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Fiber Bragg Gratings in Healthcare Applications: A

Review

Manish Mishra & Prasant Kumar Sahu

To cite this article: Manish Mishra & Prasant Kumar Sahu (2023) Fiber Bragg Gratings
in Healthcare Applications: A Review, IETE Technical Review, 40:2, 202-219, DOI:
10.1080/02564602.2022.2069608

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IETE TECHNICAL REVIEW
2023, VOL. 40, NO. 2, 202–219
https://doi.org/10.1080/02564602.2022.2069608

Fiber Bragg Gratings in Healthcare Applications: A Review

Manish Mishra and Prasant Kumar Sahu

School of Electrical Sciences, Indian Institute of Technology (IIT), Bhubaneswar, Odisha 752 050, India

ABSTRACT KEYWORDS
Fiber Bragg grating FBG is a periodic refractive change induced inside the fiber’s core due to expo- Biological sensing;
sure to optical radiation. Being miniature, EMI (electromagnetic interference) resistant, and sensitive Biomedical applications;
to physical conditions, such as temperature, strain, and relative humidity; FBGs have gained huge Fiber Bragg Gratings (FBG);
attention and their implementation can be witnessed in many domains varying from oil and mining Healthcare applications;
Internet of Things (IoT);
to medicine and healthcare application. This paper presents an overview regarding the application Optical sensors; Physiological
of FBGs as potential sensors in monitoring various vital physiological signals and activities such as signal monitoring
body temperature, heart rate, cardiorespiratory analysis and more. Intricate and delicate observa-
tions such as pressure and strain mapping in prosthetics, bone health monitoring, and measuring
small-scale forces in medical instruments such as spinal needles have also been discussed in detail.
Various methodologies and topologies of implementing FBGs for processing and analyzing phys-
iological signals have also been presented. To provide a better and suitable insight into tracking
the progress regarding the implementation of FBGs in medicine and healthcare, thematic research
in chronological order for the past decade is presented in this work. An elaborate discussion stat-
ing various issues and problems such as determination of an appropriate index for plantar pressure
monitoring, cross-sensitivity of FBGs, choice of polymer sheaths, the dependence of gait analysis on
the type of foot and size, etc., have also been addressed. At last, in the wake of evaluating past works
and future clinical applications, a conclusory remark paving a pathway for future possibilities and
applications is additionally presented in this paper.

1. INTRODUCTION
This paper presents a review on recent achievements
of optical fiber sensors application in the healthcare
domain. Quoting World Health Organization (WHO)
Constitution, we know that “Health is a state of complete
physical, mental, and social well-being and not merely
the absence of disease or infirmity [1].” According to the
various global health-related studies performed, some
interesting facts have been reported by different research
groups. The Center for Disease Control and Prevention
(CDC) has reported that cardiac-related problems are the
leading cause of death in various ethnic groups in the
United States. As per the study, every 36 s a person suf-
fering from cardiovascular disease dies [2]. In another
study, an estimate reached a count of 659,000 deaths due
to heart disease which is equivalent to a single death in
every 4 deaths. Not only the fatality but about $363 billion
were spent in a single year (2016–2017), which seems to
be a very costly effort. This cost comprised of healthcare
services, medicines, and lost productivity [3]. Hyperten-
sion, another health issue related to the cardiovascular
system, proved to be a major cause of death of over more
than half a million deaths as per other published reports
[4]. Shifting attention to other health conditions such as
musculoskeletal disorders, several facts have been dis-
covered. In the year 1997, the National Institute for Occu-
pational Safety and Health (NIOSH) released a study
regarding musculo skeletal disorders (MSD). A strong
correlation between the various musculoskeletal disor-
der and work conditions such as heavy lifting, regular
exposure to tedious routines, and repetition of force-
ful tasks was reported. MSDs include conditions such as
sprains, back pain, Hernia, and more [5]. Around 70 mil-
lion people visit physicians annually, with issues related to
MSD. As per the reported data, around $45 to $55 billion,
including compensation costs, lost wages, and produc-
tivity, is the cost paid annually due to MSDs [6]. Back
pain, being a very common ailment, is a major player
in MSDs. Around 5–10% turn out to be chronic, issues
related to back pain [7,8]. Arthritis is also very common
in the United States [9]. As per the study conducted by the
National Arthritis Data Working Group, around 27 mil-
lion suffer from osteoarthritis [10,11]. In the year 2003,
$128 billion comprising $81 billion and $47 billion of
direct and indirect costs were paid [12]. In the case of
Osteoporosis, the percentage of men and women over

