"This project fits firmly within the scope of the SBRI competition. The product being developed is a smart garment platform which aims to: • Improve operator safety by tracking and analysing their vital signs and physical performance in real-time, reducing risk by actively protecting operators from heat stress and physical injury. • Enable better communication between fellow operators and support staff • Improve the working experience/productivity of the operator through fabric-based enhanced temperature regulation, sweat wicking and active cooling. This not only provides improved comfort but could also safely extend operation time. • Minimise the effort required of support teams through more effective data analysis • Provide a single washable, reusable product that reduces overall environmental waste produced Phase 1’s feasibility study will identify the extent to which the competition objectives can be achieved through various existing solutions and ongoing developments within KYMIRA and its subcontractors."

To create a novel smart garment able to measure and assess movement during sports.

Due to an increasingly ageing population, now more than ever, it is necessary to implement a preventative care approach as opposed to reactive care for musculoskeletal conditions (osteoarthritis, knee pain, back pain) to improve the quality of life of an ever-ageing population. This enables significant time and resource savings whilst improving overall patient outcomes using objective, continuous data to support patient-specific, tailored care. Treatment and rehabilitation for patients with musculoskeletal conditions currently relies on orthoses and the use of motion capture rooms to assess recovery and movement. However, these tend to be expensive and do not provide monitoring in real-life, everyday scenarios over a long period of time. Without appropriate, tailored treatment, many patients who suffer from these chronic conditions end up needing surgery or suffer from lifelong disabilities. Additionally, clinicians are unable to assess progress in a way that is quick and objective. KYMIRA's smart wearable for remote medical monitoring offers a step-change in non-invasive continuous high-fidelity data collection across multiple clinically relevant parameters, to detect early changes and offer customised preventive and early treatment solutions. The project will build on KYMIRA's award-winning smart sports clothing solutions, which will be adapted for a medical application to remotely monitor patients with musculoskeletal conditions. The project uses smart garments equipped with sensors that capture and integrate movement and joint angle data during everyday movements and activities. This easy-to-use, flexible smart garment with embedded electronics can be worn by patients without interrupting their usual activities. Based on the data, personalised exercise and movement programmes can be provided to enable continuous improvement of musculoskeletal conditions and rehabilitation, to support health and wellbeing, one of the competition broader themes of this competition.

Now more than ever, it is necessary to implement a preventative care approach as opposed to reactive care for cardiovascular disease and arrhythmia. This enables significant time and resource savings whilst improving overall patient outcomes. In response to this clinical challenge, KYMIRA and Imperial College Healthcare NHS Trust (Imperial) are developing **a smart garment solution employing AI-enabled cardiovascular disease diagnosis, to accelerate diagnosis and personalise treatment.** This will be worn by patients requiring remote monitoring without interrupting their day-to-day activities. The project offers a step-change in non-invasive continuous high-fidelity data collection across multiple clinically relevant parameters and corresponding cardiac event classification. KYMIRA was founded to disrupt the traditional model of medical innovation. Using an advanced sportswear and newly formed medical brand, KYMIRA has created vessels through which it can commercialise and validate future medical technologies on the health market. KYMIRA's current activities include the development, manufacture and sale of their internationally acclaimed infrared KYnergy technology and developing wearable technologies for both the sports and healthcare markets. This R&D project to develop a wearable smart sensor cardiac garment will further the development of KYMIRA's novel textile-based sensors, to help people with cardiac diseases to receive more accurate diagnosis and treatment stratification.

