RU2578356C1 - Method of determining optimum value of long-term physical load, safe for operation of cardiovascular system based on kovalev method and device therefor - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: according to method for determination of optimum values of long-term physical activities, safe for operation of cardiovascular system, rest is measured in patient number of heart contractions for one minute, obtained number in one cycle and used to calculate code supplement, which is equal to 100 minus number of cardiac beats at rest, is introduced in addition code counter of heart contractions. Depending on patient's state, method includes determining value of load procedure, on which it will be automatically increase at end of each cycle during analysis, then patient is placed on ergometer, connected to a unit to generate signals of cardiac contraction. Counter for counting cycles is turned on. Completion of each pulse current is supplied in a cycle counter cycles for further load increase through load control unit, which is connected to a load of bicycle ergometer so that each incoming signal decoder increases load on certain value. Pulses of completion of cycles are fed for time duration of cycles in control unit of clock. After activation of command "Start" patient rotates pedal bicycle ergometer at constant speed 60 revolutions per minute. With completion of each cycle device lifts load procedure by a certain value until growth of number of heart contractions start to slow down. On completion of at least one cycle with continuation of increasing load on certain value examination is terminated and data of duration of each cycle, wherein at moment of completion of each cycle, number of heart contractions per minute. Also disclosed is device for realising said method.

EFFECT: invention enables selection of optimal mode of continuous physical activity.

7 cl, 1 dwg

Description

The invention relates to medicine, namely to methods and devices for determining the sensitivity of the cardiovascular system of the human body to physical activity.

The following methods are known from the prior art for determining the optimal load and device for their implementation.

So, from the description of the invention according to the patent of the Russian Federation No. 2355301 (published on 05/20/2009), a method for determining the tolerance of physical activity is known, which consists in registering the patient's electrocardiogram (ECG) obtained by bicycle ergometry examination, analyzing it by creating a mathematical model (KRG) . Variability is estimated by KRG in the period of decreasing cardiointervals duration by the module of deviations from the constructed best trend and the mean square deviation (sigma) from the trend during stabilization of cardiointerval durations. In the area of variability of cardio intervals, the trend of deviations in the aggregate is modeled by linear regression, the straight line of which gives the value of the moment the deviation modulus enters the interval of three sigma of the stabilization section. The duration of the cardio interval (CI) of the moment of entry characterizes the point of escape of the heart muscle from the autonomic control and determines the tolerance of physical activity. The value of the CI duration at the escape point of 0.487-0.413 seconds is determined as satisfactory, less than 0.487 as bad, more than 0.413 as good exercise tolerance.

Also known is a device for studying the cardiovascular system, containing a bicycle ergometer, which includes a control panel, a unit of normalized loads, an electronic unit of the amplifier and a mechanical load unit, characterized in that it additionally contains a second unit of normalized loads, a cardiomonitor with electrodes for recording cardiac abbreviations, feedback circuit, an electronic clock with a start and stop input, a control unit and a counter unit containing a heart rate counter and a cycle counter with with encryption keys at the output, interconnected so that the output of the cardiomonitor in the feedback circuit is connected to the input of the control unit, which control outputs are connected to the “Start” and “Stop” inputs of the electronic clock and to the control inputs of the mentioned counters, and the output of the heart rate signal abbreviations directly connected to the counting input of the first mentioned counter, the serial output of which is connected to the counting input of the cycle counter and the control unit, and the serial output of the cycle counter is connected to the control window and the “Stop” input of the clock, and its parallel outputs through decoder keys are connected to the inputs of the second load block, the output of which is connected to the output of the load block of the bicycle ergometer and to the input of the electronic block (RF patent No. 22742, published on April 27, 2002).

