Wireless Personal Communications (2022) 123:2473–2504

[Link]

Wireless Body Area Networks: Survey of Recent Research

Trends on Energy Efficient Routing Protocols and Guidelines

B. Shunmugapriya1 · B. Paramasivan2 · S. Ananthakumaran3 · J. Naskath1

Accepted: 19 October 2021 / Published online: 6 November 2021

© The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2021

Abstract
Wireless Body Area Network (WBAN) is a recent technologically advanced sub-category
of Wireless Sensor Networks (WSN) which consists of many bio-sensors, attached in and
around of human body, for monitoring the health-related issues from remote places. The
WBAN faces various issues and challenges during real time deployment. Energy conserva-
tion in WBAN has always been the most crucial issue for the sensor nodes, which are pow-
ered by limited capacity battery sources. During sensing and communication, sensing ele-
ments emit high temperature from its circuit and transmitting antenna due to inefficient data
routing designs. This energy may lead to form hot-spot, which affects the human tissues at
a different level. So designing an energy-efficient routing protocol is a very challenging
issue to reduce the high emission of temperatures. Different energy-efficient routing proto-
cols have been projected in this survey over the years in terms of various measuring termi-
nologies. The energy-efficient routing protocols endeavor to prolong the network lifetime
by minimizing the energy consumption in each deployed nodes. There have been a variety
of survey papers put forwarded by researchers to evaluate the performance and categorize
the different energy-efficient routing protocols for WBANs. This paper describes an over-
view of WBAN, a systematic survey of existing contracts for routing and open research
issues are discussed.

Keywords Energy-Efficient · WBAN · Survey · Routing Protocols · Network Lifetime

* B. Shunmugapriya
priyalakshminarayanan512@[Link]
1
Department of Computer Science and Engineering, National Engineering College, Kovilpatti,
Tamilnadu, India
2
Department of Information Technology, National Engineering College, Kovilpatti, Tamilnadu,
India
3
Department of Computer Science and Engineering, KL University, Vijayawada, Andhrapradesh,
India

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2474 B. Shunmugapriya et al.

1 Introduction

According to statistics from the World Population scenario: the 2017 Review, the number
of older persons—those aged 60 years or higher—is expected to double by 2050 and triple
by 2100, rising from 962 million internationally in 2017 to 201 billion in 2050 and 3.1 bil-
lion in 2100. Worldwide, the number of people aged 60 or above is increasing faster than
all younger age groups.
Universally, the number of persons aged 80 or over is projected to triple by 2050, from
137 million in 2017 to nearly 425 million in 2050. By 2100 it is expected to rise to 909
million, almost seven times it’s value in 2017 [1, 2]. Since aged people belonging to this
age group could face the risk of different types of health problems[3, 4], they might require
more frequent medical treatments to survive in the world. It would be inconvenient for
them to travel a long distance from home to the medical center every time. Periodic medi-
cal checkups are quite costly as well. Therefore, the research group concerning this issue
takes this as a serious concern with limited resources.
At present, in most of the regions of the world with economically forward and backward
countries, traditional medical care is being followed, and these caring centers monitor the
patients at a particular time of the day or a week. This method of diagnosis is not yield-
ing fruitful results to reduce their health issues. Therefore, a continuous patient monitor-
ing system [5] is needed to achieve better treatment for this age group of patients. In the
twenty-first century, rapid growth and advances in the development of microelectronics
and micro-electro-mechanical systems (MEMS), small and smart devices have been found.
The components of this device or sensor structure are shown in Fig. 1. Sensors play an
important role in day-to-day life such as home automation, precision agriculture, inventory,
remote monitoring, intelligent transportation systems, sports, entertainment, and military,
etc. Distributed sensor nodes, having a wireless transceiver that communicates wirelessly
to transmit the data, are referred to as a Wireless Sensor Network (WSN). More than one
battery-powered device can be attached to the patient’s body or on the clothes to moni-
tor different kinds of bio-signals of the person. These signals are categorized as ECG [6],
EEG, blood pressure, glucose level, etc [7, 8]. Networking all such types of sensors is
called Wireless Body Area Networks (WBAN).
Although WBAN is the sub-type of WSN, it differs from some WSN parameters and
is unable to implement all the notions of the protocol of WSN. Hence, the WBAN moni-
toring system is restricted to the human body. Bio-compatible sensor devices and more
variable network topologies are the most required in recent years due to body movement.
The main issues and challenges of WBAN are deploying the sensor nodes, the mobility of
nodes [9] during movement of patients, data storage, battery life or usage of energy effi-
ciency [10, 11], and security. The effectiveness of WBAN is defined by two critical param-
eters, namely energy consumption over the lifetime of the system and network throughput.
Energy has been a significant input for the economic and societal development of WBAN
in recent years. Since WBAN routing protocols [12–15] are power-hungry, most of the
strength of the battery is consumed during the data transmission phase. Several routing
protocols have been proposed to date for the applications of WBAN, and these protocols
are classified with respect to their intention. The first category is cluster-based routing pro-
tocols in which the network is divided into a cluster of nodes formed as a group; each
cluster has a cluster head responsible for collecting the sensed data from its cluster and for-
warding it to the base station. The main goal of this type of protocol is to minimize direct
communication between sensor nodes and sink nodes. The second class is energy-efficient

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Wireless Body Area Networks: Survey of Recent Research Trends… 2475

Fig. 1  BAN architecture and components of sensor

routing protocols, which mainly focus on reducing the temperature level of sensor nodes in
the network during the data transmission period. Cross layered based protocol is the third
level of BAN routing protocols, mainly concerned about the routing with medium access
issues. The fourth category of routing protocols is QoS based, which focuses on higher
reliability, low end-end delay, and higher packet delivery ratio. A postural movement-based
routing protocol is the fifth in a row, mainly worried about the movement of sensor nodes’
positions and thereby changing the distance between nodes and sink. Here, the action of
the nodes is taken care of, and hence the energy consumption of this event is raised consid-
erably. So, the network lifetime is decreased. The sixth category is the cost-effective rout-
ing protocol, which updates the cost feature based on appropriate data and finds its path
between routes with minimal costs. The last class in this row is the secure routing protocol,
which is the primary concern about the safety of data during the transmission period. Since
WBAN is most applied in the health sector [4], the protection of information during trans-
mission and in the database is essential. Leaking health-related data related to one patient

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2476 B. Shunmugapriya et al.

could be disastrous. All these types of routing protocols try to satisfy a particular objective
of WBAN. This study has explored different proposed routing protocols to meet specific
goals and requirements of WBAN.
Application of WBAN with Energy Efficient Routing Protocol Application of WBAN
is essential in society compared to other networking applications. It is mainly categorized
into two types, as shown in Fig. 2. They are categorized as,

• Medical application
• Non-Medical Applications

The utilization of a Wireless Body Area Network (WBAN) is limited, but its role is vital
in the life-saving of the human being. So, WBAN finds its use mostly in the medical and
healthcare systems. Hence a lot of development progress and research is going in this area
to broaden its application assortment. The following are the main applications of WBAN:
Telemedicine and remote patient monitoring, Rehabilitation and therapy, Bio-feedback,
and Ambient Assisted Living. There are different kinds of technologies incorporated with
WBAN for its application at a different level. Some of the techniques in WBAN are Blue-
tooth, Zigbee, IEEE803, Ultra-Wideband (UWB) technology, ANT protocol, and Zarlink
technology.
The manuscript is structured as follows: after this introduction with the brief state of the
art of articles discusses various energy efficient routing protocols of WBAN. Third part of
the manuscript addressed several mathematical models for WBAN routing process. Next
part of the manuscript employed the terminologies such as packet delivery rate, packet
loss and throughput used in WBAN based on the challenges of WBAN like routing, cov-
erage and connectivity of the network [16, 17]. The last conclusion phase of this article

Fig. 2  Applications of WBAN

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Wireless Body Area Networks: Survey of Recent Research Trends… 2477

highlighted the contributions of this manuscripts and future scopes of the WBAN routing
protocols.

