NZ552008A - Hypoxic training apparatus - Google Patents

Abstract

A hypoxic training apparatus is provided. The apparatus includes a bellows and a housing for the bellows. The housing is adapted to be configurable between an opened state and a closed state. The housing encloses the bellows when in the closed state. The housing provides a mount for the bellows when in the opened state.

Description

PATENTS FORM NO. 5 Fee No. 4: $250.00 PATENTS ACT 1953 COMPLETE SPECIFICATION After Provisional Nos: 552011 and 552008 Dated: 23 December 2005 and 10 July 2006 A HYPOXIC TRAINING APPARATUS WITH AN IMPROVED HOUSING WE DEVX TECH IP LIMITED, a New Zealand company of 19a Moata Road, Onehunga, Auckland, New Zealand hereby declare the invention for which we pray that a patent may be granted to us, and the method by which it is to be performed to be particularly described in and by the following statement: James & Wells Ref:230746DIV1 -c A HYPOXIC TRAINING APPARATUS WITH AN IMPROVED HOUSING Technical Field The present invention relates to apparatus for supplying a variable mix of gases. In particular it relates to apparatus for supplying a variable mix of breathable gases. 5 Further in particular it relates to an apparatus for supplying a subject with gas having a variable level of oxygen. Yet further in particular it relates to a portable apparatus for applying hypoxic training to a subject.

Background Art Hypoxic training involves supplying a subject with hypoxic air to place a beneficial 10 stress on the subject's pulmonary system. Generally this type of training is applied intermittently to allow the subject to recover from the stress by breathing normoxic air.

In this context, hypoxic air is air with a modified oxygen content and normoxic air is ambient atmospheric air. Hypoxic air has reduced oxygen levels compared to 15 normoxic air.

The benefits of hypoxic training were discovered by observation of the physiology of subjects living in a rarified atmosphere at altitude. For this reason, hypoxic training is often referred to as simulated altitude training.

Apart from the obvious convenience of having the benefit of altitude training at 20 lower altitudes, hypoxic training also allows subjects to carry out other types of training in low altitude normoxic air in between simulated altitude training sessions.

Conventional hypoxic training apparatus tends to be relatively large and heavy and therefore not portable. The applicant has observed that a hypoxic training apparatus that can be used at a variety of locations may facilitate hypoxic training 2 Jaws Ref: 232467/58 through convenience of location. The applicant has also observed that use in a variety of locations would be facilitated by a hypoxic training apparatus that is portable. The applicant has also observed that portability would be assisted if an apparatus was relatively compact and robust. The applicant has also observed 5 that an apparatus that is easily stowed would also be advantageous.

Currently, hypoxic training is generally limited to use by elite subjects because: the capital cost of the equipment is generally high; the running cost of the equipment is generally high; and/or the training equipment involves a level of risk to the health or safety of the subject.

Some existing hypoxic training apparatus provides a subject with a mix of normoxic air and nitrogen, or a similar inert gas, to create a hypoxic air mix to supply to the subject.

Most existing hypoxic apparatus requires feedback from an oxygen analyser to control the various valves that control the ratio of air and nitrogen supplied to a 15 subject. The feedback provided by the oxygen analyser is used to control proportional valves which determine the mix of air and nitrogen and, thereby, the oxygen content supplied to the subject. Feedback from the oxygen analyser is necessary due to the difficulty in positively and precisely controlling the state of the valve and thereby the mix of gases. This difficulty arises due to such factors as 20 mechanical hysteresis.

An oxygen analyser is a sophisticated and expensive piece of equipment to include in the apparatus. An oxygen analyser obviously adds considerable cost in the manufacture and maintenance of the apparatus. Also, the effectiveness of feedback from the oxygen analyser is limited by the response time of the oxygen 25 analyser, which can be considerable in terms of timeframes for feedback electronic systems. 3 Jaws Ref: 232467/58 Generally, valve systems used in hypoxic apparatus to control the rate of gas flow to a venturi for example, consist of proportional valves. A proportional valve is one which includes an aperture the size of which is adjusted to adjust the flow through the valve. The flow is proportional to the size of the aperture. Generally, 5 proportional valves are expensive and may involve characteristics which make them difficult to control, such as mechanical hysteresis. In most cases, and especially where relatively imprecise proportional valves are used, sophisticated feedback of the level of oxygen is required.

The need for conventional hypoxic training apparatus to use sophisticated 10 feedback mechanisms and to use expensive proportional values is due to the intrinsic risk involved in supplying a subject with hypoxic air with reduced oxygen levels. Therefore, conventional hypoxic training apparatus has a high capital cost and high maintenance costs.

Some hypoxic training apparatus operate by mixing ratios of compressed air and 15 compressed nitrogen. This carries with it the cost of supplying compressed air in addition to compressed nitrogen.

Some systems overcome the need to supply both compressed air and compressed nitrogen by the use of a venturi. A venturi is a conduit with a restricted passage. Accordingly to Bernoulli's equation, the pressure within the restricted portion of a 20 venturi can be determined by the pressure of gas feed into the conduit and by the dimensions of the restricted portion. If an inlet for a second gas is included in the side of the venturi, at the restricted portion, then it is possible to pre-determine a mix of the two gases by the feed pressures and dimensions of the venturi. That is, the feed pressure of the first gas and dimensions of the venturi determine the 25 pressure at the restricted portion, or neck, of the venturi. By controlling the feed pressure and dimensions of the venturi, it is possible to create a partial vacuum in 4 Jaws Ref: 232467/58 the neck of the venturi which can draw in a second gas which will mix with the first gas. The gas drawn into the neck of the venturi can be atmospheric air. This avoids the need to supply compressed air.

Some hypoxic training apparatus involves re-breathing inhaled air then treating air 5 supplied to the subject. This apparatus generally does not allow for any active control of the level of oxygen to be supplied. These systems introduce an obvious risk in a subject losing consciousness while being supplied with hypoxic air, and failing to remove themselves from the hypoxic air supply.

Given either the risk or expense associated with hypoxic systems, it is not 10 surprising that the benefits of hypoxic training have not reached far beyond use for elite subjects such as athletes or race horses.

Some conventional hypoxic training schemes are typically controlled by way of the content of oxygen that is supplied to a person. This is, a subject may be supplied with 9-12% oxygen for given intervals. However the applicant has observed that 15 given oxygen contents will produce different SP02 levels in different subjects. This means that a training system does not necessarily induce an ideal training SP02 in a given subject. The result may be training sessions that are less effective, that may take longer or that may even be dangerous.

Some existing hypoxic training systems have switches which switch hypoxic supply 20 between subjects to create the intermittent supply of hypoxic air. A normoxic supply is switched to the subject when the hypoxic supply is switched to other subjects. Typically, pairs of subjects are involved and each subject has equal periods of normoxic and hypoxic supply. Therefore, these systems apply equal periods of hypoxic and normoxic air to each subject. The applicant has observed 25 that non-equal periods of hypoxic and normoxic supply may result training sessions with improved results or with reduced session times for similar results.

Jaws Ref: 232467/58 4 Conventionally, hypoxic training systems are calibrated to supply given ratios of normoxic air and an ambient gas such as nitrogen. Nitrogen is generally supplied commercially in a high purity mix in which oxygen constitutes the main impurity. It is well known that there is trade off between the purity of nitrogen and the time 5 taken to 'generate' the nitrogen from ambient air. Additional processing time leads to additional costs associated with the nitrogen supply. For example, 95% nitrogen and 5% oxygen supply is cheaper than a 99% nitrogen and 1% oxygen supplied. However, 99% is the industry standard for bottled supplies of nitrogen.

A characteristic of the mammilian body is that once a hypoxic supply is replaced 10 with a normoxic supply, the subject's saturated oxygen levels - SP02 level -'bounces', or over compensates, relatively high. Having a subject's SP02 level bounce to a relatively high level is not optimal for hypoxic training sessions. It would be advantageous to have a system where periods of relatively high SP02 'bounce' levels are avoided during a hypoxic training session.

A hypoxic training apparatus may be supplied either directly from a nitrogen generator or with commercially bottled nitrogen. In this case, the hypoxic training apparatus, which must be carefully calibrated, will generally be calibrated to the mix of nitrogen and oxygen that is commercially available in bottled supply. This may be 99% for example. Any cost saving in setting of an on-site generator to 20 produce only 95% pure nitrogen is outweighed by the cost and complexity of recalibrating the hypoxic training apparatus.

Conventional hypoxic training apparatus tends to be relatively large and heavy. A more compact hypoxic training apparatus would facilitate use in a wide range of locations, such as in the home for example. The applicant has observed that use 25 in a variety of locations would also be facilitated by a hypoxic training apparatus that is portable. The applicant has also observed that portability would be assisted 6 Jaws Ref: 232467/58 if the apparatus was relatively compact and robust. The applicant has also observed that an apparatus that is easily stowed would also be advantageous. Accordingly, it is an object of the present invention to provide a hypoxic training apparatus that facilitates portability, or at least provides the public with a useful 5 choice in hypoxic training apparatus.

It is a further object of the present invention to provide a portable hypoxic training apparatus that is readily recalibrated for commercially bottled or on-site generated Nitrogen, or at least to provide the public with a useful choice in hypoxic training apparatus.

It is also an object of the present invention to provide a portable hypoxic training apparatus that is relatively safe to use and/or is suitable for use with minimal supervision, or at least to provide the public with a useful choice in hypoxic apparatus.

