage of always being with individuals, enabling easy detection of their movements. Smart clothing can provide feedback to family caregivers of older adults with disabilities who require in-home care. METHODS: This study describes the process of setting up a smart technology-assisted (STA) home-nursing care program, the difficulties encountered, and strategies applied to improve the program. The STA program utilized a smart-vest, designed specifically for older persons with dementia or recovering from hip-fracture surgery. The smart-vest facilitated nurses' and family caregivers' detection of a care receiver's movements via a remote-monitoring system. Movements included getting up at night, time spent in the bathroom, duration of daytime immobility, leaving the house, and daily activity. Twelve caregivers of older adults and their care receiver participated; care receivers included persons recovering from hip fracture (n = 5) and persons living with dementia (n = 7). Data about installation of the individual STA in-home systems, monitoring, and technical difficulties encountered were obtained from researchers' reports. Qualitative data about the caregivers' and care receivers' use of the system were obtained from homecare nurses' reports, which were explored with thematic analysis. RESULTS: Compiled reports from the research team identified three areas of difficulty with the system: incompatibility with the home environment, which caused extra hours of manpower and added to the cost of set-up and maintenance; interruptions in data transmissions, due to system malfunctions; and inaccuracies in data transmissions, due to sensors on the smart-vest. These difficulties contributed to frustration experienced by caregivers and care receivers. CONCLUSIONS: The difficulties encountered impeded implementation of the STA home nursing care. Each of these difficulties had their own unique problems and strategies to resolve them. Our findings can provide a reference for future implementation of similar smart-home systems, which could facilitate ease-of-use for family caregivers.

Electrochemical sensing fibers for wearable health monitoring devices.

Real-time monitoring of health conditions is an emerging strong issue in health care, internet information, and other strongly evolving areas. Wearable electronics are versatile platforms for non-invasive sensing. Among a variety of wearable device principles, fiber electronics represent cutting-edge development of flexible electronics. Enabled by electrochemical sensing, fiber electronics have found a wide range of applications, providing new opportunities for real-time monitoring of health conditions by daily wearing, and electrochemical fiber sensors as explored in the present report are a promising emerging field. In consideration of the key challenges and corresponding solutions for electrochemical sensing fibers, we offer here a timely and comprehensive review. We discuss the principles and advantages of electrochemical sensing fibers and fabrics. Our review also highlights the importance of electrochemical sensing fibers in the fabrication of "smart" fabric designs, focusing on strategies to address key issues in fiber-based electrochemical sensors, and we provide an overview of smart clothing systems and their cutting-edge applications in therapeutic care. Our report offers a comprehensive overview of current developments in electrochemical sensing fibers to researchers in the fields of wearables, flexible electronics, and electrochemical sensing, stimulating forthcoming development of next-generation "smart" fabrics-based electrochemical sensing.

Design of intelligent wearable equipment based on real-time dynamic ECG-monitoring system.

OBJECTIVES: The coronavirus disease epidemic has largely restricted the traditional offline medical treatment model. With increasing requirements for virtual medical assistance, the design of smart medical apparel has received more attention. METHODS: In this study, we designed electrocardiography (ECG)-monitoring smart clothing based on the Holter system after identifying and analyzing the needs of patients and doctors. This clothing is a wearable device that integrates monitoring and remote diagnosis, building a general network platform to support remote data transfer and sharing and online interactive auxiliary diagnosis. Creating wearable smart clothing includes multiple dimensions, such as ECG module design, clothing structural design, and a real-time monitoring app. This innovative technology is achieved by intelligently integrating limb lead wires, conductive fiber fabrics, lead interfaces, and electrode signal storage receivers, all based on the human body's sensing conduction principle. Wearable clothing that can monitor ECG in real time is designed and developed by intelligently integrating limb lead wires, conductive fiber fabrics, lead interfaces, and electrode signal storage receivers by using the human body-sensing conduction principle of real-time ECG monitoring. RESULTS: Wearable real-time ECG-monitoring clothing can help patients achieve fast virtual medical care and auxiliary diagnosis and solve the design issues associated with electrode signal storage receivers. In addition, such clothing can be applied to automatically monitor groups at high risk of heart disease. CONCLUSIONS: Our design not only meets the accuracy requirements of traditional medical diagnosis but also combines traditional real-time ECG monitoring and smart clothing, providing new options for the daily needs of patients and doctors.

Textile-Based Body Capacitive Sensing for Knee Angle Monitoring.

