Summary of the invention
To solve the above problems, and adapt to the demand of medical big data era, meet more more and more intense lifelong strong of peopleHealth demand for services meets the needs of medical expert and medical personnel effectively use big data, and the invention discloses a kind of cardiopulmonaryLocomotion evaluation and training integral system use number with case big data intelligent management system (BigCase) for coreCardiopulmonary gait test (DCW) carries out cardiopulmonary exercise functional assessment and risk stratification to patient, and issues exercise prescription；According to patientCase data and exercise prescription, control and monitor training of the patient on sports apparatus, by rehabilitation assistant remind andMonitor the implementation of the big prescription of patient 5；Doctor's client, family members' client and the professional service client of system provide individual character at any timeChange, specialized rehabilitation service.
The present invention is according to individual sports prescription, and human body physiological parameter at that time, sets sport training plan, including targetExercise intensity and target heart rate, warm-up duration and mode restore movement duration and mode.For treadmill or other locomotory apparatusTool, that is, selection training mode and parameter；When abnormal, according to abnormal difference, different processing methods is taken.For stepRow, since exercise intensity is generated by artificially changing cadence and step-length, supervised using the method for monitoring cadence and step-lengthSurvey exercise intensity, with the method for monitor heart rate come remind sporter keep exercise intensity.
In order to achieve the above object, the invention provides the following technical scheme:
Cardiopulmonary exercise assessment and training integral system, including case big data intelligent management system and and caseExample big data intelligent management system carries out the cardiopulmonary exercise functional assessment of data interaction and Personalized motion prescription is formulated system, borrowedHelp rehabilitation training and formulation optimization system, the guidance of walking and other free movements and monitoring system, client of sports apparatus；
Case big data intelligent management system is used for the case archives of storage and management patient；
Cardiopulmonary exercise functional assessment and Personalized motion prescription are formulated system and are assessed for acquiring physiological signal, from casePatient information is obtained at example big data intelligent management system, assessment result is uploaded into case big data intelligent management system, andAccording to other detection informations of assessment result and patient, risk stratification and exercise prescription design are carried out；
Patient is obtained from case big data intelligent management system by the rehabilitation training and formulation optimization system of sports apparatusExercise prescription and associated conditions information, formulate drill program, guidance and monitoring training, according to exercise rehabilitation training plan, mentionWake up and management patient's implementing plan, and monitor physical condition when rehabilitation training, acquire carry out after physiological data processing in real time andAnalysis generates training report, uploads data and report；
The guidance and monitoring system of walking and other free movements obtain patient's from case big data intelligent management systemPrescription and associated conditions information generate drill program, remind and instruct patient to carry out training according to quantity on time, and upload trainingAs a result, customization and push family members' report；
Client is used to carry out data interaction with user.
Further, cardiopulmonary exercise functional assessment and Personalized motion prescription are formulated system and are referred to using heart adaptability to changes seriesIt is denoted as to assess the numerical index of cardiopulmonary exercise function, heart adaptability to changes series index includes: resting heart rate, heart strain rate, the heartStrain limit, exercise heart rate restore.
Further, cardiopulmonary exercise functional assessment and Personalized motion prescription formulate system according to " coronary cardiopathy rehabilitation and twoThe risk stratification table of patients with coronary heart disease in the Chinese Consensus of experts of grade prevention ", in conjunction with 6 minutes walking distances and heart adaptability to changes seriesIndex carries out risk stratification.
Further, cardiopulmonary exercise functional assessment and Personalized motion prescription formulate system and determine movement according to risk stratificationStrength range calculates personalized target heart rate, selection movement duration and movement using resting heart rate, heart strain rate combination exercise intensityThe frequency.
Further, it includes: wearable physiological signal that cardiopulmonary exercise functional assessment and Personalized motion prescription, which formulate system,Acquisition module, the smart phone APP gait test module being connect with wearable physiological signal acquisition module and and smart phoneThe gait test work station of APP gait test module connection.
It further, include movement by the drill program that the rehabilitation training of sports apparatus and formulation optimization system are formulatedInstrument type, warming-up exercise time, apparatus work duration and speed, monitoring index and alarm setting when exercise rehabilitation training.
Further, by the rehabilitation training of sports apparatus and formulation optimization system include doctor workstation module andThe sports apparatus of data interaction is carried out with doctor workstation module and for the body monitoring modular of wearing.