Stillbirth affects approximately 1 in 244 births in the United Kingdom. Foetuses may exhibit signs of compromise as part of a stress response before stillbirth and a key indicator is a reduction in foetal movements. Signs of compromise often occur only hours or at best days before foetal death, so it is highly likely to be missed by current monitoring practices, which are performed intermittently and usually require a pregnant mother to alert of experiencing a reduction in movement and actively seek professional advice. It has been well documented that accurate and early identification of reduced foetal movements (RFM) and the ability to perform early clinical intervention may prevent stillbirth. Foetal movements have an important role in antenatal surveillance, but currently, there is a distinct lack of effective technology to objectively utilise this important marker of well-being in the clinical setting. Currently, the burden of identifying RFM is on the expecting mother who has to attend A&E, where an initial check is carried out and if no abnormalities are found, the patient is discharged and advised to continue to monitor movements. There is clearly a need to provide an objective measurement of RFM and reassurance to expecting mothers through a non-invasive wearable solution. Radical Fibres (RF) and KYMIRA have developed a wearable foetal movement monitoring device, BUMPE, embedded with a multi-sensor system that monitors 24-hour continuous foetal monitoring. However, the product has hit a critical standstill in its development: the active nanofibre sensor material used, polyvinylidene fluoride (PVDF), is under threat because it is manufactured from a forever-chemical (PFAS; polyfluorinated alkyl substances). These man-made chemicals build up in our bodies and environment, they do not break down. As a result, they are being phased out and banned. This Innovate UK feasibility grant will support RF and KYMIRA to move BUMPE away from these chemicals to bio-derived alternatives. The continued success of our technology relies on redeveloping it using a suitable bio-derived material and with a sustainable lifecycle. This is a significant technological challenge, as the replacement material is required to have comparable properties. Using a wearable monitoring device for foetal movement outside of a hospital is an innovative practice that will revolutionise the way care is delivered to pregnant women who experience RFM. This is an unprecedented use of wearable technology in a clinical setting, that will remove the risk of subjective assessment and save lives.

There is a strong link between fetal movement and fetal health: 25% of women perceiving reduced fetal movements (RFM) have poor perinatal outcomes. A landmark study has further shown that 55% of all stillbirths are preceded by RFM. Fetal movement monitoring and subjective maternal awareness does lead to a reduction in stillbirth numbers, with observational studies demonstrating a 30% fall in stillbirth numbers via proactive management. KYMIRA was founded to disrupt the traditional model of medical innovation. Using an advanced sportswear and newly formed medical brand, KYMIRA has created vessels through which it can commercialise and validate future medical technologies on the Health and Fitness market. KYMIRA's current activities include the development, manufacture and sale of their internationally-acclaimed infrared KYnergy technology, and developing wearable technologies for both the sports and healthcare markets. This follow-on R&D project will further the development of KYMIRA's novel textile-based sensors for long-term monitoring and analysis of fetal movements. Fetal movement is a vital indicator of wellbeing in the last trimester of pregnancy and this project aims to deliver new wearable innovations in order to identify precursors to and help reduce the occurrence of stillbirth.

Professional sports are a high-risk industry due to the potential of injury, with football being one of the top three sports with the highest amount of injuries. Catapult Sports have estimated that the average cost of an injury is ~£200,000 in fixed wages, with English Premier League teams losing an average of £45 million per season due to injuries. There is therefore a clear unmet need for elite sports teams to rely on a tool that allows them to monitor athletes and collect data on them, in order to understand players' physiology and identify early signs of fatigue/risk of injury. KYMIRA have developed smart leggings for elite sports athletes, which will later be adapted for a healthcare application, embedded with sensors that detect movement and heart rate parameters. A4I funding will allow us to work closely with NPL to resolve some issues we have experienced with our sensors, in order to provide an accurate measurement.

Now more than ever, it is necessary to implement a preventative care approach as opposed to reactive care for Musculoskeletal Disorders (osteoarthritis, knee pain, back pain) to improve the quality of life of an ever-ageing population. This enables significant time and resource savings whilst improving overall patient outcomes by providing tailored care based on objective, continuous data. Treatment and rehabilitation for patients with Musculoskeletal Disorders (MSD) currently relies on orthoses and the use of motion capture rooms to assess recovery and movement. However, these tend to be expensive and do not provide monitoring in real-life, everyday scenarios over a long period of time. Without appropriate, tailored treatment, patients who suffer from these chronic conditions end up needing surgery or suffer from lifelong disabilities. Additionally, clinicians are unable to assess progress in a way that is quick and objective. The project Smart-MOTION offers a step-change in non-invasive continuous high-fidelity data collection across multiple clinically relevant parameters, to detect early changes and offer customised preventive and early treatment solutions. Smart-MOTION will build on KYMIRA's award-winning sports clothing solutions, which will be adapted for patients with Musculoskeletal conditions. The project uses smart garments equipped with sensors that capture and integrate kinematic (movement) and physiological data during everyday movements and activities. This easy-to-use, flexible smart garment with printed electronics can be worn by patients without interrupting their usual activities. Based on the data, personalised exercise and movement programmes can be provided to enable continuous improvement of musculoskeletal conditions and promote healthy ageing.