Monitoring human movement is highly relevant in mobile health applications. Textile-based wearable solutions have the potential for continuous and unobtrusive monitoring. The precise estimation of joint angles is important in applications such as the prevention of osteoarthritis or in the assessment of the progress of physical rehabilitation. We propose a textile-based wearable device for knee angle estimation through capacitive sensors placed in different locations above the knee and in contact with the skin. We exploited this modality to enhance the baseline value of the capacitive sensors, hence facilitating readout. Moreover, the sensors are fabricated with only one layer of conductive fabric, which facilitates the design and realization of the wearable device. We observed the capability of our system to predict knee sagittal angle in comparison to gold-standard optical motion capture during knee flexion from a seated position and squats: the results showed an R2 coefficient between 0.77 and 0.99, root mean squared errors between 4.15 and 12.19 degrees, and mean absolute errors between 3.28 and 10.34 degrees. Squat movements generally yielded more accurate predictions than knee flexion from a seated position. The combination of the data from multiple sensors resulted in R2 coefficient values of 0.88 or higher. This preliminary work demonstrates the feasibility of the presented system. Future work should include more participants to further assess the accuracy and repeatability in the presence of larger interpersonal variability.

Fabrication and Evaluation of Embroidery-Based Electrode for EMG Smart Wear Using Moss Stitch Technique.

Wearable 2.0 research has been conducted on the manufacture of smart fitness wear that collects bio-signals through the wearing of a textile-based electrode. Among them, the electromyography (EMG) suit measures the electrical signals generated by the muscles to check their activity, such as contraction and relaxation. General gel-type electrodes have been reported to cause skin diseases due to an uncomfortable feel and skin irritation when attached to the skin for a long time. Dry electrodes of various materials are being developed to solve this problem. Previous research has reported EMG detectio performance and conducted economic comparisons according to the size and shape of the embroidery electrode. On the other hand, these embroidery electrodes still have foreign body sensations. In this study, a moss sEMG electrode was produced with various shapes (W3 and WF) and loop lengths (1-5 mm). The optimized conditions of the embroidery-based electrodes were derived and analyzed with the tactile comfort factors and sensing performances. As the loop length of the electrode increased, MIU and Qmax increased, but the SMD decreased due to the free movement of the threads constituting the loop. Impedance and sEMG detection performance showed different trends depending on the electrode type.

Sensor Selection for Tidal Volume Determination via Linear Regression-Impact of Lasso versus Ridge Regression.

The measurement of respiratory volume based on upper body movements by means of a smart shirt is increasingly requested in medical applications. This research used upper body surface motions obtained by a motion capture system, and two regression methods to determine the optimal selection and placement of sensors on a smart shirt to recover respiratory parameters from benchmark spirometry values. The results of the two regression methods (Ridge regression and the least absolute shrinkage and selection operator (Lasso)) were compared. This work shows that the Lasso method offers advantages compared to the Ridge regression, as it provides sparse solutions and is more robust to outliers. However, both methods can be used in this application since they lead to a similar sensor subset with lower computational demand (from exponential effort for full exhaustive search down to the order of O (n2)). A smart shirt for respiratory volume estimation could replace spirometry in some cases and would allow for a more convenient measurement of respiratory parameters in home care or hospital settings.

Development of Smart Clothing to Prevent Pressure Injuries in Bedridden Persons and/or with Severely Impaired Mobility: 4NoPressure Research Protocol.

Pressure injuries (PIs) are a major public health problem and can be used as quality-of-care indicators. An incipient development in the field of medical devices takes the form of Smart Health Textiles, which can possess innovative properties such as thermoregulation, sensing, and antibacterial control. This protocol aims to describe the process for the development of a new type of smart clothing for individuals with reduced mobility and/or who are bedridden in order to prevent PIs. This paper's main purpose is to present the eight phases of the project, each consisting of tasks in specific phases: (i) product and process requirements and specifications; (ii and iii) study of the fibrous structure technology, textiles, and design; (iv and v) investigation of the sensor technology with respect to pressure, temperature, humidity, and bioactive properties; (vi and vii) production layout and adaptations in the manufacturing process; (viii) clinical trial. This project will introduce a new structural system and design for smart clothing to prevent PIs. New materials and architectures will be studied that provide better pressure relief, thermo-physiological control of the cutaneous microclimate, and personalisation of care.

Human Arm Workout Classification by Arm Sleeve Device Based on Machine Learning Algorithms.

