Handling stress: using wearable technology to help people with PTSD

The obvious triggers of stress are all around us: pressing deadlines at work, children not sleeping through the night, a leaking roof. But sometimes it's smaller things, certain locations or specific times of day, that increase our stress levels. Understanding those triggers using wearable technology, with a focus on people who experience a lot of stress - people with PTSD - was the topic of Xueliang Li’s PhD research.

Societal challenge: Health Disciplinary perspective: People Technology

Using design to help people

Li had little experience with wearable technologies before starting his PhD at the Faculty of Industrial Design Engineering (IDE) at TU Delft. He completed his master’s at Jiangnan University in design and says the experience left him “feeling like he could have done more.” So, when he received funding from the China Scholar Council, an educational award programme from the Chinese government, to do a PhD, he knew he wanted to use design to help people more directly. “I wanted to have a direct impact on people and on society,” he says.

Through coincidence – an associate professor returned from TU Delft at the same time Li was doing his master’s – which is how he connected with IDE Professor Kaspar Jansen, who was part of a team initiating a project focused on the mental health of veterans with posttraumatic stress disorder, or PTSD. Li subsequently found his way to the Grippy project, which is a smart glove that uses a variety of sensors to monitor stress levels.

[Translate to English:] The complete set of the sensor glove, the receiver and the smartphone

Read Xueliang's thesis:

[Translate to English:] Front cover of Xueliang's thesis, bright coloured with the title 'Getting a grip on stress: Designing smart wearables as partners in stress management' on it.

Project Grippy

Grippy uses three methods of tracking data. The glove, which looks like a fingerless weightlifting glove, contains sensors that track heart rate and acceleration, a pressure sensor that the wearer can squeeze if they feel stressed and connects to a mobile phone app that tracks time and location. Li knew that users see wearables as different from other technology. “They are accessories,” he says, so users may want these devices to convey esthetic preferences or indicate a certain sense of style. There is also the wearable factor, the devices must be comfortable. He wanted to better understand how people might partner with these technologies, which can have a wide range of capabilities.

Veterans with PTSD

People, in Li’s case veterans, diagnosed with post-traumatic stress disorder, may experience stress in a variety of daily contexts but those triggers may not always be obvious. Li hoped that Grippy could help people with chronic PTSD gain better insight into their disorder and give them opportunities to help overcome some triggers. Other therapies, like exposure therapy where a patient repeatedly experiences something that causes anxiety, take place in a clinical setting. “The glove could help people with PTSD train themselves in daily life,” he says.

Li used a Research-through-Design, or RtD process during his thesis work. RtD is not a strict methodology with step-by-step instructions but rather has researchers reflect on insights as their investigation unfolds. As it was his first experience working with people with PTSD, he met with medical professionals to better understand how to approach his initial inquiries. “People with PTSD can have their own vulnerabilities and sensitivities,” he says. While speaking to people diagnosed with PTSD, he also had to be mindful of research ethics, ensuring that he didn’t reveal anyone’s personal information or create any additional psychological burdens via their involvement in the research.

[Translate to English:] Someone flexing their fingers, the handis in the glove.

[Translate to English:] Impression of the glove in action during research experiments in the lab, with test subjects.

[Translate to English:] Arm from behind, with clear view on the wearing of the sensor

Still a lot of research to be done

He says there is still a lot of research to be done on everyday wearables for therapeutic purposes. “Something that’s attached to your body all the time can’t be physically uncomfortable,” he says. Additionally, these kinds of devices must walk the fine line between pushing people enough that they can improve but, at the same time, not pushing them so far that it exacerbates their condition. Li wanted to trigger conversations about the benefits and risks of these devices, a starting point for a process that will likely take years as the technology advances.

PhD experience at TU Delft

When asked how long he’s been living in the Netherlands, he laughs and says, “too long.” Originally from Northern China, Li did a short exchange program in the Netherlands in 2015, his first time living abroad. He says he’s become attached to his life here and says that he knows there are things he will miss. “Also, I will probably behave in a way that is slightly different from people in China now,” he says.

Both the working and cultural environments were different in Delft than what he experienced in China, but he doesn’t see one as better than the other. “There is no good or bad,” Li says. He was expected to operate more independently in Delft and had more contact with stakeholders. He also lived in shared housing with roommates from across the world and highlights this “cultural exchange” as one of the benefits of his PhD experience.

Future plans

After defending his PhD, Li will go to the Southern University of Science and Technology (China), where he has secured a position at its School of Design. The new design school, which was just founded in 2021, will become an independent design institute in 2025. Though it’s located in Shenzhen, on the opposite side of the country from where he grew up, Li is excited to be going home. “I am really looking forward to life there.” He has accepted a tenure-track position and expects that, on top of continuing his research, he will have a heavy teaching workload. “There will be a lot of new students who will choose design as their future path like I did,” Li says.

Design methodology

Li used a Research-through-Design (RtD) process during his thesis work. RtD is not a strict methodology with step-by-step instructions, but it rather makes researchers think about insights as their research unfolds.