The closest analogue to the patented method is the method disclosed in the patent of the Russian Federation No. 2231284 (published on June 27, 2004). The method consists in measuring the number of heart contractions in a patient at one minute, taking it for the optimal cycle, using this number to set the code in the heart rate counter, and setting the code of the planned load in the cycle counter, automatically reducing the load during the study on the pedal of the bicycle ergometer by a certain amount with each subsequent cycle to zero, characterized in that as the code set in the heart rate counter, use the complement code, equal to the difference (100 min the number of heartbeats at rest), and as the code for the planned load, a code equal to n + 1, where n is the number of optimal cycles planned for the study, using the stopwatch block hours automatically determine the duration of each scheduled cycle separately, build a graph that displays changes the duration of each planned cycle, which assesses the response of the cardiovascular system to physical activity, and calculates the ratio of the duration of the first cycle to the last, according to it, the court t of the patient's ability to respond to exercise, at the same time believe that the closer this coefficient is to unity, the better the patient carries the load.

When implementing this method, the duration of each cycle was determined (the number of heart contractions in the patient per minute at rest is taken for one cycle) was determined separately with a decrease in the physical load on the patient's legs from a given value to zero, which made it possible to graphically display the duration of the cycles and the ability to calculate the ratio of the first cycle to the last. The above method displayed only the reaction of the cardiovascular system to reduce physical activity from a given value.

The disadvantage of the method indicated as the closest analogue is the lack of the possibility, based on the results of the patient’s research, to build a graph of the reaction of the cardiovascular system of the human body to increasing physical activity according to the duration of each cycle (hereinafter graph), according to the curve of which you can choose the optimal mode of long-term physical activity safe for the work of the cardiovascular system of this person. The disadvantage of the prototype device is the inability to supply increasing physical activity after the completion of each cycle and stop its growth at any value, to control its effect on the human body for a certain time.

As the closest analogue to the patented device, a device can be adopted for implementing a method for determining the response of the cardiovascular system to physical activity, comprising a bicycle ergometer and a device including an additional load unit, with which a counter unit consisting of a heart rate counter, a counter cycles and a decoder has the ability to automatically control, after each cycle, reducing the load from the pedals of the bicycle ergometer down to zero, as well as the device contains there is a clock with which the total time of the patient examination process is counted through the control unit, and the device further comprises a load control unit, which includes two decoder units, two counter units, a digital indicator unit and a load control unit, a cardiac signal unit, consisting from electrodes for removing cardiac signals (RF patent No. 37613, published June 27, 2003).

The disadvantages of using the known device are also the inability to build a graph of the reaction of the cardiovascular system of the human body to increasing physical activity according to the duration of each cycle (hereinafter graph), according to the curve of which in the future you can choose the optimal mode of long-term physical activity safe for work the cardiovascular system of this person. The disadvantage of the prototype device is the inability to supply increasing physical activity after the completion of each cycle and stop its growth at any value, to control its effect on the human body for a certain time.

The objective of the patented solution is to eliminate these disadvantages.

The technical result of the patented method and device for its implementation is to expand the capabilities of the prototype by obtaining additional information that makes it possible to choose the optimal mode of prolonged physical activity, safe for the human cardiovascular system.

The claimed technical result is due to the implementation of the method for determining the optimal value of long-term physical activity that is safe for the human cardiovascular system, which consists in the fact that the patient measures the number of heart contractions in one minute at rest, takes the resulting number in one cycle and uses it to calculate the supplement code, which is 100 minus the number of heart contractions of the patient at rest, enter the supplement code into the heart rate counter, then depending on the condition The patient’s measurements determine the load of the bicycle ergometer, by which it will automatically increase after each cycle during the study, then the patient is seated on the bicycle ergometer, a block is connected to it to take heart beat signals, a counter for counting cycles is turned on, and the pulse for completing each current cycle fed to the cycle counter to further increase the load through the load control unit, which is connected to the load unit of the bicycle ergometer in such a way that each incoming signal with the encoder increases the load by a certain amount, cycle completion pulses are also given to count the duration of the cycles in the clock control unit, after the start command is turned on, the patient rotates the bicycle ergometer pedals at a constant speed of 60 revolutions per minute, with the completion of each cycle the device raises the load on the bicycle ergometer pedals by a certain value until the increase in the number of heart contractions begins to slow down, at the end of at least one more cycle with a continuation of the increase in load n and a certain amount, the study is stopped and data is obtained for the duration of each cycle, and at the time of completion of each cycle, the number of heart contractions per minute (heart rate) is determined, which is calculated by the formula:

X is the number of heartbeats per minute during exercise;

pk is the number of heart contractions at rest (cycle);

tc is the duration of the cycle in seconds, while the load at which the number of heartbeats per minute stabilizes (before slowing down with increasing load) is the optimal safe load for the work of the cardiovascular system of a particular person.

