WO2023109352A1 - 一种慢性呼吸衰竭病人远程康复训练指导系统 - Google Patents

一种慢性呼吸衰竭病人远程康复训练指导系统 Download PDF

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WO2023109352A1
WO2023109352A1 PCT/CN2022/129836 CN2022129836W WO2023109352A1 WO 2023109352 A1 WO2023109352 A1 WO 2023109352A1 CN 2022129836 W CN2022129836 W CN 2022129836W WO 2023109352 A1 WO2023109352 A1 WO 2023109352A1
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training
rehabilitation
patient
prescription
recommended
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French (fr)
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邓宁
蒋望舒
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浙江大学
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    • G—PHYSICS
    • G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
    • G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
    • G16H20/00—ICT specially adapted for therapies or health-improving plans, e.g. for handling prescriptions, for steering therapy or for monitoring patient compliance
    • G16H20/30—ICT specially adapted for therapies or health-improving plans, e.g. for handling prescriptions, for steering therapy or for monitoring patient compliance relating to physical therapies or activities, e.g. physiotherapy, acupressure or exercising
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/08—Detecting, measuring or recording devices for evaluating the respiratory organs
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/22—Ergometry; Measuring muscular strength or the force of a muscular blow
    • A61B5/224—Measuring muscular strength
    • G—PHYSICS
    • G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
    • G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
    • G16H40/00—ICT specially adapted for the management or administration of healthcare resources or facilities; ICT specially adapted for the management or operation of medical equipment or devices
    • G16H40/60—ICT specially adapted for the management or administration of healthcare resources or facilities; ICT specially adapted for the management or operation of medical equipment or devices for the operation of medical equipment or devices
    • G16H40/67—ICT specially adapted for the management or administration of healthcare resources or facilities; ICT specially adapted for the management or operation of medical equipment or devices for the operation of medical equipment or devices for remote operation

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  • the invention belongs to the technical field of rehabilitation equipment, and in particular relates to a remote rehabilitation training guidance system for patients with chronic respiratory failure.
  • the exercise intensity in the current exercise prescription is usually measured by target heart rate (HR), maximum oxygen uptake (VO2max), and subjective fatigue.
  • Target heart rate (HR) depends on precision instruments for measuring heart rate during exercise
  • the parameter of maximum oxygen uptake (VO2max) depends on large instruments and equipment, which are lacking in the home environment of patients.
  • the subjective fatigue experience depends on the patient's own grasp, and it is often difficult for patients to make accurate judgments on their own state during exercise. That is to say, in the current study, the method of measuring the intensity of exercise prescription is not suitable for the home environment that lacks sophisticated and large-scale equipment and lacks the guidance of professional rehabilitation personnel.
  • the Chinese patent document with publication number CN106984008A discloses a muscle training and evaluation system; the system includes a patient information management unit, a data acquisition unit, a data processing unit, and a message output unit; wherein, the data processing unit is used to select Training parts, training actions and prescription information, and process the received training data, and upload the processing results to the message output unit; prescription information includes weight weight, treatment time, pause time/rest time, single/double rope, target value, single/dual device training mode.
  • the system generates recommended prescriptions based on patient evaluation data, and the relationship between evaluation data and recommended prescriptions is not clear.
  • the invention provides a remote rehabilitation training guidance system for patients with chronic respiratory failure, which has low equipment requirements and can realize individualized customization of exercise training tasks to a certain extent.
  • a remote rehabilitation training guidance system for patients with chronic respiratory failure including a functional assessment and rehabilitation training equipment group, a patient mobile terminal, a cloud server, and a doctor's mobile terminal;
  • the functional assessment and rehabilitation training equipment set interacts with the patient mobile terminal,
  • the patient's mobile terminal and the doctor's mobile terminal communicate with the cloud server respectively;
  • the functional assessment and rehabilitation training equipment set includes a functional assessment equipment set and a rehabilitation training equipment set;
  • the patient mobile terminal includes a functional assessment module and a rehabilitation training module;
  • the cloud server includes an assessment task management unit, a prescription recommendation A service unit, a training task management unit, and a rehabilitation training supervision unit;
  • the doctor's mobile terminal includes a prescription configuration module and a rehabilitation supervision module;
  • the functional evaluation equipment group is used to detect the functional status of the patient, and the rehabilitation training equipment group is used for the patient to perform home rehabilitation exercises;
  • the function evaluation module is used to collect the patient's functional status detection data and send it to the cloud server prescription recommendation service unit, and the rehabilitation training module is used to push rehabilitation prescriptions and collect home rehabilitation training data;
  • the function Condition detection data include maximum inspiratory pressure (MIP), maximum expiratory pressure (MEP), limb muscle strength level, peak expiratory flow rate (PEF);
  • the evaluation task management unit is used to generate the evaluation task, and push the evaluation task to the function evaluation module of the patient's mobile terminal to remind the patient to perform the function evaluation;
  • the prescription recommendation service unit divides the obtained evaluation results of the patient's respiratory muscle test, limb muscle strength test and expectoration ability test into grades, generates a recommended rehabilitation prescription corresponding to the grade, and sends the recommended rehabilitation prescription to the doctor's mobile terminal
  • the prescription configuration module is modified and confirmed by the doctor;
  • the recommended rehabilitation prescription includes respiratory muscle training, limb muscle strength training and sputum discharge ability training;
  • the training task management unit generates sports training tasks from the doctor's modified and confirmed rehabilitation prescription, and pushes the sports training tasks to the patients through the patient's mobile terminal rehabilitation training module, and guides the patients to carry out rehabilitation training.
  • the patient's home rehabilitation training data is recovered through the patient's mobile terminal. After the training module is collected, it is transmitted to the cloud server rehabilitation training supervision unit;
  • the rehabilitation training supervision unit judges the patient's home rehabilitation training, generates a rehabilitation training report and a prescription adjustment reminder, and sends the rehabilitation training report and prescription adjustment reminder to the rehabilitation supervision module of the doctor's mobile terminal.
  • the functional assessment equipment set includes a respiratory muscle tester, a peak flow meter and a portable muscle strength tester;
  • the rehabilitation training equipment set includes a breathing trainer, a weight-bearing sandbag and steps.
  • the function evaluation module includes a respiratory function evaluation unit, a sputum discharge ability evaluation unit, and a limb muscle strength evaluation unit;
  • the rehabilitation training module includes a rehabilitation prescription display unit and a training data recording unit.
  • the prescription configuration module includes a respiratory muscle training configuration unit, a sputum excretion ability training configuration unit, and a limb muscle strength training configuration unit;
  • the rehabilitation supervision module includes a functional evaluation report unit and a rehabilitation training report unit.
  • the evaluation task management unit of the cloud server generates the evaluation task periodically, and the time interval is preferably once every two weeks.
