Physiological Signatures in Blast Overpressure: Implications for Wearable Monitoring

Abstract

Blast overpressure (BOP) has been associated with injury in Service Members for more than a century, with early accounts dating to World War I descriptions of “shell shock.” While some effects are immediately visible, many are neurological, physiological, or functional and may present as delayed or cumulative “invisible injuries,” complicating detection and monitoring in training and operational environments involving repeated low-level exposure. Although physiological measures may reflect blast-related effects, no widely fielded wearable system currently integrates biosignals with BOP exposure data. This review examines physiological, neurological, and functional biosignals associated with blast exposure, with emphasis on signals sensitive to early performance or physiological degradation rather than clinical diagnosis. Human studies identify several biosignal domains with demonstrated sensitivity, including cardiovascular and respiratory measures, oculomotor activity, gait and balance, and behavioral performance. Eye tracking detects changes in oculomotor features associated with cumulative exposure, while body-worn accelerometry captures changes in gait and balance following exposure periods. Multimodal approaches that integrate eye movement and body-based measures demonstrate improved sensitivity compared to single-modality approaches. Overall, findings indicate that different biosignal domains capture complementary aspects of blast-related effects and support the use of multimodal approaches for detection. Future work may focus on real-time monitoring strategies to support earlier identification of performance and physiological changes in populations with occupational blast exposure.

Keywords: Blast Overpressure, Traumatic Brain Injury, Biosignal Monitoring, Multimodal Fusion, Real-Time Detection, Military Health, Eye Tracking, Gait And Balance, Wearable Sensors, Cardiovascular, Respiratory

DOI: 10.54941/ahfe1008212