WIRELESS BODY AREA NETWORK FOR HIP

REHABILITATION SYSTEM

Mikael Soini, Jussi Nummela, Petri Oksa, Leena Ukkonen and Lauri Sydnheimo
Tampere University of Technology, Department of Electronics, Rauma Research Unit
[email protected]

ABSTRACT
In Wearable Well-Being project PUHVI, HipGuard system for patients recovering
from hip surgery was developed. Novel wireless sensors having 3-axis acceleration
and 3-axis magnetic sensors are used to measure patients hip and leg position and
rotation. Furthermore, capacitive insole sensors are used to measure the force
between foot and a shoe. This paper concentrates on how these sensors can be
interconnected to a central unit that collects and analyzes the measured information.
Body Area Network (BAN) utilized in wearable healtcare application have several
application-specific challenges such as low-power operation, low latency data
transfer, high system reliability and autonomous network operation. This paper
thoroughly analyzes how ANT wireless sensor networking technology operates as
BAN the focus is mainly on energy efficiency, communication latency, network
size and reliability issues. Because the main focus of this paper is particularly in
the operability of ANT networking, these results can be directly utilized in many
other wireless sensor networking applications.

Keywords: body area networks, healthcare applications, wireless sensor networks.

1 INTRODUCTION

Wireless sensor networks and sensors have

several application areas such as forest fire detection,
health monitoring, industrial sensing, and home
control. Sensor networks are based on physically
small sensors exchanging mainly measured
information. Sensors usually have very limited
power, processing, and memory resources and so
interactions between nodes are limited to short
distances and low data rates. Advances in electronics
have made these wireless sensor networks viable.
For example, sensors have become smaller and more
precise, and energy efficiency of radio circuits and
microcontrollers has been improved considerably.
Sensor networks that are composed of wearable
or implanted sensors are also known as Body Area
Networks (BAN) or Wireless Body Area Networks
(WBAN) depending on how sensors are connected
with each other. Some BAN application scenarios,
related to medical healthcare, personal fitness
Figure 1: HipGuard pants for hip patient
monitoring and personal audio systems, are
rehabilitation [3].
presented in [1].
This study is part of the Wearable Well-Being This system monitors patients leg and hip
project where HipGuard system was developed for position and rotation with embedded wireless sensors
patients who are recovering from hip surgery. The having 3-axis accelerometers and 3-axis magnetic
idea behind the system is that on the one hand it is sensors. The system also measures the force between
vital to keep hip and leg movements on certain range. foot and a shoe with a capacitive insole sensor [2].
On the other hand, it is utmost important to The Central Unit attached to waist collects measured
strengthen the muscles sufficiently to enhance information from sensors and calculates leg and hip
rehabilitation. HipGuard system is depicted in Fig. 1.

