CN109308940A - Cardiopulmonary exercise assessment and training integral system - Google Patents
Cardiopulmonary exercise assessment and training integral system Download PDFInfo
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- CN109308940A CN109308940A CN201811324477.XA CN201811324477A CN109308940A CN 109308940 A CN109308940 A CN 109308940A CN 201811324477 A CN201811324477 A CN 201811324477A CN 109308940 A CN109308940 A CN 109308940A
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Abstract
The present invention provides a kind of assessment of cardiopulmonary exercise and training integral systems, including case big data intelligent management system and carry out the cardiopulmonary exercise functional assessment of data interaction with case big data intelligent management system and Personalized motion prescription formulates system, by the rehabilitation training of sports apparatus and formulation optimization system, the guidance of walking and other free movements and monitoring system, client.The present invention carries out cardiopulmonary exercise functional assessment and risk stratification to patient using case big data intelligent management system as core, using digital cardiopulmonary gait test, and issues exercise prescription;According to the case data and exercise prescription of patient, training of the patient on sports apparatus is controled and monitored, the implementation of the big prescription of patient 5 is reminded and monitored by rehabilitation assistant;Doctor's client, family members' client and the professional service client of system provide personalized, specialized rehabilitation service at any time, provide the medical treatment and rehabilitation service of intelligence, regulation and standardization, personalization.
Description
Technical field
The application belongs to medicine detection, prevention and rehabilitation technique field, is related to intelligent wearable device, more particularly to one kind
Wearable number Cardiopulmonary Exercise Test, prevention and rehabilitation training and monitoring system.
Background technique
Cardiovascular disease is the big killer of the mankind first.America and Europe has 20% crowd to suffer from cardiovascular disease, and there are 2.9 hundred million painstaking effort in China
Pipe patient.Prevention, diagnosis and the rehabilitation of cardiovascular disease all be unable to do without assessment, risk stratification, the movement of systema cariovasculare functional
Formulation, training monitoring and abnormal control.Currently, assessment and training are usually all had been manually done by doctor or nurse, imitate
Rate is low, management is discontinuous, prescription science cannot be guaranteed.What the assessment of cardiorespiratory system motor function and training were faced
Challenge is:
One, quantitative, ease for operation, easy generalization and measurement index the application assessed.Such as: cardiopulmonary exercise test
(CPX) oxygen uptake (VO2) by monitoring body under motion state, carbon dioxide output (VCO2), heart rate (HR), minute
Ventilatory capacity (VE) etc. evaluates reaction of the internal organs such as cardiopulmonary to movement.It has the characteristics that it is noninvasive, quantitative, for heart and lung diseases
Diagnosis and prognosis have important value.On the other hand, CPX measuring principle and equipment use, maintenance and data interpretation are complicated, do not allow
Easily understood by clinician and nurse and accurately uses;CPX requires measured to reach limit of sports record, and many patients are often not achieved
Limit of sports record, so that measurement result loses the effect of it should have.These greatly limit the promotion and application of CPX.
Chinese invention patent " equipment, system and method for test heart movement function ", application number 201510217071.1,
Teach the heart movement Functional Test Equipment for measuring heart adaptability to changes series index.The device intelligence, easy to use, survey
The heart adaptability to changes series index clinical meaning of amount is clear.The test equipment of heart movement function of the patent disclosure, system and
Method is a part of the invention.The patent does not relate to the cardiovascular disease danger point that measured is carried out using measurement index
The formulation of layer and athletic rehabilitation prescription, more further uses measurement index without reference in health care and rehabilitation.
Two, the intelligent management of training and monitoring.Science training must be it is personalized, outputed according to science
Exercise prescription set motor pattern, the movement duration and exercise intensity of exercising device, instruct training, and real-time monitoring
Physical condition guarantees optimal movement training effect and sports safety.
Application No. is 201710969834.7 Chinese patent disclose a kind of Personalized motion target heart rate designing system and
Its application method acquires the data such as the individual physiological index of user, biochemical indicator, sports level, medical history situation, anti-according to medicine
It controls guide and carries out scientific analysis assessment, classified according to each data target standard, by the different crowd of user's assembled classification.It should
The unprofessional exercise test of patent, be safe from danger layering, and the personalized prescription of exercise prescription is replaced to design with general classification,
Be it is worthless, practical value is not high.
Chinese patent " a kind of the method and apparatus for adjusting treadmill speed and smart machine and treadmill " application number
CN201610908260.8 discloses a kind of method and apparatus for adjusting treadmill speed, it passes through intelligent wearable device
The heart rate information for obtaining wearer is sent to server, and server uses preset algorithm calculating speed parameter, for adjusting running
The speed of machine.But this method is simultaneously infeasible: first, the exercise intensity in individual sports training is joined according to its a variety of body
Number synthesis considers to set, not only heart rate, is only set with heart rate, accuracy is lower, may cause various problems;
Second, if treadmill speed changes with changes in heart rate, due to the heart rate of people be it is continually changing, entire control process can be very
It is unstable.
Another Chinese patent " athletic rehabilitation treatment system treadmill control method ", application number CN201410125927.8
Disclose a kind of athletic rehabilitation treatment system treadmill control method, treadmill according to the exercise therapy prescription of doctor to speed,
The gradient and treatment time are controlled.I.e. if speed and the gradient adjust immediately not in range;Heart rate not in range,
Namely it regulates the speed and the gradient.It simultaneously can be real by the included electrical parameter detection circuit of physio-parameter detection equipment and sports equipment
When grasp patient body situation, once occurring abnormal, can stop treating.The patent proposes the regulation sides based on exercise prescription
Method, but still using the method constantly regulate, also use the processing method to note abnormalities with regard to deconditioning.
