Computer Standards & Interfaces 26 (2004) 241 – 249

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Design of filter to reject motion artifact of pulse oximetry

Juwon Lee a,*, Wongeun Jung a, IkTae Kang b, Youngil Kim a, Gunki Lee a
a
Department of Electronic Engineering, Bioelectronic Laboratory, Gyeongsang National University, Gajwa-dong 900, Jinjusi Jinju,
Kyungnam, Gyeongsangnamdo 660-701, South Korea
b
Department of Computer and Information Technology, YONAM College of Engineering, Gajwa-dong 780,
Jinju, Kyungnam 660-750, South Korea
Received 16 April 2003; received in revised form 26 June 2003; accepted 4 July 2003

Abstract

The performance of the pulse oximeter, an instrument which non-invasively measures oxygen saturation in blood, is
influenced by a patient’s respiration or movement. Generally, the frequency band of the motion artifact signal generated from
the patient’s movement is overlapped with that of the patient’s pulse wave which is measured by the received light sensor.
Accordingly, it is difficult to filter the motion artifact of the pulse wave by using a filter which has a cut-off frequency that is
fixed. In this study, the motion artifact is removed using the filter bank and the matched filter. Compared with traditional
adaptive filter methods, the ratio variation is 50% lower than that of the moving average filter, allowing more stable
measurement of oxygen saturation despite the patient’s movement.
D 2003 Elsevier B.V. All rights reserved.

Keywords: Oxygen saturation; Biomedical signal processing; Motion artifact filter

1. Introduction and infrared light (940 nm) through a finger or

Oxygen saturation is the ratio of the total hemo-
globin concentration to oxyhemoglobin concentra-
tion in arterial blood, and provides information on
heart and lung functions, organ-specific perfusion,
cardiovascular status, hypoxia diagnosis, etc. The
application has been extended from the area of
medicine to sports such as scuba diving, mountain-
eering and so on [1 –3]. The pulse oximeter, which
non-invasively monitors the oxygen saturation in
blood, shoots two wave lights—red light (660 nm)
* Corresponding author. Tel.: +82-5575-15353; fax: +82-5575-
97814.
E-mail address: elecwave@bioee.gsnu.ac.kr (J. Lee).
earlobe, and obtains oxygen saturation readings
from absorbance of the two differently transmitted
waves. The accuracy of the pulse oximeter, howev-
er, tends to decrease due to motion artifacts, exter-
nal lights, etc. Among them, motion artifacts are the
main factor in the deterioration of accuracy [4].
Motion artifact noise results from a patient’s respi-
ration and/or movement.
Generally, the frequency band of respiration is
0.04– 1.6 Hz; the frequency band of pulse wave of
the pulse oximeter is 0.5 –4 Hz; the frequency band
of the noise due to a patient’s movement (finger
movement, finger tremble, change of finger probe
due to walking, etc.) is 0.1 Hz or more [11,12].
Therefore, the frequency spectrum of noise due to a
patient’s movement is overlapped with that of the