Ubiquitous Computing and Communication Journal 1

position and rotation, and the force directed on foot. with wires, therefore only the Central Unit needs
Alarm signals can be sent to patients Wrist Unit if recharging. There are challenges related to durability
hip or leg positions or rotations are false. The Central of wires and connectors embedded to clothing under
Unit can be attached wirelessly to a mobile phone severe stress, for example in machine wash. Wired
with Bluetooth. Furthermore, the mobile phone can systems have poor transferability. Replacement of
be used to transfer log, alarm and history information broken sensors and wires can also be challenging.
over Internet to enable remote patient monitoring and In this work, wireless approach is chosen
diagnostic services. Therefore, HipGuard system can because of system transferability and flexibility. The
provide useful real-time information for patient rest of the paper focuses on wireless networking.
rehabilitation process. The system architecture and
operation is presented thoroughly in [3]. This paper 3 ANT WIRELESS SENSOR NETWORKING
especially concentrates on WBAN issues. TECHNOLOGY
There have been several studies that have
concentrated on WBANs. MobiHealth [4] In this study ANT wireless sensor networking
implemented a Bluetooth based sensor network for technology is utilized. ANT is an ultra-low power
health monitoring and [5, 6] have used UWB (Ultra- short range low data rate technology that uses GFSK
Wideband) to build ultra-low-power and low (Gaussian Frequency Shift Keying) modulation and
complexity sensors. Lately, IEEE 802.15.4 based TDMA (Time Division Multiple Access) based
approaches have been the most popular research field communication. Fixed packet sizes (overhead and
in this area [7, 8, 9]. Instead of wireless approach, data) and predefined slots are used for
flexible electrically conductive fabrics could be used communication reducing the amount of collisions. At
to implement BAN. Reference [10] presents a the same time, Zigbee sensor networking technology
wearable monitoring system based on DC power line uses different packet sizes. ANT suits especially for
communication [11]. Because sensors would not repetitive measurements where low latency is
require local batteries, the solution would be required. Table 1 highlights ANT features. [13]
lightweight and small. Furthermore, Intra Body
Communication (IBC) system [12] could be used for Table 1: ANT technology in a nutshell.
sensor networking to obtain low signal attenuation in
low frequencies (<1 GHz). ANT sensor networking technology features
In this work, wireless ANT technology is used to 1 Operating frequency 2,4-2,524GHz: 125 1MHz channels
interconnect HipGuard system sensors. The focus is 2 Communication range up to 10 meters
especially on ANTs energy efficiency, low 3 Operating principle TDMA
communication latency, network size and reliability. 4 Modulation GFSK
The rest of the paper is organized as follows. Section 5 True data throughput up to 20 kbps
2 discusses how BAN sensors can be connected. 6 Code space 16kB
Section 3 briefly introduces ANT wireless sensor 7 Network topology star, tree or mesh networks
networking technology. Section 4 thoroughly 8 Network devices up to 2^32
discusses how ANT operates in this kind application. 9 Data packet size 17B (8B payload)
Finally, section 5 concludes the paper.
10 Packet types Broadcast, Burst, Acknowledged
11 Transmission power 0,01 - 1mW (-20dBm to 0dBm)
2 INTERCONNECTING BODY AREA
12 Receiver sensitivity -80dBm
NETWORK SENSORS

Sensors can be interconnected to Central Unit As presented in Table 1, ANT protocol has three
either with or without wires. Both of these different message types: Acknowledged, Broadcast
approaches have their pros and cons. Regardless of and Burst. Acknowledged message requires
chosen method, reliable and low latency data transfer acknowledgements which are not usable in real-time
is needed to produce useful and accurate data for hip communication where only fresh new data is
and leg position and rotation calculations. essential. Broadcast is the simplest ANT message (8
Wireless approach enables system transferability bytes payload) which is sent on dedicated slot on
and flexibility. Sensors can be attached, for example, each time frame. Burst is a message that consists of
with straps. Sensors can also be easily replaced if two or more sequential ANT messages (at least 16
needed. There are challenges related to bytes). Fig. 2 presents ANT packet structure.
communication reliability because human body
strongly attenuate RF signal and other radio systems
can cause interference. Also, wireless sensors should
be very low-power and chargeable. Batteries should
endure without a recharge at least a week.
Figure 2: ANT packet structure.
In wired systems data and power is transferred

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 ANT enables to implement various different
sensor network topologies; in this case, a simple star
architecture is used where Central Unit operates as a
network master. The star architecture, presented in
Fig. 3, is chosen because the amount of network
nodes is low and low latency is needed in
communication. If needed, Central Unit can also
operate as a bridge to external databases and users.

Figure 3: Network architecture for HipGuard system.

Figure 4: Sensor Unit current consumption with
A channel must be established before ANT broadcast and burst messages.
nodes can communicate. In the establishment
procedure, the network master (in this case Central
Unit) chooses channel parameters (network number,
RF frequency and channel period) and advertises
them by sending packets with chosen period. A slave
(in this case Sensor Unit) listen channel traffic and
checks for the packets that master is sending.
Connection is established after slave has been
synchronized to master data packets. Master and
slave can be further paired if communication
between the devices is continuous.