Three, the exercise prescription management based on case big data, real time kinematics monitoring and intelligent control.Chinese patent is " a kind of
Medical cases big data intelligent management system ", application number 2017106087286 discloses a kind of medical cases big data intelligence
Management system, entitled BigCase.On the one hand, with reasoning by cases method with classical case come instruct current case diagnosis,
Treatment and rehabilitation.On the other hand, it proposes and case template is defined with frame systematic knowledge representation method in artificial intelligence, develop
Complex reasoning method based on case frame system, medical guide and process standard rule establishes for realization of the invention
Basis.
Summary of the invention
To solve the above problems, and adapt to the demand of medical big data era, meet more more and more intense lifelong strong of people
Health demand for services meets the needs of medical expert and medical personnel effectively use big data, and the invention discloses a kind of cardiopulmonary
Locomotion evaluation and training integral system use number with case big data intelligent management system (BigCase) for core
Cardiopulmonary gait test (DCW) carries out cardiopulmonary exercise functional assessment and risk stratification to patient, and issues exercise prescription;According to patient
Case data and exercise prescription, control and monitor training of the patient on sports apparatus, by rehabilitation assistant remind and
Monitor the implementation of the big prescription of patient 5;Doctor's client, family members' client and the professional service client of system provide individual character at any time
Change, specialized rehabilitation service.
The present invention is according to individual sports prescription, and human body physiological parameter at that time, sets sport training plan, including target
Exercise intensity and target heart rate, warm-up duration and mode restore movement duration and mode.For treadmill or other locomotory apparatus
Tool, that is, selection training mode and parameter;When abnormal, according to abnormal difference, different processing methods is taken.For step
Row, since exercise intensity is generated by artificially changing cadence and step-length, supervised using the method for monitoring cadence and step-length
Survey exercise intensity, with the method for monitor heart rate come remind sporter keep exercise intensity.
In order to achieve the above object, the invention provides the following technical scheme:
Cardiopulmonary exercise assessment and training integral system, including case big data intelligent management system and and case
Example big data intelligent management system carries out the cardiopulmonary exercise functional assessment of data interaction and Personalized motion prescription is formulated system, borrowed
Help rehabilitation training and formulation optimization system, the guidance of walking and other free movements and monitoring system, client of sports apparatus;
Case big data intelligent management system is used for the case archives of storage and management patient;
Cardiopulmonary exercise functional assessment and Personalized motion prescription are formulated system and are assessed for acquiring physiological signal, from case
Patient information is obtained at example big data intelligent management system, assessment result is uploaded into case big data intelligent management system, and
According to other detection informations of assessment result and patient, risk stratification and exercise prescription design are carried out;
Patient is obtained from case big data intelligent management system by the rehabilitation training and formulation optimization system of sports apparatus
Exercise prescription and associated conditions information, formulate drill program, guidance and monitoring training, according to exercise rehabilitation training plan, mention
Wake up and management patient's implementing plan, and monitor physical condition when rehabilitation training, acquire carry out after physiological data processing in real time and
Analysis generates training report, uploads data and report;
The guidance and monitoring system of walking and other free movements obtain patient's from case big data intelligent management system
Prescription and associated conditions information generate drill program, remind and instruct patient to carry out training according to quantity on time, and upload training
As a result, customization and push family members' report;
Client is used to carry out data interaction with user.
Further, cardiopulmonary exercise functional assessment and Personalized motion prescription are formulated system and are referred to using heart adaptability to changes series
It is denoted as to assess the numerical index of cardiopulmonary exercise function, heart adaptability to changes series index includes: resting heart rate, heart strain rate, the heart
Strain limit, exercise heart rate restore.
Further, cardiopulmonary exercise functional assessment and Personalized motion prescription formulate system according to " coronary cardiopathy rehabilitation and two
The risk stratification table of patients with coronary heart disease in the Chinese Consensus of experts of grade prevention ", in conjunction with 6 minutes walking distances and heart adaptability to changes series
Index carries out risk stratification.
Further, cardiopulmonary exercise functional assessment and Personalized motion prescription formulate system and determine movement according to risk stratification
Strength range calculates personalized target heart rate, selection movement duration and movement using resting heart rate, heart strain rate combination exercise intensity
The frequency.
Further, it includes: wearable physiological signal that cardiopulmonary exercise functional assessment and Personalized motion prescription, which formulate system,
Acquisition module, the smart phone APP gait test module being connect with wearable physiological signal acquisition module and and smart phone
The gait test work station of APP gait test module connection.
It further, include movement by the drill program that the rehabilitation training of sports apparatus and formulation optimization system are formulated
Instrument type, warming-up exercise time, apparatus work duration and speed, monitoring index and alarm setting when exercise rehabilitation training.
Further, by the rehabilitation training of sports apparatus and formulation optimization system include doctor workstation module and
The sports apparatus of data interaction is carried out with doctor workstation module and for the body monitoring modular of wearing.
Further, the guidance and monitoring system acquisition electrocardio of walking and other free movements and motor message, pass through place
Reason and analysis electrocardiosignal, obtain heart rate, monitor anomalous ecg;By handling and analyzing motor message, body posture is calculated, is estimated
Cadence, step-length when calculating and run, to calculate speed and exercise intensity.