It is a further object of the present invention to provide a portable hypoxic training 15 apparatus that allows relatively precise control of the mix of nitrogen and air, or at least to provide the public with a useful choice in hypoxic training apparatus.

It is a further object of the present invention to provide a portable hypoxic training apparatus that overcomes or mitigates problems or shortcomings associated with existing hypoxic apparatus, or at least to provide the public with a useful choice in 20 gas mixing apparatus.

All references, including any patents or patent applications cited in this specification are hereby incorporated by reference. No admission is made that any reference constitutes prior art. The discussion of the references states what their authors assert, and the applicants reserve the right to challenge the accuracy and 25 pertinency of the cited documents. It will be clearly understood that, although a 7 Jaws Ref: 232467/58 number of prior art publications are referred to herein, this reference does not constitute an admission that any of these documents form part of the common general knowledge in the art, in New Zealand or in any other country.

It is acknowledged that the term 'comprise' may, under varying jurisdictions, be 5 attributed with either an exclusive or an inclusive meaning. For the purpose of this specification, and unless otherwise noted, the term 'comprise' shall have an inclusive meaning - i.e. that it will be taken to mean an inclusion of not only the listed components it directly references, but also other non-specified components or elements. This rationale will also be used when the term 'comprised' or 10 'comprising' is used in relation to one or more steps in a method or process.

As used herein the term 'pulse' refers broadly to a valve spending a given interval in a given state.

As used herein the term 'pulse width modulation', or similar, relates to a technique whereby the a device or signal is pulsed between two states and the widths of 15 pulses, as seen over time, are modulated to vary the proportion of time, over a given interval, that the device or signal spends in a given state.

Further aspects and advantages of the present invention will become apparent from the ensuing description which is given by way of example only. 8 Jaws Ref: 232467/58 Disclosure of Invention According to one aspect of the present invention comprises a portable hypoxic training apparatus including: a bellows; a housing adapted to be configurable between an opened state and a closed state; wherein the housing substantially encloses the bellows when in the closed state and provides a mount for the bellows when in the opened state.

As used herein the term 'bellows' refers to a device which accommodates a gas and which is deformable to accommodate relatively more or less gas.

Preferably, the bellows comprises an opening at one end thereof.

Preferably, the housing includes in use an upper member and a lower member.

Preferably, the lower member has a base formed thereon, wherein the base is configured to support the apparatus in said open configuration.

Preferably, the bellows is mounted such that the opening is located substantially at 15 the lower member.

Preferably, the upper member and bellows are configured such that an opposite end of the bellows to the opening is connectable to the upper member.

Preferably, the bellows comprises a bag.

Preferably, the upper member, lower member and bag are configured such that the 20 bag is extended between the upper and lower member to a predefined degree of extension, wherein the predefined degree of extension is such that the bag is 9 Jaws Ref: 232467/58 operable to at least partially fill and partially empty with gas.

Preferably, the apparatus includes pneumatic components.

Preferably, the pneumatic components are located substantially in the lower member.

Preferably, the apparatus includes electronic components.

Preferably, the electronic components are located substantially in the upper member.

Preferably, the upper and lower members are biased towards predetermined relative positions.

Preferably, the apparatus includes a hinge formed between the upper and lower members.

Preferably, the portable hypoxic training apparatus includes a gas supply outlet.

Preferably, the gas supply outlet is provided substantially at the hinge.

Preferably, the upper and lower members are configured such that the gas supply 15 outlet is closed when the housing is in a closed state.

Preferably, the apertures are formed in the upper and lower members substantially at the hinge.

Preferably, said apertures are configured such that they are substantially aligned when the housing is in an opened state.

Preferably, said apertures are arranged such that they are substantially non-aligned when the housing is in a closed state.

Jaws Ref: 232467/58 Preferably, the portable hypoxic training apparatus includes a connector to provide connection for a gas supply conduit, said connector adapted to be inserted into said apertures when said apertures are aligned.

Preferably, the connector provides a connection for a communication line of a pulse oximetry sensor.

Preferably the portable gas mixing head comprises: a mixing volume provided with a primary inlet, a secondary inlet and an outlet, said secondary inlet including a valve which is adapted to be operated by a pulse width modulation driver, said pulse width modulation driver adapted to pulse width modulate the valve between two flow states to achieve a given flow state through the secondary inlet.

Preferably, said mixing volume comprises a venturi.

Preferably, said secondary inlet communicates substantially with a restricted passage of the venturi.

Preferably, the primary inlet includes a valve which is adapted to be operated by a pulse width modulation driver to pulse width modulate the valve between two flow states to achieve a given flow state through the primary inlet.

Preferably, the apparatus includes a controller adapted to control said pulse width modulation driver(s).

Preferably, pulse width modulation of each of the valves included with primary and secondary inlets allows control of the total flow through the venturi as well as control of the mix of nitrogen and air exiting the outlet.

Preferably, the pneumatic components include a valve, and wherein, the valve 11 Jaws Ref: 232467/58 includes: a control chamber; and a control member, said control member having a first position within the control chamber and a second position within the control chamber.

Preferably, the first position of the control member corresponds to a first degree of restriction of the control chamber and the second position of the control member relates to a second degree of restriction of the control chamber, Preferably, a clearance is provided between the control member and the control chamber in the first and second positions whereby each of the first and second 10 degrees of restriction allow some flow of gas through the control chamber.

Preferably, one of the first or second degrees of restriction may substantially prevent any flow of gas through the control chamber.

Preferably, the flow control valve includes an actuator for the control member.

Preferably, said actuator is a solanoid.

Preferably, the solanoid is adapted to pulse the control member in the first or second position for a given duration.

Preferably, the solenoid is adapted such that said duration of said pulse(s) can be determined to an accuracy of approximately a millisecond.

Preferably, the apparatus includes a pressurised gas supply connected to the 20 primary inlet.

Preferably, the pressurised gas supply includes at least one pressure regulator. Preferably, the pressurised gas supply includes at least two pressure regulators. 12 Jaws Ref: 232467/58 Preferably, a combination of pressure of the pressurised gas supply connected to the primary input and the dimensions of the venturi is adapted to create a pressure at the secondary inlet that is lower than ambient atmospheric pressure.

Preferably, the pressurised gas supply comprises a supply of inert gas.

Preferably, the pressurised has supply includes a supply of nitrogen.

Preferably, the supply of Nitrogen may comprise a Nitrogen bottle.

Preferably, the supply of nitrogen may comprise a Nitrogen generator.

Preferably, the secondary inlet is provided with a supply of air.

Preferably, the supply of air comprises ambient atmosphere.

Preferably, the controller is adapted to read calibration data, defining a pulse width modulation signal for at least one of the valves included in the primary or secondary inlets.

Preferably, the controller is adapted to read calibration data defining a duty cycle period.

Preferably, the controller is adapted to read calibration data defining a portion of said duty cycle period in which a valve is to spend in one of the two flow states.

Preferably, said portion of the duty cycle period is defined to a precision of substantially a millisecond.

Preferably, the controller is adapted to read at least one oxygen content value 20 related to at least one portion of a duty cycle related to that oxygen content.

Preferably, the controller is adapted to receive a signal from a pulse oximeter, said signal indicating a blood oxygen saturation of a subject. 13 Jaws Ref: 232467/58 Preferably, the controller is adapted to monitor said signal from a pulse oximeter and to select a given oxygen content so as to provide feedback control of said signal from a pulse oximeter.

Preferably, the controller is adapted to read pulse oximetry data defining criteria for 5 supplying hypoxic air from the outlet.

Preferably, the controller is adapted to supply hypoxic air only if said criteria is met by the received pulse oximetry signal.

Preferably, the controller is adapted to read pulse oximetry data including an initiating minimum pulse oximetry value below which supply of hypoxic air should 10 not be initiated.

Preferably, the controller is adapted to read pulse oximetry data including a suspension minimum pulse oximetry value below which supply of hypoxic air should be suspended.

Preferably, the controller is adapted to read pulse oximetry data including a 15 resumption minimum pulse oximetry level below which said supply of hypoxic should not be resumed after being suspended.

Preferably, the minimum resumption pulse oximetry value is higher than the minimum suspension pulse oximetry level.

Preferably, the controller is configured to monitor at least one time dependent 20 aspect of the pulse oximetry signal.

Preferably, the controller is adapted to read predetermined criteria from stored training session data.

Preferably, said time dependent aspect includes a rise time. 14 Jaws Ref: 232467/58 Preferably, the controller is adapted to select an oxygen content value if the rise time meets predetermined criteria.

Preferably, said time dependent aspect includes a fall time.

Preferably, the controller is adapted to select an oxygen content value if the fall 5 time meets predetermined criteria.

Preferably, said time dependent aspect includes a time to reach a predetermined level.

Preferably, the controller is adapted to select an oxygen content value according to said time to reach a predetermined level.

Preferably, the controller is adapted to read training session data defining said predetermined criteria for selecting any oxygen content valve.

Preferably, the controller is adapted to read hypoxic training session data defining intervals of supply of hypoxic air.

Preferably, the intervals of supply of hypoxic air comprise approximately 70% of the 15 total time from the start of the first said interval of supply to the end of the last said interval of supply.

Preferably, the hypoxic training data defines a number of alternating intervals of hypoxic and normoxic supply.

Preferably, the controller is adapted to receive a signal from a pulse oximeter, said 20 signal indicating a heart beat rate.

Preferably, the portable hypoxic training apparatus includes a reservoir connected to the outlet.