Wearables have been applied in the field of fitness in recent years to monitor human muscles by recording electromyographic (EMG) signals. Understanding muscle activation during exercise routines allows strength athletes to achieve the best results. Hydrogels, which are widely used as wet electrodes in the fitness field, are not an option for wearable devices due to their characteristics of being disposable and skin-adhesion. Therefore, a lot of research has been conducted on the development of dry electrodes that can replace hydrogels. In this study, to make it wearable, neoprene was impregnated with high-purity SWCNTs to develop a dry electrode with less noise than hydrogel. Due to the impact of COVID-19, the demand for workouts to improve muscle strength, such as home gyms and personal trainers (PT), has increased. Although there are many studies related to aerobic exercise, there is a lack of wearable devices that can assist in improving muscle strength. This pilot study proposed the development of a wearable device in the form of an arm sleeve that can monitor muscle activity by recording EMG signals of the arm using nine textile-based sensors. In addition, some machine learning models were used to classify three arm target movements such as wrist curl, biceps curl, and dumbbell kickback from the EMG signals recorded by fiber-based sensors. The results obtained show that the EMG signal recorded by the proposed electrode contains less noise compared to that collected by the wet electrode. This was also evidenced by the high accuracy of the classification model used to classify the three arms workouts. This work classification device is an essential step towards wearable devices that can replace next-generation PT.

Spine patient care with wearable medical technology: state-of-the-art, opportunities, and challenges: a systematic review.

BACKGROUND CONTEXT: Healthcare reforms that demand quantitative outcomes and technical innovations have emphasized the use of Disability and Functional Outcome Measurements (DFOMs) to spinal conditions and interventions. Virtual healthcare has become increasingly important following the COVID-19 pandemic and wearable medical devices have proven to be a useful adjunct. Thus, given the advancement of wearable technology, broad adoption of commercial devices (ie, smartwatches, phone applications, and wearable monitors) by the general public, and the growing demand from consumers to take control of their health, the medical industry is now primed to formally incorporate evidence-based wearable device-mediated telehealth into standards of care. PURPOSE: To (1) identify all wearable devices in the peer-reviewed literature that were used to assess DFOMs in Spine, (2) analyze clinical studies implementing such devices in spine care, and (3) provide clinical commentary on how such devices might be integrated into standards of care. STUDY DESIGN/SETTING: A systematic review. METHODS: A comprehensive systematic review was conducted in adherence to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Guidelines (PRISMA) across the following databases: PubMed; MEDLINE; EMBASE (Elsevier); and Scopus. Articles related to wearables systems in spine healthcare were selected. Extracted data was collected as per a predetermined checklist including wearable device type, study design, and clinical indices studied. RESULTS: Of the 2,646 publications that were initially screened, 55 were extensively analyzed and selected for retrieval. Ultimately 39 publications were identified as being suitable for inclusion based on the relevance of their content to the core objectives of this systematic review. The most relevant studies were included, with a focus on wearables technologies that can be used in patients' home environments. CONCLUSIONS: Wearable technologies mentioned in this paper have the potential to revolutionize spine healthcare through their ability to collect data continuously and in any environment. In this paper, the vast majority of wearable spine devices rely exclusively on accelerometers. Thus, these metrics provide information about general health rather than specific impairments caused by spinal conditions. As wearable technology becomes more prevalent in orthopedics, healthcare costs may be reduced and patient outcomes will improve. A combination of DFOMs gathered using a wearable device in conjunction with patient-reported outcomes and radiographic measurements will provide a comprehensive evaluation of a spine patient's health and assist the physician with patient-specific treatment decision-making. Establishing these ubiquitous diagnostic capabilities will allow improvement in patient monitoring and help us learn about postoperative recovery and the impact of our interventions.

Characterisation and Quantification of Upper Body Surface Motions for Tidal Volume Determination in Lung-Healthy Individuals.

Measurement of accurate tidal volumes based on respiration-induced surface movements of the upper body would be valuable in clinical and sports monitoring applications, but most current methods lack the precision, ease of use, or cost effectiveness required for wide-scale uptake. In this paper, the theoretical ability of different sensors, such as inertial measurement units, strain gauges, or circumference measurement devices to determine tidal volumes were investigated, scrutinised and evaluated. Sixteen subjects performed different breathing patterns of different tidal volumes, while using a motion capture system to record surface motions and a spirometer as a reference to obtain tidal volumes. Subsequently, the motion-capture data were used to determine upper-body circumferences, tilt angles, distance changes, movements and accelerations-such data could potentially be measured using optical encoders, inertial measurement units, or strain gauges. From these parameters, the measurement range and correlation with the volume signal of the spirometer were determined. The highest correlations were found between the spirometer volume and upper body circumferences; surface deflection was also well correlated, while accelerations carried minor respiratory information. The ranges of thorax motion parameters measurable with common sensors and the values and correlations to respiratory volume are presented. This article thus provides a novel tool for sensor selection for a smart shirt analysis of respiration.