The proposed method is based on the fact that the increase in the number of heart contractions per unit of time cannot infinitely increase with increasing physical activity. At first, while physical activity is small, the number of heart contractions increases slowly, then with increasing load with each cycle, the number of heart contractions increases, and the duration of the cycles, as a result, decreases. After a certain (individual for each person) time, the growth rate of the number of heart contractions begins to slow down, since it cannot increase indefinitely. After reducing the rate of increase in heart rate, we recommend that the study be completed. According to the graph of the time curve of the duration of the cycles, it is possible to recommend the optimal physical load, safe for the cardiovascular system of this patient. The selection of long-term physical activity for patients according to the results of the study is carried out individually.

In addition, in addition, to determine the optimal safe load, you can build a graph of the dependences calculated by the formula for the number of heartbeats per minute depending on the load or according to the duration of each cycle (in seconds) depending on the values of the increasing load power of the bicycle ergometer (in W).

The technical result is achieved by the fact that in the method of choosing the optimal value of long-term physical activity that is safe for the human cardiovascular system, the duration of each cycle is determined with increasing physical activity until the pulse growth rate decreases, despite the continued increase in load for another 1-3 cycles (the number of cycles depends on the physical capabilities of the patient and the magnitude of the load by which it changes with each cycle).

If during the study the patient develops disorders in the activity of the cardiovascular system or other body systems that go beyond the normal response to physical activity, then the research process stops at any stage. Based on the results of changing the duration of the cycles to increasing physical activity, a graph of the reaction of the cardiovascular system to physical activity is built.

In particular, the value of the load power of a bicycle ergometer per cycle can be from one to several tens of watts, this value is determined by the doctor depending on the physical condition of the patient, in our case it is 10 watts, while the initial value (load power of the bicycle ergometer for the first study cycle ) is also equal to 10 watts.

As a device for receiving heart beat signals, any device that records the work of the heart, a cardiomonitor, or a pulse oximeter, or an electrocardiograph, etc. can be used.

Also, the technical result is achieved through the use of a device for implementing the method for determining the optimal value of long-term physical activity, safe for the human cardiovascular system, containing a bicycle ergometer (to create a load), containing a control panel, decoupled through a switch with a load unit interacting via an electronic unit with a mechanical load unit, a device for removing the number of heartbeats, including an addition code generating unit, a control unit clock, node cardiac signals and node load control, while

the clock control unit includes a clock unit interacting with a clock control unit connected via a decoder to a clock counter unit, a signal delay unit and a clock control signal generating unit,

a cardiosignal assembly comprising electrodes connected to a cardiomonitor unit connected to a cardiosignal forming unit, which, in turn, is connected through a switch to a heart rate counter unit.

a bicycle ergometer load control unit, comprising an indicator connected through a decoder to a heart rate counter connected via a switch to a cycle counter and through another decoder to a bicycle ergometer load control unit, which interacts with a bicycle ergometer load unit, while the clock counter unit of the clock control unit interacts directly with the output of the heart rate counter unit at the Vk2 switch.

As a source of heartbeat signals, any device that records the work of the heart can be selected: a cardiomonitor, or a pulse oximeter, or an electrocardiograph, etc.

Next, the solution is illustrated by reference to the figure, which shows a block diagram of a device for implementing the method for determining the optimal value of long-term physical activity, safe for the human cardiovascular system.