0920-5489/$ - see front matter D 2003 Elsevier B.V. All rights reserved.
doi:10.1016/S0920-5489(03)00077-1
242 J. Lee et al. / Computer Standards & Interfaces 26 (2004) 241–249
signal of the pulse oximeter, so it is hard to remove
the noise [5,6].
Accordingly, in this paper, a signal processing
technique was proposed using the adaptive sampling
rater and the matched filter. In order to evaluate the
performance of the proposed method, we evaluated
bradycardia pulse signal which is overlapped with
the frequency band of respiration, pulse wave of
shiver signal, pulse wave due to external tap to a
finger probe, and pulse wave including motion
artifact signal generated from a patient’s walking.
The experimental results were gained in order to
design a pulse oximeter with high resistance to
patient’s movement.
2. Principles of the pulse oximeter
The non-invasive measurement principle of the
oxygen saturation in blood is based on Eq. (1), which
is derived from the Beer –Lambert law; it transmits
two different wavelength lights to a finger or earlobe,
and obtains oxygen saturation readings by calculating
the ratio of absorbance [7,8]. Here two light sources
are used: red light, in which the difference of the
absorbance of hemoglobin and oxyhemoglobin is
large, and infrared light, in which the absorbance
difference is small.
%Sa O2 ¼ ½HbO2 =ð½Hb þ ½HbO2 Þ  100%
Namely, the light is transmitted through a finger
while the red light IR0 and infrared light source IIR0
are alternatively flickered, and the luminous intensity
of the received red light and infrared light VR and
Fig. 1. Artifact noise included in the received light of the pulse oximeter.
VIR can be expressed as Eqs. (3) and (4), respec-
tively by using Eq. (2), Beer –Lambert law:
Vn ¼ Io ead ð2Þ
VR ¼ IR0 ead ; VIR ¼ IIR0 ead ð3Þ
In Eq. (2), Vn is the received luminous intensity, and a
is the extinction factor. d is the distance of medium; the
diameter variation of artery Dd occurs due to heartbeat.
Therefore, Eq. (3) can be expressed as Eqs. (4) and (5),
while considering the absolved radiation intensity of
red light and infrared light (VmaxR, VmaxIR) when the
artery diameter is the most, and those of red light and
infrared light (VminR, VminIR) when it is the least:
Vmax R ¼ IR0 eðadþaR DdÞ ; Vmin R ¼ IR0 ead ð4Þ
Vmax IR ¼ IIR0 eðadþaIR DdÞ ; Vmin IR ¼ IIR0 ead ð5Þ
Therefore, the oxygen saturation can be defined as Eq.
(6), which is the ratio of aRDd = ln(VminR/VmaxR) and
aIRDd = ln(VminIR/VmaxIR) for the n-th pulse, using
Eqs. (4) and (5):
ln½Vmax RðnÞ=Vmin RðnÞ
R¼ ð6Þ
ln½Vmax IRðnÞ=Vmin IRðnÞ
Accordingly, the oxygen saturation in the blood
(SpO2) can be obtained from Eq. (6).
ð1Þ
3. Features of motion artifacts
The pulse oximeter which non-invasively meas-
ures oxygen saturation in arterial blood is affected by
 J. Lee et al. / Computer Standards & Interfaces 26 (2004) 241–249 243

Fig. 2. Structure of the proposed signal processing.

various noise, which results from environmental
factors and/or the patient’s condition, respiration or
movement [9]. Especially, artifacts caused by the
movement of patients largely affect system perfor-
mance. Fig. 1 shows the received light signal with
motion artifacts which occur when impact is applied
to the finger probe. Noise due to movement of
the sensor or skin transformation caused by exte-
rior pressure (generally, pressure by the probe) can
affect the reflection/absorbance of light as well as
transmission length. Motion artifacts show more
amplitude variation in vertical movement than hori-
zontally when the finger probe is used; especially, the
largest amplitude variation is recorded from vertical
movement from the shoulder. The horizontal move-
ment of the arm joint shows the least amplitude
variation [5]. This noise is sudden and hard
to estimate, so accurate non-invasive measurement
of the oxygen saturation in blood is hardly obtained.
The frequency spectrum of motion artifacts overlaps
with or near that of the pulse oximeter signal, so
designing a filter to remove the noise is difficult.
Generally, the moving average method is used in
order to eliminate this motion artifact signal [8];
accordingly, the oxygen saturation is characterized to
be stable for the sudden motion artifact signal; howev-
er, for the chilly patient who has continuous shiver
noise, the oxygen saturation measurement error is
considerably large. Also, the non-linear PPG artifact
reduction methodology, which works physically by
modeling of the motion artifact signal and eliminates
the motion artifact signal while based on the inverse of
the model, shows better performance for eliminating
noises per variation of probe coupling, but this method
should re-formulate conventional calibration schemes
[10]. Therefore, in order to remove this type of noise, a
new algorithm is required.
4. Removing motion artifacts using multi-rater
The signal processing technique using the filter
bank and the matched filter was suggested in order
to design the pulse oximeter with high resistance

Fig. 3. Frequency band of the multi-rater.

244 J. Lee et al. / Computer Standards & Interfaces 26 (2004) 241–249

Fig. 4. Structure of the analog signal processing part.

against motion artifacts due to the movement of
patients (Fig. 2). This structure seeks to find the
frequency band where the influence of motion
artifacts can be minimized. Where R is the signal
obtained from the red light; IR is the signal
obtained from the infrared light; M is the parameter
to modulate the sampling frequency. The final
structure consists of the Max selection, which
selects the frequency band where the correlation
between the output signal and the reference signal
per bank is the strongest. Fig. 3 shows the simpli-
fied features of the frequency band for the sug-

Fig. 5. Implemented analog signal processing part.