Further, the characteristic measure of the also comprehensive heart rate variability of the guidance and monitoring system of walking and other free movements
And motion state, sleep state of classifying, and the heart rate variability under different sleep states is further assessed, provide personalized sleep
Dormancy quality and health state evaluation report.
Further, the guidance and monitoring system of walking and other free movements include including rehabilitation helper module and rehabilitation
Services client end module.
Compared with prior art, the invention has the advantages that and the utility model has the advantages that
The fortune of intelligence and science is carried out from cardiopulmonary exercise assessment, design exercise prescription to personalized exercise prescription is used
The system and method for moving training monitoring and management are medical treatment and health for scientifically body-building and rehabilitation providing method, system and platform
Intelligence, regulation and standardization, the personalization serviced again provides technology and means.The present invention proposes to support and realize medical treatment
The technology and methods of the knowledge representation and reasoning intelligence of case big data are allowed to and hospital HIS system and various inspections and monitoring
Equipment is connected with instrument, obtains data, realizes scientific management, real-time monitoring and the safety guarantee of diagnosis, treatment and rehabilitation training.
Detailed description of the invention
Fig. 1 is the overall structure diagram of cardiopulmonary locomotion evaluation and training integral system in the embodiment of the present invention.
Fig. 2 is the structural representation that the assessment of cardiopulmonary motor function and exercise prescription formulate (DCW) system in the embodiment of the present invention
Figure;
Fig. 3 is to show in the embodiment of the present invention by the structure of the rehabilitation training of sports apparatus and formulation optimization (CRIM) system
It is intended to;
Fig. 4 is the structural representation of guidance and monitoring (SCRA) system of walking and other free movements in the embodiment of the present invention
Figure.
Specific embodiment
Technical solution provided by the invention is described in detail below with reference to specific embodiment, it should be understood that following specific
Embodiment is only illustrative of the invention and is not intended to limit the scope of the invention.In addition, step shown in the flowchart of the accompanying drawings
Suddenly it can execute in a computer system such as a set of computer executable instructions, although also, showing in flow charts
Logical order, but in some cases, it can be with the steps shown or described are performed in an order that is different from the one herein.
Cardiopulmonary exercise assessment provided by the invention and exercise rehabilitation training integral system include that case big data is intelligently managed
Reason system (BigCase), cardiopulmonary exercise functional assessment and exercise prescription are formulated module (DCW), are instructed by the rehabilitation of sports apparatus
The guidance and monitoring modular (SCRA) of experienced and formulation optimization module (CRIM) and walking and other free movements.
Wherein, case big data intelligent management system (BigCase) uses a kind of Chinese patent " medical cases big data
Intelligent management system " content in (application number 2017106087286), the present invention uses medical cases big data intelligent management system
BigCase unite to dynamically update case, cardiopulmonary rehabilitation prescription is intelligently managed and optimized according to progress, monitors training,
Personalized service is provided.
Data acquisition and result feedback, personalized service need to be realized based on the equipment interacted with user in the present invention.
For example, heart movement testing equipment and system can be there are two types of apparatus-forms.One is level ground walking movements
Form claims " digital heart gait test ".Wearing component is worn on front, acquires a lead or multi-lead electrocardiogram and human body fortune
Dynamic signal, and hand-hold electronic equipments are sent with bluetooth or other communications by collected signal.Hand-held electronics is set
Standby is the calculating equipment of similar smart phone or tablet computer, it receives and handles electrocardio and motor message, with voice and interaction
Screen is interacted with measured;Exercise test process is controlled, motion mode and speed are reminded, warns anomalous ecg;It calculates and shows
Electrocardiogram, heart rate, cadence, step-length, distance and the exercise intensity indicated with metabolic equivalent;And signal and calculated result with wireless
Mode is sent to work station.
Another kind is the motion mode by treadmill, is claimed " digital heart Treadmill Exercise Test ".Dress component acquisition one
Lead or multi-lead electrocardiogram, are sent to hand-hold electronic equipments in a wired or wireless fashion.Hand-hold electronic equipments for example can be race
Step machine console.It is also interacted with voice and interactive screen with measured;Exercise test process is controlled, motion mode and speed are reminded
Degree warns anomalous ecg;Calculate and show electrocardiogram, heart rate, cadence, distance and the exercise intensity indicated with metabolic equivalent;And
Signal and calculated result are sent to work station in a wired or wireless fashion.It is different with horizontal plane walking movement mode to be, it runs
Forms of motion on step machine is not only horizontal plane walking, further includes that the gradient is walked and run.Speed and exercise intensity information mainly from
Treadmill controller.
Digital heart walking movement testing equipment can whenever and wherever possible, and digital heart Treadmill Exercise Test equipment can be concentrated
Management, they have their own advantages.Their common advantages are intelligent, quantitative, easy to use, will be universal cardiac function dynamic examination
It tests, promotes cardiopathic prevention and rehabilitation provides technology and equipment and supports.
Specifically, as shown in Figure 1, cardiopulmonary exercise of the present invention assessment and training integral system include 5 subsystems
System: case big data intelligent management system (BigCase) 100, cardiopulmonary exercise functional assessment and exercise prescription formulate system (DCW)
200, by the rehabilitation training of sports apparatus and formulation optimization system (CRIM) 300 and the guidance of walking and other free movements
With monitoring (SCRA) system 400, doctor and patient client end 500.
Case big data intelligent management system (BigCase) 100 is stored with the case archives of patient, is the core of whole system
The heart, all other subsystem are all attached thereto.Case big data intelligent management system (BigCase) is with frame system in artificial intelligence
System knowledge representation method indicates each medical cases example, thus completes the conversion from data to knowledge, makes to generate each
A case example can participate in Case-based reasoning and the reasoning based on guide rule, the diagnosis to be standardized, treatment
With opinion needed for rehabilitation and parameter.