This device contains a bicycle ergometer B containing a control panel PU disconnected by a switch Vk1 from the load unit BN (the control panel of the bicycle ergometer PU does not take part in further research) interacting via an electronic electronic block with a mechanical load unit M, a device for removing the number of heart contractions U, which includes a block for generating an FKD supplement code, a UCH watch clock control unit, a UKS cardiosignal unit and a UUN load control unit, while the UCH watch control unit includes a clock lock of the БЧ clock interacting with a БУЧ clock control unit connected through a DSH3 decoder to a block of counters of a СЧЧ clock, a delay unit for an UCS signal, and a block for generating a clock control signal for a FSU, a UKS cardiac signal unit containing electrodes D connected to a КМ cardiac monitor connected to the block cardiac signal FKS, a load control unit of the УУН, containing an IND indicator connected through a DSh2 decoder with a counter for counting the number of heartbeats in the SChS, which is connected to the cycle counter via a VK switch 2 SCC fishing. The SChC counter is connected through the DSh1 decoder to the BUN load control unit, which interacts with the BN load unit of the Bicycle ergonometer B, while the UHCH clock control unit of the UCH UCH clock control unit interacts through the FSU clock control signal generation unit with the output of the heart rate counter at the BK2 switch, the block generating a cardiac signal FCC is connected through a switch Vk3 with a counter unit for the number of heartbeats for counting cycles and feeding them to the cycle counter block SCC. The number of the code for the addition of the FKD block is formed by the switches included in it, and is entered by pressing the "record" button. The Reset button is connected to all counters and Kom. Start". In this case, all the counters and the “Start” block are connected and interact with the “Reset” button, which is necessary to bring the counters to their initial position before starting the study. All counters, with the exception of MF, begin counting from zero, while the MF counter starts counting from the padding code entered into it (100 minus the number of heartbeats). The operation of the device is as follows.

Before the start of the study, the doctor examines the patient and, depending on the physical condition, gender, age, state of the cardiovascular system, as well as the presence of other diseases, determines the value of the bicycle ergometer load by which it will increase after the duration of each cycle during research. This value can be from units to tens of watts. Before pressing the “Record” button, the “Reset” button is pressed to bring all the counters and the start command to the initial position (the initial position is when the counters are in a state of readiness to receive information at the beginning of the study, and the indicator of the “Start” command does not light). Then the patient is seated on a bicycle ergometer, a device for taking heart beat signals is connected to it (any device that records the work of the heart: cardiomonitor, or pulse oximeter, or electrocardiograph, etc.), allow the patient to calm down for 2-3 minutes and turn on the BK3 switch (switch VK2 should be on, and VK1 off). After turning on the BK3 switch, the heartbeat signals begin to flow to the SChC counter for counting cycles. The pulse of the completion of each current cycle through the switch Vk2 is fed to the cycle counter SCC, from where through the decoder DSh1 to further increase the load through the load control unit BUN. The BUN load control unit is connected to the BN load unit of the bicycle ergometer in such a way that each incoming signal from the DSh1 decoder increases the load by a certain amount of load growth, determined by the doctor even before starting the study for this patient, starting from zero. Pulses of completion of cycles are also given to count the time duration of the cycles in the control unit of the watch UCH. The UCH watch clock control unit counts the duration of the cycle time as follows: the pulse issued by the heart rate counter after the first cycle is completed from the SCH block is sent directly to the FSU clock control signal generation block, from where the generated signal is sent to one of the counters of the SCH clock counter and at the same time it is fed to the delay unit of the USS signal, from where, with a delay of one millisecond, it goes to another counter of the same block of counters of hours of MF. The non-delayed signal from the block of hour counters of the SCH through the DSh3 decoder is fed to the BEUCH clock control unit and from there, using transistor keys, through the relay (as in the BUN unit), it switches on the first stopwatch of the BS clock block. The delayed signal from the block of counters of the SCH is fed to another decoder of the block of DSh3 decoders and remains free; it is not used in the further operation of the device. The next signal of the next cycle from the DSh3 decoder to the BEUCH clock control unit includes the next stopwatch of the BCH clock unit, and the delayed signal of this cycle through another decoder and the clock control unit disables the countdown of the previous stopwatch, thereby fixing the time duration of the past cycle. This continues until the arrival of the last delayed signal of the last study cycle, which stops the countdown of the current cycle on the last used stopwatch. The time recorded on each stopwatch is also read by it, using the proposed formula:

calculate the number of heart contractions at the end of each cycle per minute.

