Photoplethysmography behind the Ear Outperforms Electrocardiogram for Cardiovascular Monitoring in Dynamic Environments

An increasing proportion of occupational mishaps in dynamic, high-risk operational environments have been attributed to human error, yet there are currently no devices to routinely provide accurate physiological data for insights into underlying contributing factors. This is most commonly due to limitations of commercial and clinical devices for collecting physiological data in environments of high motion. Herein, a novel Photoplethysmography (PPG) sensor device was tested, called SPYDR (Standalone Performance Yielding Deliberate Risk), reading from a behind-the-ear location, specifically designed for high-fidelity data collection in highly dynamic high-motion, high-pressure, low-oxygen, and high-G-force environments. For this study, SPYDR was installed as a functional ear-cup replacement in flight helmets worn by rated US Navy aircrew. Subjects were exposed to reduced atmospheric pressure using a hypobaric chamber to simulated altitudes of 25,000 feet and high G-forces in a human-rated centrifuge up to 9 G acceleration. Data were compared to control devices, finger and forehead PPG sensors, and a chest-mounted 12-lead ECG. SPYDR produced high-fidelity data compared to controls with little motion-artifact controls in the no-motion environment of the hypobaric chamber. However, in the high-motion, high-force environment of the centrifuge, SPYDR recorded consistent, accurate data, whereas PPG controls and ECG data were unusable due to a high-degree-motion artifacts. The data demonstrate that SPYDR provides an accurate and reliable system for continuous physiological monitoring in high-motion, high-risk environments, yielding a novel method for collecting low-artifact cardiovascular assessment data important for investigating currently inaccessible parameters of human physiology.