Robust Sensing of Distal Pulse Waveforms on a Modified Weighing Scale for Ubiquitous Pulse Transit Time Measurement

The measurement of aortic pulse transit time (PTT), the time for the arterial pulse wave to travel from the carotid to the femoral artery, can provide valuable insight into cardiovascular health, specifically regarding arterial stiffness and blood pressure (BP). To measure aortic PTT, both proximal and distal arterial pulse timings are required. Recently, our group has demonstrated that the ballistocardiogram signal measured on a modified weighing scale can provide an unobtrusive, yet accurate, means of obtaining a proximal timing reference; however, there are no convenient, reliable methods to extract the distal timing from a subject standing on the modified weighing scale. It is common to use a photoplethysmograph (PPG) attached to a toe to measure this distal pulse, but we discovered that this signal is greatly deteriorated as the subject stands on the scale. In this paper, we propose a novel method to measure the distal pulse using a custom reflective PPG array attached to the dorsum side of the foot (D-PPG). A total of 12 subjects of varying skin tones were recruited to assess the preliminary validation of this approach. Pulse measurements using the D-PPG were taken from seated and standing subjects, and the commercially available PPG were measured for facilitating comparison of timing measurements. We show that the D-PPG was the only sensor to retain the high detection rate of feasible timing values. To further test and optimize the system, various factors such as applied pressure, measurement location, and LED/photodiode configuration were tested.