2 Related Works

The related work of this manuscript discuss about various routing protocols especially
designed for wireless body area network. The routing protocols classified as cluster based
routing protocol, energy efficient routing protocol, hop based routing protocol, energy
aware routing protocol and trust based routing protocol. It is reviewed based on the param-
eters of residual energy, packet delivery rate, packet loss, life time of the network and
throughput.
Clustered Based Energy Efficiency Routing Protocol for Wireless Body Area Sensor
Networks This clustering based routing protocol [18] uses multi-hop communication [19,
20] model for wireless body area network (CRPBA) guaranteed for optimizing the energy
consumption by a sensor nodes during data transmission and through which this method
increases the network lifetime and network stability.
In this work, the authors have deployed 24 different sensors and 2 different gateway
body sensors are organized on the human body to gather the bio-signals and transmit to
the base station respectively. The base station is placed outside of the network. Here, emer-
gency data are transmitted directly to the gateway and the normal data are transmitted to
the gateway through clustering algorithm.
In order to save the energy, special cluster head is selected for each round with mini-
mum distance of gateway and maximum energy. The selection of cluster head is done by
using the following equation:
Function(D, E) = Distance∕Energy

So, the cluster head collecting data from cluster members, combined it and forward-
ing to the gateway of the body sensor, which in turn directs data to the base station. Since
maximum energy is wasted during transmission and reception of data, combine the col-
lected data from different sensors to reduce number of transmission and avoid redundant
transmission. The energy consumption model is as follows:

Es−hop = Etx = b × (Eelec + Eamp ) × d2 (1)

where ­d2 is energy loss due to the transmission or the distance between transmitter nodes to
receiving node. The energy for receiving data is calculated as follows:
Erx = b × (Eelec ) (2)
The first node dies at 3375th round when CRPBA is used and at 2611th round when
CRPBA is not used. Since each node consumes reasonable energy which helps to have
more stability period and longer network lifetime. Thus, as a result of this work is demon-
strated that CRPBA protocol consumes minimum energy till 60% of simulation time.
The major advantage of CRPBA protocol has changing cluster head, with minimum
distance and maximum energy, for each round to maintain the energy balance. However,
throughput, reliability and energy efficiency were not optimized properly in view of the
fact that due to stringent constraints in computational power and energy.

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2478 B. Shunmugapriya et al.

Hop Based Energy Efficient Routing Protocol for Wireless Body Area Sensor Networks
This is a single-hop and multi-hop communication routing protocol to achieve the highest
network stability, good throughput with the availability of sensor node, maintaining aver-
age energy consumption, and producing less path loss. In this proposed work [21], a total
8 different sensor nodes are deployed, and 2 of them are sending emergency data directly
to the sink node, are not part of the multi-hopping communication model. The forwarding
node concept has been introduced for the remaining six different sensor nodes. The authors
used a mathematical model to calculate the consumption of energy for sensing data, pro-
cessing the collected data, and transmitting the processed data to the sink is as follows:

Etx = b × (Eelec + Eamp ) × d2 . (3)

The amount of energy consumed by a sensor node in WBAN during transmission is as

follows:
Enode = Etx + Eretx + Eack + Eacc (4)
where the parameters represent transmission energy, retransmission energy, and energy
consumed while transmitting acknowledgment packet, and power used by the channel
access procedure, respectively. In this model, the Nordic nRF2401A transceiver is used
because it consumes less power. Hence, it will extend the network lifetime. The cost func-
tion mentioned in Eq. (25) is followed to find out the forwarding node for gathering data
from sensor nodes. The communication between sensor nodes and forwarding node is
based on Time Division Multiple Access (TDMA), which gives time slots for nodes to
send observed data.
This protocol is compared with the M-ATTEMPT protocol. The network lifetime and
network stability are based on the life of nodes. Since this work used Nordic nRF2401A
transceiver, the sensors spend less energy for data transmission. So, the residual power is
maintained, and the lifetime of the sensor node is extended. Therefore, the network stabil-
ity is strengthened, and through which lifetime of the network is trivially increased. Due to
the sensor nodes’ lifetime is increased, the throughput is also increased with the total num-
ber of packet received as 3.25 × 104. The path loss of the proposed work is less because the
live nodes of the proposed network are large. This work achieves the energy consumption
with the help of forwarder cost function in every round. The advantage of this work is for-
warding node selection using a cost function. This selection is used to balance the energy
of all available nodes, and it leads to an increase in the lifetime of the network. This pro-
tocol uses only six nodes to sense the bio-signals and transmit it to the nearest sink node.
Since the number of nodes in the network is very less, the distance between different nodes
is a concern. If the sink is nearby, then transmission takes less energy. On the other hand,
suppose the sink is far away from the transmitting sensor, it takes more energy. Mostly
WBAN concerns [22–24] about patients’ information and that should be taken in care,
safe, and dangerous approach. Moreover, data is traveling with the long-distance the secu-
rity of data is a concern in this point of view [25]. So, safe and secure WBAN architectural
design is urgently required at this juncture. Also, M-ATTEMPT addresses and supports the
mobility of the sensor nodes deployed on the human body, but this energy-efficient routing
protocol is discussed only about fixed nodes.
RE-ATTEMPT: A New Energy-Efficient Routing Protocol for WBAN This protocol [26]
fixed the wireless sensors on the human body according to energy levels. Here, single-
hop communication is used for emergency data and multi-hop communication for normal
data delivery. Routing with minimum hop count is selected for data delivery. The major

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Wireless Body Area Networks: Survey of Recent Research Trends… 2479

intention of this work is to increase network life time, throughput and decrease the packet
drop ratio. This protocol deals with linear integer programming model for maximization of
network life time.

• Initialization Phase: In this phase three different works have been executed as follows:
(a) each node is informed with its neighbor, (b) position of sink, (c) all possible routes
to sink. All the nodes update their routing table by exchanging HELLO messages
among themselves.
• Routing Phase: Priority based routing is proposed. For emergency data delivery high-
est priority is set. This is using the direct communication and hence its delay is very
shorter. For normal data delivery, select a route with minimum number of hops to sink
and it provides minimum delay.
• Scheduling Phase: TDMA slots are allocated to nodes by sink. For emergency data
transmission, guaranteed time slots are given to nodes in Contention Free Period (CFP)
of MAC frame [27, 28]. For normal data delivery, Contention Access Period (CAP) is
used.
• Data Transmission Phase: Allocation of time slots for nodes avoids data collision. So, it
reduces data packet loss.

For energy consumption with single-hop and multi-hop data communication model and
path loss model, this paper is used the calculation as mentioned in Eq. (23), (24) and (21)
respectively. Optimization function using Integer Linear Programming model has been
proposed with a main objective of maximizing network lifetime. This model has been fully
described in Sect. 3.1.3.
Here, RE-ATTEMPT protocol is compared with ATTEMPT protocol. The execution of
number of rounds for RE-ATTEMPT is 1577 whereas in ATTEMPT is 1450. Compara-
tively the network lifetime in RE-ATTEMPT has been increased with the following reason:
(a) relay nodes consume more energy than non-relay nodes, (b) unnecessary multi-hopping
of data is avoided in RE-ATTEMPT, (c) alternate route selection in case of dead node, (d)
hot spot detection is disabled.
Since RE-ATTEMPT protocol allows emergency data in transmission through CFP and
normal data transmission through CAP, more packets are received by sink without any col-
lision. Hence, proper scheduling using TDMA makes RE-ATTEMPT more reliable for
successful packet delivery. Therefore, packet drop ratio is decreased. If packet drop ratio
decreased then the number of packets received by sink is increased. So, the throughput is
considerably scaled up.
RE-ATTEMPT protocol has shown appreciably increased the lifetime of the network
and throughput. Maximum lifetime has been achieved through optimization integer linear
programming model. The good throughput has been attained in the course of TDMA slot
allocation.
RE-ATTEMPT protocol used mathematically proven optimization model to rise the life-
time of WBAN. Considerable scheduling phase and priority based routing boosted the col-
lision free and high speed data transmission respectively. However, more number of nodes
can be deployed for testing scalability and by which lifetime of the network can be ana-
lyzed. Suppose the authors proposed an optimization model for throughput separately, still
the packets reached at sink might be increased with a support of good path loss model.
M-ATTEMPT: A New Energy-Efficient Routing Protocol for Wireless Body Area Sensor
Networks The authors have proposed an M-ATTEMPT protocol [29], which is a thermal
aware routing protocol for WBAN. It identifies a hot-spot node as an area that has soaring

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2480 B. Shunmugapriya et al.

temperature due to heavy data transmission. The objective of this work is to sense the link
hot-spot and routes the data away from these links. It supports the mobility of the nodes.
This work dealt with the Linear programming model for maximum information extraction
and minimum energy consumption.