Further, the guidance and monitoring system acquisition electrocardio of walking and other free movements and motor message, pass through placeReason and analysis electrocardiosignal, obtain heart rate, monitor anomalous ecg；By handling and analyzing motor message, body posture is calculated, is estimatedCadence, step-length when calculating and run, to calculate speed and exercise intensity.
Further, the characteristic measure of the also comprehensive heart rate variability of the guidance and monitoring system of walking and other free movementsAnd motion state, sleep state of classifying, and the heart rate variability under different sleep states is further assessed, provide personalized sleepDormancy quality and health state evaluation report.
Further, the guidance and monitoring system of walking and other free movements include including rehabilitation helper module and rehabilitationServices client end module.
Compared with prior art, the invention has the advantages that and the utility model has the advantages that
The fortune of intelligence and science is carried out from cardiopulmonary exercise assessment, design exercise prescription to personalized exercise prescription is usedThe system and method for moving training monitoring and management are medical treatment and health for scientifically body-building and rehabilitation providing method, system and platformIntelligence, regulation and standardization, the personalization serviced again provides technology and means.The present invention proposes to support and realize medical treatmentThe technology and methods of the knowledge representation and reasoning intelligence of case big data are allowed to and hospital HIS system and various inspections and monitoringEquipment is connected with instrument, obtains data, realizes scientific management, real-time monitoring and the safety guarantee of diagnosis, treatment and rehabilitation training.
Specific embodiment
Technical solution provided by the invention is described in detail below with reference to specific embodiment, it should be understood that following specificEmbodiment is only illustrative of the invention and is not intended to limit the scope of the invention.In addition, step shown in the flowchart of the accompanying drawingsSuddenly it can execute in a computer system such as a set of computer executable instructions, although also, showing in flow chartsLogical order, but in some cases, it can be with the steps shown or described are performed in an order that is different from the one herein.
Cardiopulmonary exercise assessment provided by the invention and exercise rehabilitation training integral system include that case big data is intelligently managedReason system (BigCase), cardiopulmonary exercise functional assessment and exercise prescription are formulated module (DCW), are instructed by the rehabilitation of sports apparatusThe guidance and monitoring modular (SCRA) of experienced and formulation optimization module (CRIM) and walking and other free movements.
Wherein, case big data intelligent management system (BigCase) uses a kind of Chinese patent " medical cases big dataIntelligent management system " content in (application number 2017106087286), the present invention uses medical cases big data intelligent management systemBigCase unite to dynamically update case, cardiopulmonary rehabilitation prescription is intelligently managed and optimized according to progress, monitors training,Personalized service is provided.
Data acquisition and result feedback, personalized service need to be realized based on the equipment interacted with user in the present invention.
For example, heart movement testing equipment and system can be there are two types of apparatus-forms.One is level ground walking movementsForm claims " digital heart gait test ".Wearing component is worn on front, acquires a lead or multi-lead electrocardiogram and human body fortuneDynamic signal, and hand-hold electronic equipments are sent with bluetooth or other communications by collected signal.Hand-held electronics is setStandby is the calculating equipment of similar smart phone or tablet computer, it receives and handles electrocardio and motor message, with voice and interactionScreen is interacted with measured；Exercise test process is controlled, motion mode and speed are reminded, warns anomalous ecg；It calculates and showsElectrocardiogram, heart rate, cadence, step-length, distance and the exercise intensity indicated with metabolic equivalent；And signal and calculated result with wirelessMode is sent to work station.
Another kind is the motion mode by treadmill, is claimed " digital heart Treadmill Exercise Test ".Dress component acquisition oneLead or multi-lead electrocardiogram, are sent to hand-hold electronic equipments in a wired or wireless fashion.Hand-hold electronic equipments for example can be raceStep machine console.It is also interacted with voice and interactive screen with measured；Exercise test process is controlled, motion mode and speed are remindedDegree warns anomalous ecg；Calculate and show electrocardiogram, heart rate, cadence, distance and the exercise intensity indicated with metabolic equivalent；AndSignal and calculated result are sent to work station in a wired or wireless fashion.It is different with horizontal plane walking movement mode to be, it runsForms of motion on step machine is not only horizontal plane walking, further includes that the gradient is walked and run.Speed and exercise intensity information mainly fromTreadmill controller.