 J. Lee et al. / Computer Standards & Interfaces 26 (2004) 241–249 245

Fig. 6. Reference signals.

gested structure. According to structure in Fig. 3, The output signal of the down-samplers is interpo-
signal processing follows the equations as seen lation processed by the low-pass filter h[k], and the
below. First, Eqs. (7) and (8) remove unnecessary signal is approximated.
high-frequency noise included in the input signal
R(xR) and IR(xIR). X
k 1
yM3 ;R ½n ¼ h½kyM2 ;R ½k  n ð11Þ
X
k 1 k¼0
ylR ½n ¼ h½kxR ½n  k ð7Þ
k¼0 X
k 1
yM3 ;IR ½n ¼ h½kyM2 ;IR ½k  n ð12Þ
k¼0
X
k1
y1IR ½n ¼ h½kxIR ½n  k ð8Þ
k¼0 where M is the number of the filter bank. After the
interpolation process by Eqs. (11) and (12), the output
The normal (patient movement is the least) y1R and of each channel runs its correlation through the
y1IRsignal, where the high-frequency noise is removed, matched filter, where the reference signal is set as
is set up as a reference signal (kernel) after extraction the filter coefficient (Eqs. (13) and (14)). Channel Q,
for any period. In order to obtain the frequency feature where the correlation between each filter output and
in Fig. 3, it is divided per frequency band by Eqs. (9) the reference signal is the largest, is extracted by Eqs.
and (10), which are the down-samplers. This filter is (15) and (16).
2 2
designed to obtain yM,R and yM,IR signals, which are
similar to normal signals. X
N 1
rM ;R;Ref ½n ¼ SR;ref ½N k1 y3M ;R ½n  k ð13Þ
8 k¼0
1
>
<y n ¼ 0; FM ; F2M ; . . .
yM2 ;R ½n ¼ y1R ½n ¼ ð9Þ X
N 1
>
: rM ;IR;Ref ½n ¼ SIR;ref ½Nk1 y3M ;IR ½n  k ð14Þ
0 otherwise k¼0

8 QR ¼ IndexðMaxðrM ;R;Ref ðnÞÞÞ ð15Þ

1
>
<y n ¼ 0; FM ; F2M ; . . .
yM2 ;IR ½n ¼ y1IR ½n ¼ ð10Þ
>
:
0 otherwise QIR ¼ IndexðMaxðrM ;IR;Ref ðnÞÞÞ ð16Þ
246 J. Lee et al. / Computer Standards & Interfaces 26 (2004) 241–249

Fig. 7. Processing result of the motion artifact signal; input signal R, IR: received signal of red and infrared light, LPF: output of LPF
( fc = 10 Hz), MAF: output of the moving average filter (order = 10), AF: output of the adaptive filter (order = 10, convergence constant = 0.9),
FB: output of proposed method (Q = 48).
 J. Lee et al. / Computer Standards & Interfaces 26 (2004) 241–249 247