According to the data obtained, a safe optimal load is determined at which the number of heart contractions per minute stabilizes before they are slowed down, or a graph of the reaction of the cardiovascular system of the human body to increasing physical activity is constructed based on the number of heart contractions per minute. The pulse of completion of the first cycle turns on the start command indicator. Indication of the number of heart contractions occurs through the DSh2 decoder and the IND indicator. After turning on the “Start” command, the patient begins to pedal the bicycle ergometer at a constant speed of 60 revolutions per minute. The rate of increase in the number of heart contractions for physical activity in each patient is individual and depends on the physical condition of this patient at the time of the study. During the study, automatically, with the completion of each cycle, the device raises the load by the amount set and set by the doctor depending on the physical condition of the patient, for example 10 watts. The load of the bicycle ergometer (in this case starts from 10 W) and after each cycle it automatically increases by 10 W until the increase in the number of heart contractions begins to slow down, after which the study is terminated upon completion of another 1-3 cycles. The patient is allowed to rest for at least 30 minutes and the study is repeated, but the load is stopped increasing according to the schedule one cycle below the beginning of the pulse drop. After the termination of the growth of the load, the study session continues for another 15 minutes, if the increase in the number of heart contractions does not exceed the initial one at the time of the load shedding plus the value of one cycle according to the graph of the value of the pulse drop, the session is considered completed. If the increase in the number of heart contractions exceeds the initial one at the time of physical activity shutdown plus the value of one growth cycle according to the schedule, then after the patient has rested for at least 30 minutes, the session is repeated, but the load is switched off one more cycle earlier and continues until the desired result is obtained, i.e. termination pulse growth for a certain physical activity. This value of the load is a safe long-term load for this patient at a given time. The study session is carried out under the supervision of a doctor to eliminate unwanted complications that may occur during the study.

As a result of the study, data on the duration of each cycle are obtained. According to the duration of each cycle, a graph is constructed that displays the decrease in the duration of each cycle depending on the load. The value by which the load increases with each cycle is always constant and is set by the doctor at the beginning of the study in this case 10 W (the first cycle is 10 W, the second 20 W, the third 30 W and so on until the end of the study session).

The patented solution is further illustrated by way of example.

Example. Patient I. with a heart rate of 80 beats per minute, which is taken in one cycle. The supplement code, respectively, was taken equal to 20. The initial load was determined to be 10 W, the load of each subsequent cycle also increased by 10 W. Until the completion of the study, 12 cycles were completed. As a result, we obtained the following duration of cycles (the time during which the heart made 80 beats with an increase in load) according to the readings of the clock on the watch block:

Substituting the results in the formula:

calculated the number of heart contractions per minute after completion of each cycle:

X1 = (60 * 80) / 58 = 82.75, similarly calculated the number of heart contractions of subsequent cycles and obtained the following results:

X2 = 84.13; X3 = 85.1; X4 = 87.27; X5 = 94.11; X6 = 104.3; X7 = 120; X8 = 137.14; X9 - 154.83; X10 = 165.51; X11 = 171.42; X12 = 174.54.

Based on the data obtained, we plotted the dependence of the number of heartbeats on increasing physical activity, on the basis of which it was determined that after the 9th cycle (90 W load), the rate of increase in heart rate begins to slow down - this is the reference point from which we will reduce the load one by one cycle.

