Wearable Technology in the Study of Raynaud’s Phenomena
Ascertainment of the Potential Impact of Wearable Technology on Raynaud’s
Phenomena Utilizing Data
Isobel Taylor
, Heitor Alvelos
, Susana Barreto
and Pedro L. Granja
Instituto de Investigação e Inovação em Saúde (i3S), Universidade do Porto, Porto, Portugal
Instituto de Investigação em Design, Media e Cultura (ID+), Universidade do Porto, Porto, Portugal
Instituto de Engenharia Biomédica (INEB), Universidade do Porto, Porto, Portugal
Instituto de Ciências Biomédicas Abel Salazar (ICBAS), Universidade do Porto, Porto, Portugal
Faculdade de Engenharia da Universidade do Porto (FEUP), Porto, Portugal
Faculdade de Belas Artes da Universidade do Porto (FBAUP), Porto, Portugal
up201501444@fba.up.pt, halvelos@fe.up.pt, susanaxbarreto@gmail.com, pgranja@i3s.up.pt
Can wearable technology aid in the study of
Raynaud’s Phenomena?
Raynaud’s phenomena (RP) affects 3-20% of the
Population worldwide (Nhs, 2015). RP is the
vasoconstriction of the microvascular system in the
extremities, such as the digits, in response to cold
exposure or emotional stress. The prime quotidian
problems for sufferers are: ischemia to the
extremities, the pain this causes, loss of fine pincer
movements and the aesthetics (Fig 1.). The initial
symptom of an RP attack is often numbness; this is
not always noticed by the individual with RP.The
faster the attack is identified the sooner the
individual can attempt to re-establish blood flow,
therefore shortening the time the tissue has been
starved of nutrients. Current options include
Pharmaceutics which have side effects from
headaches to bleeding in the brain along with
problems in cross drug interactions. Pharmaceutics
also come at a cost, not just of the drug but also the
time spent with the Doctor which can be regular if a
drug that suits the individual is not easily found.
Whilst available wearables such as ski gloves and
heat focused garments limit function and dexterity
they also have a lack of data of the impact these
have. The presupposition is that a wearable data
collection device could create a database to aid in
the understanding of the condition itself as well as
any wearable or pharmaceuticals impact. The PhD
research continues from the researcher’s MRes in
Digital Media that questioned whether an RP attack
could be detected with a temperature sensor. The
study showed positive results which included taking
the skin surface and environmental temperatures of
predicting attacks initiating from data changes. The
Figure 1: Example of RP in fingers and toes. a. showing
the blue hue from the inadequate blood supply, ischemia,
the yellow/white pallor’s in b, c & d the initial loss of
blood flow from the vasoconstriction. (Wigley, 2015).
research will be advanced by focusing on data
gathering, for an accurate device, improving the
calculations involved. The aim is to create a device/
system to extract data from the skin concomitant
with external data including weather reports and geo
location incorporated through exploitation of a smart
phone for data gathering and assessment over time.
Interest also lies in how a designer can impact the
implementation of the research. The research will
centre on Primary Raynaud’s Phenomena, PRP, in
the fingers with the potential this could be used in
cases of Secondary Raynaud’s Phenomena, SRP,
and other effected extremities.
Ascertain if wearable technology can aid in the
study of symptoms of Raynaud’s Phenomena.
Taylor, I., Alvelos, H., Barreto, S. and Granja, P.
Wearable Technology in the Study of Raynaud’s Phenomena - Ascertainment of the Potential Impact of Wearable Technology on Raynaud’s Phenomena Utilizing Data.
In Doctoral Consortium (DCBIOSTEC 2017), pages 26-31
Ascertain if predictions of attacks can be made
from routines, weather reports and geographical
data. Information with the potential to be
utilized by the individual through e.g. a smart
phone, as well as a database for quantitative
Create a model from the research for further
implementation in wearable technology, design
for health and wellbeing purposes.
Report on the role of the designer as part of
development in medical/ wellbeing technology
within the field of wearable technology.
Focusing on wearable technology for health
teams, backgrounds and dates.
Create a collection of information gained from
the PhD study on RP into a report.
This section describes:
3.1 Raynaud’s Phenomenon; the medical
3.2 Technology and wearables; the state of
technology & multidisciplinary wearable
technology developments
3.3 current market; products and research.