© 2023 IETE
 M. MISHRA AND P. K. SAHU: FIBER BRAGG GRATINGS IN HEALTH CARE APPLICATIONS
50 years comprised 4.2 and 18.8, respectively [13]. After
studying the various facts and witnessing the importance
of the issue, they acted as motivation for the authors
to conduct a study and present an overview regarding
the feasibility of optical sensors (more importantly Fiber
Bragg Gratings) in the field of medicine and healthcare.
In recent years, Fiber Bragg Gratings has gained world-
wide attention. From the early ‘70s, the existence of
gratings and their fabrication have been witnessed. Mol-
lenauer et al. proposed the external inscription of gratings
by UV light interference [14–17]. In the year 1978, K. O.
Hill demonstrated the formation of FBGs at the Canadian
Communication Research Centre (CRC), Ottawa, Ont.,
Canada [18,19]. An everlasting change in the refrac-
tive index upon irradiating the optical fiber with UV
light radiation is termed photosensitivity. The gratings
obtained are also referred to as “Hill Gratings” as they
only functioned in the wavelength close to the writing
wavelength. In the experiment, 488 nm radiation was uti-
lized suggesting a two-photon process but later, Meltz et
al. showed the formation of gratings at 244nm
suggesting a single photon process (removing the lim-
itation in Hill’s gratings) [20]. In FBGs, the sensing is
performed in terms of wavelength shift which is one of
the most advantageous characteristics. There are primar-
ily two reasons behind such reasoning: first, being an
absolute parameter it is more stable and self-calibrating;
second, such parameter is loss independent, modal drift,
bends, Laser or LED aging drifts independent. Fiber
Bragg gratings have been widely used due to their vari-
ous characteristics similar to other optical devices such as
small size, ruggedness, flexibility, reliability, ease of main-
tenance, low cost due to abundance of silica, electrical
isolation (i.e. resistance to electrical shocks), immunity
to electromagnetic interferences, independence for local
electrical loads, easy manufacturing, resistivity against
corrosiveness, long haul operations, signal security (as
light doesn’t radiate significantly), negligible cross-talk,
high capability for multiplexing several sensors, high
optical frequency ranges (1013 –1016 Hz), etc. [21]. Other
than possessing such attributes, these sensors can also
be utilized to detect other variables such as force, strain,
temperature, gas concentrations, vibrations, humidity,
biotic agents using sensitive surfaces which can facili-
tate in many industries such as mining, petroleum, gas,
telecommunications, structural health monitoring, and
medical sciences [22–27]. This review centers around the
implementation of FBGs in the field of medicine and
healthcare services and comprises five sections. The first
section is the introduction, which presents the histor-
ical backdrop of FBGs and their various applications.
Section two incorporates the design, theory, fabrication
203
materials and market availability of FBG. Section three
incorporates the clinical application of FBGs in analyzing
heart and respiratory conditions, arterial pulse moni-
toring, vertebral pressure, body posture monitoring, etc.
Section four presents a discussion over various challenges
for the technology and a few limitations it faces for its
applications. Section five presents an end over inferences
drawn from the acquired information and realities over
utilization of FBGs in the clinical.
2. FIBER BRAGG GRATINGS
In the previous section of this article, it was rather nec-
essary to present the current scenario of the FBGs and
their myriad applications to justify their importance and
significance. In this section, FBG design and theory, fab-
rication materials, interrogation techniques and market
availability are described briefly.
2.1 Theoretical Background
An FBG can be defined as a periodic perturbation
produced in the optical fiber core over its length due
to exposure to focused optical radiation with a spe-
cific wavelength and intensity. Several characteristics like
material properties of the fiber, photosensitivity, and
duration of exposure to UV radiation affect the rela-
tive change in the refractive index of the gratings. The
operation of FBG can be explained in Figure 1. Gener-
ally, the reflected light is out phase and will cancel each
but in a special case called Bragg condition, the con-
structive addition of all the reflected light generates a
reflective peak of a certain wavelength in the backward
direction, popularly known as, Bragg wavelength. Bragg
wavelength, λB , is dependent upon the refractive index
of the core of the optical fiber and the periodicity of the
fiber Bragg grating, which is depicted by the empirical
equation described below:
λB = 2neff  (1)
where neff is the modal effective index and  is the period
of the FBG. To compute the reflectivity of the FBGs,
Figure 1: Behavior of a typical fiber Bragg grating
204 M. MISHRA AND P. K. SAHU: FIBER BRAGG GRATINGS IN HEALTH CARE APPLICATIONS
Coupled Mode Theory (CMT) can be referred to for
simulation purposes [28]. Now, to compute the depen-
dence of the reflected wavelength over temperature and
strain, the equation (2) can be considered:
λB
= (α + η)T + (1 − ρe )εz
λB
whereas α and η are thermal expansion coefficients
and thermo-optic coefficients, respectively. Equation (3)
describing strain effects is mentioned below:
(n2 )
ρe = {p12 –ν(p11 + p12 )}
2
where n is the refractive index of the core, ν is the Poisson
ratio, p11 and p12 are strain optic coefficients, ρ e is pho-
toelastic constant and εz is the longitudinal strain applied
on the optical fiber. Several other parameters can be also
sensed by the FBGs with the help of sensing films such
as relative humidity as explained by Yeo et al. in their
work [29]. In his work, the strain is caused due to swelling
of the polymer coating produced over the FBG sensor
portion. The equation explained by him is as follows:
λB
= ε.T + (1 − ρe )εRH + (1 − ρe )εT
λB
where αRH , εRH , and εT signify moisture expansion coef-
ficient, strain due to moisture, and thermal expansion,
respectively.
2.2 Fabrication Materials and Interrogation
Methods
Silica is an obvious choice for the fabrication of opti-
cal fibers due to several advantages previously explained,
but polymer-based optical fibers have become a pre-
mier choice of material for the fabrication purposes of
sensors and FBGs. POFs are more advantageous than
SOFs in terms of hardness and flexibility and shatter-
ing issues. POFs offer lower Young’s modulus (2.2–3.8
and 2.0–2.4 GPa for PMMA and polycarbonate), higher
impact resistance, higher fracture toughness, large core
diameters, and higher numerical apertures, higher bio-
compatibility and strain failure levels, and lower produc-
tion costs. For instance, Poly Methyl Metha Acrylate, i.e.
PMMA, offers an elastic limit which is 10% as compared
to 1–3% of silica. Strain sensitivities difference is also
15% greater than that of silica which is 115 × 105 rads/m.
The cost of POF-based systems reduces due to designing
advantages offered in numerical aperture and diameters.
In terms of temperature sensing, large negative thermo-
optic coefficients have proved to be instrumental in sens-
ing and opening new possibilities in terms of applica-
tion for POFs [30,31]. Water absorption properties can
prove to be highly useful in the field of medicine and
healthcare, especially Relative Humidity (RH) Sensing.
Biocompatibility, a major factor in terms of application of
medicine and healthcare, POFs stand apart as compared
to SOFs. Doped POFs, though, can pose a challenge in
(2) terms of biodegradability. In POFs, several types of mate-
rials such as PMMA, cyclic olefin copolymers (TOPAS
and ZEONEX), Plastic Polycarbonate (PC), PDLLA, and
cyclic transparent amorphous fluoropolymers (CYTOP)
are available for manufacturing purposes. Each above-
mentioned fabrication material offers individual advan-
tages, so the application varies with the choice of applica-
(3) tion or depends on the user’s discretion. For instance, to
employ low water absorption or high transition temper-
ature or low loss capabilities polymer materials such as
TOPAS, ZEONEX or CYTOP can be referred to for fab-
rication purposes [32,33]. Being popular with versatile
advantages offered by the POFs, certain issues also arise.
For instance, usage of PMMA, and polystyrene-based
POFs is limited to visible range (loss around 150 dB/km),
and if telecommunication range becomes the choice of
operation, then CYTOP-based POFs are chosen as they
offer lower propagation loss which is around 50 dB/km;
80–100-degree Celsius operation range is the maximum
(4)
limit imposed by POFs for suitable operation, which also
restricts their implementation. Being sensitive to several
parameters also introduces issues like cross sensitivi-
ties. Viscoelasticity, i.e. variation of mechanical proper-
ties depending upon time duration for which strain is
applied, an integral parameter of the POFs, limits their
efficient implementation. In terms of market availabil-
ity of POFs, SMFs with low attenuation capabilities are
still unavailable [30–33]. Fabrication and interrogation of
the systems are dependent upon several factors such as
availability, cost, operations, and efficiency. Phase mask
or Signac-based interference or point by point or direct
writing-based techniques are available for the fabrica-
tion of FBGs. However, the phase mask technique is
quite famous and effective in terms of implementation.
As the operation of the inscription can take a longer
time, recently there is a shift from using traditional UV
or He-Cd laser to femtosecond laser to obtain high-
quality gratings in lesser time. The time to inscribe the
gratings reduces from an hour to a matter of minutes.
Interrogation methods required for acquiring the data
from the gratings can vary drastically, as they are depen-
dent upon the sensor topology or kind of operation or
many complex systems. Restricting ourselves within the
scope of discussion, generally, Wavelength and phase
demodulation have gained a lot of attention in recent
years. In wavelength demodulation, WDM and TDM are
employed for expanding the sensor network. The number
of FBG employed is restricted by the capacity of source
 M. MISHRA AND P. K. SAHU: FIBER BRAGG GRATINGS IN HEALTH CARE APPLICATIONS 205

spectral width and wavelength of sensors. Various other

polyimide or no
techniques and general demodulation techniques can be

Optromix

−200–350°C
referred to in the available literature [30–34]. However,

Acrylate or

coating
530–2300

0.1–99.9
in medical and healthcare applications, simple interroga-

0.03–3
0.1–50

N/A
tion systems were employed comprising of simple FBG
sensors with regular demodulation systems comprising