Jaws Ref: 232467/58 Preferably, the portable hypoxic training apparatus includes a gas supply junction connected to the reservoir.

Preferably, the portable hypoxic training apparatus includes a normoxic supply valve connected to the supply junction in parallel with the reservoir, said normoxic 5 supply valve connecting the supply junction with a supply of normoxic air.

Preferably, the normoxic supply valve includes a supply line connected a supply for the primary inlet, the normoxic supply valve being adapted to be open only when gas is not being supplied to the primary inlet.

Preferably, the controller is adapted to read training session data defining any one 10 or any combination of the following parameters associated with an identifier assigned to at least one subject: duration of periods of hypoxic supply; duration of periods of normoxic supply; duration of combined hypoxic and normoxic periods; number of sessions of hypoxic and normoxic supply; number of cycles of periods of hypoxic intervals supplied in a given session.

Brief Description of Drawings Further aspects of the present invention will become apparent from the following description which is given by way of example only and with reference to the 20 accompanying drawings in which: Figure 1 schematically shows a pneumatic system according to a preferred embodiment of the present invention; 16 Jaws Ref: 232467/58 Figure 2 shows a flow control valve in a relatively closed configuration according to the same embodiment of the present invention as figure 1; Figure 3 shows a flow control valve in a relatively open configuration according to the same embodiment of the present invention as figures 1 and 2; Figure 4a shows a perspective view of a mixing head of a hypoxic apparatus according to the same embodiment of the present invention as Figures 1 to 3, shown in an opened state; shows a perspective view of a mixing head for a hypoxic apparatus according to the same preferred embodiment as figures 1 to 4a, shown here in a closed state; Figure 5a shows a perspective view of a mixing head according to an alternative embodiment as figures 4a and 4b in which the internal components are shown; Figure 5b shows a mixing head according to the same embodiment as figure 5a from an alternative view to figure 5a.

Figure 4b Figure 6 shows a screen provided by an interface of a hypoxic apparatus according to a preferred embodiment of the present invention, this 20 screen relating to training courses and programmes; Figure 7 shows an alternative screen provided by an interface of a hypoxic training apparatus according to the same preferred embodiment as figure 6, this screen relating to calibration; Figure 8 shows a process carried out by hypoxic apparatus according to a 17 Jaws Ref: 232467/58 preferred embodiment of the present invention; Figure 9 shows heart beat rates and blood oxygen saturation levels during an example hypoxic training session conducted according to a preferred embodiment of the present invention; Figure 10 depicts a process carried out by the controller of a hypoxic apparatus according to a preferred embodiment; Figure 11 depicts a process carried out by the controller of a hypoxic training apparatus according to an alternative embodiment of the present invention to figure 10, the process controls a normoxic/hypoxic valve 10 and the selection of oxygen contents during intervals of hypoxic air supply, and Figure 12 depicts a process carried out by an alternative embodiment of the present invention to figures 10 and 11, the process controls the normoxic/hypoxic valve and to selection of oxygen contents during 15 intervals of hypoxic air supply. 18 Jaws Ref: 232467/58 Best Modes for Carrying out the Invention Figure 1 is a schematic diagram of a pneumatic circuit 1 of a hypoxic training apparatus according to a preferred embodiment of the present invention.

The circuit 1 is supplied with a pressurised fluid, in this case nitrogen gas N2, from 5 the gas cylinder 2.

The gas cylinder 2 feeds a pressure regulator stage 3. This stage may have a pair or series of pressure regulators 4, 5 to regulate the pressure precisely even over the wide range of pressures of a nitrogen bottle at various stages of fill. Typically, the pressure in a nitrogen bottle may vary from 140 bar (full) to 2 bar (empty). A 10 nitrogen generator could be substituted for the gas cylinder 2.

The regulator stage 3 has an on/off valve 7 which is preferably located between the regulators 4 and 5. The regulator stage 7 feeds a flow control valve 6 via on/off valve 21 and pressure switch 20. If a supply stage on/off valve 7 of suitable maximum flow rate is used, the flow valve 6 may possibly be eliminated. The 15 supply stage on/off valve 7 controls whether any nitrogen is supplied to the rest of the system. The components 6, 20, 21, 3 and 2 act as a first supply of the circuit 1 to supply nitrogen to the circuit 1. Items 5, 6, and 7 may be arranged in a different order depending on the componentry used.

An on/off valve 21 is connected between the flow valve 6 and the supply stage 3. 20 This valve can be pulse width modulated to assist in controlling the flow from the flow valve 6 and to provide another degree of control over the mixer 10.

A pressure switch 20 is also connected between the flow valve 6 and regulator stage 3 to allow the operation of the circuit 1 to be tested.

The supply stage 3 feeds a junction 8 which taps some of the pressure of the outlet 19 Jaws Ref: 232467/58 of the supply stage 3 to a pressure activated control for an alternate gas supply on/off valve 9. An alternative, or second, gas is supplied to the system through the valve 9 which acts as a third supply for the circuit 1. In the preferred embodiment, the second gas is atmospheric, normoxic air taken from the surrounds of the 5 apparatus.

The function of the alternate gas supply on/off valve 9 is described later in this description. This valve 9 is similar to the supply stage on/off valve 7. The valve 9 is closed to the alternate supply when a positive pressure is supplied by the junction 8.

The junction 8 also feeds a mixer 10 via an on/off valve 21, pressure switch 20 and flow valve 6.

The mixer 10 has a venturi 23 which has a primary inlet, an outlet and a restriction, neck or reduced diameter portion between the two. This particular venturi includes a secondary inlet at the neck.

The characteristics of Venturis are well known to those skilled in the art. Essentially, they have a reduced diameter portion which experiences a lower pressure than the pressure of gas at the primary inlet when gas moves through the venturi. According to Bernoulli's equation various ratios of pressure at the neck versus pressure at the primary inlet can be arranged by the choice of the venturi 20 dimensions and flow rate supplied at the inlet.

The venturi dimensions and pressure at the primary inlet of the venturi 23 of the present preferred embodiment are chosen so that the pressure at the secondary inlet is lower than ambient atmospheric pressure. This allows the secondary inlet to draw in atmospheric air in a predetermined ratio to the nitrogen supplied at the 25 primary inlet. The ratio, or mix, of air and nitrogen will be strongly dependent on Jaws Ref: 232467/58 the ratio of pressures of the nitrogen and the ambient atmospheric pressure. The ratio will also depend on the flow rate allowed to enter the venturi via the primary and secondary inlets.

A flow control valve 12 is included in the secondary inlet to control the flow of gas 5 through the secondary inlet and allow control of the mix of air and nitrogen. The valve 12 controls the air flow of normoxic air from the ambient atmosphere. The valve has two flow states. The valve can pulse for a time in these states or toggle between them.

The valve 12 is provided with a controller 17 which uses a pulse width modulation 10 driver to toggle or pulse between the two flow states of the valve to control the flow through the secondary inlet.

Pulse width modulation allows a two state valve to be used in place of a conventional but more expensive proportional valve. Also, control of the time a valve is open or closed is easier to control or calibrate precisely than control of the 15 size of an aperture in a proportional valve. The time a valve is open or closed will not vary over time and over temperature ranges so mechanical issues affecting precise calibration are avoided. Also, the time precision of a two state valve with a suitable solanoid is in the order of milliseconds.

This allows precise definite settings for the flow rate. For example, if the valve is 20 open 10% of the duty cycle and closed 90% of the duty cycle, the flow rate will be set definitively at a ratio of 1:9 of the two flow states of the valve. This would be difficult to achieve with proportional valves and feedback on the valves state would be required.

Also, the flow rate could be easily adjusted to a ratio of 11:89 with a simple 25 adjustment to the calibration. This also would be difficult to achieve with 21 Jaws Ref: 232467/58 proportional valves.

The valve 12 may simply be an on/off valve although it is not necessary that one of the flow states is off.

For a given flow through the flow valve 6, the controller 17 can control the mix of 5 first and second gasses in the mixer 10 via the flow valve 12. If the first gas is nitrogen and the second is air the controller 17 can control the level of oxygen supplied by the mixer 10.

The mixer 10 feeds air of a predetermined mix to a bag or bellows 13. The bag 13 acts as a reservoir. The bag 13 is supplied with the average flow rate of the 10 subject's breathing from the mixer 10. The bag 13 feeds an output stage junction 14 which feeds a mask 15 for use by the subject (not shown).

The mask 15 is adapted for a given type of subject, which might typically be a human or a horse. Suitable masks will be apparent to those skilled in the art.

The junction 14 is fed by an alternative supply on/off valve 9 which feeds 15 atmospheric air from a third supply as an alternative to the hypoxic mix from the reservoir. The reservoir typically includes a bellows which might include a breathing bag 13. As mentioned earlier in this description the alternative supply on/off valve 9 has a control port and closes atmospheric air to the junction 14 when a hypoxic mix is being supplied to the bag 13 and junction 14.

If the nitrogen feed to the mixer 10 is shut off, the alternative supply stage valve 9 opens and the mask 15 is fed via the junction 14, by both the bag and the atmosphere simultaneously for a period. This occurs until the reservoir 13, which is no longer being fed by the mixer 10, is depleted. At this point, only atmospheric air is supplied to the mask 15, as an alternative to the hypoxic mix. Before the 25 reservoir 13 is depleted, the mask 15, at the outlet of the circuit, will be supplied air 22 Jaws Ref: 232467/58 that is a mix of normoxic air, via valve 9, and hypoxic air, from the bag 13. This mix starts at 50/50 then gradually becomes fully normoxic as the bag 13 is depleted. Alternatives to the ratio of 50/50 can be arranged by the size of the valve 9, and its associated resistance to airflow relative to that of the reservoir 13.