Cardiopulmonary exercise functional assessment and exercise prescription formulate system (DCW) 200 and obtain patient information from BigCase, will
Assessment result uploads to BigCase, and according to other detection informations of assessment result and patient, carries out at risk stratification and movement
Side's design.Movement place of patient is obtained from BigCase by the rehabilitation training and formulation optimization system (CRIM) 300 of sports apparatus
Side and associated conditions information formulate drill program, guidance and monitoring training, generate training report, upload data and report.Walking
Guidance and monitoring system (SCRA) 400 with other free movements obtain the prescription and associated conditions information of patient from BigCase,
It reminds and instructs patient to carry out training according to quantity on time, and upload training result, customization and push family members' report.Doctor, family
Belong to and professional service client is by BigCase, carries out locomotion evaluation, training and services jointly.
Fig. 2 is the structural schematic diagram that cardiopulmonary exercise functional assessment and exercise prescription formulate system (DCW).DCW includes three
Module: wearable physiological signal acquisition module 210, smart phone APP gait test module 220 and gait test work station
230.Wherein wearable physiological signal acquisition module 210 includes ECG signal sampling instrument 211, sphygmomanometer 212, BOLD contrast 213, fortune
Dynamic sensor 214.
ECG signal sampling instrument 211 is the electrocardio signal collecting unit of a standard, including sequentially connected 8 channel electrocardio letter
Number acquisition amplifying circuit, analog to digital conversion circuit, controller and telecommunication circuit.In order to obtain good electrocardio letter under motion state
Number quality filters minimizing technology using special motion artifacts;Sphygmomanometer 212 is the conventional cuff type blood with bluetooth connection
Pressure meter, only measures before gait test and after gait test and uploads pressure value;BOLD contrast 213 is worn on finger tip, motion-sensing
Comprising miniature three-dimensional acceleration and three-dimensional gyro sensor in device 214, it is worn on measured's metastomium.ECG signal sampling
Measuring signal is all uploaded to smart phone APP gait test mould by bluetooth by instrument 211, BOLD contrast 213 and motion sensor 214
Block 220.Smart phone APP gait test module 220 receives and processing electrocardio, blood oxygen and motor message, interacts, connects with measured
Data and processing result are received and uploaded to gait test work station 230.The letter that 230 real-time display of gait test work station receives
Number, it further analyzes, display, report blood oxygen signal, electrocardiosignal, motor message and heart adaptability to changes series index, with medical care
Personnel's interaction, uploads to hospital information system for measurement data and report.
Smart phone APP gait test module 220 receives the measured ID and personal information of gait test work station 230,
Generate the exercise test mode of this test.For example, can choose following modes: experiment opening for digital heart gait test
Begin, measured static one minute or more, until heart rate calmness, obtains his resting heart rate;Start walking, first with positive constant speed
Degree, and gradually accelerate, in the case where no uncomfortable feel and normal ECG, encouragement measured adds as far as possible within each minute
Speed arrives maximum speed, and walking stops after 6 minutes;Static one minute break after stopping walking, the heart rate that measurement obtains measured are extensive
Complex value.Entire test model records 8 minutes electrocardios and exercise data, i.e., static 1 minute before walking, walking 6 minutes and stops
Afterwards static 1 minute.After starting test, smart phone APP gait test module is sent with voice and text prompt to measured
Instruction, allows measured according to instruction, starts and complete to test.
Smart phone APP gait test module also receives ECG signal and BOLD contrast from ECG signal sampling instrument 211
213 oximetry data.Carry out three kinds of processing to electrocardiosignal: removal motion artifacts, detection QRS structure simultaneously calculate heart rate, detection
Anomalous ecg event.Electrocardio processing result is sent to gait test work station 230, while the also real-time display on APP.If any electrocardio
Exception or blood oxygen are abnormal, then APP is issued Xiang doctor by gait test work station 230 and warned according to the prediction scheme pre-set,
Early warning is issued to measured also by voice and text.
Smart phone APP gait test module also receives motion sensor signal from motion sensor 214.Since movement passes
Sensor 214 uses miniature 3-axis acceleration sensor and three-axis gyroscope.Three-axis gyroscope data are examined for monitoring the direction of motion
Survey turning;3-axis acceleration data are then used to detect foot and land event, accurately calculate cadence;Forward acceleration component can be used for
Estimate step-length.Step-length is the displacement in a gait cycle, to forward acceleration component measured by front accelerometer at this time
Progress once integrates to obtain speed, and quadratic integral must be displaced.In order to remove error caused by deviation when wearing, worn in measured
When upper wearing component, it is desirable that measured stands, and carries out initialization correction in 5 seconds.
There are cadence and step-length, so that it may calculate movement velocity, and then calculate the exercise intensity indicated with metabolic equivalent.Beauty
State's sports medical science meeting ACSM (American College of Sports Medicine) is used to calculate metabolic equivalent when walking
Formula are as follows:
Total metabolism equivalent (Gross METs)=1+ (0.1 × speed+1.8 × speed × gradient percentage)/3.5 milliliters/public affairs
Jin/minute
Speed unit is m/min that level road upgrade percentage is 0%.