(hermetic package),
stainless steel (non
hermetic package)
of circulators, splitters and couplers, and FBG interroga-

Silica, Teflon or PEEK

Proximion
tors.

−50–700°C
7.5–16 pm/°C,
1250–1650

1–10,000
0.05–0.1
0.1–99
2.3 Market Availability

N/A
After explaining the basic structure, theoretical aspects,
and analysis techniques, it seems rather logical to dis-

−40–120°C, 9.9 pm/°C

cuss the market availability of the fiber Bragg gratings.

Micron optics

5000 μ , 1.2 pm/μ

Normally, for application purposes, several fiber Bragg
gratings are available. Technica, Smart Fibers, Micron

1502–1597
Optics, Proximion, and many other OEMs are available.

0.25 nm

SMF 28
10 mm
> 70
Researchers can avail of the pre-fabricated sensors or can
order gratings of their desired characteristics. In general,
gratings are available with central wavelength varying in
the range of 450 nm–2800 nm, reflectivity varying in the

Fiber core

1500–1600
Manufacturers

< 1– > 80
range of 0.1–99%, bandwidth varying between 0.01 and

SMF, MMF
790–850
4 nm, the length between 0.1 and 50 mm, temperature

≤ 150
0.3–1

N/A

N/A
sensitivity varying between −80 and 700 degree Celsius,
and strain sensitivity of 1.2 pm/μ . Fiber Bragg gratings

−270 to +300°C, 11 pm/°C

in Single Mode (SM) or Multi-Mode (MM) or coated or

Single Mode SMF-28,

uncoated or other varieties of coating or packages are
Smart fibers

1.2 pm/μstrain
available. Table 1 shows the availability of various FBG

± 9000 μstrain,
9/125 μm
sensors. For other specifications, technical sheets can also
1528–1608

< 0.3 nm
be referred [35–41].
≥ 80

10

3. FIBER BRAGG GRATINGS IN MEDICAL AND

SMF, PMF, Double Cladding,
Active Fiber, ATN fiber,

HEALTHCARE APPLICATIONS
O/E land Inc.

After discussing the basic concepts, internal architecture,

Table 1: Commercially available fiber Bragg grating sensors

custom length

design, applications, and market availability of the FBG in

LMA fiber
1 – > 99.9
450–2800

the previous sections of the literature, the author would

0.01–4

like to draw the attention of the reader to the essence

N/A

N/A

of this literature review, i.e. applications of FBG in med-

1.2 pm/μ ; other options

ical applications. According to the best of the author’s

125 (std), 80, 50, 40 μm
Single-Mode Non-PM/PM
1460–1620 nm, +/-0.5;

knowledge, the application of Optical fiber sensors in

980, 1060, 1310 nm

∼ 10 pm/°C other
options available
−40°C to +275°C;

medicine can be traced back to the year to an era of the

Technica

> 15,000 μ with

0.1 nm to 1.0 nm

‘80s. Scheggi et al. proposed an optical sensor based on a

available

thermosensitive cladding applied on fiber’s end [42]. M.

DIA

H. Sun et al. has shown the usage of optical fiber sensor

1–99

1–24

setting for temperature monitoring in medical scenarios.

In this system, silica-based fiber probes were introduced
Strain range or sensitivity
Central wavelength (nm)

with a temperature precision of ±0.1°C and accuracy of

Temperature range or
Material or packaging

±0.2°C [43]. Roger A. Wolthuis et al. in their work has

Bandwidth (FWHM)

shown Febry Perot sensors can be used to detect tempera-

Reflecticity (%)

Length (mm)

sensitivity

ture and pressure as their optical reflectance varies due to

Features

changes that occurred in the optical cavity and refractive

index [44]. Y. J Rao et al. have shown a similar possibility
206 M. MISHRA AND P. K. SAHU: FIBER BRAGG GRATINGS IN HEALTH CARE APPLICATIONS
by incorporating an FBG for temperature measurement
purposes [45]. Fisher et al. also showed applications of
fiber Bragg gratings for medical ultrasound applications
[46]. Webb et al. in his work showed animal in vivo trials
for temperature monitoring based on fiber Bragg grat-
ing [47]. Considering such examples, an inference can
be obtained that associating optical fiber technology with
medicine and healthcare is quite feasible and efficient. In
the following sub-sections, an effort is made to explain
working mechanisms of measurement setups based on
FBG for different physiological parameters like cardiac
activities, heat beats, blood pressure, body temperature,
etc. A comparative analysis has been presented between
works done by various authors.
3.1 Cardiorespiratory Monitoring and Wearable
Sensors
In the medical field, monitoring heart activity is very cru-
cial as it is responsible for pumping the blood through the
whole body which is pivotal in determining the heart’s
efficacy. The earliest literature regarding the application
of FBG in respiratory monitoring can be traced back
to the contribution of Wehrle et al. and Tjin et al. who
acquired cardiorespiratory signals for physiological anal-
ysis [48–50]. In a research work performed by A F Silva et
al., he proposed simultaneous cardiac and respiratory fre-
quency measurements based on FBGs [51]. In his work, a
signal processing system was designed to filter out cardiac
and respiratory frequencies and the results were com-
pared with a standard device. To enhance the sensitivity,
the sensor was placed in a carrier structure of PVC foil to
cover as much area as possible for better results.
Lukasz Dziuda et al. report a system for a similar purpose
and place the FBG in a cushion placed in the backseat
of the patient [52]. In this work, it is reported that the
sensitivity of the FBG is 50–124 μstrain for the breathing
activities and 8.3 μstrain for the heartbeats. A permissible
error of 12% is also reported. C Massaroni et al. in their
work used six FBG sensors placed inside a T-shirt (97%
polyamide and 3% elastane) to monitor cardiac activ-
ity and respiratory movements. In their work, they have
reported varying relative errors in breathing rates when
compared with the reference data [53]. Relating to the
usage of sensor arrays, D. Lo Presti et al. have also used 12
FBGs to monitor various physiological signals [54,55]. In
both the above works, it is also confirmed that the values
of physiological signals remain untainted during the test
conducted under MRI examinations. Jan Nedoma et al.
also report an FBG device encapsulated in polydimethyl-
siloxane (PDMS) as it doesn’t react with the human skin
and is EMI resistant that can be used for monitoring
Figure 2: Arrangement of FBGs for monitoring the expansion
and contraction of the chest cavity
the heart and respiration rate [56]. In their work, they
reported a relative error of 4.41%, which is very low as
compared to the other mentioned works. Figure 2 shows
the design and implementation of FBG sensors for phys-
iological monitoring. After discussing the possibilities of
embedded FBGs in monitoring the physiological signals,
implementation of such features can be extended to the
development of wearable sensors.
Wearable sensors can be utilized to monitor physiolog-
ical data without needing the patients to be bedridden
for prolonged hours. By replacing the sensors at a prede-
fined location in the specified clothes, this technology can
obtain real-time data, hence removing the usual trouble
of the subject being stationed for a long time. Augus-
tine Grillet et al. in their work reported a comparative
study of three different sensors, namely, a macro bending
sensor, a Bragg grating sensor, and a time reflectometry
sensor placed in medical textiles for health monitoring
purposes [57]. All the three sensors can measure textile
extensions between 0% and 3%. Jens Wit et al. extend
this to monitor the cardiac activity or respiration rates
or thorax activity during high-frequency treatments such
as MRI and ECG [58]. Jinnan Zhang et al. in their work
reported a graphene-coated optical fiber sensor to moni-
tor human motion for improving a player’s performance
in sports [59]. Such implementation can be extended to
the purpose of fulfilling motion monitoring and reha-
bilitation activities. Arnaldo G. Leal-Junior et al. present
a polymer optical fiber (POF)-based sensor system for
smart walker (SW) instrumentation in which oxygen sat-
uration, breathing rate, gait cadence, and heart rate with
errors of about 1% can be detected [60]. Other wearable
systems have been reported as referred [61–68].
 M. MISHRA AND P. K. SAHU: FIBER BRAGG GRATINGS IN HEALTH CARE APPLICATIONS 207