• Initialization Phase: In this phase, three different work has been executed as follows:
(a). each node is informed with its neighbor, (b). position of the sink, (c). all possible
routes to sink. All the nodes update their routing table by exchanging HELLO mes-
sages among themselves.
• Routing Phase: Here, a path to sink with fewer hop-counts and consumes less energy
is considered for regular data routing. Also, direct communication is considered for
emergency data transmission. The energy consumed for single-hop and multi-hop com-
munication is measured using the Eqs. (23) and (24), respectively. The heating effects
of the implanted sensor nodes on the human body are recognized using the Specific
Absorption Rate (SAR) Eq. (15) and dealing with wireless communication around the
human body, Specific Absorption Rate (SAR) and heating effects of the implanted sen-
sor nodes on the human body. Whenever a node reaches a temperature threshold, then
that node breaks its link with its neighbor for few rounds. As temperature returns to
normal, it re-establishes the original route. This routing mechanism supports the mobil-
ity of the nodes.
• Scheduling Phase: TDMA slots are allocated to nodes by the sink.
• Data Transmission Phase: Allocation of time slots to nodes avoids data collision. So, it
reduces data packet loss.

The results of this protocol show good throughput with a stable network and utilize
maximum energy as possible. It consumes less power and more reliable for data delivery.
Also, it shows that during the mobility period, no loss of packet occurs in case of link
breakage. The placement of nodes is not according to energy levels. Hop-spot detection
is a good idea to normalize its temperature. However, due to this detection, data routing is
forwarded with another path. This alternate path may increase the end-to-end delay. Since
authors have proposed a path with the lowest temperature until the destination is reached,
there is possible for considerable power consumption, overall increasing hotness and waste
of bandwidth throughout the network as most nodes are involving in routing. Moreover,
it carried out low performance because of using thermal effect and mobility approach
together. So, there is a need to make a network protocol robust against frequent topological
changes.
SIMPLE: Stable Increased-Throughput Multi-hop Protocol for Link Efficiency in WBAN
One of the significant obstacles in WBAN is to recharge the batteries. There are numerous
routing protocols available for WSN, but all of them are not fit for WBAN. Sensor nodes
are deployed in WBAN at fixed places. Since WBAN dealing mainly with clinical data,
the critical data transmission required minimum attenuation, high reliability, and long life.
Sensors transmit their data to the sink through the forwarder node. It saves the energy of
nodes and network works for a more extended period [30].
Whenever a patient moves his hands, the wireless link of the sink with sensor nodes dis-
connects. Data transmission, when a link failure occurs, consumes more power of sensor
nodes and relay node dropping more packets, which causes important and critical data to
lose. The objective of this protocol [31] is to provide higher throughput and more extended
stability. It has eight sensor nodes and all of which are equal energy and computation capa-
bilities. All of these nodes are known as each other’s location, identity, and energy status.

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Wireless Body Area Networks: Survey of Recent Research Trends… 2481

SIMPLE protocol elects a new forwarder node in each round. Sink node computes the cost
function described in Eq. (25) of all nodes. A node with a minimum cost function is pre-
ferred as a forwarder node. That is, the forwarder node has maximum residual energy and
minimum distance to sink. Forwarder node assigns time slots to its children nodes for data
transmission. When a node has no data to send, it switches to idle mode. Nodes wake up
only at its transmission time.
Since energy is shared with all nodes by selecting a forwarder node in each round, the
network lifetime, as well as residual energy, is significantly increased and network stability
is maintained. So, the number of live nodes is increased. If there is a number of live nodes
are available, then more packets can be transacted from one another to sink. Thus the num-
ber of packets received at the sink is increased. Since this protocol has a more extended
stability period, live nodes have more cumulative path loss. Hence this protocol is useful
to minimize energy consumption and to avoid hot spots. However, the SIMPLE protocol
does not consider the mobility of the nodes and not having proper optimization models for
minimization of energy consumption and maximization of throughput. Figure 3 represents
the review state of routing protocols of WBAN.
iM-SIMPLE: iMproved Stable Increased-Throughput Multi-hop Link Efficient Routing
Protocol for WBAN The authors in [32] have proposed a routing protocol for minimizing
energy consumption of the network and maximizing stability period, and throughput of the
system are described in Sects. 3.1.1 and 3.1.3 respectively during multi-hop mode of com-
munication. This protocol has used the radio model, path loss model, cost function to select
a forwarding node, as mentioned in Eqs. (23), (21) and (25) respectively. Here the sink
node assigns TDMA slots for forwarding node as well as regular nodes. It supports only
the arm’s mobility, as presented in M-ATTEMPT [29]. But the movement of nodes leads to
high path loss, and therefore this action significantly reducing in throughput. The proposed
smart optimization techniques worked out economically, and the resulting performance is
excellent in terms of throughput, network lifetime, and energy consumption. The SIMPLE
and M-ATTEMPT protocols outperform this protocol’s results.
Energy-Aware Link Efficient Routing Approach ELR-W [33] is an energy-aware link
efficient routing approach for WBANs. Energy-efficient during the routing selection pro-
cess is mainly depending on the optimal utilization of the resources. The quality of the
wireless link in WBANs frequently varies, which results in low reliability and energy defi-
ciency. This mainly focused on dynamically select the best next-hop from each Body Sen-
sor Node (BSN) to the Body Node Coordinator (BNC) based on a number of hop counts,
link efficiency, distance to BNC, and residual energy. The strength of this works is consid-
ering a multi-hop path having more power of intermediate nodes is considered better for
energy balancing in WBAN. In this link efficiency model, each node determines its neigh-
boring nodes according to its communication range with the use of a HELLO packet. The
link efficiency between nodes is calculated as follows:
∑ PRN
LE = (5)
PSS

where PRN refers to the number of packets received at the neighbor node, and PSS repre-
sents the number of packets sent from the source node. The path cost function between
noses is measured as follows:

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2482 B. Shunmugapriya et al.

Fig. 3  Routing protocols of WBAN

∑ [ 1 1
]
PCF = 𝛼× +𝛽× + 𝛾 × HC + 𝛿 × d (6)
∀N ∈N
RE LE
i

It considers four parameters such as residual energy, link efficiency, hop-counts, dis-
tance to the BNC and 𝛼, 𝛽, 𝛾 are weighting factors for RE, LE and HC respectively with
priority so that 𝛼 + 𝛽 + 𝛾 = 1. A node with least cost function is chosen as next-hop for
packet forwarding. The authors created a new logic that considers link efficiency as well
as shorter path for selecting the next-hop for data transmission. The throughput and packet
drops are inversely proportional to each other. The simulation result shows that ELR-W
drops a lower number of packets which increases reliability. More stable energy efficiency
is achieved because of using effective criteria for the selection of next-hop in the net-
work. The proposed path cost function supports the load balancing in the network which
increases throughput along with a lower number of packet drops. Modeling induction and
routing to monitor hospitalized patients in multi-hop mobility-aware body area sensor net-
works: this paper [30, 34] focused on a distance-aware relaying energy-efficient (DARE)
and mutual information-based DARE (MI-DARE) routing protocols for multi-hop mobil-
ity-aware BANs. Here, threshold monitoring and data monitoring sensors are used and
these are equipped with limited energy resources. But main sensors and sink are having
very high power sources. A mathematical model for recharging a battery of a pacemaker
to monitor patients is achieved using parameters like voltage, link efficiency and quality
factor. In DARE, HELLO message exchange technique is used to know each other sensors
credentials. A body relay sensor is fixed on the patient’s body with higher energy resources
and it supports mobility. The MI-DARE routing protocol uses machine learning technique
and it removes redundant data transmission. The information similarity can be identified
using the probability distribution function:
( )
∑∑ P(Ii , Jj )
MI(I, J) = P(Ii , Jj ) log2
P(Ii )P(Jj ) (7)
i j

where I and J are the data at time ­t1 and ­t2 respectively. If MI value is high then I and J have
similar data. If MI value is zero then I and J are not similar. If MI value is neither high nor

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Wireless Body Area Networks: Survey of Recent Research Trends… 2483

zero then I and J are loosely related. In this way and due to mobility of nodes (communica-
tion distance reduced), energy consumption cost is reduced. It leads to prolong the network
lifetime which ultimately increases the number of transmitted packets. So, DARE proves
to have more throughput. But MI-DARE is not achieved throughput as much as DARE
because it does not support transmitting redundant data. The nodes in DARE protocol con-
sumes minimum energy because it uses body relays. As for as concerned about end-to-end
delay, continuously increases in DARE and high in MI-DARE since MI requires more pro-
cessing time. As a consequence, these two protocols are not opted for delay sensitive appli-
cations. The comparative analysis of MI-DARE, DARE and M-ATTEMPT are as follows:

