Test-retest reliability, validity, and responsiveness of a textile-based wearable sensor for real-time assessment of physical fatigue in construction bar-benders
Introduction
Fatigue is defined as the effect of continued work, weariness, or exhaustion of physical or mental strength that may result in a temporary loss of ability to work [1]. Around 40% of construction workers in the USA have reported experiencing extreme fatigue, which could have a negative impact on worker safety, general health, and overall productivity [2]. Long working hours, hot and humid work environments, and heavy workloads have been shown to exacerbate the detrimental effects of fatigue in construction workers [1,3,4]. Additionally, excessive fatigue may increase the risk of work-related musculoskeletal disorders and absenteeism in construction workers [5,6]. Thus, assessing physical fatigue in construction workers is critical as the first step toward minimizing their risk of physical fatigue.
Wearable sensors have been widely used to monitor physiological parameters in many industries such as health [[7], [8], [9], [10], [11]], sports [12,13], mining [14,15], and construction [[16], [17], [18], [19], [20]]. Within each industry, several commercial wearable sensors are currently available [8]. Recent advancements in wireless technology, Internet of Things, and miniature sensors have made possible a new generation of monitoring systems that can record physiological data from individuals without interfering with their daily activities in uncontrolled environments [21]. The application of wearable sensors in the construction industry is in its infancy in comparison to other industries. Recently, some studies have employed wearable sensors to assess physical exertion and fatigue via monitoring physiological parameters including heart rate (HR), breathing rate, and skin temperature in construction workers [[17], [18], [19],22,23]. For instance, Yi et al. [22] and Aryal et al. [17] assessed physical fatigue in construction workers using HR and skin temperature metrics. The classification accuracy was 9% higher when only features extracted from average skin temperature data were used, compared to when only heart rate data were used, and combining data from both sensors resulted in the highest accuracy of 82% [17]. Additionally, Anwer et al. [18] also found positive correlations between physiological parameters and subjective fatigue scores.
The development of new wearable technologies and latest progress in physiology have allowed real-time objective monitoring of physical exertion and fatigue during construction tasks. While some wearable devices can capture only one or two parameters, other devices can capture multiple parameters simultaneously [24]. For instance, the Equivital Lifemonitor (EQ02) is a wearable ambulatory device used to measure numerous physiological parameters including HR, skin temperature, and breathing rate via a chest-worn textile with embedded sensors [25]. Previous studies have evaluated the accuracy and validity of the EQ02 wearable sensor system for monitoring HR, skin temperature, and breathing rate in healthy young adults [[25], [26], [27]]. However, only one study tested the reliability of this device in monitoring physiological parameters at rest and during activities of low to moderate intensity [26]. Although the EQ02 wearable sensor system (EQ02 system hereafter) has been used extensively to examine heat strain, physical exertion, and fatigue through monitoring of physiological parameters in construction workers [[17], [18], [19],[28], [29], [30], [31]], no study has examined the reliability and validity of the EQ02 system in evaluating physiological parameters for the real-time assessment of physical fatigue during actual construction tasks. Additionally, Akintola et al. [25] found that the EQ02 system had high quantity of movement artifacts, which may affect the usage of this device during actual construction tasks. Importantly, previous studies did not examine the associations between changes in physiological parameters and objective fatigue biomarkers such as blood lactate levels during construction activities [[17], [18], [19]]. Since blood lactate levels could predict fatigue during high intensity physical exercise [32], it is important to establish the reliability, validity, and responsiveness of the EQ02 system in monitoring physiological parameters for real-time fatigue assessment before deploying it for use in on-site monitoring of construction activities. To bridge these gaps, the objectives of this study are to evaluate the test-retest reliability, validity, and responsiveness of the EQ02 system for assessing physiological parameters during a bar bending and fixing construction tasks. The major contribution of the current study is the evaluation of the performance of a chest-worn textile with embedded sensors (EQ02 system) for real-time physical fatigue assessment in construction workers.