3.2 Arterial Pulse and Temperature Monitoring work. Prolonged working hours can coerce a human
being to trespass its limitations and hence, can cause var-
Arterial pulse plethysmography is a technique in which
ious vertebral problems. Christopher R. Dennison et al.
the volumetric variations due to pulsating blood in the
in their work have attempted to capture lumbar inter-
artery are monitored to get an arterial pulse waveform.
vertebral disc pressure using FBGs and reported aver-
Shweta Pant et al. in their work have shown the monitor-
age sensitivity, the average coefficient of determination,
ing of arterial pulse waveform using FBGs to get accel-
and average hysteresis −5.77 ± 0.085 pm/MPa, 0.99 and
erated pulse plethysmographs [69]. In her work, an FBG
2.13% of full scale, respectively [81]. As the vertebral por-
is placed on a tapered hollow polymer tube, and with the
tion is many sections, L1 and L2 and L4 and L5 were the
help of an interrogator, the waveforms are analyzed. APG
primary targets. The FBG was placed inside a hypoder-
waveform can be divided into various sections in which
mic needle and the results were compared with two stan-
the amplitudes of each section are compared, and each
dard strain gauges for comparative studies. Zamir Ahmed
ratio has its significance. Each ratio is useful in the deter-
Abro et al. have presented a Smart Sensing Garment
mination of physiological parameters and suffers from
(SSG) which comprises FBGs encapsulated inside silica
prominent variations occurring with physical changes
gel and bending sensors to monitor the body postures
associated with the body. Similar work regarding arterial
and various gestures [82]. In this work, the response of
pulse was also performed by Cátia Sofia Jorge Leitão et
the wavelength shifts from FBGs and bending responses
al. in his work but using reflected waves from the target
was recorded for monitoring various bodily actions like
artery, i.e. carotid artery (around the neck portion) for the
ankle twist, wrist twist, and elbow bending. Daniela Lo
monitoring purposes [70]. The author reports a sensitiv-
Presti et al. proposes encapsulated FBGs to be used for
ity of 727 μV/μm, quantized resolution of 76 μV, and dis-
monitoring neck positions or musculoskeletal disorders
placement resolution of 0.1 μm. Yet, the results acquired
[83]. In their work, the sensors were placed in frontal and
are dependent upon the distance between reflector and
sagittal positions to measure flexion–extension and axial
equipment, temperature fluctuations, and handling con-
rotation repetitions and respiratory frequency. Errors less
figurations which can introduce artifacts and can yield
than 6.9% and 1.9% have been reported for different
abrupt results. Other works related to arterial pulse iden-
breathing activities. In the treatment of pressure ulcers,
tification have been also reported [71,72]. Optical fibers
Cátia Tavares et al. have reported a system in which FBGs
are resistant to electromagnetic interferences (EMI). This
are employed in six different positions of the wheelchair
property can play a major role in MRI and ECG where
which can make a recovering patient suffer from such
there is too much EMI and which can affect the val-
pathology [84,85]. Under some conditions, patients are
ues obtained from electrical devices. G. Palumbo et al.
unable to move their bodies for a prolonged period which
in their work describe the possibilities of application
may cause the skin and underlying tissue to suffer from
of optical fiber sensors during radio frequency thermal
localized damages. An arrangement to monitor neck pos-
ablation (RFTA) treatments [73]. In their work, several
ture is shown in Figure 3. To prevent from development
FBGs bounded to RFTA probes are employed near RF
of such pathological problems, an alarming system can
electrodes, and real-time temperature increase during
be made to notify the medical staff or user to change
different and consecutive RF discharges were monitored.
his position to relieve the body parts from a prolonged
A temperature resolution of 0.1 °C and spatial resolution
pressure scenario.
of 5 mm were reported by the author. Shikha Ambastha et
al. in their work reports, a device based on FBGs to per-
form a thermal analysis for tumor-affected tissue regions. 3.4 Orthopedic Monitoring, Prosthetics, and
As tissue affected by tumor generates very high tempera- Plantar Pressure Monitoring
tures in surrounding regions due to increased blood flow
In orthopedic sciences, issues related to joints, ligaments,
and metabolism, a possibility of detection and treatment
tendons, and other musculoskeletal parts are addressed.
through thermography is presented [74]. Similar studies
The study of the nature, amplitude, and distribution of
related to the above discussions are also presented in the
load on the orthopedic parts is necessary for designing
literature [75–80].
optimum quality prosthetics and effective implementa-
tion. Christopher R Dennison et al. in their work have
shown that it is possible to measure the force and stress
3.3 Vertebral Pressure and Body Posture
in articular joints of the human body. In his work, an
Monitoring
FBG is embedded inside an incompressible and mechan-
Vertebral pressure and back pain-related queries can arise ically suitable polymer annulus with a polyamide sheath
due to prolonged working hours at different forms of over it. Being incompressible, when the force is applied
208 M. MISHRA AND P. K. SAHU: FIBER BRAGG GRATINGS IN HEALTH CARE APPLICATIONS
Figure 3: Neck position monitoring for computer workers
(adapted from [83])
over the sheath, the volume of the annulus is maintained
and strains are passed over to the fiber-containing FBG.
Sensitive to the strain, the wavelength shifts are propor-
tional to the amount of force applied over the sheath. It
has been reported that the sensitivity of the sheathed sen-
sors is more than unsheathed sensors [86]. Ebrahim A.
Al-Fakih et al., in his work, has also made an effort to
measure the pressures between the stump and the pros-
thetic sockets of a trans-tribal amputee [87,88]. A sensing
pad was created with FBG embedded in a thin layer of
epoxy and which in turn was embedded in a silicone
material to form a pressure sensor. The reported sensitiv-
ity of the sensor was 127 pm/N. José Rodolfo Galvão et al.
have performed strain mapping in carbon fiber prosthesis
using arrays of FBGs. In his work, a normalized response
of FBGs was recorded and represented in terms of color
mapping to identify regions of more strain-affected areas
[89,90]. Sharath Umesh et al. in their work report the
measurement of joint angle measurement by develop-
ing a called FBG goniometer (FBGG) which converts the
rotational motion of a joint into strain variation on a can-
tilever, which is acquired by the FBG sensor [91]. The
system is reported to have the capability of measuring
joint angles in the range of 0–200 degrees and with a reso-
lution of 0.06 degrees. M. Fátima Domingues et al. report
a similar device for monitoring the knee angular flex-
ion/extension during motion [92]. In this setup, the FBG
sensor was embedded in a K tape and was placed around
the knee section and relative shifts were computed for the
knee movements. Similar works regarding joints, pros-
thetics, and other body sockets have also been reported
in the literature [93–99].
Figure 4: A schematic of foot pressure monitoring
In plantar pressure monitoring, the distribution of stress
in different locations of the human feet can be studied
and gait analysis can be performed. The earliest work
can be traced back to Hao et al. who designed a sys-