The controller 17 might typically be a micro-controller but other suitable controllers will be known to those skilled in the art. The controller 17 may control a solenoid that drives the supply value 12. It may do this via a pulse width modulation driver, amplifier or other suitable means known to those skilled in the art.

Controllers that provide a processor that can carry out the steps herein described 10 will be known to those skilled in the art, and any of these may be incorporated.

The controller 17 receives a pulse oximetry signal from a pulse oximeter 19, which measures the blood oxygen calibration, or SP02, of the subject (not shown). This oximeter 19 may have an attachment 110 for the ear of the subject, if the subject is human for example. An ear-fitted oximeter allows the subject to carry out a 15 relatively wide range of tasks during hypoxic training. Typing is one example. However, any suitable oximeter known to those skilled in the art can be used to provide the controller 17 with a measurement of SP02 or blood oxygen saturation.

The controller 17 monitors the oximeter reading during a training programme. The oximeter indication can be used as feedback for continuous control of the mix of 20 hypoxic air supplied by the mixer 10 or may be used to shut off nitrogen supply to the reservoir 13 and open valve 9 to a normoxic supply when the oximeter indication does not satisfy given conditions. Feedback control typically consists of choosing an oxygen content of hypoxic air that is likely to maintain or restore a given SP02 level as indicated by the oximeter 19.

A hypoxic training session or programme will typically involve intermittent supply of 23 Jaws Ref: 232467/58 hypoxic air to the mask 15 with normoxic air supplied via valve 9 in periods between hypoxic supply periods. The preferred programme has 70% of the time of a session as hypoxic and 30% of the time normoxic with the normoxic periods starting with an even mix of hypoxic and normoxic supplies. As discussed above, 5 the even mix changes gradually to full normoxic as the reservoir 13 is depleted.

The controller 17 may monitor time dependent characteristics of the oximeter indication such as SP02 maxima and minima rise, fall and settle times of SP02 levels. The controller may also monitor time dependent characteristics such as whether the SPO2 is tapering off and increasing or decreasing at a changing rate. 10 Here, settle times are the time taken to reach a given SP02 level. This may be the time taken to fall to a given higher SP02 or time taken to rise to a given SP02 from a lower level.

Typically, a programme might consist of 7 to 8 minutes with the hypoxic supply on and 2 to 3 minutes with hypoxic supply off. The mix of air to nitrogen might be 15 constant for the programme and maintained using feedback from the oximeter 19 to be constant over the five minute hypoxic interval.

As discussed in greater detail with reference to figure 7, the apparatus may be calibrated occasionally with an oxygen analyser so that the controller will be able to set calibrated mixes of hypoxic air. Typically, the controller will read a stored duty 20 cycle time such as 400ms and read a portion of the duty cycle for the valve 12 to spend in one of its two states. For example, it may spend 100ms open every 400ms. The controller 17 may access this data by reference to a given oxygen content for the hypoxic air. For example, 8% may correspond to a 400ms duty cycle and 100ms spent 'open' per data cycle. This allows the controller 17 the 25 option of supplying calibrated mixes of hypoxic air and using the oximeter only in a safety capacity. Various alternative options of control and/or training programmes 24 Jaws Ref: 232467/58 will be apparent to those skilled in the art and these might include the use of calibrated mixes or real time feedback control from the oximeter 19.

The controller 17 will typically not commence supply of nitrogen to the mixer 10 until it receives an oximeter 19 indication that meets criteria read by the controller 5 17. This provides a safety feature for use of the apparatus. In this case, a subject would not be supplied hypoxic air until their blood oxygen level had been indicated to ensure that they are in fact wearing the oximeter 19.

The supply of hypoxic air may then be conditional on the subject maintaining a safe blood oxygen level and exhibiting no adverse time dependent blood oxygen level 10 characteristics. This mode of operation would ensure that the hypoxic training apparatus could not be used other than in a safe manner.

The use of feedback from an oximeter 19 attached to the subject eliminates the need for an oxygen analyser to analyse the levels of oxygen in the hypoxic air supplied to the subject. The oxygen analyser would only be used to calibrate the 15 duty cycle and open time for a given oxygen content. This calibration data need only be set occasionally. The use of an oxygen analyser only for calibration allows for significantly more economical construction of the apparatus as an oxygen analyser is generally an expensive piece of equipment. It also allows for a more robust compact and portable apparatus.

The use of feedback directly from an oximeter 19 connected to a subject also adds a degree of intrinsic safety to the apparatus over apparatus that only uses feedback from the mix. This facilitates use of the apparatus in unsupervised environments such as in the home.

Additionally, the use of an oximeter 19 to provide feedback to control the circuit 1 25 allows more precise control of hypoxic training conditions. This is because training Jaws Ref: 232467/58 creates a given SP02 level in the subject and it is this condition that creates suitable beneficial stress to the subject. Simply providing a given 02 content in the hypoxic supply will create differing SP02 levels in different subjects.

Figures 2 and 3 show a valve 24 which may be substituted for the on/off valve 12 in 5 the secondary feed of the mixer 10. The valve 24 has two different flow states, each corresponding to a different ratio of flow. The valve 24 can toggle between these flow states. The valve is used in conjunction with a pulse width modulation controller to control the flow of air into the secondary inlet of a venturi in the mixer 10. The flow rate toggles between two flow states, neither state corresponding to 10 zero flow, to create a given ratio of the two flow states over a given interval. This achieves a rate of flow intermediate to those of the two flow states of the valve.

Figure 2 shows the valve 24 in a relatively closed configuration in which the flowrate through the valve 24 will be relatively low.

Figure 3 shows the same valve 24 in a relatively open configuration in which the 15 flowrate through the valve 24 will be relatively high.

The valve 24 has a valve body 25, solanoid bolt 26, and a solanoid 27. The valve body 25 has a threaded end 28 for connection to the secondary inlet of the venturi 10. The valve body 25 and solanoid 27 are separated by a spacer 29, which might be a set of washers or be a drilled hole(s) in the valve of the body. The spacer 29 20 allows coarse adjustment of how far the solanoid bolt 26 extends into the valve body 25 at maximum extension. The valve body 25 and solanoid 27 may be separated more or less by the choice of spacer 29 to allow coarse adjustment of the restriction of the control passage 32 and thereby coarse adjustment of the restricted flow rate of the valve.

The valve has an inlet passage 30, an outlet passage 31 and a control passage 32. 26 Jaws Ref: 232467/58 Positioning of the solanoid bolt 26 in an extended position into the valve body 25 and control passage 32 (as shown in figure 2) causes a partial restriction of the control passage 32. The partially restricted and unrestricted states of the passage 32 correspond to two different states of flow through the passage 32. This allows 5 the flow of gas through the valve body 25 to be controlled between restricted and unrestricted flow states. When the solanoid bolt 26 is extended, as shown in figure 2, a first relatively restricted flow is allowed through the valve body 25. When the solanoid bolt 26 is retracted, as shown in figure 3, a second relatively unrestricted flow is allowed through the valve body 25.

The controller 17 controls the solanoid 27 to either retract or extend the solanoid bolt 26 between two extreme positions such as those shown in figures 2 and 3. Flow rates intermediate to the two flow rates can be achieved by pulse width modulation of the solanoid 27. For example, the first rate might relate to a feed for the venturi 23 which achieves the most hypoxic output mix to the mask 15. The 15 second rate might relate to a feed that achieves the least hypoxic mix of the mask 15. Pulse width modulation between the two rates achieves mixes in between these two extremes.

The solanoid control valve 24 is an economical valve for the hypoxic apparatus because it does not need to seal or completely close off gas flow. This means that 20 frictional contact is not needed between parts of the valve. This reduces wear and eliminates the need for any seals between moving parts.

Figures 4a and 4b show a mixing head housing 40 forming part of a hypoxic training apparatus according to a preferred embodiment of the present invention. Figure 4a shows the housing 40 in an open state while figure 4b shows the housing 25 40 in a closed state. 27 Jaws Ref: 232467/58 Referring to figure 4a, the housing 40 is formed from a first, or upper, member 41 and a second, or lower, member 42 connected at a hinge 43. Typically the hinge 43 is formed from interlocking hinge portions of the upper member 41 and lower member 42.

The housing 40 has a bellows 44 connected between the upper member 41 and lower member 42. The upper member 41 and lower member 42 provide a mounting for the upper end and lower end, respectively, of the bellows 44. The term 'bellows' is intended to encompass any flexible container which can deform to accommodate various volumes of gas. The bellows shown in figure 4a is formed 10 by a flexible wall connected between, and at the periphery of the circumference of, the upper member 41 and lower member 42. The bellows can deform by either inward movement of the walls or by relative movement of the upper member 41 and lower member 42. The suitability of either approach for specific applications of the invention will be apparent to those skilled in the art. The upper member 41 and 15 lower member 42 may hinge inwards towards each other to deflate the bellows 44.

The housing 40 has a gas supply aperture 45 formed in the upper member 41 on the interlocking portion which forms part of the hinge 43. A corresponding gas outlet aperture (not shown) is formed in the corresponding portion of the lower member 42. The gas supply aperture 45 on the upper portion and the 20 corresponding aperture (not shown) formed in the lower member 42 is arranged so that they are aligned only when the upper member 41 and lower member 42 are in an open configuration. This alignment of the apertures, prevents dust or contaminants entering the supply for the bellows 44 when not in use and provides a gas supply outlet when the mixing head is in use.