  • the prescription recommendation service unit of the cloud server divides the acquired patient's respiratory muscle test evaluation results into two grades: strong and weak, and generates a recommended rehabilitation prescription corresponding to the grade;
  • the respiratory muscle training methods are suggested breathing method and external diaphragm muscle pacing breathing method;
  • the respiratory muscle training methods are respiratory trainer training and manual resistance breathing training;
  • the division method of weak grade and strong grade is: calculate MIPpre and MEPpre of the patient, compare with MIPmea and MEPmea, MIPpre is the predicted value of maximum inspiratory pressure, MEPpre is the predicted value of maximum expiratory pressure, MIPmea is the measured value of maximum inspiratory pressure, MEPmea is the measured maximum expiratory pressure;
  • the prescription recommendation service unit of the cloud server divides the obtained evaluation results of the patient's limb muscle strength test into three grades A-C, and generates a recommended rehabilitation prescription corresponding to the grades;
  • the training methods for limb muscle strength are neuromuscular electrical stimulation and power training;
  • the limb muscle strength training method is active anti-gravity training, and the active anti-gravity training includes heel raising, squatting against the wall, sit-stand training, wall push-ups, seated rowing, seated leg flexion and extension ;
  • the limb muscle strength training method is resistance training, and the resistance training includes shoulder press, dumbbell lateral raise, step step, weight-bearing arm lift, and elastic band resistance;
  • the prescription recommendation service unit at the cloud server divides the obtained evaluation results of the expectoration ability test into two grades of assistance and autonomy, and generates recommended rehabilitation prescriptions corresponding to the grades;
  • the training method of expectoration ability is postural drainage technique
  • the training methods for expectoration ability are cough training and active breathing and circulation technology
  • auxiliary level and independent level The division method of auxiliary level and independent level is as follows:
  • the doctor is allowed to set the amount of exercise for each exercise training item, and the total amount of exercise V period of a single exercise in each exercise cycle is expressed as:
  • V period the number of repeated days in the cycle * the number of repetitions in a single day * the intensity of a single exercise
  • V period is set according to the patient's functional status detection data
  • the number of repetitions in the cycle and the number of repetitions in a single day are set in accordance with the type of specific exercise training items
  • the intensity of a single exercise is calculated based on V period , the number of repetitions in the cycle, and the number of repetitions in a single day .
  • the single exercise intensity is only measured by the exercise physical load, and the measurement parameters that do not depend on the patient's physiological indicators are selected, and the measurement method depends on the specific exercise item.
  • the cloud server training task management unit generates and stores the exercise training task plan list in each exercise cycle according to V period , specifically, determines its exercise interval time according to the specific exercise training item type, and according to the number of repetitions in the cycle and Exercise Intervals generates a list of individual sport training times.
  • the patient's mobile terminal rehabilitation training module receives the exercise training task from the cloud server training task management unit, and pushes the rehabilitation training content that needs to be performed that day to the patient in the form of a daily task list.
  • the push content includes the name of the exercise task, a single The specific configuration parameter value of exercise intensity and the instruction of exercise method guide patients to carry out rehabilitation training.
  • the patient is instructed to:
  • the patient's mobile terminal rehabilitation training module When the patient is performing respiratory muscle training, limb muscle strength training, or sputum excretion training, the patient's mobile terminal rehabilitation training module will pop up “Is it complete?" after the patient's training is completed, and the patient can choose "Completed” or “Not completed according to the standard” ;
  • a voice encouragement will pop up: “Keep working hard”, and an input box will pop up to remind the patient to input physiological parameters during the training process;
  • an input box will pop up to remind the patient to input the actual training content and physiological parameters during the training process.
  • the prescription adjustment reminder includes strength reduction reminder and strength increase reminder;
  • the cloud server rehabilitation training supervision unit regularly sends rehabilitation training reports and prescription adjustment reminders to the doctor's mobile terminal rehabilitation supervision module. Doctors can adjust rehabilitation prescriptions according to the patient's rehabilitation training reports and prescription adjustment reminders.
  • the cloud server rehabilitation training supervision unit regularly sends The function evaluation module of the patient's mobile terminal sends a re-evaluation task to remind the patient to perform a staged evaluation to judge the rehabilitation effect and adjust the rehabilitation prescription.
  • the system of the present invention grades the test results of the patient's functional status, divides the test and evaluation results of the patient's respiratory muscles into two subclasses, strong and weak, and divides the test and evaluation results of the limb muscle strength into three subclasses of A, B, and C.
  • the evaluation results of the expectoration ability test are divided into two sub-categories: autonomous and auxiliary, and the connection between them and the recommended rehabilitation prescriptions is established, that is, rehabilitation prescriptions containing different training methods are recommended according to different evaluation levels, which not only further refines the training Classification system, and for the training of the same part, it can describe the differences in the training methods of different patients.
  • the system of the present invention can recommend recommended rehabilitation prescriptions corresponding to different subcategories, realizing individual customization to a certain extent.
  • the patient uses easily available tools in the home environment to perform exercise training at a specified intensity according to the exercise training tasks pushed by the present invention, thereby realizing more precise control of the amount of exercise and keeping the patient in a beneficial range of the amount of exercise.
  • the intensity of a single exercise can often directly reflect the patient's functional condition, and the exercise intensity can be measured numerically, so that the patient can feel the changes in the exercise intensity during the long-term training process, and then feel a certain degree of self-importance. Changes in functional aspects (such as limb muscle strength) can enhance patients' perception of the effect of rehabilitation training, thereby promoting patients' long-term persistence.
  • Figure 1 is a structural diagram of the remote rehabilitation training guidance system for patients with chronic respiratory failure.
  • Fig. 2 is a working flow chart of the remote rehabilitation training guidance system for patients with chronic respiratory failure.
  • FIG. 1 The structure diagram of the remote rehabilitation training guidance system for patients with chronic respiratory failure is shown in FIG. 1 , and the work flow chart is shown in FIG. 2 .
  • a remote rehabilitation training guidance system for patients with chronic respiratory failure including a functional assessment and rehabilitation training equipment group, a patient mobile terminal, a cloud server, and a doctor's mobile terminal;
  • the functional assessment and rehabilitation training equipment set interacts with the patient mobile terminal,
  • the patient's mobile terminal and the doctor's mobile terminal communicate with the cloud server respectively;
  • the functional assessment and rehabilitation training equipment set includes a functional assessment equipment set and a rehabilitation training equipment set;
  • the patient mobile terminal includes a functional assessment module and a rehabilitation training module;
  • the cloud server includes an assessment task management unit, a prescription recommendation A service unit, a training task management unit, and a rehabilitation training supervision unit;
  • the doctor's mobile terminal includes a prescription configuration module and a rehabilitation supervision module;
  • the functional evaluation equipment group is used to detect the functional status of the patient, and the rehabilitation training equipment group is used for the patient to perform home rehabilitation exercises;
  • the function evaluation module is used to collect the patient's functional status detection data and send it to the cloud server prescription recommendation service unit, and the rehabilitation training module is used to push rehabilitation prescriptions and collect home rehabilitation training data;
  • the function Condition detection data include maximum inspiratory pressure (MIP), maximum expiratory pressure (MEP), limb muscle strength level, peak expiratory flow rate (PEF);
  • the evaluation task management unit is used to generate the evaluation task, and push the evaluation task to the function evaluation module of the patient's mobile terminal to remind the patient to perform the function evaluation;
  • the prescription recommendation service unit divides the obtained evaluation results of the patient's respiratory muscle test, limb muscle strength test and expectoration ability test into grades, generates a recommended rehabilitation prescription corresponding to the grade, and sends the recommended rehabilitation prescription to the doctor's mobile terminal
  • the prescription configuration module is modified and confirmed by the doctor;
  • the recommended rehabilitation prescription includes respiratory muscle training, limb muscle strength training and sputum discharge ability training;
  • the training task management unit generates sports training tasks from the doctor's modified and confirmed rehabilitation prescription, and pushes the sports training tasks to the patients through the patient's mobile terminal rehabilitation training module, and guides the patients to carry out rehabilitation training.