tem based on FBGs for foot pressure monitoring [100].
R. Suresh et al. report a system comprising FBGs in
an array to study pressure patterns and provide better
treatment for diseases such as diabetes and gonarthro-
sis [101]. A sensing sole is made with FBGs embedded
inside layers’ carbon composite material for monitoring
pressure around the feet. The reported sensitivity was
1.2 pm/kPa and a resolution of 0.8 kPa. Tsair-Chun Liang
et al. also report a similar system with 6 FBGs which
is 2 more as compared to the R. Suresh et al. research
work. In the reported research work, the author has dis-
tributed the pressure regions of the foot and has extended
the work by considering different foot types [102]. An
arrangement to measure the pressure areas is shown in
Figure 4. A correlation study was also performed to val-
idate the relationship between the plantar pressure and
wavelength shifts of the FBGs giving an r value of 0.671
(Pearson coefficient). Maria Fátima Domingues et al. also
report a similar system with 5 FBGs and reports a sensi-
tivity of 11.06 pm/N. Temperature compensation is also
provided for insole measurement and pressure mapping
in her research work [103]. Continuing the operation
of pressure monitoring and gait analysis, an IoT-based
e-Health solution architecture is also reported for remote
monitoring and analysis is also reported in the literature
[104–107].
3.5 Bone Health Monitoring and Force
Measurement in Surgical Instruments
Among various features of the human body, the strength
of the skeletal structure is of prime essence. Calcium
being the chief mineral associated with bone strength, it
becomes necessary to monitor the bone decalcification
by performing strain analysis. Bone Mass Density (BMD)
 M. MISHRA AND P. K. SAHU: FIBER BRAGG GRATINGS IN HEALTH CARE APPLICATIONS
measurement is used to determine the extent of bone
decalcification. Using FBGs for the essential strain anal-
ysis can overcome the limitations (radiation exposure,
inaccurate values, and corrective measure for age, gen-
der, and ethnicity) of usual techniques like Dual Energy
X-ray Absorptiometry (DEXA), Quantitative Ultrasound
Assessment (QUS), and Quantitative Computer tomog-
raphy (QCT). V. Mishra et al. in their work report an
FBG-based system capable of measuring the μstrain val-
ues in tibia bone sample to determine the extent of
decalcification. In this technique strain values, less than
5 μstrain can be measured accurately. In their work, it was
shown that bone decalcification resulted in reduced mod-
ulus of elasticity and hence diminished bone strength
[108]. A. Bimis et al. in their work use an FBG set
up to determine the hygroscopic induced strain in cal-
cium phosphate bone cement. The shift in values of peak
wavelength, i.e. Bragg wavelength, was in the proportion
of change in bone weight after treatment [109]. Other
works related to stress–strain mapping and analysis of
bone and bone cement have been presented in the liter-
ature [110–113]. In medical procedures and practices, it
becomes essential for practitioners to study the interac-
tion of the needle to perform treatment on the patients.
Xingchi He et al. in their works present a device in which
3 FBGs are integrated on the forceps tip with temperature
compensation to perform a precise and accurate inci-
sion [114]. The author reports a resolution of 0.25 mN.
Shikha Ambastha et al. in her work also report on a simi-
lar device in which FBG is integrated with a spinal needle
during treatment of lumbar puncture [115]. The FBG of
3 mm is placed in the middle position of the sensing bar
to measure the applied force. The author reports strain
sensitivity (per applied force), force sensitivity, and reso-
lution of −38 μ /N, −46.4 pm/N, and 0.021 N. Chaoyang
Shi et al. in their works, also report an FBG-based dis-
tal force sensor in which FBG is tightly stretched and
glued along the central line of the force-sensitive flexure
of the device. The author reports a resolution of 21 mN
within a force measurement of 0–12 N [116]. Similar
works have also been reported in the literature [117–120].
Table 2 shows the comparative analysis of past works
performed.
3.6 Internet of Things (IoT) and Healthcare
After discussing varieties of techniques and implemen-
tation of FBG-based physiological monitoring systems,
it becomes necessary to discuss its viability for integra-
tion with the Internet of Things (IoT), which is a cur-
rently extensively used technology. In IoT, the idea is to
integrate various sensing and actuating points through
internet acting as a channel for communication. Using
209
IoT, data accessing points can be accessed, monitored,
regulated, and their retrieved data can be analyzed and
manipulated for further operations. Remotely monitor-
ing and regulating operations becomes essential if the
data needs to be continuously monitored. For instance,
in a reported work by Arnold G. Leal Junior et al. a
smart walker system has been reported to monitor car-
diorespiratory and gait monitoring. In the work, a sys-
tem architecture has been proposed to acquire the data
from the POF sensor and send it to the Smart Walker
through Bluetooth for wireless communications. After
acquiring the data, it can be sent over to the cloud for
further processing data and analysis. Remote operation
and handling of the smart walker are also proposed in
the reported work [60]. In another work, a test bench
is reported for respiratory monitoring of the workers.
In the reported work, Bluetooth connectivity is pro-
vided from a custom module available, and data were
sent wirelessly to the laptop for further processing. To
synchronize and study the data simultaneously, sepa-
rate GUI (Graphical User Interface) were reported [61].
Domingues et al., in their reported literature, showed
a proposed schematic for making the system compati-
ble with IoT standards. As explained by the author, the
system would require, three basic elements for making
the architecture IoT compatible: a small-sized sensor for
efficient packaging and deployment without hindering
the daily activities; an acquisition device that not only
is capable of acquiring the data but also can operate
on it to get meaningful results; and a wireless gateway
which can any of the mediums like WiFi, Bluetooth or
a smartphone for visualizing, monitoring, and commu-
nicating purposes [92]. In another reported work of the
same author, the possible architecture for plantar pres-
sure monitoring has been suggested with the module
comprising a sensing unit, an interrogating cum acquisi-
tion module, and a communication gateway for efficient
connectivity [104]. As it can be seen from the above dis-
cussions, various works and possible architectures have
been reported for efficient implementation of the IoT
with FBG and optical technology-based sensors. Though
it can be inferred, such possibility of equipping the fea-
tures of IoT with optical sensors is still in developmental
stages. Improper synchronization between Optical Fiber
Sensors and demodulation modules, efficiency and capa-
bility of demodulation units, multiplexing capabilities in
the operational range of sensors, size of interrogators and
scarcity in market availability and more, may be possi-
ble for the above delay in realization. But this also opens
new pathways for future research endeavors in the field
optical fiber sensing and remote applications. With the
advent of the age of Artificial Intelligence, Machine learn-
ing algorithms, Neural Networks, and Industrial Internet
210 M. MISHRA AND P. K. SAHU: FIBER BRAGG GRATINGS IN HEALTH CARE APPLICATIONS