Figure 4b shows the mixing head with the upper member 41 and lower member 42 in a closed configuration. In this view, the bellows 44 is not visible as it is enclosed 28 Jaws Ref: 232467/58 entirely within the closed housing formed by the upper member 41 and the lower member 42.

Figure 5a shows a perspective view of an alternative embodiment to figures 4a and 4b of the mixing head. In this embodiment the bellows 44 comprises a breathing 5 bag rather than a flexible wall connected between the upper member 41 and lower member 42. It will be appreciated by those skilled in the art that they container may be complete flexible (as in the bag 44 depicted in Figures 5a and 5b), or partially flexible, or partially rigid (as in the configuration depicted in figures 5a and 5 in which the internal area of the bellows is formed from the bag 44 and the upper 10 41 and lower 42 members of the housing 40) and variations thereof. Here parts have been removed to reveal internal components. Figure 5a shows the upper member 41 and the lower member 42 pivotally connected at a hinge 43. The lower member 42 has a flat base 95 formed thereon. The flat base 95 allows the lower member 42 to rest in a stable manner on a flat surface (not shown).

The lower member 42 also has an internal aperture 96 formed therein to allow parts of pneumatic components to project out of the lower member and through a corresponding internal aperture 94 formed in the upper member 41 when these members 41 and 42 are in a closed configuration.

Figure 5b also shows the bellows 44 formed in part by a breathing bag 44a which 20 provides the reservoir 13 of the pneumatic circuit 1. The breathing bag 44a is shown attached to the pneumatic components in the lower member 42. An opposite end is shown attached to the upper member 41, although Figure 5a does not show the connection point. This configuration of the breathing bag 44a is upside-down compared to conventional use of a breathing bag. However, this 25 unconventional arrangement allows connection of the breathing bag 44a to pneumatic components housed in the lower member 42. Housing these 29 Jaws Ref: 232467/58 components in the lower member 42 allows their weight, relative to electronic components, to act to stabilise the housing 40 when in an open configuration.

The dimensions of the upper member 41 and lower member 42 and the location of the connection point (not shown) of the opposite end of the breathing bag 44a to a 5 pneumatic circuit are chosen to provide optimal extension of the breathing bag 44a for it to operate in an upside down configuration. In this optimal extension the pneumatic circuitry does not have to work to lift or stretch the bag while partially filling or emptying it.

The pneumatic circuitry housed the lower member 42 includes a control valve 12 10 connected to a mixer 10. The mixer 10 is also connected to a second control valve 21 which is connected to flow control valve 6. The mixer is connected to a junction 14. Also connected to the junction 14, in parallel, is an on/off valve 9. A pressure switch 20 is also shown housed in the lower member 42.

The electronic component including the controller 17 is shown housed in the upper 15 member 41. The relatively light weight of electronic componentry, and the fact that the upper member 41 is substantially hollow, means that the upper member 41 does not destabilise the device even when in an open configuration.

Figure 5b shows an alternative perspective view to Figure 5a. Visible in Figure 5b, but not in 5a, is an entry point 98 for a supply of nitrogen, and an electronic 20 connection 99, which might be an internet port or a craft port.

Figure 5b shows a connector 91 for a gas supply hose for a mask 13 (not shown in this figure). The connector 91 connects to a gas supply outlet formed by the aperture 45 in the upper member and the corresponding aperture (not shown) in the lower member 42 when these apertures are aligned. The connector 91 25 incorporates a connection for a pulse oximetry sensor 110.

Jaws Ref: 232467/58 Figure 5b also shows a user interface 100 which includes an LCD screen 101 and two buttons 102 and 103. This interface 100 allows the subject (not shown) to carry out basic control operations such as selecting their program, stopping and starting the program and pausing the program.

Figure 6 shows a screen of an internet protocol graphical user interface (GUI) provided by a preferred embodiment of the hypoxic training apparatus. The interface is provided by the apparatus in a format that is viewable with an internet browser. This means that any browser enabled computer can interface with the apparatus without requiring any apparatus specific software to be installed.

The screen shown in figure 1 has an identifier for the subject in field 51. It also has an identifier for a particular program assigned to the subject in field 52. Field 52 is a control that allows the particular program to be chosen.

The screen shown in figure 6 has an identifier for the training subject in field 51. It also has an identifier for a particular training session programme assigned to the 15 subject in field 52. Field 52 is a control that allows a particular session or programme to be chosen.

Field 53 indicates the number of the next training session. Field 54 indicates the number of times a training session will cycle through hypoxic and normoxic supplies. Field 55 indicates the type of programme of training sessions that will be 20 administered. This is indicated by a number or a name, such as 'Basic Course'.

The lower part of the screen shows a table which sets out the parameters that define a training session.

The first column 57 of the table 56 shows a session number.

The second column 58 shows an 02 setting which indicates an oxygen content to 31 Jaws Ref: 232467/58 be selected by default for the training session.

The third column 59 shows the period of hypoxic supply in seconds.

The fourth column 60 shows the period in seconds when hypoxic supply to the reservoir 13 or bellows 44 is turned off and the valve 9 is opened to the normoxic 5 atmosphere.

The fifth column 61 shows the number of times a hypoxic/normoxic cycle will be repeated.

The sixth column 62 shows the maximum allowable pulse rate as indicated by a pulse oximeter. The apparatus may suspend supply of hypoxic air if this is 10 exceeded.

The seventh column 63 shows the minimum acceptable pulse, rate, or heartbeat rate, below which supply of hypoxic air may be exceeded.

The eighth column 64 shows a preset level of SP02. This preset might be referred to as SP02 Min. This is the suspension minimum SP02 level. When an SP02 that 15 is below the suspension minimum is detected, the hypoxic supply will be suspended. This embodiment will store how many times this occurs and will monitor how long a subject has been below the suspension minimum. If, for example it occurs 2 times this embodiment may cancel the training session. Also, some embodiments may store this parameter as part of a training session data set 20 which is read by the controller 17.

The ninth column 65 shows a second preset SP02 level, referred to as SP02 H/01. This is the target training SP02 level. In this embodiment the programme will enable a hypoxic/normoxic mix for a period of 5 seconds when an SP02 lower than shown in column 65 is observed. This embodiment will also store data indicating 32 Jaws Ref: 232467/58 when this has occurred.

The tenth column 66 shows a third preset SP02 level, referred to as SP02 H/02. This is the resumption minimum SP02 level. In this embodiment once interrupted, the hypoxic air supply will not be resumed until the SP02 of column 66 is observed. 5 Meanwhile, normoxic air will be supplied.

Other embodiments may have an initiation minimum SP02 (not shown) level below which a training session will not be initiated. Other embodiments may also have a minimum suspension interval defining the minimum interval supply of hypoxic air is suspended in any given instance.

The screen also includes buttons 67 to 70 which allow modification of sessions and courses. Here a programme is simply a set of courses common to a subject. The programme might be designated by the subject's name or code unique to the subject. Hence a course is defined by the data in boxes and columns 57 to 66.

As will be understood by those skilled in the art the screen depicted in figure 6 and 15 the data described with reference to it is read from a data store associated with the apparatus and the same data store, or an equivalent, is read by the controller 17 to affect the functionality defined by this data.

Figure 7 shows another screen of the internet protocol graphical user interface (GUI) provided by a preferred embodiment of the hypoxic training apparatus. This 20 screen illustrates calibration of the hypoxic circuit 1 with pulse width modulation of valves 12 and 21. These valves are pulse width modulated to control flow into the venturi 23. The flow of nitrogen through valve 21 and normoxic air through valve 12 determines the mix of oxygen in air exiting the venturi 23. It will be apparent to those skilled in the art that if a valve 21 is pulse width modulated then valve 6 may 25 possibly be omitted. 33 Jaws Ref: 232467/58 Alternative embodiments of the apparatus may replace the GUIs with a coded file sent over an electronic interface such as the internet or a craft interface or other interfaces known in the art.

Calibration of the circuit 1 will now be described with reference to figure 7 and the 5 functionality of the on/off valves being used for both valves 12 and 21.

In the preferred embodiment, the valve 21 supplies nitrogen to the primary inlet of the venturi 23. The valve 12 supplies normoxic air into the secondary inlet at the neck of the venturi 23. In the preferred embodiment valve 12 is the valve described with reference to figures 2 and 3. However, the valve 12 may be an 10 on/off valve (not shown).

Box 67 sets the period Pulse Width Modulation (PWM) duty cycle in milliseconds. Both valves, 12 and 21, will be pulse width modulated using the same duty cycle period.

Box 68 sets the percentage time of the PWM duty cycle period for which valve 12 15 will be open. In figure 7 the value 80 denotes that of the 400 ms PWM period, the valve 12 will be open for 80% of the time, or 320 ms.

Box 69 is similar to box 68 except that it relates to valve 21.

Boxes 68 and 69 are GUI inputs which allow an operator to set calibration data for a given oxygen content for the output of the circuit 1. This calibration would be 20 carried out using an oxygen analyser to monitor the oxygen content of air supplied by the circuit 1. Adjusting one or both of the boxes 68 and 69 would adjust the oxygen content (%02).