After the patient rested for at least 30 minutes, the study was repeated, but the load was stopped in this case after the 8th cycle, i.e. 80 W, if the number of heart contractions during 15 minutes of work under a load of 80 W increases more than 154.83 per minute - the study session was stopped and the patient was given the opportunity to rest for at least 30 minutes. After resting, the study was repeated, but the load was stopped after the 7th cycle, i.e. 70 watts, if within 15 minutes of the study the number of heart contractions does not exceed 154.83 per minute, the study is stopped.

In this patient, the number of heart contractions stabilized before the rate of increase in the number of heart contractions (reference point) began to decrease at a load of 70 watts. This load value of 70 W is the maximum safe load for this patient at the time of the study.

In order to overcome the incrementally increasing load of the bicycle ergometer, the patient is forced to press on the pedals with a force from several Newtons to several hundred Newtons.

Claims (7)

1. The method of determining the optimal value of long-term physical activity, safe for the human cardiovascular system, characterized in that the patient measures the number of heart contractions in one minute at rest, takes the resulting number in one cycle and uses it to calculate the supplement code, which equal to 100 minus the number of heart contractions of the patient at rest, enter the supplement code in the counter of the number of heart contractions, then depending on the condition of the patient determine the load of the bicycle ergometer, on which it will automatically increase after each cycle during the study, then the patient is seated on a bicycle ergometer, a heartbeat signal receiving unit is connected to it, a counter for counting cycles is turned on, and the pulse of completion of each current cycle is fed into the cycle counter to further increase the load through load control unit, which is connected to the load block of the bicycle ergometer in such a way that each incoming signal from the decoder increases the load by a certain amount, the pulse the completion of cycles is also given for counting the duration of the cycles to the clock control unit, after the start command is turned on, the patient rotates the pedals of the bicycle ergometer at a constant speed of 60 revolutions per minute, with the completion of each cycle the device raises the load of the bicycle ergometer by a certain amount until the number of heart contractions increases does not start to slow down, at the end of at least one more cycle with continued increase in the load by a certain amount, the study is stopped and data are received each cycle, and at the time of completion of each cycle, determine the number of heart contractions per minute (heart rate), which is calculated by the formula:

X is the number of heartbeats per minute during exercise;
pk is the number of cardiac contractions at rest;
tc is the duration of the cycle in seconds, while the load at which the number of heart contractions per minute stabilizes after their deceleration is the optimal safe load for the work of the cardiovascular system of a particular person. 2. The method according to p. 1, characterized in that in order to determine the optimal safe load, an additional graph is plotted according to the formula for the number of heart contractions per minute depending on the load or according to the duration of each cycle depending on the values of the increasing load. 3. The method according to p. 1, characterized in that the load of the bicycle ergometer for one cycle is selected in the range from one to several tens of watts. 4. The method according to p. 1, characterized in that the magnitude of the load of the bicycle ergometer per cycle is taken equal to 10 watts. 5. The method according to p. 1, characterized in that the unit for receiving heart beat signals is a cardiomonitor, or a pulse oximeter, or an electrocardiograph. 6. The device for implementing the method according to claim 1, characterized in that it contains a bicycle ergometer containing a control panel, isolated through a switch with a load unit interacting through an electronic unit with a mechanical load unit, a heartbeat signal receiving unit, including a code generating unit add-ons, a clock control unit, a cardiac signal unit and a load control unit, while
the clock control unit includes a clock unit interacting with a clock control unit connected via a decoder to a clock counter unit, a signal delay unit and a clock control signal generating unit,
a cardiosignal assembly comprising electrodes connected to a heartbeat signal acquisition unit associated with a cardiosignal forming unit,
a load control unit comprising an indicator connected through a decoder with a counter for counting cycles, connected through a switch to a cycle counter and through another decoder with a load control unit that interacts with the load block of the bicycle ergometer, while the clock counter unit of the clock control unit interacts directly with the unit heart rate counter, the cardio signal generating unit is connected via a switch to the counter unit for counting cycles, which also interacts with the f rmirovaniya code completion. 7. The device according to claim 6, characterized in that the block for receiving heart beat signals is a cardiomonitor or a pulse oximeter or an electrocardiograph.

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