Table 2: Comparative analysis of past works

Year Sensor type Purpose Observations Reference
Cardiorespiratory monitoring
2011 FBG Cardiac and respiratory frequency Embedded FBGs employed for cardiovascular signals [51]
monitoring interrogation
2012 FBG Monitoring respiration and cardiac An FBG inside a cushion-based system was reported with [52]
activity an error of 12% and contained artifacts
2017 FBG Cardiorespiratory activity monitoring MRI compatible biocompatible embedded FBG based [56]
system for cardiovascular monitoring. Results contained
a maximum relative error for heart rate and respiratory
rate were 5.86% and 4.41%
2020 FBG Respiratory monitoring A test bench has been developed for analyzing [61]
performance of a FBG-based wearable sensor. A
difference of 0.7 breaths/min has been reported
2020 FBG Respiration rate sensing Monitoring of respiration has been performed using FBG [62]
interfaced audrino system. Optical sensor response was
better than an electronic sensor in terms of reliability
and responsivity
2021 FBG Heart activity monitoring Implantable FBG sensor to sense mechanical cardiac [63]
activity. An error of 2.7 ± 0.7 bpm has been reported
2021 FBG Respiratory monitoring A FBG on a polymeric mask used for respiratory [64]
monitoring.an error of 2.88% has been reported.
2021 FBG Cardiorespiratory monitoring A system based on mechanical gyroscope and flexible FBG [65]
has been reported. Error less than 6.1% and 7.7% for
heart rate and respiratory rate have been reported
2021 FBG Respiratory monitoring An array of five FBGs embedded in a mattress for [66]
cardiorespiratory monitoring and analysis. Error less
than 0.26 bpm have been reported
Arterial pulse monitoring
2013 FBG Blood pressure monitoring Mounted FBG (silicone diaphragm)-based system [71]
producing results with accuracy of 99.99% and 79.99%
for systolic and diastolic blood pressures
2015 Plastic Optical Fiber Arterial pulse waveform monitoring Sensitivity to micro-movements up to 370 μm, with a [70]
displacement resolution of 0.1 μm were reported and
artifacts-prone results were present
2017 3 Port Circulator Heartbeat, respiration, and pulse wave Pulse Wave Velocity evaluation reporting errors within 5% [72]
velocity limit
2019 FBG Arterial pulse by finger Mounted FBG-based systems with contrasting features like [69]
plethysmography smooth implementation and usage, higher sensitivity,
biocompatibility, small footprints, etc. were reported
2021 FBG Blood pressure monitoring Radial arterial pulse waveform has been acquired using an [77]
FBG-based system and further analysis of systolic and
diastolic blood pressures have been reported. Average
accuracy of 89.85% and 94.20% have been acquired for
SBP and DBP
2021 FBG APW measurement A FBG-based force and displacement sensor has been [78]
reported which comprises of planar spring structure and
sensor frame. A resolution of 0.47 mN, linearity error of
4.08%, and displacement sensitivity of 0.103 μm have
been reported
2021 FBG Pulsation strain A plastic FBG sensor has been reported for recording [79]
pulsation strain in the fingertip. An accuracy of
±5.5 bpm has been reported
Vertebral pressure and body posture monitoring
2018 FBG and bend sensors Monitoring of body posture An FBG smart belt comprising of embedded FBG sensors [82]
inside a special silica gel was used for investigating the
change of body postures that arise from the different
diseases such as stroke and bone fracture
2020 FBG Neck monitoring and respiratory Different breathing activities produced results with errors [83]
frequency monitoring of 6.9% and 1.9%. adding more FBG can lead to an
increase in system efficacy
2020 FBG Pressure ulcer prevention An FBG (6) based alert and detection system is employed [84]
on a wheelchair for monitoring purposes
2020 FBG Lower back movement monitoring An FBG based system used for lumbar flexion extensions [85]
detection is reported. A sensitivity of 0.20 nm/m has
been reported
Orthopedic monitoring and prosthetics
2010 FBG Contact force and stress measurement A comparative study between the contact sensor and [86]
of articular joints FBG sheathed sensor was performed. PolyimideTM
sheathed sensor had increased sensitivity relative to an
unsheathed sensor.
(continued).
 M. MISHRA AND P. K. SAHU: FIBER BRAGG GRATINGS IN HEALTH CARE APPLICATIONS 211