The needs of older women are largely ignored in many areas of life, and this is particularly true when it comes to sport and exercise. Yet sustaining fitness and activity levels for women as they age has life-changing and lasting benefits in relation to physical health, happiness and mental wellbeing. In the older female population, a particular barrier to remaining physically active is lower limb pain and injury risks. Women aged 50+ face particular barriers to getting and/or staying physically active. As well as an increased incidence of pain, discomfort and injury, this group are not well-supported in terms of assistive and appropriate sports technologies, sportswear and footwear -- which tend to be developed for, and marketed to, young people.  In fact, the majority of exercise and sport-related injury prevention research is conducted on young, often male, adults, largely in the context of elite sports. The effects of gender and ageing on bodily biomechanics and physiology remain poorly understood, making it challenging to remove or even address these barriers and changes to injury risks. Furthermore, conventional biomechanics studies are limited to laboratory-based research with small participant numbers, preventing large-scale data insights of normal people, doing normal sports, in normal settings. There is an urgent need to progress our understanding of female sports biomechanics through life, and develop relevant technologies and products to support inclusive sports participation by women of all ages.  Project MISFIT aims to address this gap in the Healthy Ageing space by developing a new movement analytics service that is designed specifically for older women. This will provide evidence-based information regarding bespoke exercise regimes and injury prevention to support continued safe participation in physical activity. MISFIT will build on KYMIRA's award-winning sports apparel solutions, which will be adapted for older females. The project uses smart garments equipped with sensors and pressure measuring insoles, to capture and integrate kinematic (movement), kinetic (force) and physiological data during everyday sports. MISFIT will enable large-scale data-gathering to provide population-level insights into injury mechanisms and optimum exercise regimes as women get older. MISFIT will translate the data and learnings to provide a sports advisory service to users. In a further innovation, award-winning sports footwear developer Ida Sports will use the service to inform the user-centric design of a new range of sports footwear to support women to continue in sport participation as they age.

The market for digitally supported fitness is vibrant, but recognised players focus on high achievement messages for the already motivated and engaged. In the meantime, prior to the COVID-19 pandemic, over six million people aged 55+ in England were physically inactive, and one million more became inactive during the pandemic lockdowns. This negative impact has been most acute across areas of high deprivation and "under-represented" groups, who are not engaging, physically or digitally, with the market -- those over 75, BAME, and those experiencing disability, chronic conditions, or mental health issues. The FitBees service addresses this significant, and important, market gap. It combines AI home sensors and wearable technologies, motivational encouragement, and local community connections to support physical activity. The aim of the FitBees service is to engage 'under-represented" groups to: initiate tech-enabled activity assessments to share their needs and challenges; partner with their circle of support and local actuators to co-create community-based activity plans; remain motivated and supported. It will also enable health and care practitioners to access activity diaries to assess changing needs; and enable local authorities and support organisations to optimise community resources aimed at active ageing. FitBees is led by Tendertec Limited, a company with an AI platform (CareBox) that monitors daily living activities and vitals for people with carers. CareBox is currently piloted in the UK and EU and the learnings derived from this service confirm the importance of turning data intelligence into real-life actions for people with support needs. Alongside is KYMIRA, a company producing patented smart garments that provide biomechanical assessment of the lower extremities. During the project, users will participate in research, testing, and an iterative co-design process. This will be in collaboration with research teams at the University of the West of England (UWE), Hft Trust Ltd, an organisation supporting independent living for those with learning difficulties, and The Community Housing Group (Amica24). The vision for FitBees is to become an exemplar to be replicated across the UK and help those people most likely to become inactive and socially isolated to reap the benefits of physical activity combined with social connection.