3.1 Raynaud’s Phenomenon
(RP) describes excessive vasoconstriction of the
digital microvasculature in response to cold
exposure and emotional stress (Pauling, 2013). This
causes vessels in the extremities to constrict,
stopping blood flow, short term this can be painful,
longer term damaging, long term can cause
irreversible damage. Raynaud’s comes in 2 forms,
Primary, PRP, and secondary, SRP. Primary
Raynaud’s is idiopathic, a condition in itself,
secondary RP is a symptom of another condition.
Amputations are not common but do occur in RP
patients; amputations occurring from vascular
diseases, which includes RP, counts for the highest
number of amputations in the developed world
(Ziegler-Graham, 2008). Current solutions for
patients leave a lot to be desired; medical
prescriptions have substantial side effects, effects
from headaches to bleeding in the brain. Along with
the main non-pharmaceutical suggestion is ‘avoid
the cold’ (Raynauds, 2009). The research predicts
gathering detailed quotidian data will aid in research
and further illuminating the details of RP by taking
recordings including temperature readings; usually
only taken in clinical environments whereas RP
attacks take place at home, at work, when traveling.
The utilization of individual and local data will have
great potential in the improvement of the wellbeing
of those with the condition on a quotidian basis. For
the purpose of the PhD research I will be focusing
on the hands and ensuring the outcome can be
adapted for the other effected extremities; toes, nose,
ears. Medically the focus will be on Primary
Raynaud’s though in many cases the outcome is
likely to inherently be of use to those with
Secondary Raynaud’s. From observations at the
2015 Raynaud’s and Scleroderma conference UK it
became evident that the patients were not satisfied
with the current methods of coping with the ailment.
A search of current medications and devices
revealed problems, listed in the research problem,
highlighted by patients interviewed before and
during the conference. [The 2016 Raynaud’s
conference was much the same in regard of the
patients finding the current options lacking].
3.2 Technology and Wearables
There has been a growing increase in the space for
designers to collaborate in science, health and
technology, particularly noticeable in wearable
technology teams. Wearable technology has and is
able to bring together designers, scientists and
engineers to incorporate the technology into a form
fitting for the identified user and purpose. This has
been a rare occurrence in history from Leonardo da
Vinci [1452 - 1519]; design, art, medicine, science
and engineering, James L. Acord [1944 - 2011]; art,
nuclear science, Eduardo Kac [1962-]; art, biology.
An example of a current wearable technology team
is Studio XO with founders Benjamin Males,
engineer, and Nancy Tilbury fashion design, (Studio,
2016). Wearable technology as a field has hit mass
media with its own reality TV show, founded by
Intel: ‘America’s greatest makers
(Americasgreatestmakers, 2016). Although a
relatively young field, in regard to fields such as
biology and chemistry, this in part goes to show the
increase in interest and popularity. The most
common focus for wearable technology regarding
wellbeing is in sports, fitness and elderly care, “As
of September 30, there were 266 wearable devices
on the market (including 118 fitness wearables)”
(Herz, 2014). This is not to say wearable technology
is the universal answer to healthcare problems;
“Potentially, these devices could give patients direct
access to personal analytics that can contribute to
their health, facilitate preventive care, and aid in the
Wearable Technology in the Study of Raynaud’s Phenomena - Ascertainment of the Potential Impact of Wearable Technology on Raynaud’s
Phenomena Utilizing Data
management of ongoing illness. However, how this
new wearable technology might best serve medicine
remains unclear. “(Piwek, 2016) Wearable
technology is on the rise, yet not all who purchase/
obtain devices will keep up use and devices may not
work with accuracy; This systematic review
indicated higher validity of steps, few studies on
distance and physical activity, and lower validity for
energy expenditure and sleep. The evidence
reviewed indicated high interdevice reliability for
steps, distance, energy expenditure, and sleep for
certain Fitbit models. As new activity trackers and
features are introduced to the market,
documentation of the measurement properties can
guide their use in research settings. (Evenson,
2015). Reliability of the technology is of great
importance, particularly with a medical condition
focused device.
3.3 Current Market and Research
The financial market of wearable technology in
health is on the rise. According to a report by Pira
International (now called Smithers Pira, 2012) by
2021 the smart material market will be worth just
under 2,000 million, medical and healthcare
making up just under 1/3
of the market (Wilson,
Specifically regarding RP; most heated gloves
and socks on the market have been ski or fishing
based with a smaller number for hiking and motor
bikers. RP sufferers at the SRUK conferences cite
use of hand warmers and normal thick gloves and
socks but none have cited use of any RP specific
made product apart from silver gloves. Silver gloves
and socks whilst marketed as an aid to RP have very
little scientific evidence to prove this. RP also has a
particularly high rate of the placebo effect. However,
although RP sufferers have cited use of silver
products none have given any particular feedback on
their use other than a thin glove being useful at times
and the ability to use touch screens, both of which
could be achieved with a non-silver glove. This is
not to say silver is not useful: evidence does show
antibacterial properties and conductivity that will be
assessed as part of the material options in practical
developments (see methodology). Also, these
devices do not collect data or make predictions.