Section snippets
Subjective approaches for assessing physical fatigue
Several subjective questionnaires were developed in the early 1990s to quantify physical fatigue in the general population [33,34]. Subsequently, numerous construction-related studies developed a variety of subjective questionnaires to assess construction workers' workload or physical fatigue [[35], [36], [37], [38], [39]]. However, because no standardized scale for assessing physical fatigue has been developed, different studies assessed physical fatigue using different scales [39], precluding
Research methods
This study was divided into two phases. First, a pilot study was conducted in a laboratory setting to evaluate the reliability, validity, and responsiveness of a wearable sensor (i.e., EQ02) for the real-time assessment of physiological parameters during a simulated construction task. Second, a field study on an actual construction site was conducted to evaluate the accuracy and reliability of the wearable sensor in real-time monitoring of physiological changes pertaining to physical fatigue of
Results
Demographic characteristics of the study participants are presented in Table 1.
Discussion
This study evaluated the test-retest reliability, convergent validity, and responsiveness of the EQ02 system in terms of real-time monitoring of physiological parameters that are related to physical fatigue in healthy apprentice construction bar-benders. The results demonstrated good to excellent between-day test-retest reliability of the EQ02 system in measuring physiological parameters during bar bending and fixing tasks. Liu et al. [26] reported an excellent same day test-retest reliability
Limitations and future research directions
The present study has several limitations. First, while this study examined three physiological parameters extracted from the EQ02 system for real-time assessments of fatigue in construction workers, the system can capture other physiological information (such as heart rate variability, electrocardiogram (ECG), ECG based breathing, breathing wave, and acceleration). Future studies should evaluate the usefulness of these physiological parameters for real-time assessments of fatigue in
Scientific contributions
The present study offers several scientific contributions. First, it established the test-retest reliability and validity of the EQ02 wearable system for real-time assessments of physical fatigue during construction tasks. Second, this is the foremost study to use an objective fatigue measure (i.e., blood lactate levels) to examine the association between physiological parameters and physical fatigue in construction workers. Future construction studies may consider using blood lactate levels as
Conclusions
The purpose of this study was to determine the absolute and relative reliability of textile-based wearable sensors for monitoring physical fatigue associated with bar bending and fixing construction tasks. Additionally, it sought to establish correlations between physiological parameters and subjective fatigue scores or blood lactate levels in order to establish convergent validity. This study was divided into two phases. To begin, a laboratory pilot study was conducted to determine the
CRediT authorship contribution statement
Shahnawaz Anwer: Conceptualization, Methodology, Data curation, Investigation, Formal analysis, Writing – original draft. Heng Li: Conceptualization, Methodology, Writing – review & editing, Funding acquisition, Supervision. Maxwell Fordjour Antwi-Afari: Conceptualization, Methodology, Validation, Writing – review & editing. Waleed Umer: Conceptualization, Methodology, Writing – review & editing, Supervision. Imran Mehmood: Conceptualization, Methodology, Visualization, Writing – review &
Declaration of competing interest
The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
Acknowledgments
The authors acknowledged the following two funding grants: 1. General Research Fund (GRF) Grant (BRE/PolyU 152047/19E) entitled “In Search of a Suitable Tool for Proactive Physical Fatigue Assessment: An Invasive to Non-invasive Approach”; and 2. General Research Fund (GRF) Grant (BRE/PolyU 15210720) entitled “The development and validation of a noninvasive tool to monitor mental and physical stress in construction workers”.
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2022, Automation in ConstructionCitation Excerpt :Ten male participants (i.e., construction rebar workers) were voluntarily recruited to participate in the experiments. Construction rebar workers were recruited and participated in this study because repetitive rebar tasks (e.g., preparing and assembling rebars) are physically demanding and often involve long working hours, awkward working postures, and manual lifting activities [15,18]. The participants mean age, weight, height, and shoe size were 38 ± 1.82 years, 76 ± 2.79 kg, 1.75 ± 0.32 m, and 10.32 ± 1.03 EU size, respectively.