1. McCartney, Patricia R. PhD, RN, FAAN

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Futurist John Naisbitt predicts that the digital technology "revolution" of the 20th century will transform to a technology "evolution" of innovations in the 21st century as applications are refined (Naisbitt, 2006). A healthcare example of this evolution is the application of digital miniaturization to textiles, alternately referred to as "flexible electronics," "e-fabrics," "smart fabrics," or simply "smart clothes." Information on flexible electronics is available from general audience newspapers, commercial Web sites, and the engineering literature; however almost no information is available in the health sciences literature.


What are "smart clothes"? They are clothes that have fabric sensors (electrodes) directly in contact with the skin and sensors placed in clothing pockets (not directly in contact with the skin). The sensors collect data continuously and may use wireless transmission for real-time analysis or record data for later analysis. Whereas more conventional electrodes stick to the skin or are held in place by straps, these electrodes are embedded in the garment itself. In some garments, miniature wires are woven in along with the fabric threads, whereas in other garments the fabric yarn itself has conductive properties. The clothes are designed to be user friendly: soft, thin, elastic, comfortable, and discreet. Some applications require a moist interface for signal detection (perspiration or wetness). Flexible textiles can monitor many parameters, including heart rate, electrocardiograph rhythm, respiratory rate, oxygen saturation, movement, and location of the wearer.


Currently, available commercial products focus on sportswear that monitors heart rate (sports bra and shirts; Numetrex:, Textronics: Healthcare applications remain within research settings and include monitoring related to conditions such as sudden infant death syndrome, sleep apnea, cough measurement (cystic fibrosis), cardiovascular conditions, and stress (autism). These comfortable monitoring garments enable better continuous data collection in clinical trials in general. The LifeShirt vest is widely used in research with adults and children and by firemen in practice, but it is not available to the public (Vivometrics:


The Institute for Soldier Nanotechnologies (ISN) conducts basic research on miniaturization for "smart battle garb," including "detect and respond" fabrics that can potentially react to collected information (Massachusetts Institute of Technology, 2006). Videos and links on the ISN site demonstrate some of the possibilities: soft polymers that change to a hard protective shield upon impact, an "exomuscle" jacket that monitors heart rate and responds to cardiac arrest with chest compression, a garment chip that creates a molecular gate (the size of a red blood cell) to channel body fluids for laboratory analysis, and wearable devices that analyze biological warfare antigens and inject an appropriate antidote. Monitoring real-time location and physiology identifies the "point of need," a new triage concept. These fabrics will provide the ultimate body-clothing interaction, and clothing might become the first responder!!


What can we anticipate for maternal-child smart clothes? What valuable information could infant pajamas or a maternity stretch panel provide? Can we anticipate more effective ambulatory monitoring, less unnecessary office or emergency room visits, and improved opportunities for self-care? Send us an e-mail at MCN and tell us your vision!!




Massachusetts Institute of Technology. (2006). Institute for soldier nanotechnologies: ISN. Retrieved November 8, 2006, from[Context Link]


Naisbitt, J. (2006). Mind set: Reset your thinking and see the future. New York: HarperCollins. [Context Link]