  • the patient's home rehabilitation training data is recovered through the patient's mobile terminal. After the training module is collected, it is transmitted to the cloud server rehabilitation training supervision unit;
  • the rehabilitation training supervision unit judges the patient's home rehabilitation training, generates a rehabilitation training report and a prescription adjustment reminder, and sends the rehabilitation training report and prescription adjustment reminder to the rehabilitation supervision module of the doctor's mobile terminal.
  • the functional assessment equipment set includes a respiratory muscle tester, a peak flow meter, and a portable muscle strength tester;
  • the rehabilitation training equipment set includes a breathing trainer, a weight-bearing sandbag, and a step ;
  • the function evaluation module includes a respiratory function evaluation unit, an evaluation unit for expectoration ability, and a limb muscle strength evaluation unit;
  • the rehabilitation training module includes a rehabilitation prescription push unit and a training data recording unit;
  • the doctor's mobile terminal Among them, the prescription configuration module includes a respiratory muscle training configuration unit, a sputum elimination ability training configuration unit, and a limb muscle strength training configuration unit;
  • the rehabilitation supervision module includes a function assessment report unit and a rehabilitation training report unit.
  • the evaluation task management unit of the cloud server generates evaluation tasks regularly, and the time interval is preferably once every two weeks; after the functional status of the patient is tested, the prescription recommendation service unit of the cloud server divides the obtained evaluation results of the patient's respiratory muscles into two categories: strong and weak. Level, generate the recommended rehabilitation prescription corresponding to the level;
  • the respiratory muscle training methods are suggested breathing method and external diaphragm muscle pacing breathing method;
  • the respiratory muscle training methods are respiratory trainer training and manual resistance breathing training;
  • the division method of weak grade and strong grade is: calculate MIPpre and MEPpre of the patient, compare with MIPmea and MEPmea, MIPpre is the predicted value of maximum inspiratory pressure, MEPpre is the predicted value of maximum expiratory pressure, MIPmea is the measured value of maximum inspiratory pressure, MEPmea is the measured maximum expiratory pressure;
  • the prescription recommendation service unit of the cloud server divides the obtained patient limb muscle strength test evaluation results into three grades A-C, and generates recommended rehabilitation prescriptions corresponding to the grades;
  • the training methods for limb muscle strength are neuromuscular electrical stimulation and power training;
  • the limb muscle strength training method is active anti-gravity training, and the active anti-gravity training includes heel raising, squatting against the wall, sit-stand training, wall push-ups, seated rowing, seated leg flexion and extension ;
  • the limb muscle strength training method is resistance training, and the resistance training includes shoulder press, dumbbell lateral raise, step step, weight-bearing arm lift, and elastic band resistance;
  • the prescription recommendation service unit of the cloud server divides the obtained sputum discharge ability test and evaluation results into two levels of assistance and autonomy, and generates recommended rehabilitation prescriptions corresponding to the levels;
  • the training method of expectoration ability is postural drainage technique
  • the training methods for expectoration ability are cough training and active breathing and circulation technology
  • auxiliary level and independent level The division method of auxiliary level and independent level is as follows:
  • the doctor is allowed to set the amount of exercise for each exercise training item, and the total amount of exercise V period of a single exercise in each exercise cycle is expressed as:
  • V period the number of repeated days in the cycle * the number of repetitions in a single day * the intensity of a single exercise
  • V period is set according to the patient's functional status detection data
  • the number of repetitions in the cycle and the number of repetitions in a single day are set in accordance with the type of specific exercise training items
  • the intensity of a single exercise is calculated based on V period , the number of repetitions in the cycle, and the number of repetitions in a single day .
  • the intensity of a single exercise is only measured by the physical load of the exercise, and the measurement parameters that do not depend on the patient's physiological indicators are selected.
  • the measurement method depends on the specific exercise event, including:
  • the single exercise intensity of suggestive breathing method is measured by the number of breaths per minute
  • the single exercise intensity of external diaphragm pacing breathing method is measured by the duration of a single session
  • the single exercise intensity of breathing trainer training is measured by inspiratory resistance, exhalation resistance and the number of breaths;
  • the single exercise intensity of manual resistance breathing training is measured by the weight of abdominal objects and the duration of breathing;
  • the single exercise intensity of step step training is measured by the step height and the number of steps;
  • the single exercise intensity of weight-bearing arm lifting training is measured by the position of the arm raised and the weight of the weight;
  • the single exercise intensity of the dumbbell lateral raise training is measured by the load weight
  • the single exercise intensity of sitting leg flexion and extension was measured by the angle of leg flexion.
  • the cloud server training task management unit generates and stores the sports training task plan list in each exercise cycle according to the V period . Specifically, the exercise interval is determined according to the specific exercise training item type, and the exercise interval is determined according to the number of repetitions in the cycle and the exercise interval. Generate a list of individual sport training times.
  • the patient mobile terminal rehabilitation training module receives the exercise training tasks from the cloud server training task management unit, and pushes the rehabilitation training content that needs to be performed on the day to the patient in the form of a daily task list.
  • the push content includes the name of the exercise task and the intensity of a single exercise. Specifically configure parameter values and exercise method instructions to guide patients in rehabilitation training.
  • the push content also includes recommended values of expiratory pressure and recommended inhalation pressure, and the patient sets the expiratory pressure and inhalation pressure of the respiratory trainer according to the recommended values.
  • the push content also includes recommended weight-bearing weights, and the patient selects the weight of the weight-bearing sandbags used during training based on the recommended values.
  • the push content also includes a recommended value of the step height, and the patient selects the step height used for training according to the recommended value.
  • the patient's mobile terminal rehabilitation training module When the patient is performing respiratory muscle training, the patient's mobile terminal rehabilitation training module will pop up “Is it complete?" after the patient's training is completed, and the patient can choose "Completed” or “Not completed according to the standard”;
  • an input box will pop up to remind the patient to input the actual number of completed groups, duration, minimum oxygen saturation, oxygen inhalation or not, maximum heart rate, Borg scale value, etc.
  • the patient's mobile terminal rehabilitation training module will pop up “Is it complete?” after the patient's training is completed, and the patient can choose "Completed” or “Not completed according to the standard”;
  • an input box will pop up to remind the patient to enter the actual number of completed groups, single group times, weight value, maximum heart rate, Borg scale value, etc.