It will be appreciated that the oxygen content can be adjusted with adjustments to only valve 12. However, the preferred embodiment of the present invention has a 34 Jaws Ref: 232467/58 valve 21 to allow not only the oxygen content but the total volume of air supplied by circuit 1. This is advantageous in preventing a subject from maintaining high SP02 levels by breathing relatively more air to compensate for a lower oxygen content.

Columns 70 to 73 represent a lookup table used by the controller 17 of the circuit 1. 5 In operation, the controller 17 looks up, or reads, the valve pulse times in columns 71 or 73 that relate to a given 02 content in columns 70 or 72. In some embodiments the controller 17 may adjust the selection of 02 content so as to attempt to maintain a given SP02 level. Here the controller 17 uses the SP02 level as feedback to control the SP02 level of a training subject.

The values in columns 70 and 72 are the oxygen contents required by a course. The values in columns 71 and 73 are the percentage open times of the PWM cycles for valves 12 and 21. Typically, the operator who is calibrating the circuit 1 will find the values for columns 71 and 73 by adjusting boxes 68 and 69 while observing an oxygen analyser. Also, typically, but not necessarily, the operator will 15 choose values for columns 71 and 73 that achieve the different oxygen contents in columns 70 and 72 for the same, given total flow rate. This flow rate might be 15 to 16 litres per minute for a human subject.

Figure 8 illustrates an algorithm carried out by the hypoxic training apparatus according to a preferred embodiment.

Box 51 denotes a step in which the apparatus receives programme or session data for a subject. It receives this via an internet protocol interface (not shown) provided by the apparatus.

At box 52 a user identifies themselves to the apparatus. This may be done by way of an electronic card, although suitable alternatives will be known to those skilled in 25 the art.

Jaws Ref: 232467/58 At box 53 a memory store is accessed for details on the users programme or course and pre-training checks are carried out according to the information in the memory store. This information includes data entered into the memory at box 51 but also includes data recorded by the apparatus during previous training sessions. 5 This data includes the time elapsed since the user's last session and also the times the oximetry level of the subject falls below a given preset, such as that shown in figure 6, column 64. Various other suitable pre-training checks against corresponding stored information will be apparent to those skilled in the art.

At box 54 a system check is carried out. This involves testing that a reasonable 10 SP02 observed. It also involves testing the circuit 1 shown in figure 1 by activating various valves, such as valve 7, and monitoring pressure switches such as pressure switch 20.

At box 55 an oximetry test is carried out. This oximetry testing supplies the subject with hypoxic air of a given oxygen level and monitoring their SP02 level, and 15 measuring the interval taken for the SP02 level to reach a given preset, such as 90% for example. This measurement can be used to assist in characterising the subject's response to hypoxic training. This may be used to select an oxygen content to use initially for a training session.

At box 55 the oxygen content of the hypoxic air supply to a person may be 20 adjusted. The adjustment is made according to information in the memory store and also to the measurement taken at box 54.

In a preferred embodiment, programmes include parameters that determine whether the oxygen levels should be adjusted at all, during a training session under what conditions it should be adjusted and by how much it should be adjusted. For 25 example, a programme assigned to an athlete may specify that the oxygen level in the hypoxic air supplied to the subject should be decreased if the oximetry level 36 Jaws Ref: 232467/58 measured in the subject does not fall to 90% in a given time interval. A programme assigned to someone with a cardio disorder may specify that a given oxygen level is used for all sessions irrespective of any favourable characteristics observed by the apparatus during training sessions.

At box 56 the hypoxic training session commences with hypoxic air being supplied while the oximetry level of the subject is monitored. This interval is specified in figure 2, at column 59.

If the first pulse oximetry level present corresponding to a suspension minimum oximetry level is reached, the hypoxic supply to the bag 13, shown in figure 1, will 10 be suspended until either a time interval has expired or a second resumption minimum oximetry level is observed. This operation is described with reference to figures 11 and 12 below. Interrupting the hypoxic supply will cause the subject to be supplied initially with a mix of hypoxic air from the bag 13 and normoxic air from the ambient atmosphere, through valve 9. If the resumption minimum oximetry 15 level is not reached in a given interval the controller 17 may, in some embodiments, select a higher oxygen content.

As the bag 13 is gradually depleted, the mix becomes gradually more normoxic. This gradual replacement of hypoxic with normoxic air has been found to avoid the oximetry level monitored in the subject 'bouncing' high when the hypoxic supply is 20 interrupted and replaced with a normoxic supply.

At box 57 the hypoxic supply is assessed for an interval indicated in figure 6, column 60. This allows the subject to recover. In the preferred embodiment the hypoxic interval applied in box 56 is approximately 70% of a hypoxic/normoxic cycle in the preferred embodiment also, the normoxic interval, specified in box 57 25 of figure 6, is approximately 30% of the hypoxic/normoxic cycle. 37 Jaws Ref: 232467/58 At box 58 the subject's oximetry level is monitored while they are supplied normoxic air and time dependent aspects are observed. The rise time, fall time taken to reach a given level or other metrics known to those skilled in the art can be used as a basis for the controller 17 selecting a new oxygen content. The rise 5 time, in particular, may also be used to indicate the subjects response to performance under treatment. This indication may be displayed to the subject.

At box 59, the number of hypoxic/normoxic cycles is repeated until the maximum number specified in figure 6, column 61 is reached.

Figure 9 shows an example of the heart beat rates and SP02 levels indicated by a 10 pulse oximeter that is monitored by the controller 17. The upper curve shows SP02 level in percentages. The lower curve shows heart rates in beats per minute.

Figure 9 shows intervals of lower SP02 level corresponding approximately to intervals when hypoxic air is supplied to a subject.

Figure 9 also shows intervals of higher SP02 levels corresponding approximately to 15 intervals of the hypoxic air supply being interrupted.

Figure 10 shows process 70 carried out by the controller 17 to control the oxygen content in hypoxic air supplied to the subject. This occurs during boxes 56 to 59 as shown in figure 8. The process 70 involves adjusting a selection of the oxygen content in response to a pulse oximetry signal received by the controller 17 from 20 the pulse oximeter 19. Box 71 depicts the controller 17 monitoring the pulse oximetry signal.

Box 72 depicts the controller determining that a first predetermined level, referred to as set point 1, and may be SP02 H/01+3 has not been reached within a predetermined interval. Typically this interval is 80 seconds. This condition prompts 25 the controller 17 to adjust the oxygen content downwards. Typically a downward 38 Jaws Ref: 232467/58 adjustment of 0.5% oxygen content would be made. The sub-process depicted by box 72 would be repeat so that another downward adjustment of 0.5% would be made if the first set point wasn't reached in another 80 seconds. By this sub-process the oxygen content is adapted to the response of the subject to hypoxic 5 air. This means that subjects with widely differing responses to hypoxic air will experience similar SP02 levels and thereby receive similar levels of beneficial stress from hypoxic training.

Box 73 depicts the controller determining that the first predetermined level, set point 1has been reached that a second set point level, set point 2, has not been 10 reached within a second predetermined interval. Set point 2 may be SP02 H/01 in the preferred embodiment the valve 9 is opened for a short interval, 5 seconds for example. This causes the apparatus to supply a mix of the hypoxic air from the breathing bag 13 and normoxic air via the valve 9.

Box 74 depicts the controller determining that the first and second predetermined 15 levels, set points 1 and 2, have been reached within a predetermined interval. This may indicate that the subject is too responsive to the hypoxic stress provided by the oxygen content. This condition prompts the controller to adjust the oxygen content upwards. Typically an upward adjustment of 0.5% increase would be made. Additionally, the valve 9 may be opened to allow the subjects SP02 level to 20 be restored to the first predetermined level, set point 1.

Box 75 depicts the controller monitoring the rate of change of the pulse oximetry level after a given interval. An interval of 10 seconds might be used. If the rate of decline, for example, of the pulse oximetry level is not approaching zero or a positive rate of decline, the controller is prompted to adjust the oxygen content 25 upwards by 0.5% and to open the valve 9 for a predetermined interval of, typically, 5seconds. 39 Jaws Ref: 232467/58 Figure 11 depicts an alternative algorithm to figure 10 carried out by the controller 17 (depicted in figure 1) of a hypoxic training apparatus according to an alternative embodiment of the present invention. This particular algorithm is carried out during intervals when a stored training session dictates that hypoxic air is to be supplied to 5 a subject.

The algorithm depicted in Figure 11 controls the pneumatic circuit 1 (depicted in figure 1) to attempt to hold the subject's SPO2 level at an optimal level for hypoxic training. This optimal level is being put in the form of a set of SPO2 presets which are typically stored on the controller 17. Some of these presets are shown in 10 Figure 6 at columns 64 to 66. These presets are SPO2 min 64, (SP02H/01) 65, SPO2 H/02. Other presets will be provided by offsets from H/01, in particular. Typically, the additional preset of SPO2 H/01 + 3 will be provided by adding the value of 3 to the SPO2 H/01 preset. Also typically, a preset of SPO2 H/01 -1 will be provided by subtracting the value of 1 from SPO2 H/01. Various values for presets 15 will be apparent to those skilled in the art. However, the control algorithm according to the present invention allows relatively fine control of SPO2 levels in the subject and these allow relatively low SPO2 presets to be set. These low presets provide improved effectiveness of hypoxic training sessions.