Gait test work station 230 has five big tasks: first is that receiving and showing from smart phone APP gait test module
220 signal and processing result;Second is that further analyzing and handling these data and processing result, the heart of measured is generated
Electricity moves, the assessment parameter and report of heart rate motor reaction;Third is that providing the interactive and information processing function for medical staff;Four
It is other inspections and the test data according to test result and measured, risk stratification is carried out to it, and further issue movement
Prescription;Fifth is that interacting with case big data intelligent management system (BigCase) 100, test result is uploaded, enriches case data;
Using the functions such as the BigCase risk stratification provided and exercise prescription formulation, serviced for measured.
It is heart strain that cardiopulmonary exercise functional assessment and exercise prescription, which formulate the main measurement index that system (DCW) 200 is provided,
Ability series (Chronotropic Competence Indices CCI) index and walking distance.Heart adaptability to changes lacks
The important Danger Indexes of cardiovascular disease are of great significance in the prevention and treatment and rehabilitation of cardiovascular disease, have been international cardiovasculars
The common recognition on boundary.Repeatedly large-scale test in the world, including famous U.S.'s Framingham cardiac studies, to 3000 Healthy Peoples
Tracking, the French follow-up study for lasting 23 years to 5713 Healthy Peoples for lasting 15 years, all show that CI is that All death independently refers to
Mark, including sudden death.
Regulation of the autonomic nerve to cardiorespiratory system is by sympathetic nerve, parasympathetic nerve, sinoatrial node, cardiac muscle, peripheral tissues
What the closed-loop system of equal compositions was completed.The activation of sympathetic nerve increases sinus-node self-activity, is passed excitability by atrioventricular node
It is directed at His-Purkinje system, drives heart contraction, and accelerates loosening for cardiac muscle cell in diastole;Vagus nerve passes through the heart
Interior ganglionic cholinergic neuron inhibits the pacemaker activity (reduce heart rate) of sinoatrial node, reduces the conduction and reduction between chamber
The excitability of His-Purkinje system.During exercise, due to peripheral tissues' metabolic demand, sympathetic activation makes sinoatrial node certainly
Rule property increases, while driving heart contraction.For ordinary person, increase and the myocardial contractive power enhancing of heart rate occur simultaneously, also referred to as
Bowditch effect.Heart output increases rapidly, ensure that the conveying of oxygen and nutrient.However, even if not finding cardiovascular device matter
Property problem people, there is also heart adaptability to changes lack problem.Sympathetic stimulation is inadequate or sympathetic nerve in this groups of people movement
Excitation effectively do not increase sinus-node self-activity.
The definition of heart adaptability to changes series index and its range of normal value in the case where gait test are as follows:
1, resting heart rate Resting Heart Rate RHR: body remains static down, mood is in tranquility
Under heart rate, range of normal value 60-80BPM.Research and clinical practice prove that resting heart rate is abnormal, especially irregular change,
It is admission rate and the raised sign of the death rate.
2, heart strain rate Chronotropic Rate CR: defining heart strain rate CR is change rate of the heart rate to amount of exercise,
Or change the variation of caused heart rate for unit exercise equivalent, it is rate of straining of the heart to movement, calculation formula is as follows:
CR=(HRstage-HRrest)/(METstage-1)
Its normal value is that exercise metabolism amount increases by a unit amount, and heart rate increases 10BPM.It is too high or too low to can mean that friendship
Sense and parasympathetic nerve activity, sinoatrial node or cardiac muscle go wrong.
Heart strain rate connects exercise intensity and heart rate, is the important indicator of personalized target heart rate.With rehabilitation into
Exhibition and medication etc., heart strain rate can constantly change, therefore, target heart rate in exercise prescription should with the variation of heart strain rate and
Adjustment in time.
3, heart strain limit Chronotropic Limit CL: namely heart rate reserve Heart Rate Reserve
(HRR), i.e., heart is the attainable maximum dynamic range of reply campaign.This depends not only on the mobility of heart itself,
Also autonomic nerve ability of regulation and control is depended on.The present invention is calculated by following formula:
CL=HRR=(HRmax-HRrest)/(HRPredM-HRrest)
Wherein maximum heart rate predicted value (HRPredM), general 220-age is predicted in the world.In cardiopulmonary exercise test, reach
Heart rate when having arrived limit of sports record is peak heart rate HRmax, and then calculated CL value should be between 0.8-1.3.
In gait test, because of the limitation of this forms of motion of walking, the HR that reaches in testmaxIt is that maximum walking is exerted
Power maximum heart rate achieved.This is smaller than the CL to be reached capacity when moving in CPX, usually > 0.4 can.Such as: one
A 60 years old normal person walks 500 meters in 6 minutes.Maximum speed reaches 100 ms/min, exercise equivalent 3.86MET.If his is static
Heart rate is 75BPM, CR=12BPM/MET, his CL=12* (3.86-1)/(220-60-75)=0.4
4, (Heartrate Recovery after Exercise (HRE) is defined as the peak motion heart for exercise heart rate recovery
The difference of 1 minute heart rate after rate and movement stop, heart rate is restored to the speed of resting heart rate after expression movement stops.This is cardiovascular
The hazard index of disease.A large amount of research has shown that HRE is a kind of very strong prognostic indicator.Europe and America heart association
Combined paper thinks that 1 minute campaign heart rate restores to reflect the speed of parasympathetic nerve reactivation, and normal value must not be lower than
12。
Cardiac function risk stratification
Complete cardiopulmonary exercise gait test after, according to 6 minutes walking distances can carry out cardiac function compromise state into
Row classification (layering).Europe, the United States, plus cardiac rehabilitation and it is secondary prophylactically can combined paper the danger based on 6 minutes walking distances
Danger layering is classified and contacts with the cardiac functional grading of New York Heart association (NYHA) and the cardiac function of Canadian heart association (CCS)
Get up.The former two is supervisor's evaluation, 6 minutes walking distance (low danger > 400m;Middle danger 300m~400m;High-risk < 300m) it is objective
Evaluation.Following table is that 6 minutes walking distances are embedded in the result of the coronary heart disease risk layered sheet of Chinese expert.Low danger requirement in table
It all refers to scale to meet, high-risk needs an index and meet.If this can be removed without revascularization.