  • the patient's mobile terminal rehabilitation training module When the patient is undergoing sputum removal ability training, the patient's mobile terminal rehabilitation training module will pop up “Is it complete?" after the patient's training is completed, and the patient can choose "Completed” or “Not completed according to the standard";
  • an input box will pop up to remind the patient to enter the number of exhalations, inhalation times, exhalation time, inhalation time, PEF value, Borg scale value, etc. when the patient is actually completed.
  • the prescription adjustment reminder includes strength reduction reminder and strength increase reminder
  • the cloud server rehabilitation training supervision unit regularly sends rehabilitation training reports and prescription adjustment reminders to the doctor's mobile terminal rehabilitation supervision module. Doctors can adjust rehabilitation prescriptions according to the patient's rehabilitation training reports and prescription adjustment reminders.
  • the cloud server rehabilitation training supervision unit regularly sends The function evaluation module of the patient's mobile terminal sends a re-evaluation task to remind the patient to perform a staged evaluation to judge the rehabilitation effect and adjust the rehabilitation prescription.

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Abstract

一种慢性呼吸衰竭病人远程康复训练指导系统，包括功能评估及康复训练设备组、患者移动终端、云服务端及医生移动终端；所述的功能评估及康复训练设备组与患者移动终端进行交互，所述的患者移动终端和医生移动终端分别与云服务端进行通信。该系统能够将获取的患者呼吸肌测试评价结果、四肢肌力测试评价结果和排痰能力测试评价结果划分等级后，生成与等级对应的推荐康复处方，并对运动强度进行数值化描述；能够实现推荐康复处方的个体化定制，并可以对患者居家康复训练的运动量较为精确的控制，使患者处于其运动量的有益区间。

Description

一种慢性呼吸衰竭病人远程康复训练指导系统 技术领域
本发明属于康复器械技术领域，具体涉及一种慢性呼吸衰竭病人远程康复训练指导系统。
背景技术
慢性呼吸衰竭患者由于呼吸功能的限制，普遍存在运动量下降进而导致活动能力下降、生存质量下降的问题。运动疗法作为肺康复治疗的核心，对慢性呼吸衰竭疾病患者的治疗与康复具有重要意义，在增强活动能力，减缓呼吸困难，减少急性发作，提高生存质量以及延长生存时间等方面能够发挥重要作用。
慢性呼吸衰竭患者的临床表现具有很强的异质性，针对患者个体的特殊和独特的需求，运动处方应该个体化定制。最理想的是，专业的康复师针对所有身体部位(腿部、手臂、躯干等)提出各种不同难度的训练方式居家康复通常缺少康复医师的直接指导，患者难以获取与其当前疾病状态最适配的训练方案。而当前的远程康复系统所采用的训练方式分类方法不足以描述不同训练方案之间的差异，难以体现不同患者之间、同一患者不同时期之间所采取的训练方案的区分度，另外，基于当前的训练方式分类方法难以建立训练方式与患者评估结果之间的直接关联。
运动处方面临的最大挑战之一是让患者以正确的强度进行训练，即在他们有益的心率区域内进行训练，这是有效性的关键。居家康复通常缺少康复医师的直接指导，患者很难合理的掌握运动量，运动量不足会导致不能达到训练效果，影响康复进程，运动量大则可能使患者疲劳，患肢负荷大，甚至产生二次伤害。
目前所开具的运动处方中的运动强度通常使用靶心率(HR)、最大摄氧量(VO2max)、主观疲劳感受来衡量。靶心率(HR)依赖与运动过程中测量心率的精密仪器设备，最大摄氧量(VO2max)参数依赖于大型仪器设备，患者居家环境缺少此类仪器设备。主观疲劳感受依靠患者自己把握，患者在运动过程中往往难以对自己的状态做出准确判断。即当前研究中，对运动处方的强度衡量方法不适用于缺少精密、大型仪器设备，缺少 专业康复人员指导的居家环境。
公开号为CN106984008A的中国专利文献公开了一种肌肉训练与评估系统；该系统包括患者信息管理单元、数据采集单元、数据处理单元、报文输出单元；其中，数据处理单元用于根据患者信息选择训练部位、训练动作和处方信息，并对接收的训练数据进行处理，将处理结果上传至报文输出单元；处方信息包括砝码重量、治疗时间、暂停时间/休息时间、单/双绳索，目标值、单/双机设备训练模式。该系统依据患者评估数据，生成推荐处方，未明确评估数据与推荐处方之间的关系。
发明内容
本发明提供了一种慢性呼吸衰竭病人远程康复训练指导系统，设备要求低，能够在一定程度上实现运动训练任务的个体化定制。
具体采用的技术方案如下：
一种慢性呼吸衰竭病人远程康复训练指导系统，包括功能评估及康复训练设备组、患者移动终端、云服务端及医生移动终端；所述的功能评估及康复训练设备组与患者移动终端进行交互，所述的患者移动终端和医生移动终端分别与云服务端进行通信；