Development and Characterization of Embroidery-Based Textile Electrodes for Surface EMG Detection.

The interest in wearable devices has expanded to measurement devices for building IoT-based mobile healthcare systems and sensing bio-signal data through clothing. Surface electromyography, called sEMG, is one of the most popular bio-signals that can be applied to health monitoring systems. In general, gel-based (Ag/AgCl) electrodes are mainly used, but there are problems, such as skin irritation due to long-time wearing, deterioration of adhesion to the skin due to moisture or sweat, and low applicability to clothes. Hence, research on dry electrodes as a replacement is increasing. Accordingly, in this study, a textile-based electrode was produced with a range of electrode shapes, and areas were embroidered with conductive yarn using an embroidery technique in the clothing manufacturing process. The electrode was applied to EMG smart clothing for fitness, and the EMG signal detection performance was analyzed. The electrode shape was manufactured using the circle and wave type. The wave-type electrode was more morphologically stable than the circle-type electrode by up to 30% strain, and the electrode shape was maintained as the embroidered area increased. Skin-electrode impedance analysis confirmed that the embroidered area with conductive yarn affected the skin contact area, and the impedance decreased with increasing area. For sEMG performance analysis, the rectus femoris was selected as a target muscle, and the sEMG parameters were analyzed. The wave-type sample showed higher EMG signal strength than the circle-type. In particular, the electrode with three lines showed better performance than the fill-type electrode. These performances operated without noise, even with a commercial device. Therefore, it is expected to be applicable to the manufacture of electromyography smart clothing based on embroidered electrodes in the future.

Validity of trunk acceleration measurement with a chest-worn monitor for assessment of physical activity intensity.

BACKGROUND: Recent advancements in wearable technology have enabled easy measurement of daily activities, potentially applicable in rehabilitation practice for various purposes such as maintaining and increasing patients' activity levels. In this study, we aimed to examine the validity of trunk acceleration measurement using a chest monitor embedded in a smart clothing system ('hitoe' system), an emerging wearable system, in assessing the physical activity in an experimental setting with healthy subjects (Study 1) and in a clinical setting with post-stroke patients (Study 2). METHODS: Study 1 involved the participation of 14 healthy individuals. The trunk acceleration, heart rate (HR), and oxygen consumption were simultaneously measured during treadmill testing with a Bruce protocol. Trunk acceleration and HR were measured using the "hitoe" system, a smart clothing system with embedded chest sensors. Expiratory gas analysis was performed to measure oxygen consumption. Three parameters, moving average (MA), moving standard deviation (MSD), and moving root mean square (RMS), were calculated from the norm of the trunk acceleration. The relationships between these accelerometer-based parameters and oxygen consumption-based physical activity intensity measured with the percent VO2 reserve (%VO2R) were examined. In Study 2, 48 h of simultaneous measurement of trunk acceleration and heart rate-based physical activity intensity in terms of percent heart rate reserve (%HRR) was conducted with the "hitoe" system in 136 post-stroke patients. RESULTS: The values of MA, MSD, RMS, and %VO2R were significantly different between levels 1, 2, 3, and 4 in the Bruce protocol (P < 0.01). The average coefficients of determination for individual regression for %VO2R versus MA, %VO2R versus MSD, and %VO2R versus RMS were 0.89 ± 0.05, 0.96 ± 0.03, and 0.91 ± 0.05, respectively. Among the parameters examined, MSD showed the best correlation with %VO2R, indicating high validity of the parameter for assessing physical activity intensity. The 48-h measurement of MSD and %HRR in post-stroke patients showed significant within-individual correlation (P < 0.05) in 131 out of 136 patients (correlation coefficient: 0.60 ± 0.16). CONCLUSIONS: The results support the validity of the MSD calculated from the trunk acceleration measured with a smart clothing system in assessing the physical activity intensity. TRIAL REGISTRATION: UMIN000034967. Registered 21 November 2018 (retrospectively registered).

Smart Electronic Textiles for Wearable Sensing and Display.