Metric MI-DARE DARE M-ATTEMPT

(Nadeem et al., 2016)

Stability Period Highest Moderate Least

Network Lifetime Highest Moderate Least
Energy Consumption Least Moderate Highest
Packet Delivery Ratio High High Moderate
End-to-End Delay High High Least

Cluster Based Energy Efficient Routing Protocol for Wireless Body Area Network
Author has proposed cluster based energy efficient routing protocol [35] and has fixed
eight different sensors nodes on the human body with same energy in homogenous
mode. The Base Station (BS) is placed outside the network and rechargeable gate-
way is placed at the centre of the network. For clustering formation LEACH protocol
is used. Here clustering model and cluster head are proposed to reduce the distance
between nodes. Moreover having gateway at center of the network the distance is further
reduction of transmission distance. Hence with this short nature of distance enhance
the throughput and reduce the energy consumption of nodes. Also it achieved good
throughput and residual energy. Though this article has achieved reasonable result but is
not recommended any new techniques or ideas to solve the existing energy consumption
research issues.
Weighted Energy-Balanced Efficient Routing Algorithm for Wireless Body Area
Network This article’s main intention is try to solve the hot-spots problem. A dynamic
routing algorithm [36] based on multipath choosing strategy is proposed. The authors
optimized the selection of path between source and destination node. This optimization
could enhance the lifetime of the whole network. The path choosing strategy considers
channel condition and the remaining energy of each node. Dijkshtra algorithm is used to
determine a route which has a maximization of the minimum energy. As per the study of
energy efficiency for WBANs, the node next to central node always becomes a hot-spot
because it takes so much of forwarding tasks and data transmission. To solve this issue
the improved DRA algorithm is proposed as follows:

1. Network Establishment: Initialize all nodes in the network and generate location of node
i by ­(xi, ­xj).
2. Calculate distance matrix according to the co-ordinates of the nodes.
3. Estimate transmission energy cost and gets the energy consumption matrix.

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2484 B. Shunmugapriya et al.

� �−1∕r
4. Calculate weight for each node using Wi = where r is the coefficient
E
∑i
Ek
k=1,2,3,…,N

that adjusts the influence of the weight. Multiply the coefficient to corresponding value
in the energy consumption matrix.
5. Use Dijkstra algorithm to derive one minimum energy consumption path to the central
node, during which mark the nodes that are chosen as a relay node so that every node
is just used only once.

Thus routing is established and starting to transmit data through the optimal path. In
this algorithm weight r indicates a constraint of remaining energy when node chooses
the best route. The simulation result shows that when r is set as smaller then the pro-
posed routing strategy consider more factor of remaining energy. The appropriate value
for r is like 0.1 ≤ r ≤ 0.5. The final results are shown that it preserved the node at hot
spot with proper r value. Hence number of live nodes with minimum energy is increased
and hence life time is extended. However this method protects the hot-spot nodes for
small period of time, further transaction with sink is performed by a node which is also
nearby central node. This proposal may provide a few more lifetime. But any way the
node first is going to die is this kind sensor because it makes more data transmission
than other.
Optimized Cost Effective and Energy Efficient Routing Protocol for Wireless Body Area
Networks The OCER and E-OCER protocols [37] have shown all the considerations of
energy dissipation for data transmission, retransmission and reception. Here probability
of link reliability also measured. The OCER and E-OCER are considered for intra-BAN
and inter-BAN (multi-hop communication) networks respectively. Node table and routing
table are constructed to register the credentials of each node. In order to minimize energy
consumption, data followed by a node is thoroughly investigated using cost function. The
following optimized cost function is framed using Genetic Algorithm [38] to determine a
optimized next hop node (forwarder node) with minimum value of cost for sending data.
Three weights w1 , w2 , w3 are considered for three parameters residual energy, path loss and
link reliability in the cost function.
Minimize:
| E − Ek (NT) | | | | |
Cost = w1 × || max | + w × | LinkRmax − LinkRk (NT) | + w × | PLmax − PLk NT) |
E | 2 | LinkR | 3 | PL |
| max | | max | | max |
(8)
subject to: w1 + w2 + w3 = 1. Where,
0.5 < w1 < 1.0
0 < w2 < 1 − w1
w3 = 1 − w1 − w2

The authors considered three different scenarios for result analysis. In first scenario,
only fixed number of packets (1000 packets) is sent and all nodes are static. Secondly, vari-
able number of packets is sent and all nodes are static. Finally, mobility of source node
with moving speed of 1 m/s vertically is considered. As a result, for intra-BAN communi-
cation OCER protocol performed well in terms of energy consumption and for inter-BAN
communication E-OCER protocol performed not up to the level since communication link

13
Wireless Body Area Networks: Survey of Recent Research Trends… 2485

is not strengthened but it is probably reliable. So, link efficiency is needed for most reliable
transmission.
Even Energy Consumption and Backside Routing An improved routing protocol for
effective data transmission in wireless body area networks. The main objective of this arti-
cle [39] is to extend the network lifetime, increase throughput and efficient node transition
when body posture is changed. In order to achieve to increase lifetime of the network, the
author has recommended minimum standard deviation value to select a forwarder node
instead of just calculating a cost function mentioned in Eq. (25). The corresponding stand-
ard deviation function is as follows: � ∑n 2
i=1 (Ni −m)
Standard Deviation Function (i) = n
�
∑n 2
i=1 (Ni ) (9)
= − m2 , i = 1, 2, … , n,
n
RE(N )+ RE(N )+...+RE(N )
where m = 1
n
2 n
, where RE(Ni ) is the residual energy of node N.
Selected Path = minimum [Standard Deviation Function (i)], i = 1,2,…,n. Through cal-
culation during selection of a path to transmit data, even energy consumption of the sen-
sors has been achieved in this article. Another different approach is adopted in routing
strategy by considering sensors on the back of the body to achieve higher connection prob-
ability. Here path loss of the connection is also considered. The path loss in between two
nodes at front side is d­ 3.5 and back side is d­ 7 is used. Regarding the body posture movement
of the patient, the nodes shall move from signal range to another range. Suppose more par-
ent nodes are available in the signal range, the design has to be developed by considering
conditions. When a parent node reaches a maximum degree, it should not exclude the new
node and decide a node to keep out based on their priority and critical need. These assump-
tions have been simulated and achieved an extended network lifetime, good throughput,
and a regulated moved node from the communication range. Moreover, the number of sen-
sors on both on front and backside of the body can be increased.
Energy Efficient Thermal and Power Aware (ETPA) Routing in Body Area Networks
This paper [40] is mainly devoted to minimize average temperature rise and more efficient
usage of the available resources. It is a multi-hop transmission and it concentrates on indi-
vidual link based on energy efficiency. A HELLO messages are sent periodically in every
four frames. In each cycle (every four frames), each node broadcasts its temperature, avail-
able energy level through HELLO message. Suppose node i becomes capable of calculat-
ing the cost of transmission to node j using the following equation:
( j
) ( ) ( )
Pm − Pi Tj Em − Ej
C(i, j) = 𝛼1 + 𝛼2 + 𝛼3 , (10)
Pm Tm Em

where 𝛼1 , 𝛼2 and 𝛼3 are non-negative coefficients, Pi is received power at node i from node
j

j, Pm is maximum received power at each nodes, Tm is representing maximum temperature

allowed and Em is denoting maximum available energy at each nodes. Also two different
assumptions are considered like packets stored for more than 2 frames must be dropped
and packets which are exceeding the max_hop-count must be dropped. The following path
loss model over a distance di.j is considered for whole body as received signal strength
from node i to node j in this work.

13
2486 B. Shunmugapriya et al.