Table 2: Continued.
Year Sensor type Purpose Observations Reference
2013 FBG Amputees trans tribal stump/socket Epoxy-coated FBG-based sensing pad system was reported [87]
interface pressure with a sensitivity of 127 pm/N and a maximum FSO
hysteresis of around ∼ 0.09 in real-time operation.
2016 FBG Interface pressure measurement within FBG sensing pad was developed with required sensitivity, [88]
prosthetics sockets enhanced durability, and the lowest possible hysteresis
error. Results closer to F socket sensors were reported
2017 FBG Strain mapping in prosthetics An FBG (8) system for detection of deformation of the [89]
mechanical structure of the prosthesis at different
points, which can be helpful to record training sessions,
detect material failures, or study ground reaction forces
during periodic evaluations
2018 FBG Joint angle measurement An FBG-based system for angular measurements reporting [91]
a range of 0–200° and resolution of 0.06°
2018 FBG Knee kinematic monitoring An e-health system to monitor the knee angular [92]
flexion/extension during gait analysis
2018 FBG Knee angle measurement An FBG-based system with tunable sensitivity and range [97]
up to 150° is reported
2018 FBG Gait evaluation in prosthetics A temperature-compensated force evaluation system [90]
based on FBGs was reported with a sensitivity of
10 pm/N and 10.3 pm/°C was reported
2019 FBG Human foot joint monitoring An FBG with polydimethylsiloxane (PDMS) membrane [94]
was used to perform angle measurements. An error of
12.4 (8.9)° for the right foot and 14.6 (8.0)° for the left
foot was reported. Sensitivity toward wire tensions and
dependence on foot width and other deformities are yet
to be investigated
2019 FBG Normal and shear stress measurement An FBG (2)-based system with different spatial orientations [93]
in prosthetics was employed for strain analysis. Pe – Lite material was
used instead of silicone liners
2019 FBG Body joint monitoring An FBG based smart ring used for measuring elbow and [95]
knee angle with sensitivities of 0.0056 and 0.0276 nm/°
was reported
2019 FBG Knee joint posture monitoring An FBG belt developed for angle monitoring with a [96]
sensitivity of 0.3 nm/° was reported
2020 FBG Knee extension monitoring A polymer encapsulated FBG sensor is reported for [98]
monitoring and discriminating the knee flexion
movement during different gait positions. An
approximate linear response is reported for sensitivity
upto 3.94 nm/mm
2021 FBG Joint movement monitoring A system based on embedded FBGs (silicone tubes) for [99]
joint movement monitoring has been reported. A
sensitivity of 5.6 ± 0.5 pm/degree is reported
Plantar pressure monitoring
2015 FBG Plantar pressure monitoring An embedded FBG (4)-based system for pressure mapping [101]
with a sensitivity of 1.2 pm/kPa and resolution of
0.8 kPa was reported. The dependence of mapping on
factors like foot size and width, location of sensors,
sensor contact area, and gender difference is yet to be
investigated
2016 FBG Plantar pressure monitoring A silicone-embedded FBG (6) system was reported for foot [102]
type classification
2017 FBG Vertical force monitoring An FBG-based system for ulcer determination in diabetic [103]
patients with sensitivity up to 11.06 pm/N is reported
2017 FBG Gait analysis A cloud-based FBG (6) sensor system for gait analysis and [104]
detection is reported
2018 FBG Gait shear and plantar pressure A real-time cloud-based FBG system is reported for gait and [105]
monitoring plantar pressure analysis. A mobile app was designed
for accessing real-time data
2020 FBG Gait analysis A embedded FBG based system was reported. The [106]
system is utilized four FBGs for analyzing foot pressure
distribution and gait varieties
2021 FBG Plantar pressure A FBG-based system to detect foot plantar pressure was [107]
demonstrated. A pressure sensitivity of 1.46 pm/kPa
with a value of R2 = 0.998.
Bone health monitoring
2010 FBG Strain analysis of tibia bone An FBG-based system was reported capable of measuring [108]
the µstrain values in tibia bone sample to determine the
extent of decalcification
(continued).
212 M. MISHRA AND P. K. SAHU: FIBER BRAGG GRATINGS IN HEALTH CARE APPLICATIONS