4 ANT OPERABILITY

In this section, the operability of ANT network

is studied. Evaluation parameters are sensor energy
consumption, system latencies, network size and
communication reliability. As a comparison, Figure 5: Central Unit current consumption per
IEEE802.15.4 based BAN operability has been slave with broadcast and burst messages.
studied in [14] and [15] as a function of throughput,
latency and network size. Sensor measurement results are 16 bytes in
length. This consists of 10-byte accelerometer data
4.1 Energy consumption and 6-byte magnetic sensor data. Measurement
Energy consumption is an important parameter results can be transmitted either with one 16-byte
in wireless systems and devices because decent burst packet or with two 8-byte broadcast packets. In
battery life times are needed for usability reasons. this section broadcast and burst packets are
Here, Sensor Unit and Central Unit energy compared from energy efficiency perspective. To
efficiency is evaluated. Sensor Unit is a wireless achieve equal payload data rate broadcast packets
sensor having 3-axis accelerometer and 3-axis must be sent at double rate compared to burst
magnetic sensors. Central Unit operates as WBAN packets; in this case, payload data rate required by
master collecting data from Sensor Units. the application is 256 bytes per second that is 16
In these measurements, the transmission power messages per second 16 bytes (burst) or 32
was set to maximum (1 mW) because it has no messages per second 8 bytes (broadcast).
significant effect on sensor node total power In Sensor Unit case (see Fig. 4), sending one
consumption and it provides better reliability and burst packet consumes 1.6 % more current compared
less retransmission in this challenging environment. to two broadcast packets, when data rate is 256 bytes
Operating voltage was set to 3 V. Fig. 4 and Fig. 5 per second. The difference is negligible.
present the current consumption of a Sensor Unit and In Central Unit case (see Fig. 5), using two
Central Unit. broadcast packets increase Central Units current
consumption about 18 % compared to one burst
packet, when data rate is 256 bytes per second. This

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is for case where Central Unit has one slave; having 4.2.2 Data transmission latency
multiple slaves (n) will increase current consumption In addition to start-up latency, there is data
n times. In the simplest case, Central Unit has three transmission latency. This is the time where data is
sensors that are attached to thigh, shin and transmitted from Sensor Unit to Central Unit when
metatarsus. the receiver and the transmitter are in active mode
In CSMA (Carrier Sense Multiple Access) based that is they are synchronized. The durations of
sensor networking, the receiver current consumption different phases related to transmission and reception
is usually dominant because receiver must be active of 8-byte ANT message were measured with an
practically all the time if low latency is needed. oscilloscope. Results are shown in Fig. 6.
However, TDMA based technique, used in ANT,
enables low power receiver operation because
predefined slots are used and reception of one ANT
packet takes less than 1ms.
Measurement data transmission frequency has
the most significant effect on current consumption.
Lower data transmission frequency would enable
longer battery lifetimes but it would degrade the
application operability because of longer latencies.
The longer latency would decrease the accuracy of
position, rotation and force calculations. In this work Figure 6: ANT packet transmission and reception.
it was estimated that, at least, data rate of 256 bytes
per second is needed for this application. The data transmission phases and their durations
are presented in Table 3. It can be seen that the
4.2 Communication latencies transmission of one message lasts for 19 ms.
Real-time operation is vital in this type of
application where user adjusts his or her behaviour Table 3: Data transmission latency in ANT.
according to measurements. Next, ANT based
system start-up and data transmission latencies are Different phases in data transmission Duration
studied. 1 Packet formation in C, transmission to radio circuit 6 ms
2 Packet handling at the transmitter 4 ms

