The accuracy of tidal volume measured with a smart shirt during tasks of daily living in healthy subjects: Cross-sectional study

Background: The Hexoskin is a smart shirt that can take continuous and objective measurements and could be part of a potentialtelemonitoring system.Objective: The aim of this study was to determine the accuracy of the calibrated Hexoskin in measuring tidal volumes (TVs)in comparison to spirometry during various tasks.Methods: In a cross-sectional study, the TV of 15 healthy subjects was measured while performing seven tasks using spirometryand the Hexoskin. These tasks were performed during two sessions; between sessions, all equipment was removed. A one-Timespirometer-based calibration per task was determined in session 1 and applied to the corresponding task in both sessions.Bland-Altman analysis was used to determine the agreement between TV that was measured with the Hexoskin and that measuredwith spirometry. A priori, we determined that the bias had to be less than ±5%, with limits of agreement (LOA) of less than ±15%.Lung volumes were measured and had to have LOA of less than ±0.150 L.Results: In the first session, all tasks had a median bias within the criteria (±0.6%). In the second session, biases were ±8.9%;only two tasks met the criteria. In both sessions, LOA were within the criteria in six out of seven tasks (±14.7%). LOA of lungvolumes were greater than 0.150 L.Conclusions: The Hexoskin was able to correctly measure TV in healthy subjects during various tasks. However, afterreapplication of the equipment, calibration factors were not able to be reused to obtain results within the determined boundaries.Trial Registration: Netherlands Trial Register NL6934; https://www.trialregister.nl/trial/6934.