Table 2: Continued.
Year Sensor type Purpose Observations Reference
2012 FBG Strain monitoring in bone An FBG (12)-based system was reported with sensors attached to [109]
cement different locations and strain was measured. The results were
compared with an FE model and a correlation of 97% was reported
2016 FBG Strain measurement of bone An FBG system was reported for monitoring of absorption process and [110]
cement the hygroscopic response of the hardened and dried bio cement
when exposed to humidity is explained
2017 FBG Strain analysis on bone A silicone-coated FBG was reported for stress monitoring purposes [111]
with good linearity and a correlation coefficient of 0.9987 between
mechanical deformation and wavelength
2020 FBG Multipoint temperature A FBG-based multipoint temperature analysis along the bone during [112]
monitoring of microwave microwave ablation is presented. A total no forty fiber Bragg
thermal ablation in bones gratings (4 arrays having 10 FBGs each) have been utilized. Ability of
multi point sensing was demonstrated
2020 FBG Strain and fracture recovery A system based on FBG arrays (embedded and coiled) were utilized [113]
for monitoring strain patterns. Load less than 100 N were able to be
sensed by the FBGs
Temperature monitoring
2016 FBG Temperature monitoring Review for various fiber optic sensors employed for thermal monitoring [76]
during thermal treatments
2017 FBG FBG thermometer An FBG system for thermal detection and analysis with high precision, [75]
accuracy, and linearity was reported
2019 FBG Thermography of embedded An FBG-based system for detection of brain tumor by performing [74]
tumor thermography having a sensitivity of 9–10 pm/°C, resolution of
0.1 °C, and response time of 0.38 s was reported.
2021 FBG Breast cancer detection FBG thermal sensor array has been reported for analyzing surface [80]
temperature distribution. A thermal variation of values > = 0.3
degree Celsius around tumor region
Wearable sensors
2012 Macro bending sensor, Respiratory movement A comparison study of three different types of sensors embedded [58]
optical reflectometry in medical textiles was performed and successful detection of
sensor and FBG elongations between 0% and 3% is reported with other possible
medical applications.
2018 Graphene-coated optical Human motion monitoring Graphene-coated optical sensors with high stretching capabilities, [59]
fiber sensor bending range up to 150° was reported
2019 Polymer optical fiber Health assessment A Smart walker system with capabilities of testing myriad features such [60]
as oxygen saturation, breathing rate, gait cadence, and heart rate
with errors of about 1% was reported
2016 FBG Respiratory monitoring An FBG (6)-based wearable garment for monitoring respiratory [53]
activities was reported
2017 FBG Respiratory monitoring, vital An FBG (12) array used for monitoring the cardiorespiratory parameters [55]
signs monitoring with distributed sensing capabilities was reported
2019 FBG Respiratory and cardiac A silicone-encapsulated FBG-based system was used to monitor cardiac [54]
monitoring activities with strain sensitivity of 0.125 nm/μ , the temperature
sensitivity of 0.012 nm/°C, and negligible response to humidity was
reported.
2020 FBG Breathing rate monitoring Array of FBGs have been placed in elastic belts for evaluating the [67]
breathing rate. Chest and Abdomen regions have been reported to
be effective for identification of breathing patterns
2021 FBG Heart rate monitoring Encapsulated array of FBGs have been utilized to assess the Heart [68]
activity. Different configuration and placements of FBGs have been
compared and analyzed
Force monitoring in surgical instruments
2012 FBG Force sensing micro-forceps An FBG based system with incorporated temperature compensation [114]
having force resolution of 0.25mN was reported
2016 FBG Force monitoring in spinal A temperature-independent FBG based system with a resolution of [115]
needle 0.021 N was reported
2017 FBG Micro indentation Sensor An FBG based system for assessment of properties of articular cartilage [119]
System was reported
2018 FBG Force comparison for lumbar A temperature-independent FBG-based system for force determination [117]
puncture in lumbar tissue with the resolution of 0.021 N was reported
2019 FBG Distal Force Sensor for An FBG-based system with a linearity error of 0.14% and resolution of [116]
Laparoscopic Surgery 21 mN within a measurement range of [0,12 N] was reported
2019 FBG Micro indentation technique An FBG-based micro indenter in which FBG is inscribed near the optical [118]
for osteoarthritis diagnosis fiber was reported for arthritis diagnosis was reported
2021 FBG Clamping force sensor A FBG-based system was reported for acquiring force feedback during [120]
laparoscopic surgery. The reported sensitivities for different loading
conditions, i.e. [0, 10 N] are 56.2, 51.1, and 47.5 pm/N
 M. MISHRA AND P. K. SAHU: FIBER BRAGG GRATINGS IN HEALTH CARE APPLICATIONS
of Things (IIoT), hope can be made for seeing the dawn
of this next-generation technology.
4. DISCUSSIONS
In the previous sections, several applications of FBGs
have been discussed and their implementation in myr-
iad fields have been explored. FBGs are sensitive to many
parameters like strain, temperature, pressure, etc. which
makes them very efficient and versatile. As FBGs can
sense multiple parameters at the same time, they also
suffer from cross-sensitivity. Providing the measurement
setup every time with a temperature compensation mod-
ule elevates the cost. So there is a need of employing
FBGs capable of self-referencing capabilities leading to
reduced cost and a redundant FBG [101,102]. In car-
diorespiratory monitoring, relative errors of 5–6% were
reported due to improper placement of sensors or unsuit-
able packaging. The relative distance between the sensor
and contact area can be a probable reason for the incurred
error [52,53]. Such an issue can be addressed by devel-
oping thinner and sensitive encapsulating films without
affecting the desired outcomes or reducing the distance
between the sensor and the location under observation.
The non-uniformities or irregularities in the acquired
physiological signal waveforms introduce errors while
analyzing various physiological waveforms such as PPG,
waveforms related to cardiac and respiratory activities,
breathing patterns, and many more. Such waveforms and
patterns can be treated with better peak distinguishing
algorithms or smoothening filters to acquire results with
higher accuracy and precision [58,69,72]. In vertebral or
posture monitoring, acquiring precise and accurate strain
distribution is essential. For such purposes, more FBGs
or FBG arrays are required, which can further elevate
the cost of the system. Hence, there is a tradeoff between
cost and system accuracy and complexity [82–84]. In the
treatment or diagnosis of ulcer or tumor, thermal map-
ping can be performed for the detection of the affected
area which requires FBGs to be highly sensitive toward
temperature fluctuations [74]. Gait analysis or pressure
mapping utilizing a higher quantity of FBGs can pro-
duce precise and accurate results, which is a prime factor
for distinguishing different footprints [90,93,101,102]. In
plantar pressure monitoring, the strain mapping depends
upon the factors like sensor location, contact area, foot
size, width, gender difference, and foot sole measure-
ments which are still needed to be expedited. The study of
foot requires division of foot area which further depends
upon the type of indexes (arch, FP1-6, FFI) that can
produce varying results, hence the choice of index is of
the utmost value for conducting such studies [101]. To
achieve higher tensile strength and sensitivity sheathed
213
(encapsulated) sensors are preferred over unsheathed
sensors [86]. In terms of sheathed sensors, a compara-
tive study of various polymers like poly dimethyl siloxane
(PDMS), carbon composite material (CCM), and Sili-
cone is required to determine the levels of sensitivity and
accuracy [86,94,101].
5. CONCLUSION
This review has been written with the view of pre-
senting the current status of the FBGs in the field of
medicine and healthcare. It has been already shown
that not only the FBGs are capable of sensing vari-
ous physiological signals but they can also be imple-
mented in different topologies to meet user-specific
needs. From cardiorespiratory to vertebral posture mon-
itoring, FBGs can be employed anywhere with minimal
usage of space at the target location. To extrapolate more
information, different algorithms and programs can be
developed, providing accurate results and operational
efficiency. Encapsulating FBGs with sensitive polymer
sheaths enhances their bending and rotational operation
capabilities, which allows the installation of FBGs in dif-
ficult places in human anatomy. Incorporating the limita-
tions with recent developments and trends can make this
technology more lucrative to the investors and stakehold-
ers to meet the demands and needs of general healthcare.
ACKNOWLWDGEMENTS
This work was carried out in the DST – FIST sponsored MOE
Lab of IIT Bhubaneswar.
DISCLOSURE STATEMENT
No potential conflict of interest was reported by the author(s).
ORCID
Manish Mishra http://orcid.org/0000-0001-9671-8209
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 M. MISHRA AND P. K. SAHU: FIBER BRAGG GRATINGS IN HEALTH CARE APPLICATIONS
AUTHORS
Manish Mishra received his BTech (2015)
degree in instrumentation & control
engineering from JSSATE, Noida, Uttar
Pradesh, India. He received his MTech
degree from the National Institute of Tech-
nology (NIT), Agartala, Tripura, India.
Currently, he is a research scholar candi-
date of the School of Electrical Sciences, at
the Indian Institute of Technology (IIT), Bhubaneswar, Odisha,
India. His area of interest is optical technology, optical sensors.
Corresponding Author. Email: mm29@iitbbs.ac.in
219
Prasant Kumar Sahu is working as an
associate professor at the Indian Insti-
tute of Technology Bhubaneswar, Odisha,
India. He received his doctorate degree
from the Indian Institute of Technology,
Kharagpur, West Bengal, India. He has
published articles and papers in various
conferences and journals. His research
interests are optical communication, optical sensor systems,
speech and signal processing, analog and digital communica-
tion systems.
Corresponding author: E-mail: pks@iitbbs.ac.in