4.2.1 Start-up latency 3 Packet transmission over the air 1 ms

4 Packet handling at the receiver, transmission to C 8 ms
Start-up latency is the time from sensor wake-up
Total time 19ms
to completed synchronized connection. If sensors are
active, they will normally stay synchronized and this
start-up phase can be omitted. Start-up phase is 4.3 Network size
needed when sensor is started up due to initial setup, The used NRF24AP1 radio circuit can handle
reconfiguration, battery reload or if sensor is about 200 eight byte ANT packets per second. In this
resynchronized to network. work the measurement data was 16 bytes in length
Table 2 presents the measurement results where and therefore one burst or two broadcast packets are
synchronization latency is studied in a function of required for transmitting one measured value from
message rate. Transmitter is the master node sending Sensor Unit to Central Unit. Thus Central Unit can
synchronization messages and receiver is the sensor handle maximum of 100 measurements per second.
node in synchronization mode. Results show that As mentioned above, the measurement data
there is a compromise between start-up latency and transmission frequency needs to be at least 16 Hz.
energy consumption. Therefore, the maximum number of Sensor Units in
this ANT based WBAN is 6. Lower data
Table 2: Sensor start-up latency in ANT. transmission frequency would enable more network
nodes but it could degrade the application operability.
Transmitter (master) Receiver (slave)
Message rate Synchronization time 4.4 Data transfer reliability
1 8 messages/s 1490 ms (avg)
Data transfer reliability is important parameter in
2 16 messages/s 630 ms (avg)
ANT operation. Only fresh new data is essential in
3 32 messages/s 270 ms (avg)
this type of system, thus retransmissions are not used.
4 64 messages/s 80 ms (avg)
Measurement results considering ANT data delivery
reliability in unobstructed path are presented in Fig.
7. Transmission power was set to 0.01 mW. These
results are used as reference for cases where
Bluetooth and human body interference in ANT is
studied.

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 Table 4: Bluetooth interference in ANT.

1000 packets are transmitted between ANT devices

Test Description Received
1 Bluetooth (BT) OFF at position A 99,80 %
2 Bluetooth (BT) ON at position A 99,80 %
3 BT ON at position B, BT data transfer is ON 97,30 %
4 BT ON at position A, BT data transfer is ON 87,40 %

It can be seen that when Bluetooth device is

transmitting inside the ANT network some packet
loss is experienced. Because Bluetooth uses
frequency hopping technique these losses are
tolerable. Also, Bluetooth data transfer is ON only
for a short period of time and it was seen that active
Figure 7: ANT communication reliability in Bluetooth device without data transfer do not affect
unobstructed path. ANT communication. Furthermore, Bluetooth can
avoid crowded frequencies by using AFH (Adaptive
From the reference measurements, it can be seen Frequency-hopping spread spectrum) defined in
that reliable ANT communication range is over 5 Bluetooth specification v1.2. If IEEE802.11x would
meters even with the lowest possible transmission be used, ANT should be configured to operate on
power (0.01 mW) in unobstructed open air different channel than IEEE802.11x to enable
propagation environment. However, Bluetooth and communication [16].
human body are potential sources of interference in
ANT network operation which are taken into 4.4.2 Human body interference
consideration. Human body causes large signal attenuation
which has a remarkable effect on wireless
4.4.1 Bluetooth interference communication reliability [17]. This causes
Bluetooth interference in ANT network challenges for sensor node positioning.
operation is important to study because data transfer Electromagnetic channel model for human body
from Central Unit to a mobile phone was could be used to help sensor positioning [18]. In this
implemented with Bluetooth. study, human body interference was evaluated by
ANT and Bluetooth are operating at the same 2.4 strapping transmitting Sensor Units to seven
GHz ISM (Industrial, Scientific and Medical) band. different positions, presented in Fig. 9. The Central
Bluetooth utilizes FHSS (Frequency Hopping Spread Unit receiving measurement data was attached to test
Spectrum) technique using 79 1 MHz bandwidth persons waist. The transmission power was set to 1
channels, whereas ANT uses single dedicated 1 MHz mW. Measurements were performed outside to
channel. Fig. 8 shows the measurement setup for prevent radio wave reflections from environment.
evaluation. Bluetooth and ANT transmission power
were set to 1 mW.

Figure 8: Bluetooth interference measurement setup.

The results considering the effect of Bluetooth

on ANT communication reliability are shown in
Table 4.

Figure 9: Human body interference measurement

setup and different sensor positions.

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