( )
dij
Pir (dij ) = Pis − Po − 10n log − X𝜎 . (11)
d0

The probability of selecting the link between node i and node j is measured using fol-
lowing equation:
N( ) ( )
∏ 𝛼2 (Tj − Tw ) + 𝛼3 (Ew − Ej ) −mij + Pth
con(i, j) = Q ×Q (12)
w=1,
𝛼1 𝜎 𝜎∕Pm
w≠i,j
x −x2
where Q(x) = √
1
∫ e 2 dx . In this way the probability of single-hop and multi-hop com-
2𝜋 −∞
munication from source to destination is determined. A single node’s temperature and
energy at time instant t is calculated as follows:

Ti(t+1) = q(t+1)
i
+ Ti(t) and (13)

Ei(t+1) = Ei(t) − q(t+1)

i (14)

respectively. The total energy and temperature at time t0 when all the packets have reached
the destination is as follows:
t0
(t )
∑ (j)
Ei 0 = Ei(0) − qi and (15)
j=1

t0
(t0 )
∑ (j)
Ti = Ti(0) + qi (16)
j=1

respectively. In order to minimize temperature rise, the following optimization problem is

(t )
proposed in this article: minimize maxi Ti 0 subject to 𝛼1 ≥ 0, 𝛼2 ≥ 0 and 𝛼3 ≥ 0. This pro-
posed routing protocol has shown significantly higher depletion time which leads to longer
lasting communication and efficient usage of resources in WBAN. However the cost func-
tion is not considering the link reliability for reliable data transmission.
Designing an Energy Efficient WBAN Routing Protocol This paper [41] is mainly
concerned about Specific Absorption Rate (SAR) which is used to measure a node is
crossing the limited heat energy or not. Suppose heat energy is crossed the threshold
value then the patients’ tissue on the location will be damaged and that particular node
will not be useful to generate data or forward the data. So, the life time of the network
will be decreased. This paper has studied thoroughly about SAR and measured SAR, for
e units of energy is required to(transmit ) a single bit, then for transmission of q bits,
using as follows: SAR ≅ k × q × dt = k × q× transmission power.
d(e)

In( order to act as) relay/forwarder node, a node should satisfy the following inequal-
i
E (t−Δt)−E (t)
ity: rem Δt rem < threshold . This threshold value is a positive value and it is cor-
responding SAR value not exceeding 1.6 W/kg. Energy remaining, link reliability
between two nodes and node reliability are considered as a parameter to select a suitable
relay node. A fitness function is also calculated to find out neighbor node as follows:
F j (t) = 𝛼ERj (t) + 𝛽R(i,j) (t) + 𝛾Rj (t) + 𝛿(1 − SARRatioj (t)), where 𝛼, 𝛽, 𝛾, 𝛿 are weights

13
Wireless Body Area Networks: Survey of Recent Research Trends… 2487

assigned such that 𝛼 + 𝛽 + 𝛾 + 𝛿 = 1. The result shown that if we assign more weight to
SARRatioj (t) than individual weight then energy is distributed between suitable forward-
ers. Hence this proposed scheme is used to alleviate temperature rise and increasing the
network lifetime.
EAR-BAN: Energy Efficient Adaptive Routing in Wireless Body Area Networks EAR-
BAN is a centralized cluster based multi-hop routing protocol [42, 43] proposed by
combining the benefits of direct and multi-hop transmission methods. The survey of this
papers [44–48] reveal the fact that with increasing number of body node and decreas-
ing distance from node coordinator, the cluster based routing approach is more energy
efficient. Here on-body node with highest priority and in-body node with lowest priority
is considered as default. A node distance from coordinator node is measured from signal
strength of HELLO message. The node coordinator selects a node as CH of each cluster
which has highest impact factor (IF) and minimum required energy (Ecum) to maintain
cluster operation for each round of each cluster. The IF is calculated using energy and
priority of the node as follows:
( ) ( )
Ei Pi
IF = 𝛼 +𝛽 (17)
Emax Pmax

and the minimum required energy is measured is as follows:

Ecum = (No. of cluster member)
× (energy consumed by a node for transmitting data in its active time slot)

If (Ecum > Eavailable) then coordinator node chooses a nearby node as relay node
to transmit data to coordinator node. Also the relay node must satisfy the condition
(Eavailable ≥ Edependent). If (Ecum < Eavailable) then CH directly sends data to coordinator node.
If (cluster(cluster(CH(Ecum))) < Eavailable) then coordinator node chooses nearby CH’s
to transfer data towards coordinator node. The chosen CH must satisfy the condition
(Eavailable ≥ Edependent). The simulation result of this work shows the fact that uniform dis-
tribution of body nodes prolonged the network lifetime when coordinator node is placed at
the centre of the human body.
A Low Overhead Tree-Based Energy-Efficient Routing Scheme for Multi-hop Wire-
less Body Area Networks Using fixed power levels to send packets either wastes energy
or fails to meet data transmission. Since the quality of link is changing dynamically, it is
great challenge to predict it in WBAN and this algorithm selects the transmission power to
ensure that sensors transmit packets with enough power. So, this paper [49, 50] consider-
ing jointly adaptive power control and routing in multi-hop WBANs. This work has three
modules like route selection, link quality estimation and data forwarding. The total energy
consumption of node n with different power levels with packets forwarded by and origi-
nally transmitted by node i are calculated using following equation:
L
∑
Ci = Ci,l (18)
l=1
( )
where i ∈ {1, 2, 3, ..., N} and l ∈ {1, 2, 3, ..., L}, Ci,j = wl mRi,l + mSi,l .
This mechanism is to adopt a power levels of node i according to link quality. To meet
the QoS requirement [51] a node may use high power level. To measure the transmission
quality (cost) energy-aware expected transmissions (eETX) is used. Since this protocol

13
2488 B. Shunmugapriya et al.

is tree based architecture, expected transmissions (ETX) is used to show the link quality
between a node and its parent node. In this work transmission quality is represented by link
quality and energy consumption states [52, 53]. Here, link eETX between a node i and its
neighbor i at power level l is defined as follows:
� �
Ci
ql (i, i) = wl pl (i, i) + 𝛼 ∑ . (19)
i� ∈I � Cn�

If 𝛼 is very small the link quality is good and if 𝛼 is very large link quality is weak. Also
this paper has defined the path eETX of a sensor node as the path eETX of its neighbor
plus the eETX of its link to its neighbor. Therefore the path eETX of node i is denoted
as follows: q(i, s) = ql (i, i) + q(i, s). This power-adaptive routing algorithm’s aim is to find
the path from node i to sink s with lowest path eETX as parent node and it is expressed as
q∗ (i, s) = minl,i (ql (i, i) + q(i, s). In order to find q∗ (i, s), this scheme is adaptively choosing
relay and power levels. Each node sends HELLO message containing the values of ql (i, i),
l and Ci,l to its neighbors. The experimental detail has considered three different body pos-
tures like standing (static), walk (3 km/h) and run (7 km/h). The transmission power is sup-
ported by with four levels such as 0 dBm, − 5 dBm, − 10 dBm and − 15 dBm. This works
focused on four different mechanisms in order to equip the proposed algorithm as robust
against for any kind of challenges. The simulation result has shown that EERS is achieved
a good tradeoff between reliability, delay and energy consumption.
An Energy Efficient Fuzzy Based Adaptive Routing Protocol for Wireless Body Area
Network This paper [54–56] considered both direct message passing and cluster based
technique. The fuzzy logic concept is used for selecting a CH according to node priority,
node deployment density[ 31], remaining energy and distance with coordinator node. Here
maximum transmission range is 100 cm. If the priority of the node is 0.5 then it is treated
as implanted node and if the priority of the node is 1 then it is considered as on-body criti-
cal node. The only non-critical nodes are clustered based on their impact factor (IF), dis-
tance node’s deployment density. The IF is defined as follows:
RE(i) Pi
I.F = + (20)
E0 P0

and it requires two parameters such as energy and priority of a node. The probability of
each node to become a CH is the output of fuzzy Inference system. For every cluster, the
average distance of all the cluster members to its CH is calculated as follows:
∑N
DCH (i)
Dm,ck = i=1 , (21)
N
where DCH (i) is the distance of ith cluster member to its CH and N is the number of cluster
members in a cluster. The nearest node of the given node is selected∑ifN a node satisfies the
P (i)
following two conditions: Dm,ck < Dm and Dm,ck < Di . Where Dm = i=1 NBNC and Di is the
distance of the ith cluster member from the BNC. To avoid the congestion and loss of data
packets, TDMA time slots are used. CH is being changed in each and every round to dis-
tribute the energy consumption among all the nodes. The CH node should satisfy the con-
dition that remaining energy of a node greater than minimum threshold energy of a node.
This protocol obtained considerable stability period and network lifetime. Also transmits
more packets [57, 7].