Current devices in research specifically for RP
include 2 groups from Universities Nottingham
Trent and Virginia Commonwealth. Nottingham
Trent have funding from the Raynaud’s and
Scleroderma society UK (Sruk 2016) for developing
a heating glove, previously they have developed a
thread for monitoring temperature within socks to
test for ulcers in patients with diabetes. At the
Virginia Commonwealth university an engineering
student developed a 2-layer glove to heat fingers and
hands in regard to RP (Ugincius, 2016). If the
Virginia group collect and use data, as the mediation
seems to suggest, the interest to this research project
will lie in what data they collect and how they use it.
Clinical analysis of RP is conducted in controlled
environments and with patient information (Murray,
2015). Wearable technology allows data to be
collected over prolonged periods of time at the
patient’s home. This data collected and processed
could show patterns such as times of day RP attacks
are most common, temperatures that trigger RP
attacks, sudden loss of blood flow. Within clinical
environments tests to study RP include the cold
challenge which examines temperature of the fingers
following exposure to 15°C water submersion for 60
or 120 seconds over 25 minutes using a thermal
imaging camera. Within the challenge the specialist
looks for the rate the finger temperature changes
over 25 minutes. The research will broaden this
temperature reading study to days, weeks, months
and more. Including the ability to record attacks that
may be related to weather conditions as well as
temperature levels in the locations that matter most
to the patients as managing their condition in the
locations the attacks occur.
The presupposition is that the answer will be found
in the field of wearable technology; this field
enables real time data capture and analysis
concomitant with an external direct impact on the
affected area/s. Real time data includes human and
external such as finger temperature, weather reports
and geo location. The aim is to achieve this through
qualitative practice-based research by use of the
appropriate materials, currently being identified, in
articulation with syntax capable of learning and
adapting and with the capability of prediction to
alert the user. Research initiates with a foundation of
literature and market research focusing on the users;
interviews and surveys with doctors, specialists,
patients and relevant agents.
The overall methodology being followed is
represented by the following action research cycle:
DCBIOSTEC 2017 - Doctoral Consortium on Biomedical Engineering Systems and Technologies
Figure 2: Methodology diagram, based on the general
action research cycle diagram.
(Fig. 2) When iii. is the evaluations of i. and ii. then iiii. is
the specific testing of prototypes and finalisation of the
The research focuses on collecting data for the
individual user and for an overall study towards RP
The method will test usability and performance
of a wearable device for collecting data and software
for mobile phones for gathering and communication.
To be completed through finding, developing and if
need be synthesizing optimum materials and parts
for detecting and code for mobile software.This
research will be principally compiled with primary
and secondary research utilizing key academics,
medical doctors and researchers, in addition to
secondary research based on extensive archived
material, internet sources, published papers, patents,
market reports, company websites, conference
reports, magazines, newspapers and newsletters.
A series of user aims/criteria are being compiled
including; How safe is it? And Durability? forming a
flow chart to analyse the developments and final
Resources; material laboratories and time,
executing this research in Porto means access to
material science academics and laboratories for
developing the physical device. Within the
researchers MRes physical parts and materials were
obtained through samples issued by companies on
request and meeting any additional costs,
expectation is that this method of compiling parts for
research will carry forward.
The action research cycle will be addressed in 3
4.1 Foundation,
4.2 Core,
4.3 Finalisation.
4.1 Foundation
The foundation is formed from comprehensive
understanding of the condition itself and the
problems that restrict daily function. The outcome of
this segment will be a list of criteria enabling the
assessment of a device for RP, in order to ensure that
the designed and developed outcome meets the
needs it is intended for and to comprehensively
answer the research question. To form this criteria,
the methods being used are as follows: Interviews
and surveys with RP patients, Information from
medical specialists, observations made from the
researcher in reviewing the information and
literature review. These will include interviews and
observations of persons without RP as a person with
RP may not know or remember the difficulties in
certain situations even without RP. These potential
findings are not to be ignored as if there is an aid to
the problem it will still be of use to the RP sufferer
but it is important to distinguish what it helping in
regards to RP and what is helping RP aside. This
section includes the literature and market review.