where SR,Ref and SR,IRef are reference signals; the processed. The sampling frequency fs was set at 200
output selected by Index Q is entered into the low- Hz for the output signal of the simulator. The
pass filter through the gate. obtained input signal R and IR signals passed
through the LPF (15-order, FIR filter, cut-off fre-
quency fc = 10 Hz), and down-sampled and up-sam-
M ¼Q ð17Þ pled using 50 filter banks. Then, the interpolation
process was done with the LPF ( fc = 10 Hz). The
signal containing the largest correlation was filtered
through the LPF ( fc = 10 Hz) using the matched filter
X
K 1
yR ¼ h½ky3M ;R ½n  k ð18Þ from the output of each channel, and the final signal
k¼0 was produced. The coefficient of the matched filter
used a normal signal without any motion artifacts as
its reference signal (Fig. 6). Fig. 7 shows the filtering
result of the signal which was supposed as the
X
K 1 patient’s finger trembling. The output results of the
yIR ¼ h½ky3M ;IR ½n  k ð19Þ moving average filter (filter order: 10) and the
k¼0 adaptive filter with the line enhancement structure
(filter order: 10, convergence constant: 0.9), which
are the traditional methods, were compared. Accord-
Finally, the output where motion artifacts are ing to Fig. 7, the adaptive filter showed many
removed is obtained by the final LPF Eqs. (18) variations and errors due to the amplitude variation
and (19). during the convergence when measuring oxygen
saturation in real-time; the moving average filter
showed more stable output than the adaptive filter.
5. Experiment and results More motion artifact components were removed than
LPF, but still motion artifacts remained. The signal
The analog signal processing part for processing while normal walking of normal patient
the pulse oximeter signal was designed to estimate (SpO2 = 98%, HR (heart rate) = 73) was filtered for
the performance of the suggested signal processing any period (Table 1), and Fig. 8 shows the ratio
technique. The structure of the analog signal pro- variation. According to Fig. 8, the ratio variation was
cessing part and its implemented board are shown in maximized during the period where motion artifacts
Figs. 4 and 5. The 89C2051 microprocessor was
used for the board, with the LED driver alternatively
transmitting red light and infrared light at 1 kHz. Table 1
Maximum ratio variation
The LED for the red light source transmits 660 nm
wavelength light; the LED for the infrared transmits Signal type Shiver Brad + Tap Brad + Normal
respiration shiver patient
940 nm wavelength light. The transmitted light noise (normal
penetrated the finger, and the signal from the re- walking)
ceived light sensor removed the high-frequency SpO2 [%], (98%) (88%) (98%) (88%) (98%)
noises generated from the lead line of the sensor. HR 55 bpm 45 bpm 55 bpm 45 bpm 73 bpm
Then, the signal was amplified 10 times, and the Adaptive 0.0322 0.1386 0.0431 0.9747 0.3997
signal component from the red light and that from filter
the infrared light were divided. Each divided signal Moving 0.0201 0.0051 0.0115 0.0032 0.2254
average
was output while removing noise using the 50 Hz filter
secondary active LPF. The SpO2 simulator and Filter 0.0175 0.0129 0.0107 0.0045 0.1169
BIOPAC equipment of BioTeck, USA, were used bank (the
for the analog processing part. The pulse oximeter suggested
signal including motion artifacts were collected and method)
248 J. Lee et al. / Computer Standards & Interfaces 26 (2004) 241–249
Fig. 8. Ratio variation due to motion artifacts. Adaptive filter (- - -), moving average filter (- -), filter bank (—).
were included. The suggested technique provides
less variation than the adaptive filter and the moving
average filter. The simulation result is in Table 1
based on the suggested technique. The moving
average filter showed better output for the Brad + res-
piration noise and Brad + shiver signal. When applied
to actual patients, less variation appeared in the
suggested technique.
6. Conclusion
Because the frequency of noise signals due to a
patient’s movement overlaps that of the pulse oxi-
meter signal when measuring oxygen saturation, it is
hard to filter the noise, and the accuracy and reliabil-
ity of the pulse oximeter decrease. In this study, we
proposed the signal processing technique using the
filter bank and the matched filter in order to design a
pulse oximeter containing strong resistance against
the motion artifact. According to the simulation
result, performance improved by more than 50% in
the suggested method than by traditional methods. It
is recommended that the technique be applied to the
monitoring system for moving patients.
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ing Inherent Insensitivity to Artifact 48 (4) (2001) 452 – 461.
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Juwon Lee received the B.S. degree in elec-
tronic engineering of Jinju National University
in 1997, M.S. degree in electronic communi-
cation engineering of Korea Maritime National
University in 1999and Ph.D. degree in elec-
tronic engineering of Gyeongsang National
University, South of Korea in 2003. Currently,
he is studying for robot control using electro-
myogram in Biomedical Electronic Eng. Lab.
of Gyeongsang National University.He is interested in biomedical
signal processing, medical mesurement system, image processing,
artificial intelligence, HCI and related areas.
Wongeun Jung received the B.S. degree in
electronic engineering of Jinju National Uni-
versity in 1997, M.S. degree in electronic
engineering of Gyeongsang National Univer-
sity, in 2002. Since, he is presently the Ph.D.
course student in Electronic Engineering of
Gyeongsang National University. He is inter-
ested in biomedical signal processing and
electronic applications.
 J. Lee et al. / Computer Standards & Interfaces 26 (2004) 241–249 249

Iktae Kang received the B.S. degrees in
Computer Engineering 1981 and 1983 all
from Kyungpook National University. His
Ph.D. degree received in electronic engi-
neering of Gyeongsang National University
in 1995. He engaged in the Electronics and
Communications Research Institute (ETRI)
of Korea in 1987 and he visited AIT
Company of USA in 1987. Since then, he
has been professor in Yonam Institute of
Digital Technology. He is interested in medical measurement system
and system monitoring based on Web.
Gunki Lee received his M.S. degree in
electrical engineering in 1978, and Ph.D.
degree in biomedical engineering in 1990
all from Yonsei University. Heb is presently
professor of the Department of electronic
engineering and president of Engineering
Research Institute (ERI), Gyeongsang na-
tional university. He is interested in biomed-
ical signal processing, telemedicine and
ubiquitous networks.

Youngil Kim was born in Kyoungju,

Korea, in 1956. He received his M.S. and
Ph.D degrees in Electronic Engineering in
1981 and 1985, respectively, from yonsei
University. Since 1987, he has been with
the Department of Electronic Engineering,
Gyeongsang National University, where he
is presentlya professor. He is also a research-
er of Research Institute for computer,
Information and Communication at the
same university. He is interested in speech
signal processing, digital signal processing and related areas.