Monitoring muscles in motion with wearable ultrasound technology

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Ultrasound is a powerful technology that helps healthcare professionals take the first images of your child in utero and allows us to look at soft tissue, such as muscles, tendons, and most internal organs. But ultrasound largely requires patients to be static, meaning crucial information is missed about how muscles or organs behave when they’re most strained during exercise. Now, novel advances and innovative designs from the Netherlands and beyond are bringing ultrasound devices into the wearable medtech era, with exciting possibilities to monitor muscles and organs in motion. These technologies are pushing boundaries in both the medical and sports worlds while helping to diagnose patients, to help athletes train, or to shorten their road to recovery.

Movement missed with traditional ultrasound

Ultrasound works by emitting high-frequency sound waves from a probe in contact with gel on the skin. These waves reflect off body tissues back toward the probe and are converted into detailed real-time images or videos that allow medical practitioners to evaluate soft tissue structures for diagnosis or treatment purposes. For instance, a doctor or physiotherapist might use ultrasound to investigate soft tissues, including the heart or muscles, to assess for their correct function, potential tears, or injury.

However, while the pocket-sized portability of ultrasound devices has increased their use in point-of-care settings outside of hospitals, significant drawbacks remain. The practitioner must manually hold traditional devices in place to keep sufficient contact of the ultrasound probe with the skin and patients must be largely static during the assessment. Information about muscles during movement, when they’re most likely to show an injury, is simply lost.

“The physiotherapist, the sports doctor, the radiologist, they don’t see what happens to the muscle while the athlete is in motion. Sometimes the patient has pain in the hamstring, but if they’re doing a static ultrasound scan, they do not see what happens with the muscle during a functional movement,” says Victor Donker, CEO of Usono, a Dutch company from Eindhoven specializing in ultrasound accessories that allow dynamic and continuous ultrasound imaging during movement.

If they’re doing a static ultrasound scan, they do not see what happens with the muscle during a functional movement” – Victor Donker, CEO of Usono

A wearable ultrasound revolution for the future

To address this issue, a steady wave of novel, potentially revolutionary, ultrasound technologies are emerging from academic labs worldwide that incorporate wearability from the outset. For instance, researchers from the Massachusetts Institute of Technology have developed a wearable, flexible ultrasound device for the early detection of breast cancer by tracking real-time dynamic changes in breast tissue. The team went on to develop a similar ultrasound patch to monitor bladder volume that could help patients with kidney or bladder disorders track how well these organs are functioning.

For now, most research focuses on ultrasound wearables for different medical purposes, but they have vast potential for use in sports medicine in the future. This promise was shown by researchers at the University of California San Diego who developed a wearable ultrasound patch the size of a large plaster that allows continual monitoring of the heart during exercise to detect any abnormalities missed with traditional ultrasound approaches performed only at rest. Early iterations of wearable ultrasound devices also required wires to transmit ultrasound data, but advances in wireless technology now enable the transmission of images directly from devices for an even more user-friendly experience.

A wearable solution for today?

While these groundbreaking devices developed in the US will undoubtedly improve human health in the future, they remain relatively far from the clinic.

In contrast, Western Europe is already leading the way in commercially available wearable ultrasound technology, with a company called Novosound from Glasgow, Scotland, recently securing a patent for their wearable, WiFi-enabled ultrasound device that monitors blood pressure on the wrist. Other potential uses include monitoring dehydration, muscle loading and recovery, and tissue and ligament movement.

However, for clinicians or physiotherapists working with elite or amateur athletes, a solution that allows them to instantly convert existing portable ultrasound devices into wearables for hands-free monitoring of muscles during movement would improve diagnosis and treatment today.

A Dutch company called Usono is meeting this need with CE-marked wearable mounts that allow the secure attachment of existing ultrasound devices to the area of interest, including the quad muscles, hamstrings, calf muscles, knees, and other joints.

While bulkier and less streamlined than research lab-based wearable ultrasound devices, patients and athletes can still perform activities without hindrance. Independent researchers validated the mounting devices in peer-reviewed studies indicating only a moderate compromise on image quality even during prolonged imaging while endurance running.

Olympic weightlifters and some top football clubs are currently benefiting from the rich information provided about their muscles during movement via the mounted ultrasound devices. Dynamic ultrasound monitoring is already accelerating the diagnosis and recovery process. “Thanks to the direct feedback during exercise, healthcare professionals can optimize the rehab process,” emphasizes Donker. “It’s very rewarding to hear that people are treated better and they’re now having less pain.”

While the mounting brackets are currently mostly used to aid professional sports people, Donker aims to eventually reach amateur athletes. “It’s our goal to have an impact on the lives of many and not only on a few elite athletes.”

Dutch innovation and collaboration

Usono benefits from close links with the innovation community in the BrainPort region, encompassing Eindhoven and the surrounding area. “The way that we work together is quite unique. It’s very open, very innovative, very like-minded,” highlights Donker. The networks and support from within the Benelux region as a whole have also contributed to the advancements made by Usono. “I think, in general, the connections in the rest of the Netherlands and Belgium are also really good,” says Donker.

Ultimately, monitoring muscles in motion is in its infancy, but the future of wearable ultrasound technology will undoubtedly change people’s lives by continual monitoring of patients, reducing injuries, and optimizing treatments for professionals and amateurs alike.

Photo: Dutch Olympic Gold medalist Frederique Matla “wearing” Usono ProbeFix Dynamic in combination with GE HealthCare Vscan Air™ Copyright Usono B.V. & GE HealthCare”