13
Wireless Body Area Networks: Survey of Recent Research Trends… 2489

Modified New-Attempt Routing Protocol for Wireless Body Area Network HELLO mes-
sage is used to spread a node’s information to nearby nodes and all the nodes update their
routing table accordingly. It uses both multi-hop communication [19] and for emergency
purpose uses direct communication. This protocol [58] selects a new forwarder node using
the following equation in each and every round in order to equally distribute the energy
among the nodes.
RE(i)
CF(i) = (22)
d∗q

where d is the distance between sink and a node i, q represents average data rate of all
nodes. The cost function with maximum value is chosen as a forwarder node. Residual
energy, network lifetime, path loss and throughput are the performance metrics considered
to analyze the working level of the protocol.
ESR: Energy Aware and Stable Routing Protocol for WBAN Networks The objective
of this paper [59, 60, 17] is to select energy efficient path with stable link to reach stable
coordinator. A new path established from source node to destination node with multi-hop
distance using route request (RREQ) and response (RREP) messages. While RREQ and
RREP is flowing on either direction, the concerned nodes routing tables are updated. The
best path is selected from source to destination based on energy consumption and path
stability. In order to reach this path this paper has proposed two different function such as
energy aware function and link stability aware function are defined. The energy cost func-
tion of node i belonging to the path j denoted by feni,j(t) and defined as follows:
Elevi,j (t)
feni,j (t) = × wi,j (23)
DRi,j (t)

where
Ei,j (t)
Elevi,j (t) =
Eaverage

and ­DRi,j(t) is the rate at which energy is consumed at a given node. The minimum residual
energy of nodes making a route j form source to destination is measured as follows:
n−1
fepj (t) = min(feni,j (t)) (24)
i=1

The stability cost function of the link from i to k at time t is given as follows:
SDl (t)
fsli,j (t) = Ml i,k(t) where mean of m distances recorded between nod I to k is represented
i,k
as follows:
∑tm
di,k (t)
Mli,k (t) = t=t1
(25)
n
and standard deviation of the distances recorded between the node i to k is measured as
follows:

13
2490 B. Shunmugapriya et al.

√
√ tn
√1 ∑
SDli,k (t) = √ (d (t) − Mli,k (t))2 . (26)
n t=t1 i,k

The path cost function stability is the maximum stability cost of the links constituting a
path and it is defined as follows:
n−1
fspj (t) = max(fsli,k (t)) (27)
i=1

where n is the nodes number of path from j to k as the neighbor node of the node i.e.
If fspj (t) tends to zero then the link is stable else if fspj (t) tends to one/infinity then the
link is unstable. Therefore this paper has proposed a path selection principle by combining
the energy consumption and link stability of a path from node i to j. The path model has
defined as follows:
𝛽
fpj (t) = 𝛼fepj (t) +
fspj (t) (28)

where 𝛼 + 𝛽 = 1. A path with maximum fpj (t) is chosen to forward the data packets. The
simulation result has shown clearly that this model improves the network performance,
consumes less energy and minimizes routing overhead traffic. Also it improves the mobile
WBAN network performance.
Trust and Thermal Aware Routing Protocol (TTRP) for Wireless Body Area Networks [61]
Trust is a calculation that can be obtained by observing the packet forwarding behavior of
relay node and is a continuous fractional value between 0 and 1. If trust value of a node is less
than 0.5 then that node is untrusted node, and if trust value is greater than 0.6 then that node
is treated as trusted relay node. The trust is divided into two categories like direct-trust and
indirect-trust. The total trust of a node is obtained using the following equation:
Rk
ITRi,Rj
TRi,Rj (t) = 𝛼DTRi,Rj (t) + 𝛽 (t). (29)
NRj

Here the direct trust ­DTRi,Rj indicates that direct trust of relay node Ri over Rj at time t
and ITRi,Rj
Rk
represents the indirect trust of relay node Ri over Rj obtained through Rk at time
t. The weights 𝛼 and 𝛽 are assigned to direct and indirect trust respectively where 𝛼 + 𝛽 = 1
and 𝛼 > 𝛽 . NRj represents all neighboring relay nodes of Rj.
The motivation of temperature aware routing is to distribute traffic load and therefore
minimize number of nodes becomes a hotspot. The following composite function (CF) bal-
ances traffic load in the network based on temperature and it selects all the trusted nodes
along the routes. CF = (w1 ∗ Trust) + (w2 ∗ Temp) where w1 and w2 are weights of trust
and temperature respectively and w1 + w2 = 1. Suppose a relay node reaches a threshold
value then it is marked as hotspot node by its neighboring node. Therefore a route with
minimum cost will be selected for relay data packets to gateway node.
When threshold value of temperature exceeds and/or trust value of neighboring node is
below the threshold the link failure may occur. This could be handled by this protocol in
maintenance phase. Therefore TTRP is protecting against malicious nodes and avoid the
hotspot issue. Including of weighting factors of temperature and trust minimizes the evolv-
ing of hotspots and finding new routes.

13
Wireless Body Area Networks: Survey of Recent Research Trends… 2491

3 Emergent Standpoints and Thematic on Mathematical Modeling

The formulation of a problem requires an analysis of the proposed system. This analysis
will show various phases and the way it can be controlled.

3.1 Integer Linear Programming Model

To construct a model in which effectiveness of the system is expressed as a function of the

variables defining the system. The general form of the model can be represented as follows:
E = f (xi , yj )

where E = Effectiveness of the system, xi = Variables of the system that can be controlled,
yj = variables of the system that cannot be controlled but do not affect E.
Deriving a solution from such a model consists of determining those values of control
variables xi, for which the measure of effectiveness is optimized. Optimization includes
both maximization and minimization. In order to optimize energy consumption minimi-
zation [32] and throughput and network lifetime maximization [26], linear programming
based mathematical models are proposed. The reason for choosing linear programming
models is (a) to attain optimum use of productive factor, (b) more objective than subjec-
tive, (c) better for adjustments to meet changing conditions, (d) allows modification of
its mathematical solutions, (e) highlights the bottlenecks in the processes.
Let us consider the subsequent general Integer linear programming (LP) representation:
n n
∑ ∑
Maximize∕Minimize Z = cj xj , aij xj ≤ bi , (bi ≥ 0) i = 1, 2, 3, … , m
j=1 j=1

xj ≥ 0, j = 1, 2, 3, … , n

where variables xj (j = 1, 2, 3, … , n) are called decision variables, cj , aij and

bi (i = 1, 2, 3, … , m);j = (1, 2, 3, … , n) are constants determined from the definition of the
problem. The constants cj are called objective function coefficients, and constants bi are
called stipulations and constants subject to, aij are called structural coefficients. In general
in Linear Programming (LP)m < n.

3.1.1 Maximum Throughput Model

In WBAN, each bit of information should be taken care of; otherwise, it leads to miss-
ing a few data related to patients. Thus the objective is to increase successful packet
reception at the sink. The authors [32] proposed a model for collecting data by for-
warder node from its member nodes and then forward it to the sink. [62] Formulated
the following Integer Linear Programming models discussed on [32] aims to maximize
the number of successfully received packets at the sink throughout the network lifetime.
∑
Maximize r Ps , ∀r ∈ R.
Subject to
Aif = Afs = 1, ∀i, f ∈ N (30)

13
2492 B. Shunmugapriya et al.

Pif = Pfs = 0, ∀i, f ∈ N (31)

Ei ≥ Emin , ∀i ∈ N (32)

pl ≥ pmin , ∀l ∈ L (33)
∑
𝜆i t ≤ cbi , ∀i ∈ N (34)
i

In this objective function, constraint 1 fulfills the essential requirement that is all the
links are established. Violation of restrictions 2–4 leads to packets being dropped, which
ultimately leads to decreased throughput. Violation of restriction 5 leads to packets arrival
beyond the handling capacity, causing reduced throughput as well as increased delay.

3.1.2 Minimum Energy Consumption Model

In [62] formulated the following Integer Linear Programming model to minimize energy
consumption based on the optimal solution designed on [32]. Here two different types of
nodes, forwarder and regular, are considered. Data collection from other normal nodes,
data aggregation, and transmit the aggregated data to sink are done by the forwarder
node. Each of these tasks consumes different energy. Sending energy of the forwarder
node depends on the amount of data collected from other nodes, distance from the sink,
and aggregation of the received data. So, the energy is consumed in two ways: Data
Transmission and Data Reception.