所述的功能评估及康复训练设备组包括功能评估设备组和康复训练设备组；所述的患者移动终端包括功能评估模块和康复训练模块；所述的云服务端包括评估任务管理单元、处方推荐服务单元、训练任务管理单元和康复训练监督单元；所述的医生移动终端包括处方配置模块和康复监督模块；
所述的功能评估及康复训练设备组中，功能评估设备组用于检测患者的功能状况，康复训练设备组用于患者进行居家康复运动；
所述的患者移动终端中，功能评估模块用于收集患者的功能状况检测数据并发送至云服务端处方推荐服务单元，康复训练模块用于推送康复处方和收集居家康复训练数据；所述的功能状况检测数据包括最大吸气压(MIP)、最大呼气压(MEP)、四肢肌力等级、呼气峰值流速(PEF)；
所述的云服务端中：
评估任务管理单元用于生成评估任务，并将评估任务推送至患者移动终端功能评估模块，提醒患者进行功能评估；
处方推荐服务单元将获取的患者呼吸肌测试评价结果、四肢肌力测试 评价结果和排痰能力测试评价结果划分等级后，生成与等级对应的推荐康复处方，并将推荐康复处方发送至医生移动终端处方配置模块由医生修改确认；所述的推荐康复处方包括呼吸肌训练、四肢肌力训练和排痰能力训练；
训练任务管理单元将医生修改确认后的康复处方生成运动训练任务，并将运动训练任务通过患者移动终端康复训练模块推送给患者，并指导患者进行康复训练，患者居家康复训练数据经患者移动终端康复训练模块收集后传输至云服务端康复训练监督单元；
康复训练监督单元对患者居家康复训练情况进行判断并生成康复训练报告和处方调整提醒，将康复训练报告与处方调整提醒发送至医生移动终端康复监督模块。
优选的，功能评估及康复训练设备组中，所述的功能评估设备组包括呼吸肌测试仪、峰流速仪以及便携式肌力测试仪；所述的康复训练设备组包括呼吸训练器、负重沙袋以及台阶。
优选的，患者移动终端中，所述的功能评估模块包括呼吸功能评估单元、排痰能力评估单元和四肢肌力评估单元；所述的康复训练模块包括康复处方展示单元和训练数据记录单元。
优选的，医生移动终端中，所述的处方配置模块包括呼吸肌训练配置单元、排痰能力训练配置单元和四肢肌力训练配置单元；所述的康复监督模块包括功能评估报告单元以及康复训练报告单元。
优选的，云服务端评估任务管理单元定期生成评估任务，时间间隔优选每两周一次。
优选的，云服务端处方推荐服务单元将获取的患者呼吸肌测试评价结果划分为强、弱两个等级，生成与等级对应的推荐康复处方；
弱级对应的推荐康复处方中，呼吸肌训练方式为暗示呼吸法和体外膈肌起搏呼吸法；
强级对应的推荐康复处方中，呼吸肌训练方式为呼吸训练器训练和徒手抗阻力呼吸训练；
弱级和强级的划分方法为：计算患者的MIPpre和MEPpre，与MIPmea和MEPmea比较，MIPpre为最大吸气压预测值，MEPpre为最大呼气压预测值，MIPmea为最大吸气压实测值，MEPmea为最大呼气压实测值；
MIPpre的计算方法为：
男：MIPpre＝143–0.55*年龄
女：MIPpre＝104–0.51*年龄
MEPpre的计算方法为：
男：MEPpre＝268–1.03*年龄
女：MEPpre＝170–0.53*年龄
(1)当MIPmea<0.3*MIPpre时，生成弱级对应的推荐康复处方；
(2)当MIPmea>0.3*MIPpre且MEPmea>0.3*MEPpre时，生成强级对应的推荐康复处方；
(3)当MIPmea>0.3*MIPpre且MEPmea<0.3*MEPpre时，判断为测量值有误，生成的推荐康复处方为空。
优选的，云服务端处方推荐服务单元将获取的患者四肢肌力测试评价结果划分为A-C三个等级，生成与等级对应的推荐康复处方；
A级对应的推荐康复处方中，四肢肌力训练方式为神经肌肉电刺激和助力训练；
B级对应的推荐康复处方中，四肢肌力训练方式为主动抗重力训练，所述的主动抗重力训练包括提踵、倚墙下蹲、坐立训练、墙俯卧撑、坐式划船、坐姿腿屈伸；
C级对应的推荐康复处方中，四肢肌力训练方式为抗阻训练，所述的抗阻训练包括肩部推举、哑铃侧平举、台阶跨步、负重举臂、弹力带抗阻；
A级、B级和C级的划分方法为：
(1)当MRC六级肌力评估法的评估结果为0-1级时，生成A级对应的推荐康复处方；
(2)当MRC六级肌力评估法的评估结果为2-3级时，生成B级对应的推荐康复处方；
(3)当MRC六级肌力评估法的评估结果为4级时，生成C级对应的推荐康复处方；
(4)当MRC六级肌力评估法的评估结果为5级及以上时，生成的推荐康复处方为空。
优选的，云服务端处方推荐服务单元将获取的排痰能力测试评价结果划分为辅助、自主两个等级，生成与等级对应的推荐康复处方；
辅助等级对应的推荐康复处方中，排痰能力训练方式为体位引流技术；
自主等级对应的推荐康复处方中，排痰能力训练方式为咳嗽训练以及主动呼吸循环技术；
辅助等级和自主等级的划分方法为：
(1)当呼气峰值流速PEF≥250mL时，生成自主等级对应的推荐康复处方；
(2)当呼气峰值流速PEF＜250mL时，生成辅助等级对应的推荐康复处方。
优选的，将推荐康复处方发送至医生移动终端处方配置模块由医生修改确认时，允许医生对每一个运动训练项目进行运动量的设置，每个运动周期内单项运动的运动总量V period表示为：
V period＝周期内重复日数*单日重复次数*单次运动强度；
其中，V period根据患者的功能状况检测数据设置，周期内重复次数、单日重复组数根据具体运动训练项目类型设置，单次运动强度根据V period、周期内重复日数、单日重复次数计算得到。
单次运动强度仅采用运动物理负荷衡量，选取不依赖于患者生理指标的衡量参数，衡量方法取决于具体的运动项目。
优选的，云服务端训练任务管理单元依据V period生成每个运动周期内的运动训练任务计划列表并存储，具体的，依据具体运动训练项目类型确定其运动间隔时间，并依据周期内重复次数与运动间隔时间生成单项运动训练时间列表。
优选的，患者移动终端康复训练模块接收来自云服务端训练任务管理单元的运动训练任务，以每日任务列表的形式向患者推送当日需要进行的康复训练内容，推送内容包括运动任务名称、单次运动强度的具体配置参数值以及运动方法的指示，指导患者进行康复训练。
优选的，指导患者进行康复训练过程中：
当患者进行呼吸肌训练、四肢肌力训练或排痰能力训练时，患者移动终端康复训练模块在患者训练完成后弹出“是否完成？”，患者可选择“已完成”或“未按标准完成”；
如果患者选择“已完成”，弹出语音鼓励：“继续加油”，并弹出输入框， 提醒患者输入训练过程中生理参数；
如果患者选择“未按标准完成”，弹出输入框，提醒患者输入实际完成的训练内容及训练过程中生理参数。
优选的，所述的处方调整提醒包括强度降低提醒和强度增加提醒；
生成强度降低提醒的情形包括：
(1)针对单一训练项目，如果出现“未按标准完成”，生成对应训练项目强度降低提醒；
(2)针对单一训练项目，如果出现“Borg量表值大于等于7”，生成对应训练项目强度降低提醒；
(3)针对四肢肌力训练，如果出现“心率值>(220–患者年龄)”，生成四肢肌力训练项目强度降低提醒；