The algorithm 80 begins with box 81 representing the apparatus supplying hypoxic 20 air of a given starting oxygen content. The oxygen content setting would typically correspond to one of the values shown in column 70 or 72 of Figure 7. Typically an oxygen content of 10% would be used. At box 82 the control circuit determines whether a predetermined time interval has elapsed. This time interval is typically 80 seconds. If the time interval has not elapsed, the algorithm moves onto box 83. 25 If the predetermined time interval has elapsed the algorithm moves onto box 84 where the SPO2 level of the subject, as measured by a pulse oximeter, is compared to the set point H/01 + 3. Looking at the example represented by 40 Jaws Ref: 232467/58 session 1 of Figure 6 H/01 + 3 would be 80 + 3 = 83%. If the SP02 level is lower than H/01 + 3, the algorithm judges that the subject is showing sufficient response to the hypoxic stress and the algorithm continues onto box 83. If, however, the SP02 level is not below H/01 + 3 the algorithm moves to box 85 at which the 5 oxygen content of hypoxic air supplied to the subject is reduced by half a percent. Reducing oxygen content will involve selecting a new oxygen content, such as 9.5% for example. This will correspond in the table shown in Figure 7 to new 'on times' which are applied to a pulse width modulation signal supplied by the controller, or an associated pulse width modulated driver to a solenoid associated 10 with valve 12 of the pneumatic circuit 1.

At box 83, the algorithm determines whether the SPO2 level is less than H/01. If this is not the case the algorithm proceeds to box 86. If the SPO2 level detected is determined to be lower than H/01 the algorithm moves to box 87 where the hypoxic/normoxic valve, as represented by valve 9, in the pneumatic circuit 1 is 15 opened for 5 seconds. This causes the subject to be supplied with a mix of hypoxic and normoxic air initially. This mix becomes normoxic as the subject depletes the reservoir 13 (as shown in figure 1).

Also at box 87, the oxygen level is select to be 0.5 higher than the current SPO2 level. This means that when the subject is showing excessive response to the 20 hypoxic training stress, the oxygen level is increased to reduce the stress.

At box 86 the algorithm determines whether the SPO2 level is less than H/02. If it is not, the algorithm moves onwards and eventually back to box 82. If the SPO2 is less than H/02 the algorithm moves to box 88 where the normoxic/hypoxic valve 9 is opened for a brief interval which is followed by the algorithm determining at box 25 89 whether the SPO2 level has risen above H/01 - 1. If it has not risen above this level the interval represented by box 88 is repeated. The action of boxes 88 and 41 Jaws Ref: 232467/58 89 are to open the hypoxic/normoxic valve 9 until the SPO2 is above H/01-1. When the algorithm determines, at box 88 that this has eventually occurred, the algorithm proceeds onwards and eventually back to box 82.

In the loop represented by boxes 88 and 89 another decision process represented 5 by box 90 is carried out. At box 90 the algorithm determines whether the SPO2 has fallen below H/0 min. If it has, the algorithm moves onto box 91 which represents a brief delay and the algorithm moves onto box 88. Meanwhile, at box 92 the algorithm determines whether 5 seconds has passed while the algorithm is in the loop represented by boxes 89, 90 and 91. If this has occurred, the subject will 10 have had an SPO2 lower than H/O min for 5 seconds or more. If that is the case, the algorithm terminates the training session. This termination of the hypoxic training session is a safeguard against a subject suffering ill effects at a blood saturation level that is too low.

After boxes 86 or 90, the process returns to box 82.

Figure 12 depicts a process similar to that depicted in figure 11 carried out according to an alternative embodiment of the present invention. The algorithm depicted in figure 12 has an additional loop represented by boxes 93, 94 and 95. Box 93 determines whether a sufficient time interval has passed for SPO2 levels to taper off. At box 94 the algorithm determines whether a time dependant fall in 20 SPO2 levels is tapering off. If it is, the algorithm moves on to box 83. If the SPO2 levels have not tapered off valve 9 is opened for 5 seconds and the oxygen content is increased by 0.5%. This prevents the subject from responding too aggressively and overshooting target SPO2 levels, such as HOI.

The use of pulse width modulation of a two state valve reduces cost significantly by 25 removing the need for expensive proportional valves and expensive feedback systems, such as those that include oxygen analysers. 42 Jaws Ref: 232467/58 The use of a flow control by valves 12 and 21 at both inputs of a venturi 23 allows the circuit 1 to be calibrated for a given oxygen content but also at a given total supply flow rate at the mask 15. Control of the flow rate prevents a subject breathing more air in response to a lower oxygen content in the air they are 5 supplied. This could negate the effect of supplying air with lower oxygen content.

The use of calibrated pulse times of two state valves against oxygen content allows improved feedback response. This is because any feedback based on a pulse oximetry level will not include any response time related to adjustments of values to achieve a suitable oxygen content as supplied to the subject.

The use of SP02 as an indicator for control of a programme provides a cheaper and/or safer and/or more effective training apparatus.

A two state valve that does not need to have a zero flow sate provides a low cost valve for controlling the flow of fluids. More importantly, calibration data for the control of a two state valve allows positive determination of the operation of the 15 valve. This is because a two state valve is unlikely to vary it's characteristics over time, due to mechanical hysteresis and similar effects. Also, pulse width modulation data can be set during a calibration process. Due to the positive determination of the valve states the data will relate consistently over time to a given oxygen content without the need for feedback of oxygen contents. Thus, 20 response times of an oxygen analyser will be eliminated.

Aspects of the present invention have been described by way of example only and it should be appreciated that modifications and additions may be made thereto without departing from the scope thereof. 43 Jaws Ref: 232467/58

Claims (85)

Claims:

1. A portable hypoxic training apparatus including: a bellows; a housing adapted to be configurable between an opened state and a closed state; wherein the housing substantially encloses the bellows when in the closed state and provides a mount for the bellows when in the open state.

2. The portable hypoxic training apparatus of claim 1, wherein the bellows comprises an opening at one end.

3. The portable hypoxic training apparatus of claim 1 or claim 2, wherein the housing includes in use an upper member and a lower member.

4. The portable hypoxic training apparatus of claim 3, wherein the lower member has a base formed thereon, wherein the base is configured to support the apparatus in said open configuration.

5. The portable hypoxic training apparatus of claims 3 or 4, wherein the bellows is mounted such that the opening is located substantially at the lower member.

6. The portable hypoxic training apparatus of claim 5, wherein the upper member and bellows are configured such that an opposite end of the bellows to the opening is connectable to the upper member.

7. The portable hypoxic training apparatus of any one of claims 1 to 6, wherein the bellows comprises a bag. 44 intellectual Pnooertv ~ Office of N.Z, 1 9 JUL 2007

Receive- member, lower member and bag are configured such that the bag is extended between the upper and lower member to a predefined degree of extension, wherein the predefined degree of extension is such that the bag is operable to at least partially fill and partially empty with gas.

9. The portable hypoxic training apparatus of any one of claims 3 to 8, wherein the apparatus includes pneumatic components.

10. The portable hypoxic training apparatus of claim 9, wherein the pneumatic components are located substantially in the lower member.

11. The portable hypoxic training apparatus of any one of claims 3 to 10, wherein the apparatus includes electronic components.

12. The portable hypoxic training apparatus of claim 11, the electronic components are located substantially in the upper member.

13. The portable hypoxic training apparatus of any one of claims 3 to 12, wherein the upper and lower members are biased towards predetermined relative positions.

14. The portable hypoxic training apparatus of any one of claims 1 to 13, wherein the apparatus includes a hinge formed between the upper and lower members.

15. The portable hypoxic training apparatus of claim 14, wherein the portable hypoxic training apparatus includes a gas supply outlet.

16. The portable hypoxic training apparatus of claim 15, wherein the gas supply outlet is provided substantially at the hinge.

17. The portable hypoxic training apparatus of claim 16, wherein the upper and 45 Jaws Ref: 232467/58 members are configured such that the gas supply outlet is closed when the housing is in a closed configuration.

18. The portable hypoxic training apparatus of claim 17, wherein the apertures are formed in the upper and lower members substantially at the hinge.

19. The portable hypoxic training apparatus of claim 18, wherein said apertures are configured such that they are substantially aligned when the upper and lower members are arranged such that the housing is in an open configuration.

20. The portable hypoxic training apparatus of claim 19, wherein said apertures are arranged such that they are substantially non-aligned when the upper and lower members are arranged such that the housing is in the closed state.

21. The portable hypoxic training apparatus of claim 20, including a connector to provide connection for a gas supply conduit, said connector adapted to be inserted into said apertures when said apertures are aligned.

22. The portable hypoxic training apparatus of claim 21, wherein the connector provides a connection for a communication line of a pulse oximetry sensor.

23. The portable hypoxic training apparatus of any one of claims 9 to 10, wherein said pneumatic components include: a mixing volume provided with a primary inlet, a secondary inlet and an outlet, said secondary inlet including a valve which is adapted to be operated by a pulse width modulation driver, said pulse width modulation driver adapted to pulse width modulate the valve between two flow states to achieve a given flow state through the secondary inlet.

24. The portable hypoxic training apparatus of claim 23, wherein said mixing volume 46 intellectual Property Office of N.2. 1 9 JUL 2007 3 E C EIV F comprises a venturi.

25. The portable hypoxic training apparatus of claim 23, wherein said secondary inlet communicates substantially with a restricted passage of the venturi.

26. The portable hypoxic training apparatus of any one of claims 23 to 25, wherein the primary inlet includes a valve which is adapted to be operated by a pulse width modulation driver to pulse width modulate the valve between two flow states to achieve a given flow state through the primary inlet.

27. The portable hypoxic training apparatus of any one of claims 23 to 26, wherein the apparatus includes a controller adapted to control said pulse width modulation driver(s).