**Fuell: Developing a prototype, personalised Driver Monitoring System ("pDMS")** Fuell Limited, and partner, KYMIRA Limited, will build a working production prototype of a driver monitoring system to meet EuroNCAP's 2025 Roadmap requirement for _"driver monitoring systems that effectively detect impaired and distracted driving"_. The innovative personalised Driver Monitoring System (pDMS) will use multiple data inputs from the car - how it is being driven and how it is interacting with the outside world - and uniquely, the physiological status of the driver. There are many systems that monitor the first aspects but none that combine them with the driver's physiological status, particularly with regard to inattention. This project will add to an existing Fuell system that detects the onset of drowsiness by continuously monitoring and then warning the driver up to 20 minutes before a likely sleep event. Human error causes the majority of vehicle accidents (Euro NCAP 2020) and 20% of accidents cite driver fatigue (European Road Safety Observatory 2018). Driver distraction is a global problem, costing billions, taking lives. That measuring driver distraction is a major issue is highlighted by EuroNCAP's 2025 Roadmap but also by US Senators (Sen E Markey and Sen R Blumenthal) having recently proposed legislation requiring all vehicles to have driver monitoring systems within 6 years. The original Fuell system uses Heart Rate Variability (HRV) derived from the Photoplethysmography (PPG) sensor on a Garmin smartwatch. Fuell has since added the capability to use remote Photoplethysmography (rPPG) using a camera (in-vehicle or a smartphone) to detect vital signs and has also included the capability of using a steering wheel sensor as an ECG data input. With this project, Fuell will add to its existing system, the ability to detect driver distraction based on head position and gaze direction, a machine-learning approach combining all channels of data to deliver a weighted decision model and a working production prototype of the integrated solution ready to be deployed at scale. This will deliver the Fuell personalised DMS (pDMS) - the most complete system available globally.

Smart wearables are becoming increasingly pervasive, driven by sustained advances in miniaturisation of electronics, improvements in sensors and connectivity, and a growing capability to embed electronics in a variety of products. The next generation of wearable electronics will include smart garments where the electronics are embedded within the textiles themselves and are therefore invisible to the user. These wearables would be used in a variety of different applications, including sports for improved monitoring and performance, medicine for easy to use, continuous health monitoring in the home, and by the military. Through this project, the consortium aims to solve challenges related to the scaled manufacture of such garments to create flexible, durable, and comfortable textiles for future wearable applications.

In the UK, 1 in every 225 births is a stillbirth (baby born dead after 24 completed weeks of pregnancy); equivalent to 3,400 babies dying each year. Around nine in ten stillbirths occur before the onset of labour. One in three stillbirths occur in babies who have reached term and seem to be completely healthy. Women who have suffered stillbirth can develop mental health problems afterwards; one study showed women experiencing stillbirth were 4x more like to have depression and 7x more likely to have post-traumatic stress disorder compared to women having live births. The results are long-lived, with women reporting anxiety and depression up to two years afterwards. Over 50% of mothers experiencing stillbirth noticed slowed fetal movement beforehand. However, movements differ between women and between pregnancies, and perceptions of movement are subjective. KYMIRA, a market-leading developer of e-textiles successfully commercialised within the performance sports sector, now wish to create a wearable technology for non-invasive, 24-hour fetal movement monitoring deploying a polyvinylidene fluoride (PVDF)-based piezoelectric sensor to help prevent stillbirth. This project will enable KYMIRA and Radical Fibres Limited to develop and test prototypes in a clinical setting, generating preliminary safety and efficacy data to inform a post-project clinical trial. These outputs align with the 2016 National Maternity Review, which recommends personalised care based on unbiased information.