A large amount of clinical test proves in the world, and than 6 minutes walking distances of heart adaptability to changes series index are in risk stratification
In it is even more important.The maximum heart rate wherein reached is related to walking distance, and heart strain rate and heart rate restore all to be the dynamic of heart
The direct digital representation of state function.Therefore, to carry out risk stratification using heart adaptability to changes series index more scientific, objective
It sees.
The formulation of exercise prescription
Exercise prescription includes four aspects, it may be assumed that the movement frequency, exercise intensity, type of sports, movement duration.According to danger
It is layered result and the wish of patient, we can determine whether the movement frequency, type of sports, movement durations.For example, danger low for one
Patient, we can suggest him once a day, move 20-30 minutes, have warming-up exercise in 10 minutes before movement, there is 10 points after movement
Clock reactivates.He can choose skelp, excercises, taijiquan etc..
Exercise intensity metabolic equivalent and target heart rate metering.After smoothly completing digital cardiopulmonary gait test, if also selected
The training mode to skelp is selected, it can be directly using the heart strain limit reached in digital cardiopulmonary gait test, namely most
Big heart rate.By target heart rate selection, the 80-100% of maximum heart rate can in gait test.
On the other hand, since gait test form limits the performance of locomitivity, we can be adopted in the following method
To determine exercise intensity, the target heart rate of the heart strain rate calculating personalization measured is used.
The first step carries out risk stratification according to cardiac rehabilitation guide, according to risk stratification as a result, determining movement deposit: low
Endanger 7MET, middle danger 6MET, high-risk 5MET;
Second step, recommending exercise intensity is the 60%-80% of movement deposit, it may be assumed that 4-5.5MET of low danger, middle danger 3.5-
4.5MET, high-risk 3.0-4.0MET.For rigid setting in motion trainer, lower amount of exercise is taken, it is then incremental, it increases
Amount of exercise.
Third step calculates personalized target heart rate according to recommendation exercise intensity and heart adaptability to changes series index.Here, the heart is answered
Variability varies with each individual, and is to calculate us to be illustrated with an example:
Have a low danger patient, setting in motion for a period of time, we prefer that movement is 5MET by force;
Target heart rate is calculated according to the resting heart rate (75BPM) of measurement and heart strain rate (13B/MET):
HRexerc=75+13* (5-1)=127BPM
4th step, risk stratification and exercise prescription are inputted in the case database of the patient.
Fig. 3 is in the embodiment of the present invention by the knot of the rehabilitation training of sports apparatus and formulation optimization (CRIM) system 300
Structure schematic diagram.After cardio-pulmonary function assessment, risk stratification and exercise prescription setting, the case of the patient in case big data
The necessary data for carrying out cardiac rehabilitation is had been provided with, patient can setting in motion rehabilitation training.By sports apparatus
Rehabilitation training and formulation optimization (CRIM) system 300 equipment in hospital or recovery centre, and with case big data intelligent management system
System 100 is connected.By the rehabilitation training of sports apparatus and formulation optimization (CRIM) system 300 include doctor workstation module 310,
Sports apparatus and control module 320, body monitoring modular 330.
After patient comes hospital or recovery centre, doctor or rehabilitation are an apprentice of in case big data intelligent management system 100 and are adjusted
The rehabilitation prescription and corresponding data of the patient out generates this rehabilitation programme, issues disease according to prescription, data and patient's wish
People's rehabilitation training hand-held intelligent equipment 321.And with 321 brush doctor workstation module of rehabilitation training intelligent rehabilitation equipment, 310 screen
The rehabilitation training plans of the patient are passed in his rehabilitation training intelligent rehabilitation equipment 321 by two dimensional code on curtain.The drill program
Include him using which kind of sports apparatus, do how long warming-up exercise, on the instrument with which kind of speed movement how long,
Monitoring index and alarm setting when exercise rehabilitation training.Meanwhile doctor or rehabilitation teacher issue the wearable monitoring device of patient
330, including electrocardioscanner 331, sphygmomanometer 332, BOLD contrast 333.It is real-time by bluetooth that all monitoring devices will acquire data
It is transmitted to patients ' recovery training hand-held intelligent equipment 321.
Patients ' recovery training hand-held intelligent equipment 321 by hand-held intelligent communicate and calculate equipment (be often used smart phone or
Tablet computer) and be mounted above APP composition.The APP of patients ' recovery training hand-held intelligent equipment 321 has a two big functions: one
It is to remind and manage the implementation of patients ' recovery drill program according to exercise rehabilitation training plan.The a certain sports apparatus of patient selection
Afterwards, it is communicated by bluetooth with the foundation of sports apparatus 322, and its classification and parameter is obtained with the two dimensional code of the instrument.According to movement
Rehabilitation programme sends control instruction (being then speed and the gradient if it is treadmill) to sports apparatus 322, while sending out to others
Send verbal cue.Such as: " now beginning to move, please be ready ".