(a) Forwarder node data transmission,

(b) Normal node data transmission,
(c) Data transmission of all nodes during entire network lifetime,
(d) Data reception by forwarder node,
(e) Data reception for the entire network life time.

Assume that Aif represents a link between normal node and forwarder node. Simi-
larly, Afs represents a link between forwarder and sinks. Fifs represents traffic flow
between a node and forwarder. Also, Ffst represents the total traffic flow between for-
warder node and
� sink. �
∑
Minimize Ei + Ef ∀i, f ∈ N .where Ei = Aif (ETx−elec + ∈amp ndifn ), energy con-
i∈N ∑
sumption of sensor nodes. Ef = Aif (ERx−elex ) + Eda + Afs (ETx−elec + ∈amp ndfsn ), energy
consumption of forwarder node.
Subject to
Ei ≤ E0 ∀i ∈ N (35)

Ef ≤ E0 ∀f ∈ N (36)

∑
Fift ≤ Cif ∀i ∈ N (37)
i

13
Wireless Body Area Networks: Survey of Recent Research Trends… 2493

Ffst ≤ Cif ∀f ∈ N (38)

∑
bif + 𝜆f t ≥ btfs ∀i, f ∈ N (39)
i

dif ∧ dfs → dmin (40)

Constraints 30 and 31 represent the energy capacity constraints or normal node and for-
warder node. Constraints 32 and 33 state that the total flow of data with their physical link
capacities. Violating these two constraints leads to high energy consumption. Constraint 34
guarantees that the flow conservation with parameters of length of data and data generation
rate at forwarder node at a time. Constraint 35 warns us that the communication distance
needs to be minimized.

3.1.3 Network Lifetime

Consider there are n different number of sensor nodes and (n + 1)th node is as Sink. The
locations of every node know each other by broadcasting HELLO message. Also consider
network lifetime R rounds and let Pi,j be the total number of packets that node i transmits
to node j, during round r. The objective function to achieve maximum network lifetime is
as follows:
∑
Maximize R = i ri.
Subject to
∑ ∑
tx rx
C1 ∶ (Pi,j × Ei,j )+ (Pj,i × Ej,i ) ≤ Ei ∀i ∈ n,
(41)
i,j j,i

∑
C2 ∶ min Txire ∀i ∈ n, (42)
i

∑
C3 ∶ min Liun ∀i ∈ n, (43)
i

∑
n+1
C4 ∶ min di,j ∀i, j ∈ n, (44)
i

∑ ∑ ∑
C5 ∶ 𝛾i,j + (Γi × tr ) ≤ 𝛾j,i ∀i, j ∈ n,
(45)
i,j i j,i

C6 ∶ 0 ≤ 𝛾i,j ≤ Pi,j ∀i, j ∈ n, (46)

∑
C7 ∶ 𝛾i,n+1 = T ∀i ∈ n. (47)
i
∑ ∑
𝛾i,j = 𝛾j,i Constraint 30 guarantees that the available energy of the node Ei is
i,j i,j
respected by the link capacities. Constraint 31 ensures minimizing packet retransmissions,

13
2494 B. Shunmugapriya et al.

which results in a long network lifetime. Constraint 32 notes that the wasteful transfer of
data over the lifespan of the network is minimized. Constraint 33 implies the direct rela-
tionship between the distance of contact and the lifespan of the network. Constraint 34
indicates that the data flow should not surpass the outgoing flow of the generated data; oth-
erwise, loss or retransmission of the data packet will lead to more energy consumption.
Constraint 35, instead, guarantees the capacity of the flow network links.
Constraint 36 informs us that capacity on the links/edges of the flow network must be
maintained.

3.2 Path Loss Model

In general, Signal attenuation is called Path Loss. Otherwise, it can be defined as the dif-
ference between the transmitted power and received power where antenna gain may or may
not be considered. In WBANs, the objects movement inside the body and outside the body
may affect the transmitted signal. As far as concern in WBANs, path loss depends on dis-
tance and frequency. The path loss model (in dB) as a function of distance between trans-
mitter and receiver is analyzed in [61] using the following equation.
( )
d
PL = PL0 + 10n log10 + 𝜎s (48)
d0

where PL0 is path loss at reference distance d0, The path loss exponent is n (for space its
value is 2 and for human body its value varies from 4 to 7), D is the distance from transmit-
ter to receiver 𝜎s is standard deviation.
In WBANs path loss may happen due to free space loss, reflection, refraction and dif-
fraction. By having such disturbance, the transmitting/transmitted signals’ frequency may
be in weak. This path loss could be analyzed on [61] using the following equation.
( )2
4𝜋d
PL0 = 10 log10 (49)
𝜆
or
( )2
4𝜋df
PL0 = 10 log10 (50)
c

where, f is frequency of the propagating wave, 𝜆 is wave-length of the propagating wave,

and c is the speed of light. Most of papers related to WBANs used operating frequency of
2.4 GHz ISM band.

3.3 Radio Model

Many radio models have been proposed for mode of communication in the literature. The
amount of energy consumed depends on the modes of communication used. In WBAN,
data packets can be transmitted in two ways: (a) Transmit emergency data directly to the
Sink node using Single-hop communication, (b) Transmit the data in normal way using
Single-hop or Multi-hop mode of communication.

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Wireless Body Area Networks: Survey of Recent Research Trends… 2495

3.3.1 Single‑HOP Communication Model

The energy consumption during single-hop communication is calculated on [37] as follows:

Etx = Eelec + Eamp Es−hop = Etx (51)
Etx = Eelec + EampEs−hop = Etxwhere, Etx is transmission energy, where, Eelec is the energy
consumed for processing data and Eamp is the energy consumed by transmit amplifier.

Es−hop = Etx = b × (Eelec + Eamp ) × d2 (52)

where d2 is energy loss due to the transmission or the distance between transmitter node to
receiving node.
Usually, receiving, processing, and transmission of data on each intermediate node take
much time, which causes delays. Sometimes, this delay is also augmented due to conges-
tion and becomes intolerable in some severe scenarios. So, single-hop communication is
used to reduce this setback. In single-hop communication, the sensor node uses the full
power of the battery to send its data directly to the Sink node. Due to this direct commu-
nication, the delay can be reduced and can be useful to take of the patients as quickly as
possible.

3.3.2 Multi‑Hop Communication Model

The energy consumption during Multi-hop communication is calculated on [37] as follows:

Em−hop = Etx + Erx

Em−hop = Etx + Erxwhere Erx is the energy consumed for receiving data. If the system is
transmitting b-bits to a distance of n-hops the transmission energy will be n × b × Etx and
receiving energy will be (n − 1) × b × Erx . Since the initial node transmits only and an
intermediary nodes receive n-bits and then transmit these received bits. So the energy con-
sumed for Multi-hop is:
Em−hop = (n × b × Etx ) + ((n − 1) × b × Erx )

Erx = Eelec

Given that the receiving energy is equivalent to the energy consumed to process
received data. Then the previous equation can be written as:

Em−hop = ((n × b) × (Eelec + Eamp ) × d2 ) + ((n − 1) × b × Eelec )

Em−hop = ((n × b) × Eelec ) + ((n × b) × Eamp × d2 ) + ((n × b) × Eelec ) − b × Eelec )

Em−hop = (2 × (n × b) × Eelec ) + ((n × b) × Eamp × d2 ) − (b × Eelec ) (53)

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2496 B. Shunmugapriya et al.

3.3.3 Cost Function

Multi-hop communication model is preferred to minimize energy consumption and maxi-

mize throughput in WBAN. A forwarder node has to be selected to balance the energy.
This selection can be done by calculating the cost function of all nodes. Suppose i is the
identification of a node then the cost function is computed as follows:
di
CFi = (54)
REi

where di is the distance between the node, i and sink, and REi is the residual energy of node
i. REi is calculated by subtracting the presently consumed energy from previously available
total energy. Hence, the forwarder node has minimum di and maximum REi.

3.3.4 Radiation Energy Analysis

Radio signals generated through wireless communication generate electromagnetic fields,

which is absorption of human tissue leading to temperature rise. The amount of radiation
energy absorbed by human tissue is referred as the Specific Absorption Rate (SAR) [63].