Digital heart walking movement testing equipment can whenever and wherever possible, and digital heart Treadmill Exercise Test equipment can be concentratedManagement, they have their own advantages.Their common advantages are intelligent, quantitative, easy to use, will be universal cardiac function dynamic examinationIt tests, promotes cardiopathic prevention and rehabilitation provides technology and equipment and supports.
Specifically, as shown in Figure 1, cardiopulmonary exercise of the present invention assessment and training integral system include 5 subsystemsSystem: case big data intelligent management system (BigCase) 100, cardiopulmonary exercise functional assessment and exercise prescription formulate system (DCW)200, by the rehabilitation training of sports apparatus and formulation optimization system (CRIM) 300 and the guidance of walking and other free movementsWith monitoring (SCRA) system 400, doctor and patient client end 500.
Case big data intelligent management system (BigCase) 100 is stored with the case archives of patient, is the core of whole systemThe heart, all other subsystem are all attached thereto.Case big data intelligent management system (BigCase) is with frame system in artificial intelligenceSystem knowledge representation method indicates each medical cases example, thus completes the conversion from data to knowledge, makes to generate eachA case example can participate in Case-based reasoning and the reasoning based on guide rule, the diagnosis to be standardized, treatmentWith opinion needed for rehabilitation and parameter.
Cardiopulmonary exercise functional assessment and exercise prescription formulate system (DCW) 200 and obtain patient information from BigCase, willAssessment result uploads to BigCase, and according to other detection informations of assessment result and patient, carries out at risk stratification and movementSide's design.Movement place of patient is obtained from BigCase by the rehabilitation training and formulation optimization system (CRIM) 300 of sports apparatusSide and associated conditions information formulate drill program, guidance and monitoring training, generate training report, upload data and report.WalkingGuidance and monitoring system (SCRA) 400 with other free movements obtain the prescription and associated conditions information of patient from BigCase,It reminds and instructs patient to carry out training according to quantity on time, and upload training result, customization and push family members' report.Doctor, familyBelong to and professional service client is by BigCase, carries out locomotion evaluation, training and services jointly.
Fig. 2 is the structural schematic diagram that cardiopulmonary exercise functional assessment and exercise prescription formulate system (DCW).DCW includes threeModule: wearable physiological signal acquisition module 210, smart phone APP gait test module 220 and gait test work station230.Wherein wearable physiological signal acquisition module 210 includes ECG signal sampling instrument 211, sphygmomanometer 212, BOLD contrast 213, fortuneDynamic sensor 214.
ECG signal sampling instrument 211 is the electrocardio signal collecting unit of a standard, including sequentially connected 8 channel electrocardio letterNumber acquisition amplifying circuit, analog to digital conversion circuit, controller and telecommunication circuit.In order to obtain good electrocardio letter under motion stateNumber quality filters minimizing technology using special motion artifacts；Sphygmomanometer 212 is the conventional cuff type blood with bluetooth connectionPressure meter, only measures before gait test and after gait test and uploads pressure value；BOLD contrast 213 is worn on finger tip, motion-sensingComprising miniature three-dimensional acceleration and three-dimensional gyro sensor in device 214, it is worn on measured's metastomium.ECG signal samplingMeasuring signal is all uploaded to smart phone APP gait test mould by bluetooth by instrument 211, BOLD contrast 213 and motion sensor 214Block 220.Smart phone APP gait test module 220 receives and processing electrocardio, blood oxygen and motor message, interacts, connects with measuredData and processing result are received and uploaded to gait test work station 230.The letter that 230 real-time display of gait test work station receivesNumber, it further analyzes, display, report blood oxygen signal, electrocardiosignal, motor message and heart adaptability to changes series index, with medical carePersonnel's interaction, uploads to hospital information system for measurement data and report.
Smart phone APP gait test module 220 receives the measured ID and personal information of gait test work station 230,Generate the exercise test mode of this test.For example, can choose following modes: experiment opening for digital heart gait testBegin, measured static one minute or more, until heart rate calmness, obtains his resting heart rate；Start walking, first with positive constant speedDegree, and gradually accelerate, in the case where no uncomfortable feel and normal ECG, encouragement measured adds as far as possible within each minuteSpeed arrives maximum speed, and walking stops after 6 minutes；Static one minute break after stopping walking, the heart rate that measurement obtains measured are extensiveComplex value.Entire test model records 8 minutes electrocardios and exercise data, i.e., static 1 minute before walking, walking 6 minutes and stopsAfterwards static 1 minute.After starting test, smart phone APP gait test module is sent with voice and text prompt to measuredInstruction, allows measured according to instruction, starts and complete to test.