The second largest function of the APP of patients ' recovery training hand-held intelligent equipment 321 is to receive electrocardio, blood pressure and blood oxygen number
According to being handled and analyzed in real time, data and processing result are uploaded to doctor workstation module 310.Pass through when noting abnormalities
Doctor workstation module 310 is alarmed Xiang doctor and rehabilitation teacher.Simultaneously with presetting, adjust automatically sports apparatus speed is reminded
Patient pays attention to.Patients ' recovery training hand-held intelligent equipment 321 is wirelessly connected with doctor workstation module 310 by wifi.
Motor pattern and amount of exercise monitoring and adjustment
Using sports apparatus exercise rehabilitation training need optimize be motor pattern, exercise intensity and move duration choosing
It selects.In exercise prescription, exercise intensity is usually there are two types of objective representation method, first is that the exercise intensity indicated with metabolic equivalent,
Another kind is indicated with target heart rate.Since heart strain rate varies with each individual, for same exercise intensity, the target heart rate of different people is not
The same.Meanwhile some variations can also occur for same person's different time and different conditions, heart strain rate.Heart strain rate
Variation leads to the variation of target heart rate.Therefore, it is usually transported in the case where being difficult to real-time measurement exercise intensity with target heart rate to control
Dynamic training strength.When using sports apparatus, we can know exercise intensity in real time, should control exercise prescription with exercise intensity
Implementation preferably.If exercise prescription is indicated with target heart rate, the heart that can be used in heart adaptability to changes series index is answered
Target heart rate is converted into the exercise intensity of metabolic equivalent expression by variability and resting heart rate.Here, heart strain rate is to contact generally to transport
The index of fatigue resistance and personalized target heart rate;Resting heart rate corresponds to the stationary state that metabolic equivalent is one.
We use trapezoidal motion mode.The exercise intensity according to determined by sport training plan and movement duration, preceding
Respectively add Motor preparation and the exercise recovery stage of certain time length afterwards.For example, the sport training plan of a certain patient is strong with 5MET
Degree movement 20 minutes.The formula given according to American Society of Sports Medicine, can calculate the gradient and speed on a treadmill, and
Start before plus 2 minutes accelerators, after plus 2 minutes moderating process.In entire motion process, as long as no electrocardio, blood
Pressure, blood oxygen are abnormal, just maintain former design sport training plan, the adjustment of speed of not taking exercises and movement duration.Doctor workstation
Module 310 calculates heart adaptability to changes series for according to the variation of electrocardio, blood pressure and blood oxygen parameter in entire sport training process
Index, heart rate variability, blood pressure and blood oxygen running parameter, and provide training report.Sometimes, in order to improve rehabilitation training effect,
It, can be with certain regular varying motion intensity in entire movement duration.
Fig. 4 is the structure of guidance and monitoring (SCRA) system 400 of walking and other free movements in the embodiment of the present invention
Schematic diagram.Guidance and monitoring (SCRA) system 400 and case big data intelligent management system 100 of walking and other free movements
It is connected, including 420 module of rehabilitation assistant and rehabilitation service client modules 410.Rehabilitation service client modules 410 further wrap
Include medical and nursing work station 411-1, doctor's mobile client 411-2, family members' client 412 and professional service client 413.Patient steps on
There are two types of situations using rehabilitation assistant progress cardiac rehabilitation for note: one is during phase rehabilitation in hospital, body is more weak, can only
Bedside movement is done, needs to carry out real-time monitoring using rehabilitation assistant;Second is that starting the house rehabilitation of three phases.Patient begins to use rehabilitation
Before helper module 420 carries out rehabilitation training, need to be registered by medical and nursing work station 411-1: case is an apprentice of in doctor or rehabilitation
The patient data is recalled in big data intelligent management system 100, rehabilitation implementation plan is generated according to doctor's advice, with what is scanned the two-dimensional code
Form, will be in the smart phone APP 422 of patient related information input rehabilitation assistant.Rehabilitation assistant wearing is allotted to patient simultaneously
Equipment 421.
Rehabilitation helper module 420 reminds according to the big prescription of rehabilitation 5 and doctor's advice and patient is assisted to implement rehabilitation training, and can
To carry out intellectual monitoring, provide rehabilitation training report.Rehabilitation helper module 420 includes wearable device 421 and smart phone APP
422.Wearable device 421 measures electrocardio and motor message simultaneously, is sent to smart phone APP 422 by bluetooth.Smart phone APP
422 processing in real time and analysis electrocardio and motor message.By handling and analyze electrocardiosignal, heart rate is accurately obtained, monitoring premature beat,
The anomalous ecgs such as atrial fibrillation, arrhythmia cordis;By handling and analyzing motor message, i.e., 3 dimension acceleration signals and 3 dimension gyroscope letters
Number, accurately it is inferred to body posture: lies, sits, stands, walks, runs, falls down;Cadence, step-length when estimation is left and run, to survey
Calculate speed and exercise intensity.
The recovery function that smart phone APP 422 is provided includes: to remind patient's medication according to quantity on time;Patient is reminded to open on time
Beginning exercise rehabilitation training, electrocardio, breathing, type of sports and the intensity of real-time monitoring patient, position, at the movement of setting
Side, reminds the insufficient or excessive of amount of exercise;Remind dyskinesia (such as falling down) and anomalous ecg;All data are recorded, according to need
It uploads or saves;Report is automatically generated, is referred to for doctor.