Within the literature the topic spans many
disciplines including: medicine, data processing,
product design, engineering and technology.
Although most of this is being accomplished within
the early stages of the PhD research, this work will
remain ongoing throughout as the information may
be updated and crucial elements may be found at any
time throughout the research time frame. A list of
criteria the device should meet will be formed from
section 4.1; the list is to be updated as and when new
information is obtained for the outcome to be
assessed against.
4.2 Core
The core of the PhD will lie in the prototyping, data
collecting, analysis and developments. Although
focus lies on the data and algorithms the device will
use to inform the user and aim to predict attacks.
However, materials and technology used are also
highly important. Materials used must allow the
outcome device to be comfortable to wear,
functional, durable, aesthetic and in many ways
above all desirable. A device that is highly
functional for its use but not desirable will not be
used sufficiently and will ultimately fail at its
purpose. The desirability will be evaluated
throughout the process from materials, designs,
shape, comfort, static, sound and feel against other
materials, not just skin. The device prototypes will
use temperature sensors with Bluetooth to transmit
Wearable Technology in the Study of Raynaud’s Phenomena - Ascertainment of the Potential Impact of Wearable Technology on Raynaud’s
Phenomena Utilizing Data
to a mobile app. The mobile app will also be
developed in this segment to tie the wearable
sensors, weather data and communication to the user
together for assessment.
The outcome of this segment will be: The
identification of risk factors employable in wearable
technology and how to record the risk factors,
physical prototypes, a mobile app to assess the
location of the user utilising online weather data and
routines found through correlations of temperature
drops over the course of a day.
4.3 Finalisation
This section concerns trials, testing and evaluation.
Prototypes are to be tested against the developed
criteria. Prototypes to be tested on RP patients to
gain feedback and alterations to be made for further
developments. Accuracy of the data the prototypes
record to be assessed and tested. Also mass scale
development to be assessed, questioning how the
prototype could be developed in a factory setting.
This also entails a costing evaluation to compare
current methods in managing the condition against
the potential of the prototype to aid in understanding
of when the attacks are problematic to aid the user in
adaption in their daily routines. Software will also be
written to collect data from individuals to create a
large database for finding patterns in RP attacks and
environmental changes that effect RP.
A report on whether wearable technology, in
the form of the prototypes developed, can aid in
research and prediction of symptoms of
Raynaud’s Phenomena.
Various prototypes using human biological data
to understand when an attack takes place,
showing designs tested and evaluated.
An app for prediction and prevention with the
ability to work with the wearable technology
A study ascertaining the potential difference a
wearable device, with and without use of the
developed app, can make to someone with a
medical/wellbeing condition. Highlighting the
gain of control over the personal data and
A database of temperature findings, both from
literature reviews and case studies. / Database of
finger temperatures, ‘normal’ exposed to
particular environments and recovery
A model from the research for further
implementation in wearable technology, design
for health and wellbeing purposes.
A report on the role of the designer as part of
development in medical technology within the
field of wearable technology. Focusing on
teams working on wearable technology for
health, their backgrounds and dates.
A model from the research for further
implementation in wearable technology, design
for health and wellbeing purposes.
At the current stage of the research criteria is being
extracted from the foundation research for the
prototype assessment. This includes literature review
of RP from the medical field, recent wearable
technology devices aimed at RP patients and data on
continued use of wearable technology for generating
personal data regarding health, wellbeing and
fitness. The core of the research is under way in
testing what materials will be most favourable to
establish the form of the wearable and tie in with the
sensors needed. Algorithms are being drafted to
analyse the data from the wearable and weather data
to process into easily readable charts. As part of the
ongoing foundation review on the RP condition
conferences are being attended including the SRUK
annual patient conference bringing together RP
experts, doctors and patients. Surveys are being
developed to gain a more personal understanding of
how RP effects sufferers during their daily lives.
These will be sent out to the SRUK members, the
Scleroderma and Raynaud’s association UK. RP
patient’s groups within Porto will also be sought to
compare results between different geographic
Isobel Taylor is grateful to The Portuguese
Foundation for Science and Technology (FCT) and
the Doctoral Program in Design of the University of
Porto for her PhD scholarship ref.
DCBIOSTEC 2017 - Doctoral Consortium on Biomedical Engineering Systems and Technologies
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Wearable Technology in the Study of Raynaud’s Phenomena - Ascertainment of the Potential Impact of Wearable Technology on Raynaud’s
Phenomena Utilizing Data