Smart phone APP gait test module also receives ECG signal and BOLD contrast from ECG signal sampling instrument 211213 oximetry data.Carry out three kinds of processing to electrocardiosignal: removal motion artifacts, detection QRS structure simultaneously calculate heart rate, detectionAnomalous ecg event.Electrocardio processing result is sent to gait test work station 230, while the also real-time display on APP.If any electrocardioException or blood oxygen are abnormal, then APP is issued Xiang doctor by gait test work station 230 and warned according to the prediction scheme pre-set,Early warning is issued to measured also by voice and text.
Smart phone APP gait test module also receives motion sensor signal from motion sensor 214.Since movement passesSensor 214 uses miniature 3-axis acceleration sensor and three-axis gyroscope.Three-axis gyroscope data are examined for monitoring the direction of motionSurvey turning；3-axis acceleration data are then used to detect foot and land event, accurately calculate cadence；Forward acceleration component can be used forEstimate step-length.Step-length is the displacement in a gait cycle, to forward acceleration component measured by front accelerometer at this timeProgress once integrates to obtain speed, and quadratic integral must be displaced.In order to remove error caused by deviation when wearing, worn in measuredWhen upper wearing component, it is desirable that measured stands, and carries out initialization correction in 5 seconds.
There are cadence and step-length, so that it may calculate movement velocity, and then calculate the exercise intensity indicated with metabolic equivalent.BeautyState's sports medical science meeting ACSM (American College of Sports Medicine) is used to calculate metabolic equivalent when walkingFormula are as follows:
Total metabolism equivalent (Gross METs)=1+ (0.1 × speed+1.8 × speed × gradient percentage)/3.5 milliliters/public affairsJin/minute
Speed unit is m/min that level road upgrade percentage is 0%.
Gait test work station 230 has five big tasks: first is that receiving and showing from smart phone APP gait test module220 signal and processing result；Second is that further analyzing and handling these data and processing result, the heart of measured is generatedElectricity moves, the assessment parameter and report of heart rate motor reaction；Third is that providing the interactive and information processing function for medical staff；FourIt is other inspections and the test data according to test result and measured, risk stratification is carried out to it, and further issue movementPrescription；Fifth is that interacting with case big data intelligent management system (BigCase) 100, test result is uploaded, enriches case data；Using the functions such as the BigCase risk stratification provided and exercise prescription formulation, serviced for measured.
It is heart strain that cardiopulmonary exercise functional assessment and exercise prescription, which formulate the main measurement index that system (DCW) 200 is provided,Ability series (Chronotropic Competence Indices CCI) index and walking distance.Heart adaptability to changes lacksThe important Danger Indexes of cardiovascular disease are of great significance in the prevention and treatment and rehabilitation of cardiovascular disease, have been international cardiovascularsThe common recognition on boundary.Repeatedly large-scale test in the world, including famous U.S.'s Framingham cardiac studies, to 3000 Healthy PeoplesTracking, the French follow-up study for lasting 23 years to 5713 Healthy Peoples for lasting 15 years, all show that CI is that All death independently refers toMark, including sudden death.
Regulation of the autonomic nerve to cardiorespiratory system is by sympathetic nerve, parasympathetic nerve, sinoatrial node, cardiac muscle, peripheral tissuesWhat the closed-loop system of equal compositions was completed.The activation of sympathetic nerve increases sinus-node self-activity, is passed excitability by atrioventricular nodeIt is directed at His-Purkinje system, drives heart contraction, and accelerates loosening for cardiac muscle cell in diastole；Vagus nerve passes through the heartInterior ganglionic cholinergic neuron inhibits the pacemaker activity (reduce heart rate) of sinoatrial node, reduces the conduction and reduction between chamberThe excitability of His-Purkinje system.During exercise, due to peripheral tissues' metabolic demand, sympathetic activation makes sinoatrial node certainlyRule property increases, while driving heart contraction.For ordinary person, increase and the myocardial contractive power enhancing of heart rate occur simultaneously, also referred to asBowditch effect.Heart output increases rapidly, ensure that the conveying of oxygen and nutrient.However, even if not finding cardiovascular device matterProperty problem people, there is also heart adaptability to changes lack problem.Sympathetic stimulation is inadequate or sympathetic nerve in this groups of people movementExcitation effectively do not increase sinus-node self-activity.
