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Physiological and Behavior Monitoring Systems for Smart Healthcare Environments: a Review

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Physiological and Behavior Monitoring Systems for Smart Healthcare Environments: a Review sensors Review Physiological and Behavior Monitoring Systems for Smart Healthcare Environments: A Review Mariana Jacob Rodrigues 1,2,* , Octavian Postolache 1,2 and Francisco Cercas 1,2 1 Iscte–Instituto Universitário de Lisboa, Av. das Forças Armadas, 1649-026 Lisboa, Portugal; [email protected] (O.P.); [email protected] (F.C.) 2 Instituto de Telecomunicações, Av. Rovisco Pais, 1, 1049-001 Lisboa, Portugal * Correspondence: [email protected] Received: 14 March 2020; Accepted: 10 April 2020; Published: 12 April 2020 Abstract: Healthcare optimization has become increasingly important in the current era, where numerous challenges are posed by population ageing phenomena and the demand for higher quality of the healthcare services. The implementation of Internet of Things (IoT) in the healthcare ecosystem has been one of the best solutions to address these challenges and therefore to prevent and diagnose possible health impairments in people. The remote monitoring of environmental parameters and how they can cause or mediate any disease, and the monitoring of human daily activities and physiological parameters are among the vast applications of IoT in healthcare, which has brought extensive attention of academia and industry. Assisted and smart tailored environments are possible with the implementation of such technologies that bring personal healthcare to any individual, while living in their preferred environments. In this paper we address several requirements for the development of such environments, namely the deployment of physiological signs monitoring systems, daily activity recognition techniques, as well as indoor air quality monitoring solutions. The machine learning methods that are most used in the literature for activity recognition and body motion analysis are also referred. Furthermore, the importance of physical and cognitive training of the elderly population through the implementation of exergames and immersive environments is also addressed. Keywords: healthcare; internet of things; smart environments; physiological signs monitoring; activity recognition; indoor air quality 1. Introduction Healthcare systems combined with the Internet of Things (IoT) technology help improve quality of life, health and life expectancy. These systems can be effectively implemented by acquiring environmental data, as well as the subject’s behavioral and physiological information from various distributed smart sensors. Following the IoT concept, all collected data is securely sent to the cloud and can be processed by data analysis algorithms to ascertain the existence of actuation patterns and make the system react to unexpected changes. These smart sensors can be expressed by smart wearable objects that provide health status information in unobtrusive ways, by sensing units embedded on daily used objects (e.g., smart wheelchair) and by other sensing systems that monitor indoor environmental conditions, including noise levels, air quality and lighting quality. As one of the growing industries, IoT for healthcare has been widely explored by academia [1,2], with a special focus on providing personalized, secure and effective health monitoring of patients. Such monitoring becomes an essential element for the older population that, with the increasing average of life expectancy, may develop mental and physical illnesses. Sensors 2020, 20, 2186; doi:10.3390/s20082186 www.mdpi.com/journal/sensors Sensors 2020, 20, 2186 2 of 26 Sensors 2020, 20, x FOR PEER REVIEW 2 of 26 The concept of smart home or smart environment is generally given to environments with smart quality.technologies Such services that provide consist to of their common inhabitants automat usefuled mechanisms services that and substantially functions that help give improve the ability their tolife monitor quality. and Such control services home consist appliances, of common windows, automated air conditioning mechanisms system, and functions doors and that so give forth. the However,ability to there monitor are anda wide control variety home of services appliances, that classify windows, smart air homes conditioning differently system, and doorsthat provide and so differentforth. 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Health-relatedHealth-related data data can can be be remotely remotely obtained obtained by by any any healthcare healthcare entity entity (caregivers, (caregivers, doctors doctors and and physiotherapists)physiotherapists) while while patients patients live live independently independently in in their their preferred preferred environment, environment, due due to to telehealth telehealth andand telemedicine telemedicine concepts [[6,7].6,7]. ThisThis isis importantimportant because because medical medical diagnostics diagnostics taken taken directly directly from from the thepatient’s patient’s home home can can greatly greatly reduce reduce hospital hospital bills bills and allowand allow a better a better treatment, treatment, specifically specifically tailored tailored for the forpatient. the patient. 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