Increasing demand of using everyday clothing in wearable sensing and display has synergistically advanced the field of electronic textiles, or e-textiles. A variety of types of e-textiles have been formed into stretchy fabrics in a manner that can maintain their intrinsic properties of stretchability, breathability, and wearability to fit comfortably across different sizes and shapes of the human body. These unique features have been leveraged to ensure accuracy in capturing physical, chemical, and electrophysiological signals from the skin under ambulatory conditions, while also displaying the sensing data or other immediate information in daily life. Here, we review the emerging trends and recent advances in e-textiles in wearable sensing and display, with a focus on their materials, constructions, and implementations. We also describe perspectives on the remaining challenges of e-textiles to guide future research directions toward wider adoption in practice.

Wearables and their applications for the rehabilitation of elderly people.

Globally, there has been a change in the population pyramid with an accelerated aging process. This increase requires a greater challenge to maintain autonomy and independence. Currently, there are technologies developed with a focus on health. This is given by the development of wearables and their areas of applications. As a general context, this technology is characterized by the research field in energy generation, the development of external devices for human control and monitoring, clothing, smart textiles, and electronics. The latter are classified into three areas of application: monitoring and safety; fabrics, perception, and physical activity; and rehabilitation. A literature review is conducted to identify the state-of-the-art in these fields within the last years. The progress in monitoring systems and intelligent textiles is evidenced, being able to highlight remote feedback, materials, and wearability both at a commercial and user level. A discussion is included to address the main challenges and future trends in the application of wearables in elderly people.

Analysis of Efficiency of Thermoelectric Personal Cooling System Based on Utility Tests.

Thermoelectric modules can find practical application in clothing with a cooling function. A personal cooling system using Peltier modules integrated with clothing was developed and tested with the participation of a person. A dedicated electronic controller was designed that enabled the power or temperature to be controlled and recorded. In the research, the influence of heat sinks and the method of controlling the operation of the module on the cooling efficiency was assessed. The research was aimed at selecting the operating mode of the controller and choosing the arrangement of modules comparing cooling efficiency. The research showed that by selection of appropriate controlling mode, the electric power used can be reduced while keeping the cooling efficiency at the same level. The location of Peltier modules in places where they can tightly adhere to the body increases their performance.

Smart Clothing as a Noninvasive Method to Measure the Physiological Cardiac Parameters.

In response to global aging, there have been improvements in healthcare, exercise therapy, health promotion, and other areas. There is a gradually increasing demand for such equipment for health purposes. The main purpose of smart clothing is to monitor the physical health status of the user and analyze the changes in physiological signals of the heart. Therefore, this study aimed to examine the factors that affect the measurement of the heart's physiological parameters and the users' comfort while wearing smart clothing as well as to validate the data obtained from smart clothing. This study examined the subjective feelings of users (aged 20-60 years) regarding smart clothing comfort (within 12 h); the median values were comfortable and above (3.4-4.5). The clothing was combined with elastic conductive fiber and spandex to decrease the relative movement of the fiber that acts as a sensor and increase the user's comfort. Future studies should focus on the optimization of the data obtained using smart clothing. In addition to its use in medical care and post-reconstructive surgery, smart clothing can be used for home care of older adults and infants.

Effect of Cyclical Bending and Rubbing on the Characteristic Impedance of Textile Signal Lines.

This article presents the results of tests on the resistance of new textile signal lines to bending and abrasion. The textile signal lines are one of the most important parts of the electronic system incorporated into modern smart garments. The main application of the lines presented in this article is the transmission of digital signals or high-frequency analogue signals. The tested lines were made of fabrics with sewn paths made of electro-conductive fabric. The construction of a measuring stand for testing the electric properties of textile transmission lines is shown. This article presents the effects of bending and abrasion on the resistance of electro-conductive strips, which are one of the elements of textile signal lines. The article also presents the effects of bending and abrasion on the characteristic impedance of constructed textile signal lines. Statistical analysis of the obtained results is also presented.

A User Centered Methodology for the Design of Smart Apparel for Older Users.

Smart clothing plays a big role to foster innovation and to. boost health and well-being, improving the quality of the life of people, especially when addressed to niche users with particular needs related to their health. Designing smart apparel, in order to monitor physical and physiological functions in older users, is a crucial asset that user centered design is exploring, balancing needs expressed by the users with technological requirements related to the design process. In this paper, the authors describe a user centered methodology for the design of smart garments based on the evaluation of users' acceptance of smart clothing. This comparison method can be considered as similar to a simplified version of the quality function deployment tool, and is used to evaluate the general response of each garment typology to different categories of requirements, determining the propensity of the older user to the utilization of the developed product. The suggested methodology aims at introducing in the design process a tool to evaluate and compare developed solutions, reducing complexity in design processes by providing a tool for the comparison of significant solutions, correlating quantitative and qualitative factors.