Smart phone APP 422 also has the function of sleep monitor, it integrate heart rate variability characteristic measure (time domain
NN50, SDSD, VLF, LF and HLF relative value and motion state of frequency domain, 3 kinds of sleep states of classifying: waking up, shallowly sleep, sound sleep, and
Further heart rate variability of the assessment under these different conditions provides personalized sleep quality and health state evaluation report
It accuses.
Smart phone APP also detects movement of getting up, and points out and slow down movement, fall prevention.This is outstanding for the elderly
Its is important.
By family members' client 412, user can consult the case data of related patient, can also be to case big data intelligence
It can management system customization report or timing Real-time Monitoring Data.For example, family members can customize: 8 points of every night, push patient this
The case where one day 5 big prescription of execution and exercise rehabilitation training report;Anomalous ecg and while falling down, send Hot Report immediately.
The technical means disclosed in the embodiments of the present invention is not limited only to technological means disclosed in above embodiment, further includes
Technical solution consisting of any combination of the above technical features.It should be pointed out that for those skilled in the art
For, various improvements and modifications may be made without departing from the principle of the present invention, these improvements and modifications are also considered as
Protection scope of the present invention.
Claims (10)
1. cardiopulmonary exercise assessment and training integral system, it is characterised in that: including case big data intelligent management system,
And the cardiopulmonary exercise functional assessment and Personalized motion prescription system of data interaction are carried out with case big data intelligent management system
Determine system, be by the rehabilitation training of sports apparatus and formulation optimization system, the guidance of walking and other free movements and monitoring
System, client;
Case big data intelligent management system is used for the case archives of storage and management patient;
Cardiopulmonary exercise functional assessment and Personalized motion prescription formulate system for acquiring physiological signal, being based on digital cardiopulmonary walking
Test is assessed, and obtains patient information from case big data intelligent management system, assessment result is uploaded to the big number of case
According to intelligent management system, and according to other detection informations of assessment result and patient, risk stratification and exercise prescription design are carried out;
The fortune of patient is obtained from case big data intelligent management system by the rehabilitation training and formulation optimization system of sports apparatus
Dynamic prescription and associated conditions information formulate drill program, guidance and monitoring training, according to exercise rehabilitation training plan, remind and
Patient's implementing plan is managed, and monitors physical condition when rehabilitation training, is handled and is analyzed in real time after acquiring physiological data,
Training report is generated, data and report are uploaded;
The guidance and monitoring system of walking and other free movements obtain the prescription of patient from case big data intelligent management system
With associated conditions information, drill program is generated, reminds and instruct patient to carry out training according to quantity on time, and upload trained knot
Fruit, customization and push family members' report;
Client is used to carry out data interaction with user.
2. cardiopulmonary exercise assessment according to claim 1 and training integral system, it is characterised in that: cardiopulmonary exercise
Functional assessment and Personalized motion prescription formulate system and use heart adaptability to changes series index as assessment cardiopulmonary exercise function
Numerical index, heart adaptability to changes series index include: resting heart rate, heart strain rate, heart strain limit, exercise heart rate recovery.
3. cardiopulmonary exercise assessment according to claim 1 and training integral system, it is characterised in that: cardiopulmonary exercise
Functional assessment and Personalized motion prescription formulate system according to coronary disease in " coronary cardiopathy rehabilitation and secondary prevention China Consensus of experts "
The risk stratification table of patient carries out risk stratification in conjunction with 6 minutes walking distances and heart adaptability to changes series index.
4. cardiopulmonary exercise assessment according to claim 1 and training integral system, it is characterised in that: cardiopulmonary exercise
Functional assessment and Personalized motion prescription formulate system and determine exercise intensity range according to risk stratification, use resting heart rate, the heart
Strain rate combination exercise intensity calculates personalized target heart rate, selection movement duration and the movement frequency.
5. cardiopulmonary exercise assessment according to claim 1 and training integral system, it is characterised in that: cardiopulmonary exercise
It includes: wearable physiological signal acquisition module and wearable physiological signal that functional assessment and Personalized motion prescription, which formulate system,
The smart phone APP gait test module of acquisition module connection and the walking being connect with smart phone APP gait test module
Experiment work station.
6. cardiopulmonary exercise assessment according to claim 1 and training integral system, it is characterised in that: by movement
The drill program that the rehabilitation training of instrument and formulation optimization system are formulated includes: sports apparatus type, warming-up exercise time, instrument
Move duration and speed, monitoring index and alarm setting when exercise rehabilitation training.
7. cardiopulmonary exercise assessment according to claim 1 and training integral system, it is characterised in that: by movement
The rehabilitation training of instrument and formulation optimization system include: doctor workstation module and carry out data with doctor workstation module
Interactive sports apparatus and the body monitoring modular for wearing.
8. cardiopulmonary exercise according to claim 1 assessment and training integral system, it is characterised in that: walking and its
The guidance of its free movement and monitoring system also acquire electrocardio and motor message, by handling and analyzing electrocardiosignal, obtain the heart
Rate monitors anomalous ecg;By handling and analyzing motor message, body posture is calculated, cadence, step when estimation is left and run
It is long, to calculate speed and exercise intensity.
9. cardiopulmonary exercise according to claim 1 assessment and training integral system, it is characterised in that: walking and its
The characteristic measure and motion state of the guidance of its free movement and the also comprehensive heart rate variability of monitoring system, sleep state of classifying,
And the heart rate variability under different sleep states is further assessed, provide personalized sleep quality and health state evaluation report
It accuses.
10. cardiopulmonary exercise according to claim 1 assessment and training integral system, it is characterised in that: walking and
The guidance of other free movements and monitoring system include including rehabilitation helper module and rehabilitation service client modules.
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