𝜎|E|2
SAR = (W∕kg), (55)
𝜌
where 𝜎 is the electrical conductivity of tissue, E is the electric field induced by radiation
and 𝜌 is the density of tissue. The objective of the SAR is to maintain a low temperature to
avoid routing on hot spot. The result referred in [63] is that SAR of 8 W/kg for 15 min can
cause significant tissue damage. The norm of the Federal Communications Commission
(FCC) states that the upper limit of SAR for near-field exposure is 1.6 W/kg for any tissue
averaged over one gram, while the upper limit of 2.0 W/kg for 10 g of tissue is specified by
the International Commission on Non-Ionizing Radiation Safety (ICNIRP). The analysis
in[63] converts these SAR values into a rise in temperature, and the maximum values for
potential human head and brain temperature changes are 0.31 °C and 0.13 °C for the FCC
standard and 0.60 °C and 0.25°C for the ICNIRP standard. The study in [63] also shows
that a temperature increase of 0.1 °C is sufficiently high to cause an extreme thermoregula-
tory response from the human body.

4 Terminologies Used in WBAN Routing Protocol

In this section, this paper explains the parameters generally used in the development of
WBAN routing protocol [42, 58, 16]. Most importantly, some of these terms are used to
classify the surveyed energy-efficient routing protocols in succeeding sections.

4.1 Network Lifetime

It is one of the vital assessments metric that is mostly used to evaluate the energy efficiency
of WBAN. The key reason to propose a energy efficient routing protocol for WBAN is to
increase the network lifetime. In a WSN, the network lifetime generally defined as the max-
imum duration of time that a Wireless body area Network would be fully active. Or other

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Wireless Body Area Networks: Survey of Recent Research Trends… 2497

the time duration between the network boot/renew to the end when the final sensor nodes
or the bulk of sensor nodes expire [64]. The collapse of any one sensor node may lead to
network breakdown. Each and every node of the network is very important for increasing
the energy efficiency of WBAN.

4.2 Throughput

The general definition of throughput is a calculate of how many units of information a sys-
tem can process in a given time amount or other the rate of successful message deliverance
over a communication channel [16].

4.3 Residual Energy

Its energy level generally measures the life span of a sensor nodes after a given network
data transmission round. Usually, the energy level in sensor nodes after every network data
transmission phase is referred to as its residual energy. When improving the network per-
formance by the best possible use of residual energy and enhancing network lifetime [65].
The residual energy of sensor node can be calculated as:
Total number of rounds
∑
E (residual energy) = E(initial deployment) − E (data transmission round)
initial round=0

4.4 Path Loss

In WBAN, the sensor nodes are placed in different places of the human body. Path loss is
an attenuation of a transmitted signal for source to destination. Path loss may measure in
free space and on-body associations for bodies with considerably different physical struc-
tures [66]. When WBAN wants to increase the performance, channel characterization and
representation are required by revise path loss characteristics of the channels. The path loss
is dependent on frequency as well as the distance of the transmitter to the receiver side. If
the medium is the line of sight, then the signal achieves very minimum attenuation. But
WBAN is dealing with the human body, and it is not a line of sight, messages may have
some mitigation. The path loss component in the human body varies from 4 to 7 and in free
space are 2.

4.5 Packet Delivery Rate

Since this paper is dealing with WBAN, packet delivery rate (PDR) is very important [29].
The medical data must be reached fully to the intended destination place within a certain
period of time, or otherwise, the sent data is useless. The PDR is that by several packets
obtained at the sink node divided by the number of packets sent from the source.

13
 2498

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Table 1  Comparison WBAN and other Networks
Properties/Networks Wireless sensor networks Wireless body area networks MANET VANET

Scalability Large area coverage (m) Limited to the human body Large area coverage (Kms) Wide area coverage (Kms)
Deployment Density very densely deployed Low Density Based on mobility of nodes Based on mobility of nodes
Data rate and Frequency 54 Mbps and 2.4 Ghz 10 Mbps 11 Mbps and 2.4 Ghz 27 Mbps and 5.9 Ghz
On-body: 3.1–1.6 Ghz
In-plant: 402–405 MHz
Network topology Star/mesh Star Peer-to-peer /Star Peer-to-peer/Star
Energy Scavenging Solar or wind power Motion or body heat Solar or wind power Vehicle battery
Mobility No mobility Body Movement High Very high
Standards and Technologies IEEE 802.11 and WiFi IEEE 802.15.6 and zigbee/Blue- IEEE 802.11 and IEEE 802.11p and DSRC, WAVE
tooth/WiFi
Change in Network Topology No No Slow Frequently and fast
B. Shunmugapriya et al.
Wireless Body Area Networks: Survey of Recent Research Trends… 2499

5 WBAN and Other Networks

Compared to other Wireless Networks scalability, WBAN is restricted to the limited cover-
age area and low density of nodes. Moreover, WBAN uses maximum star-based central-
ized topology and standard of WBAN defined in terms of using communicating technolo-
gies. Table 1 describes the comparison between WBAN with other wireless technologies.

6 Conclusion and Future Directions

This paper has discussed different energy-efficient routing protocols concerning tempera-
ture based, cluster-based, cost-effective based, link-aware based, and QoS based protocols.
We have demonstrated the structure of the sensor unit and the types of WBANs. This paper
has analyzed and described a linear integer optimization approach for maximization of net-
work lifetime and throughput and, minimization of energy consumption of WBAN. The
comparison of WBANs and other wireless networks technologies are given and, research
opening in WBAN also presented and also dealt with path loss model to increase through-
put, radio model for communication and radiation energy analysis model to reduce the hot-
spot which affect the human tissues. All the discussed protocols of this paper, irrespective
of their special interest, mainly considered to select a forwarder node with minimum cost
function value and maximum energy of the node. This literature found that for normal and
emergency data communication, the used communication model is multi-hop and single-
hop, respectively. The temperature-based routing protocols are mainly concerned about
hot-spot regions. These regions are avoided or data packets are re-routed to reach the sink.
The cluster and cross-layer based protocols are taking care of the connectivity of nodes to
disseminate the data. Since WBAN is concerned about patients’ data, connectivity among
the nodes, and security of data are very important. QoS routing protocols are taking care of
the reliability of data.
We consider that a routing protocol in WBANs aim is to reduce the heat energy and
send the data as soon as possible by selecting minimum cost function with maximum
energy nodes on the path. The safety of the human body is the most important than other
things. So, energy-efficient routing protocol should be taken as the primary objective of
WBAN, among other metrics. Future routing protocols for WBANs should be considered
to receive the QoS and reliable data. So, the security of the data needs to be considered. To
transfer the data efficiently, link capacity and quality need to be upgraded. By deploying
more number of bio-sensors in the human body, hot-spot nodes may be avoided. This could
be done by designing the efficient energy utilized routing protocol is needed. So, the tissues
of the human body will not be affected.

Declarations
Conflict of interest We author of the above titled paper hereby declare that the work included in the above
paper is original and WBAN routing survey is carried out by the authors indicated in it. Further, We author
declare that the work submitted for Wireless Personal Communications An International Journal has not been
published already or under consideration for publication in any Journals/Conferences/Symposia/Seminars.

13
2500 B. Shunmugapriya et al.

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Publisher’s Note Springer Nature remains neutral with regard to jurisdictional claims in published maps
and institutional affiliations.

B. Shunmugapriya received her Master of Engineering in Computer

Science and Engineering from MS University, Tamilnadu, India. She
works as a Assistant Professor in National Engineering College,
Tamilnadu, India. Currently,she is pursuing Ph.D. in Anna University,
Tamilnadu, India. Her research interests are related to Wireless Body
Area Networks.

Dr. B. Paramasivan received his Doctoral degree in Information and

Communication Engineering from Anna University, Tamilnadu, India.
He works as a Professor in Department of Information Technology
National Engineering College, Tamilnadu, India. His research interests
include wireless networks: wireless sensor networks, Mobile Adhoc
Networks.

Dr. S. Ananthakumaran has completed his Bachelors and Masters in

Computer Science and Engineering. He has also completed his Ph.D.
in Computer Science and Engineering. His research area is VLSI Cir-
cuits & WSN. Currently he is working as Associate Professor in the
KL University. His interest includes wireless sensor network and clus-
ter computing.

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2504 B. Shunmugapriya et al.

Dr. Naskath Jahangeer received her Master of Engineering in Com-

puter Science and Engineering from Anna University, Tamilnadu,
India. She works as a Senior Grade Assistant Professor in National
Engineering College, Tamilnadu, India. Currently, she has also com-
pleted her Ph.D. in Anna University, Tamilnadu, India. Her research
interests are related to Mobile Adhoc networks.

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