28. The portable hypoxic training apparatus of any one of claims 26 or 27, wherein pulse width modulation of each of the valves included with primary and secondary inlets allows control of the total flow through the venturi as well as control of the mix of nitrogen and air exiting the outlet.

29. The portable hypoxic training apparatus of any one of claims 23 to 28, wherein the pneumatic components include a valve, and wherein the valve includes: a control chamber; and a control member, said control member having a first position within the control chamber and a second position within the control chamber.

30. The portable hypoxic training apparatus of claim 29, wherein the first position of the control member corresponds to a first degree of restriction of the control chamber and the second position of the control member relates to a second degree of restriction of the control chamber, intellectual Property 4? Office of N.Z. 1 9 JUL 2007 RECEIVE

31. The portable hypoxic training apparatus of claim 30, wherein a clearance is provided between the control member and the control chamber in the first and second positions whereby each of the first and second degrees of restriction allow some flow of gas through the control chamber.

32. The portable hypoxic training apparatus of claims 30, wherein one of the first or second degrees of restriction may substantially prevent any flow of gas through the control chamber.

33. The portable hypoxic training apparatus of any one of claims 29 to 32, wherein the flow control valve includes an actuator for the control member.

34. The portable hypoxic training apparatus of anyone of claims 30 to 32, wherein said actuator is a solanoid.

35. The portable hypoxic training apparatus of claim 34, wherein the solanoid is adapted to pulse the control member in the first or second position for a given duration.

36. The portable hypoxic training apparatus of claim 35, wherein the solenoid is adapted such that said duration of said pulse(s) can be determined to an accuracy of approximately a millisecond.

37. The portable hypoxic training apparatus of any one of claims 23 to 36, wherein the apparatus includes a pressurised gas supply connected to the primary inlet.

38. The portable hypoxic training apparatus of claim 37, wherein the pressurised gas supply includes at least one pressure regulator.

39. The portable hypoxic training apparatus of claim 38, wherein the pressurised gas supply includes at least two pressure regulators. 48 1 9 JUL 2007

40.

41.

42.

43.

44.

45.

46,

47

48, The portable hypoxic training apparatus of any one of claims 37 to 39, wherein a combination of pressure of the pressurised gas supply connected to the primary input and the dimensions of the venturi is adapted to create a pressure at the secondary inlet that is lower than ambient atmospheric pressure. The portable hypoxic training apparatus of any one of claims 38 to 40, wherein the pressurised gas supply comprises a supply of inert gas. The portable hypoxic training apparatus of claim 41, wherein the pressurised has supply includes a supply of nitrogen. The portable hypoxic training apparatus of claim 42, wherein the supply of Nitrogen comprises a Nitrogen bottle. The portable hypoxic training apparatus of claim 42, wherein the supply of nitrogen comprises a Nitrogen generator. The portable hypoxic training apparatus of any one of claims 23 to 44, wherein the secondary inlet is provided with a supply of air. The portable hypoxic training apparatus of claim 45, wherein the supply of air comprises ambient atmosphere. The portable hypoxic training apparatus of any one of claims 23 to 46, wherein the controller is adapted to read calibration data, defining a pulse width modulation signal for at least one of the valves included in the primary or secondary inlets. The portable hypoxic training apparatus of claim 47, wherein the controller is adapted to read calibration data defining a duty cycle period. 49

49. The portable hypoxic training apparatus of any one of claims 48, wherein the controller is adapted to read calibration data defining a portion of said duty cycle period in which a valve is to spend in one of the two flow states.

50. The portable hypoxic training apparatus of claim 49, wherein said portion of the duty cycle period is defined to a precision of substantially a millisecond.

51. The portable hypoxic training apparatus of any one of claims 49 or 50, wherein the controller is adapted to read at least one oxygen content value related to at least one portion of a duty cycle related to that oxygen content.

52. The portable hypoxic training apparatus of any one of claims 23 to 51, wherein the controller is adapted to receive a signal from a pulse oximeter, said signal indicating a blood oxygen saturation of a subject.

53. The portable hypoxic training apparatus of claim 52, wherein the controller is adapted to monitor said signal from a pulse oximeter and to select a given oxygen content so as to provide feedback control of said signal from a pulse oximeter.

54. The portable hypoxic training apparatus of any one of claims 52 or 53, wherein the controller is adapted to read pulse oximetry data defining criteria for supplying hypoxic air from the outlet.

55. The portable hypoxic training apparatus of claim 54, wherein the controller is adapted to supply hypoxic air only if said criteria is met by the received pulse oximetry signal.

56. The portable hypoxic training apparatus of any one of claims 54 or 55, wherein the controller is adapted to read pulse oximetry data including an initiating intellectual Property 50 Office of N.Z. 19 JUL 2007 3P.CF' V c initiated.

57. The portable hypoxic training apparatus of any one of claims 54 to 56, wherein the controller is adapted to read pulse oximetry data including a suspension minimum pulse oximetry value below which supply of hypoxic air should be suspended.

58. The portable hypoxic training apparatus of any one of claims 54 to 57, wherein the controller is adapted to read pulse oximetry data including a resumption minimum pulse oximetry level below which said supply of hypoxic should not be resumed after being suspended.

59. The portable hypoxic training apparatus of claim 58, wherein the minimum resumption pulse oximetry value is higher than the minimum suspension pulse oximetry level.

60. The portable hypoxic training apparatus of any one of claims 52 to 59, wherein the controller is configured to monitor at least one time dependent aspect of the pulse oximetry signal.

61. The portable hypoxic training apparatus of any one of claims 52 to 60, wherein the controller is adapted to read predetermined criteria from stored training session data.

62. The portable hypoxic training apparatus of any one of claims 60 or 61, wherein said time dependent aspect includes a rise time.

63. The portable hypoxic training apparatus of claim 62, wherein the controller is adapted to select an oxygen content value if the rise time meets predetermined criteria.

64. The portable hypoxic training apparatus of any one of claims 60 to 63, wherein 51 Jaws Ref: 232467/58 said time dependent aspect includes a fall time.

65. The portable hypoxic training apparatus of claim 64, wherein the controller is adapted to select an oxygen content value if the fall time meets predetermined criteria.

66. The portable hypoxic training apparatus of any one of claims 60 to 65, wherein said time dependent aspect includes a time to reach a predetermined level.

67. The portable hypoxic training apparatus of claim 66, wherein the controller is adapted to select an oxygen content value according to said time to reach a predetermined level.

68. The portable hypoxic training apparatus of any one of claims 61 to 67, wherein the controller is adapted to read training session data defining said predetermined criteria for selecting any oxygen content valve.

69. The portable hypoxic training apparatus of any one of claims 61 to 68, wherein the controller is adapted to read hypoxic training session data defining intervals of supply of hypoxic air.

70. The portable hypoxic training apparatus of claim 69, wherein the intervals of supply of hypoxic air comprise approximately 70% of the total time from the start of the first said interval of supply to the end of the last said interval of supply.

71. The portable hypoxic training apparatus of any one of claims 61 to 70, wherein the hypoxic training data defines a number of alternating intervals of hypoxic and normoxic supply.

72. The portable hypoxic training apparatus of any one of claims 61 to 71, wherein the controller is adapted to receive a signal from a pulse oximeter, said signal 52 Jaws Ref: 232467/58 indicating a heart beat rate.

73. The portable hypoxic training apparatus of any one of claims 23 to 72, wherein the portable hypoxic training apparatus includes a reservoir connected to the outlet.

74. The portable hypoxic training apparatus of claim 73, wherein the portable hypoxic training apparatus includes a gas supply junction connected to the reservoir.

75. The portable hypoxic training apparatus of claim 74, wherein the portable hypoxic training apparatus includes a normoxic supply valve connected to the supply junction in parallel with the reservoir, said normoxic supply valve connecting the supply junction with a supply of normoxic air.

76. The fluid supply valve of claim 75 wherein the normoxic supply valve includes a supply line connected a supply for the primary inlet, the normoxic supply valve being adapted to be open only when gas is not being supplied to the primary inlet.

77. The portable hypoxic training apparatus of any one of claims 61 to 76, wherein the controller is adapted to read training session data defining any one or any combination of the following parameters associated with an identifier assigned to at least one subject: duration of periods of hypoxic supply; duration of periods of normoxic supply; duration of combined hypoxic and normoxic periods; number of sessions of hypoxic and normoxic supply; 53 Jaws Ref: 232467/58 number of cycles of periods of hypoxic intervals supplied in a given session.

78. The portable hypoxic training apparatus of any one of claims 61 to 77, wherein the controller is adapted to generate a signal for a display, said signal representing at least one of said time dependent aspects.

79. A portable hypoxic training apparatus substantially as herein described and illustrated with reference to figure 1.

80. A portable hypoxic training apparatus substantially as herein described and illustrated with reference to figures 2 and 3.

81. A portable hypoxic training apparatus substantially as herein described and illustrated with reference to figures 4a and 4b.

82. A portable hypoxic training apparatus substantially as herein described and illustrated with reference to figures 5a and 5b.

83. A portable hypoxic training apparatus substantially as herein described and illustrated with reference to figures 6 to 10.

84. A portable hypoxic training apparatus substantially as herein described and illustrated with reference to figure 11.

85. A portable hypoxic training apparatus substantially as herein described and illustrated with reference to figure 12. DEVX TECH IP LIMITED by their authorised agents JAMES & WELLS 54 Jaws Ref: 232467/58