Seamless vital sign monitoring with fiber optic sensing technology: validating the sitting SMART MAT for community health in static and mobile conditions

Abstract

Background Continuous vital sign monitoring is critical but often labor-intensive. Fiberoptic technologies, like the SMART MAT, offer non-invasive assessment. Adapting this for a seated posture addresses clinical needs by promoting safe patient mobilization and reducing complications associated with prolonged bed rest. Objectives To validate the accuracy of the sitting SMART MAT for respiratory rate (RR), heart rate (HR), oxygen saturation (SpO2), and systolic and diastolic blood pressure (SBP/DBP) against established clinical reference standards. Methods This cross-sectional study compared sitting SMART MAT readings with clinical reference measurements under stationary and mobile wheelchair conditions. Accuracy was assessed using Mean Absolute Error (MAE), Mean Absolute Percentage Error (MAPE), Bland-Altman Limits of Agreement (LoA), repeated-measures ANOVA, and effect size. Results Data from 130 participants were analyzed. HR readings demonstrated high accuracy (MAE = 3.67–4.81 bpm) with tight LoA. RR error was minimal (MAE = 2.85–2.86 breaths/min) statically but increased during motion (MAE = 5.03–5.21 breaths/min). SpO2 remained highly stable (MAE = 1.08–1.21%), well within standard clinical tolerance. SBP showed solid central accuracy (MAE = 6.48–7.51 mmHg) but wider LoA occasionally exceeded the ±5 mmHg threshold, functioning best as a continuous trend monitor. DBP variance was negligible (MAE = 4.65–5.46 mmHg). Conclusion The current SMART MAT is a viable, integrated multimodal platform. HR, RR, and DBP are comparable to clinical reference standards, while SBP requires careful interpretation. By accommodating a functional sitting posture, the contactless system reduces immobility-related complications and demonstrates high feasibility for continuous, real-world monitoring.