生成强度增加提醒的情形包括：
(1)针对单一训练项目，如果连续一周出现“已完成”，生成对应训练项目强度增加提醒；
(2)针对四肢肌力训练，如果出现“训练过程肌力级别>四肢肌力测试评价时肌力级别”，生成四肢肌力训练项目强度增加提醒；
(3)针对排痰能力训练，如果出现“训练后PEF值–排痰能力测试评价时PEF值>50”，生成排痰能力训练项目强度增加提醒。
云服务端康复训练监督单元定期向医生移动终端康复监督模块发送康复训练报告和处方调整提醒，医生可以根据患者康复训练报告和处方调整提醒进行康复处方的调整，云服务端康复训练监督单元定期向患者移动终端功能评估模块发送重新评估任务，提醒患者进行阶段性评估从而进行康复效果的判断以及康复处方的调整。
与现有技术相比，本发明的有益效果在于：
(1)本发明系统对患者功能状况检测结果进行分级，将患者呼吸肌测试评价结果分为强、弱两个子类，将四肢肌力测试评价结果划分为A、B、C三个子类，将排痰能力测试评价结果划分为自主、辅助两个子类，并建立了其与推荐康复处方之间的联系，即根据不同的评价等级推荐包含不同的训练方式的康复处方，不但进一步细化了训练分类体系，而且对于同一部位的训练，能够描述不同患者训练方式的差异。
(2)对于需要进行同一部位的训练，而功能状况检测结果不同的患者， 本发明系统能够推荐不同子类对应的推荐康复处方，一定程度上实现个体化定制。
(3)患者在居家环境中利用易获得的工具，依据本发明推送的运动训练任务进行指定强度的运动训练，从而实现对其运动量较为精确的控制，使患者处于其运动量的有益区间。
(4)本发明系统中，单次运动强度往往能够直接反映患者的功能情况，对运动强度进行可见的数值化衡量，患者能够感受到长期训练过程中运动强度的变化，进而感受到自身某一方面(如四肢肌力)功能的变化，能够增强患者对康复训练效果的感知，从而促进患者的长期坚持。
附图说明
图1为所述的慢性呼吸衰竭病人远程康复训练指导系统结构图。
图2为所述的慢性呼吸衰竭病人远程康复训练指导系统工作流程图。
具体实施方式
下面结合附图与实施例，进一步阐明本发明。应理解，这些实施例仅用于说明本发明，而不用于限制本发明的范围。
所述的慢性呼吸衰竭病人远程康复训练指导系统结构图如图1所示，工作流程图如图2所示。
一种慢性呼吸衰竭病人远程康复训练指导系统，包括功能评估及康复训练设备组、患者移动终端、云服务端及医生移动终端；所述的功能评估及康复训练设备组与患者移动终端进行交互，所述的患者移动终端和医生移动终端分别与云服务端进行通信；
所述的功能评估及康复训练设备组包括功能评估设备组和康复训练设备组；所述的患者移动终端包括功能评估模块和康复训练模块；所述的云服务端包括评估任务管理单元、处方推荐服务单元、训练任务管理单元和康复训练监督单元；所述的医生移动终端包括处方配置模块和康复监督模块；
所述的功能评估及康复训练设备组中，功能评估设备组用于检测患者的功能状况，康复训练设备组用于患者进行居家康复运动；
所述的患者移动终端中，功能评估模块用于收集患者的功能状况检测数据并发送至云服务端处方推荐服务单元，康复训练模块用于推送康复处方和收集居家康复训练数据；所述的功能状况检测数据包括最大吸气压 (MIP)、最大呼气压(MEP)、四肢肌力等级、呼气峰值流速(PEF)；
所述的云服务端中：
评估任务管理单元用于生成评估任务，并将评估任务推送至患者移动终端功能评估模块，提醒患者进行功能评估；
处方推荐服务单元将获取的患者呼吸肌测试评价结果、四肢肌力测试评价结果和排痰能力测试评价结果划分等级后，生成与等级对应的推荐康复处方，并将推荐康复处方发送至医生移动终端处方配置模块由医生修改确认；所述的推荐康复处方包括呼吸肌训练、四肢肌力训练和排痰能力训练；
训练任务管理单元将医生修改确认后的康复处方生成运动训练任务，并将运动训练任务通过患者移动终端康复训练模块推送给患者，并指导患者进行康复训练，患者居家康复训练数据经患者移动终端康复训练模块收集后传输至云服务端康复训练监督单元；
康复训练监督单元对患者居家康复训练情况进行判断并生成康复训练报告和处方调整提醒，将康复训练报告与处方调整提醒发送至医生移动终端康复监督模块。
其中，功能评估及康复训练设备组中，所述的功能评估设备组包括呼吸肌测试仪、峰流速仪以及便携式肌力测试仪；所述的康复训练设备组包括呼吸训练器、负重沙袋以及台阶；患者移动终端中，所述的功能评估模块包括呼吸功能评估单元、排痰能力评估单元和四肢肌力评估单元；所述的康复训练模块包括康复处方推送单元和训练数据记录单元；医生移动终端中，所述的处方配置模块包括呼吸肌训练配置单元、排痰能力训练配置单元和四肢肌力训练配置单元；所述的康复监督模块包括功能评估报告单元以及康复训练报告单元。
云服务端评估任务管理单元定期生成评估任务，时间间隔优选每两周一次；患者进行功能状况检测后，云服务端处方推荐服务单元将获取的患者呼吸肌测试评价结果划分为强、弱两个等级，生成与等级对应的推荐康复处方；
弱级对应的推荐康复处方中，呼吸肌训练方式为暗示呼吸法和体外膈肌起搏呼吸法；
强级对应的推荐康复处方中，呼吸肌训练方式为呼吸训练器训练和徒 手抗阻力呼吸训练；
弱级和强级的划分方法为：计算患者的MIPpre和MEPpre，与MIPmea和MEPmea比较，MIPpre为最大吸气压预测值，MEPpre为最大呼气压预测值，MIPmea为最大吸气压实测值，MEPmea为最大呼气压实测值；
MIPpre的计算方法为：
男：MIPpre＝143–0.55*年龄
女：MIPpre＝104–0.51*年龄
MEPpre的计算方法为：
男：MEPpre＝268–1.03*年龄
女：MEPpre＝170–0.53*年龄
(1)当MIPmea<0.3*MIPpre时，生成弱级对应的推荐康复处方；
(2)当MIPmea>0.3*MIPpre且MEPmea>0.3*MEPpre时，生成强级对应的推荐康复处方；
(3)当MIPmea>0.3*MIPpre且MEPmea<0.3*MEPpre时，判断为测量值有误，生成的推荐康复处方为空。
云服务端处方推荐服务单元将获取的患者四肢肌力测试评价结果划分为A-C三个等级，生成与等级对应的推荐康复处方；
A级对应的推荐康复处方中，四肢肌力训练方式为神经肌肉电刺激和助力训练；
B级对应的推荐康复处方中，四肢肌力训练方式为主动抗重力训练，所述的主动抗重力训练包括提踵、倚墙下蹲、坐立训练、墙俯卧撑、坐式划船、坐姿腿屈伸；
C级对应的推荐康复处方中，四肢肌力训练方式为抗阻训练，所述的抗阻训练包括肩部推举、哑铃侧平举、台阶跨步、负重举臂、弹力带抗阻；
A级、B级和C级的划分方法为：
(1)当MRC六级肌力评估法的评估结果为0-1级时，生成A级对应的推荐康复处方；
(2)当MRC六级肌力评估法的评估结果为2-3级时，生成B级对应的推荐康复处方；
(3)当MRC六级肌力评估法的评估结果为4级时，生成C级对应的推荐康复处方；