Smart wearables are becoming increasingly pervasive, driven by sustained advances in miniaturisation of electronics, improvements in sensors and connectivity, and growing capability to embed electronics in a variety of products. The market has seen steady growth in recent years, and this is projected to continue. KYMIRA believes the next generation of wearables will heavily include garments in which the electronics are embedded within the fabric textiles themselves. As such, this is what KYMIRA focuses R&D on and is in line to produce products for roll-out in the coming 3-5 years.These electronics embedded wearables will look to be powered by small, flexible batteries, if any. This is where energy harvesting (EH) mechanisms will prove valuable and by embedding these technologies within textile fabrics, truly self-sufficient viable products can be developed. Several EH techniques have been investigated for wearables, and PV cells have consistently been demonstrated as being highly efficient in their capabilities to provide power. Lightricity have developed industry leading PV cells capable of harvesting energy from outdoor as well as indoor light sources with very high efficiency, demonstrating their wide applicability.This project combines the electronic(e)-textile technology of KYMIRA, superior EH technology from Lightricity and flexible power storage solutions of Cambridge Display Technologies to develop a flexible, durable and comfortable e-textile solution capable of powering future wearable technologies.

To develop a new type of ‘smart’ garment, incorporating embedded electronic sensors and components within the garments themselves, capable of transmitting data from the garments for analysis.

"Smart wearables are becoming increasingly pervasive, driven by sustained advances in miniaturisation of electronics, improvements in sensors and connectivity, and growing capability to embed electronics in a variety of products. For example, smart glasses and smartwatches are now widely available. Smart garments are also appearing on the market: OMSignal market garments that monitor heart rate, steps taken and breathing depth, which is washable once the microprocessor has been detached; Athos market a biometric shirt with integrated sensors to measure muscle activity, whereby wiring is encapsulated and docking station enables wireless data transfer for analysis. Wearable energy-harvesting devices first appeared almost 100 years ago, with the self-winding wrist-watch (itself based on the self-winding pocket watch that first appeared in the late 1700s). Given this context, it is perhaps surprising that the uptake of energy harvesting technologies has been slow in the market for wearable electronics. However, we believe this is set to change. The next generation of wearable electronics will include garments whereby the electronics are embedded within the textiles. These will be powered by energy-harvesting technologies that are also embedded into the textiles. Through this project, we will create flexible, durable and comfortable textiles that will power future wearable technologies."

KYMIRA was founded to disrupt the traditional model of medical innovation. Using a sportswear brand, KYMIRA has created a vessel through which it can commercialise and validate future medical technologies on the Health and Fitness market. Revenue from which is then invested in medical validation and further R&D. KYMIRA's current activities include the development, manufacture and sale of their internationally acclaimed infrared sportswear brand KYMIRA Sport, and developing wearable platform technologies including energy harvesting and e-textiles for primary use within the medical and domestic healthcare markets.

KYMIRA was founded to disrupt the traditional model of medical innovation. Using a sportswear brand, KYMIRA has created a vessel through which it can commercialise and validate future medical technologies on the Health and Fitness market. Revenue from which is then invested in medical validation and further R&D. KYMIRA's current activities include the development, manufacture and sale of their internationally acclaimed infrared sportswear brand KYMIRA Sport, and developing wearable platform technologies including energy harvesting and e-textiles for primary use within the medical and domestic healthcare markets. This project will explore the feasibility of integrating their current wearables R&D into foetal movement monitoring, a vital indicator of wellbeing in the last trimester of pregnancy.

This project seeks to validate the early stage energy harvesting technology being developed at KYMIRA Ltd. The intended outcomes are to take our ideas or concepts and over 12 months, develop these into initial working prototypes. To do this we will be experimenting with and refining a number of prominent energy harvesting methods and redeveloping them to suit our needs. Through experimentation we intend to identify the most efficient methods and optimal utilisation areas. The project is focused on developing the concept of a wearable energy harvesting solution with resulting outcomes being used for consumer applications such as sportswear and also medical, military and space exploration use cases. KYMIRA Ltd. currently trades in the performance sportswear market having co-developed a passive wearable technology that we utilise within our products to enhance performance and accelerate recovery. With customers on every continent around the world and multiple awards to our name we are well renowned for our technically innovative approach and desire to disrupt the technology markets of tomorrow.