(4)当MRC六级肌力评估法的评估结果为5级及以上时，生成的推荐康复处方为空。
云服务端处方推荐服务单元将获取的排痰能力测试评价结果划分为辅助、自主两个等级，生成与等级对应的推荐康复处方；
辅助等级对应的推荐康复处方中，排痰能力训练方式为体位引流技术；
自主等级对应的推荐康复处方中，排痰能力训练方式为咳嗽训练以及主动呼吸循环技术；
辅助等级和自主等级的划分方法为：
(1)当呼气峰值流速PEF≥250mL时，生成自主等级对应的推荐康复处方；
(2)当呼气峰值流速PEF＜250mL时，生成辅助等级对应的推荐康复处方。
优选的，将推荐康复处方发送至医生移动终端处方配置模块由医生修改确认时，允许医生对每一个运动训练项目进行运动量的设置，每个运动周期内单项运动的运动总量V period表示为：
V period＝周期内重复日数*单日重复次数*单次运动强度；
其中，V period根据患者的功能状况检测数据设置，周期内重复次数、单日重复组数根据具体运动训练项目类型设置，单次运动强度根据V period、周期内重复日数、单日重复次数计算得到。
单次运动强度仅采用运动物理负荷衡量，选取不依赖于患者生理指标的衡量参数，衡量方法取决于具体的运动项目，包括：
暗示呼吸法的单次运动强度采用每分钟呼吸次数衡量；
体外膈肌起搏呼吸法的单次运动强度采用单次持续时长衡量；
呼吸训练器训练的单次运动强度采用吸气阻力、呼气阻力以及呼吸次数衡量；
徒手抗阻力呼吸训练的单次运动强度采用腹部置物重量、呼吸持续时长衡量；
台阶跨步训练的单次运动强度采用台阶高度与台阶个数衡量；
负重举臂训练的单次运动强度采用举臂位置与负重重量衡量；
哑铃侧平举训练的单次运动强度采用负重重量衡量；
坐姿腿屈伸的单次运动强度采用屈腿角度衡量。
云服务端训练任务管理单元依据V period生成每个运动周期内的运动训练任务计划列表并存储，具体的，依据具体运动训练项目类型确定其运动间隔时间，并依据周期内重复次数与运动间隔时间生成单项运动训练时间列表。
患者移动终端康复训练模块接收来自云服务端训练任务管理单元的运动训练任务，以每日任务列表的形式向患者推送当日需要进行的康复训练内容，推送内容包括运动任务名称、单次运动强度的具体配置参数值以及运动方法的指示，指导患者进行康复训练。
具体的，当运动训练任务包括呼吸训练器训练时，推送内容还包括呼气压力推荐值以及吸气压力推荐值，患者依据推荐值设置呼吸训练器的呼气压力以及吸气压力。
具体的，当运动训练任务包括肩部推举、哑铃侧平举、负重举臂、徒手抗阻力呼吸训练时，推送内容还包括负重重量推荐值，患者依据推荐值选择训练时使用的负重沙袋重量。
具体的，当运动训练任务包括台阶跨步时，推送内容还包括台阶高度推荐值，患者依据推荐值选择训练时使用的台阶高度。
指导患者进行康复训练过程中：
当患者进行呼吸肌训练时，患者移动终端康复训练模块在患者训练完成后弹出“是否完成？”，患者可选择“已完成”或“未按标准完成”；
如果患者选择“已完成”，弹出语音鼓励：“继续加油”，并弹出输入框，提醒患者输入“最低氧饱和”和“Borg量表值”；
如果患者选择“未按标准完成”，弹出输入框，提醒患者输入实际完成的组数、时长、最低氧饱和、吸氧与否、最高心率、Borg量表值等。
当患者进行四肢肌力训练时，患者移动终端康复训练模块在患者训练完成后弹出“是否完成？”，患者可选择“已完成”或“未按标准完成”；
如果患者选择“已完成”，弹出语音鼓励：“继续加油”，并弹出输入框，提醒患者输入“Borg量表值”、“心率”、“当前肌力级别”；
如果患者选择“未按标准完成”，弹出输入框，提醒患者输入实际完成的组数、单组次数、负重重量值、最高心率、Borg量表值等。
当患者进行排痰能力训练时，患者移动终端康复训练模块在患者训练 完成后弹出“是否完成？”，患者可选择“已完成”或“未按标准完成”；
如果患者选择“已完成”，弹出语音鼓励：“继续加油”，并弹出输入框，提醒患者输入“PEF值”、“Borg量表值”。
如果患者选择“未按标准完成”，弹出输入框，提醒患者输入实际完成时呼气次数、吸气次数、呼气时长、吸气时长、PEF值、Borg量表值等。
所述的处方调整提醒包括强度降低提醒和强度增加提醒；
生成强度降低提醒的情形包括：
(1)针对单一训练项目，如果出现“未按标准完成”，生成对应训练项目强度降低提醒；
(2)针对单一训练项目，如果出现“Borg量表值大于等于7”，生成对应训练项目强度降低提醒；
(3)针对四肢肌力训练，如果出现“心率值>(220-患者年龄)”，生成四肢肌力训练项目强度降低提醒；
生成强度增加提醒的情形包括：
(1)针对单一训练项目，如果连续一周出现“已完成”，生成对应训练项目强度增加提醒；
(2)针对四肢肌力训练，如果出现“训练过程肌力级别>四肢肌力测试评价时肌力级别”，生成四肢肌力训练项目强度增加提醒；
(3)针对排痰能力训练，如果出现“训练后PEF值–排痰能力测试评价时PEF值>50”，生成排痰能力训练项目强度增加提醒。
云服务端康复训练监督单元定期向医生移动终端康复监督模块发送康复训练报告和处方调整提醒，医生可以根据患者康复训练报告和处方调整提醒进行康复处方的调整，云服务端康复训练监督单元定期向患者移动终端功能评估模块发送重新评估任务，提醒患者进行阶段性评估从而进行康复效果的判断以及康复处方的调整。
以上所述的实施例对本发明的技术方案进行了详细说明，应理解的是以上所述的仅为本发明的具体实施例，并不用于限制本发明，凡在本发明的原则范围内所做的任何修改、补充或类似方式替代等，均应包含在本发明的保护范围之内。

Claims (10)

  1. 一种慢性呼吸衰竭病人远程康复训练指导系统，包括功能评估及康复训练设备组、患者移动终端、云服务端及医生移动终端；其特征在于，所述的功能评估及康复训练设备组与患者移动终端进行交互，所述的患者移动终端和医生移动终端分别与云服务端进行通信；
    所述的功能评估及康复训练设备组包括功能评估设备组和康复训练设备组；所述的患者移动终端包括功能评估模块和康复训练模块；所述的云服务端包括评估任务管理单元、处方推荐服务单元、训练任务管理单元和康复训练监督单元；所述的医生移动终端包括处方配置模块和康复监督模块；
    所述的功能评估及康复训练设备组中，功能评估设备组用于检测患者的功能状况，康复训练设备组用于患者进行居家康复运动；
    所述的患者移动终端中，功能评估模块用于收集患者的功能状况检测数据并发送至云服务端处方推荐服务单元，康复训练模块用于推送康复处方和收集居家康复训练数据；所述的功能状况检测数据包括最大吸气压、最大呼气压、四肢肌力等级、呼气峰值流速；
    所述的云服务端中：
    评估任务管理单元用于生成评估任务，并将评估任务推送至患者移动终端功能评估模块，提醒患者进行功能评估；
    处方推荐服务单元将获取的患者呼吸肌测试评价结果、四肢肌力测试评价结果和排痰能力测试评价结果划分等级后，生成与等级对应的推荐康复处方，并将推荐康复处方发送至医生移动终端处方配置模块由医生修改确认；所述的推荐康复处方包括呼吸肌训练、四肢肌力训练和排痰能力训练；
    训练任务管理单元将医生修改确认后的康复处方生成运动训练任务，并将运动训练任务通过患者移动终端康复训练模块推送给患者，并指导患者进行康复训练，患者居家康复训练数据经患者移动终端康复训练模块收集后传输至云服务端康复训练监督单元；
    康复训练监督单元对患者居家康复训练情况进行判断并生成康复训练报告和处方调整提醒，将康复训练报告与处方调整提醒发送至医生移动 终端康复监督模块。
  2. 根据权利要求1所述的慢性呼吸衰竭病人远程康复训练指导系统，其特征在于，云服务端评估任务管理单元定期生成评估任务，时间间隔优选每两周一次。
  3. 根据权利要求1所述的慢性呼吸衰竭病人远程康复训练指导系统，其特征在于，云服务端处方推荐服务单元将获取的患者呼吸肌测试评价结果划分为强、弱两个等级，生成与等级对应的推荐康复处方；
    弱级对应的推荐康复处方中，呼吸肌训练方式为暗示呼吸法和体外膈肌起搏呼吸法；
    强级对应的推荐康复处方中，呼吸肌训练方式为呼吸训练器训练和徒手抗阻力呼吸训练；
    弱级和强级的划分方法为：计算患者的MIPpre和MEPpre，与MIPmea和MEPmea比较，MIPpre为最大吸气压预测值，MEPpre为最大呼气压预测值，MIPmea为最大吸气压实测值，MEPmea为最大呼气压实测值；
    MIPpre的计算方法为：
    男：MIPpre＝143–0.55*年龄
    女：MIPpre＝104–0.51*年龄
    MEPpre的计算方法为：
    男：MEPpre＝268–1.03*年龄
    女：MEPpre＝170–0.53*年龄
    (1)当MIPmea<0.3*MIPpre时，生成弱级对应的推荐康复处方；
    (2)当MIPmea>0.3*MIPpre且MEPmea>0.3*MEPpre时，生成强级对应的推荐康复处方；
    (3)当MIPmea>0.3*MIPpre且MEPmea<0.3*MEPpre时，判断为测量值有误，生成的推荐康复处方为空。
  4. 根据权利要求1所述的慢性呼吸衰竭病人远程康复训练指导系统，其特征在于，云服务端处方推荐服务单元将获取的患者四肢肌力测试评价结果划分为A-C三个等级，生成与等级对应的推荐康复处方；
    A级对应的推荐康复处方中，四肢肌力训练方式为神经肌肉电刺激和助力训练；
    B级对应的推荐康复处方中，四肢肌力训练方式为主动抗重力训练， 所述的主动抗重力训练包括提踵、倚墙下蹲、坐立训练、墙俯卧撑、坐式划船、坐姿腿屈伸；
    C级对应的推荐康复处方中，四肢肌力训练方式为抗阻训练，所述的抗阻训练包括肩部推举、哑铃侧平举、台阶跨步、负重举臂、弹力带抗阻；
    A级、B级和C级的划分方法为：
    (1)当MRC六级肌力评估法的评估结果为0-1级时，生成A级对应的推荐康复处方；
    (2)当MRC六级肌力评估法的评估结果为2-3级时，生成B级对应的推荐康复处方；
    (3)当MRC六级肌力评估法的评估结果为4级时，生成C级对应的推荐康复处方；
    (4)当MRC六级肌力评估法的评估结果为5级及以上时，生成的推荐康复处方为空。
  5. 根据权利要求1所述的慢性呼吸衰竭病人远程康复训练指导系统，其特征在于，云服务端处方推荐服务单元将获取的排痰能力测试评价结果划分为辅助、自主两个等级，生成与等级对应的推荐康复处方；
    辅助等级对应的推荐康复处方中，排痰能力训练方式为体位引流技术；
    自主等级对应的推荐康复处方中，排痰能力训练方式为咳嗽训练以及主动呼吸循环技术；
    辅助等级和自主等级的划分方法为：
    (1)当呼气峰值流速≥250mL时，生成自主等级对应的推荐康复处方；
    (2)当呼气峰值流速＜250mL时，生成辅助等级对应的推荐康复处方。
  6. 根据权利要求1所述的慢性呼吸衰竭病人远程康复训练指导系统，其特征在于，将推荐康复处方发送至医生移动终端处方配置模块由医生修改确认时，允许医生对每一个运动训练项目进行运动量的设置，每个运动周期内单项运动的运动总量V period表示为：
    V period＝周期内重复日数*单日重复次数*单次运动强度
    其中，V period根据患者的功能状况检测数据设置，周期内重复次数、 单日重复组数根据具体运动训练项目类型设置，单次运动强度根据V period、周期内重复日数、单日重复次数计算得到。
  7. 根据权利要求6所述的慢性呼吸衰竭病人远程康复训练指导系统，其特征在于，所述的单次运动强度仅采用运动物理负荷衡量，选取不依赖于患者生理指标的衡量参数，衡量方法取决于具体的运动项目。
  8. 根据权利要求1所述的慢性呼吸衰竭病人远程康复训练指导系统，其特征在于，患者移动终端康复训练模块接收来自云服务端训练任务管理单元的运动训练任务，以每日任务列表的形式向患者推送当日需要进行的康复训练内容，推送内容包括运动任务名称、单次运动强度的具体配置参数值以及运动方法的指示，指导患者进行康复训练。
  9. 根据权利要求1所述的慢性呼吸衰竭病人远程康复训练指导系统，其特征在于，指导患者进行康复训练过程中：
    当患者进行呼吸肌训练、四肢肌力训练或排痰能力训练时，患者移动终端康复训练模块在患者训练完成后弹出“是否完成？”，患者可选择“已完成”或“未按标准完成”；
    如果患者选择“已完成”，弹出语音鼓励：“继续加油”，并弹出输入框，提醒患者输入训练过程中生理参数；
    如果患者选择“未按标准完成”，弹出输入框，提醒患者输入实际完成的训练内容及训练过程中生理参数。
  10. 根据权利要求9所述的慢性呼吸衰竭病人远程康复训练指导系统，其特征在于，所述的处方调整提醒包括强度降低提醒和强度增加提醒；
    生成强度降低提醒的情形包括：
    (1)针对单一训练项目，如果出现“未按标准完成”，生成对应训练项目强度降低提醒；
    (2)针对单一训练项目，如果出现“Borg量表值大于等于7”，生成对应训练项目强度降低提醒；
    (3)针对四肢肌力训练，如果出现“心率值>(220–患者年龄)”，生成四肢肌力训练项目强度降低提醒；
    生成强度增加提醒的情形包括：
    (1)针对单一训练项目，如果连续一周出现“已完成”，生成对应训练项目强度增加提醒；
    (2)针对四肢肌力训练，如果出现“训练过程肌力级别>四肢肌力测试评价时肌力级别”，生成四肢肌力训练项目强度增加提醒；
    (3)针对排痰能力训练，如果出现“训练后呼气峰值流速–排痰能力测试评价时呼气峰值流速>50”，生成排痰能力训练项目强度增加提醒。
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