The definition of heart adaptability to changes series index and its range of normal value in the case where gait test are as follows:
1, resting heart rate Resting Heart Rate RHR: body remains static down, mood is in tranquilityUnder heart rate, range of normal value 60-80BPM.Research and clinical practice prove that resting heart rate is abnormal, especially irregular change,It is admission rate and the raised sign of the death rate.
2, heart strain rate Chronotropic Rate CR: defining heart strain rate CR is change rate of the heart rate to amount of exercise,Or change the variation of caused heart rate for unit exercise equivalent, it is rate of straining of the heart to movement, calculation formula is as follows:
CR=(HRstage-HRrest)/(METstage-1)
Its normal value is that exercise metabolism amount increases by a unit amount, and heart rate increases 10BPM.It is too high or too low to can mean that friendshipSense and parasympathetic nerve activity, sinoatrial node or cardiac muscle go wrong.
Heart strain rate connects exercise intensity and heart rate, is the important indicator of personalized target heart rate.With rehabilitation intoExhibition and medication etc., heart strain rate can constantly change, therefore, target heart rate in exercise prescription should with the variation of heart strain rate andAdjustment in time.
3, heart strain limit Chronotropic Limit CL: namely heart rate reserve Heart Rate Reserve(HRR), i.e., heart is the attainable maximum dynamic range of reply campaign.This depends not only on the mobility of heart itself,Also autonomic nerve ability of regulation and control is depended on.The present invention is calculated by following formula:
CL=HRR=(HRmax-HRrest)/(HRPredM-HRrest)
Wherein maximum heart rate predicted value (HRPredM), general 220-age is predicted in the world.In cardiopulmonary exercise test, reachHeart rate when having arrived limit of sports record is peak heart rate HRmax, and then calculated CL value should be between 0.8-1.3.
In gait test, because of the limitation of this forms of motion of walking, the HR that reaches in testmaxIt is that maximum walking is exertedPower maximum heart rate achieved.This is smaller than the CL to be reached capacity when moving in CPX, usually > 0.4 can.Such as: oneA 60 years old normal person walks 500 meters in 6 minutes.Maximum speed reaches 100 ms/min, exercise equivalent 3.86MET.If his is staticHeart rate is 75BPM, CR=12BPM/MET, his CL=12* (3.86-1)/(220-60-75)=0.4
4, (Heartrate Recovery after Exercise (HRE) is defined as the peak motion heart for exercise heart rate recoveryThe difference of 1 minute heart rate after rate and movement stop, heart rate is restored to the speed of resting heart rate after expression movement stops.This is cardiovascularThe hazard index of disease.A large amount of research has shown that HRE is a kind of very strong prognostic indicator.Europe and America heart associationCombined paper thinks that 1 minute campaign heart rate restores to reflect the speed of parasympathetic nerve reactivation, and normal value must not be lower than12。
Cardiac function risk stratification
Complete cardiopulmonary exercise gait test after, according to 6 minutes walking distances can carry out cardiac function compromise state intoRow classification (layering).Europe, the United States, plus cardiac rehabilitation and it is secondary prophylactically can combined paper the danger based on 6 minutes walking distancesDanger layering is classified and contacts with the cardiac functional grading of New York Heart association (NYHA) and the cardiac function of Canadian heart association (CCS)Get up.The former two is supervisor's evaluation, 6 minutes walking distance (low danger > 400m；Middle danger 300m~400m；High-risk < 300m) it is objectiveEvaluation.Following table is that 6 minutes walking distances are embedded in the result of the coronary heart disease risk layered sheet of Chinese expert.Low danger requirement in tableIt all refers to scale to meet, high-risk needs an index and meet.If this can be removed without revascularization.
A large amount of clinical test proves in the world, and than 6 minutes walking distances of heart adaptability to changes series index are in risk stratificationIn it is even more important.The maximum heart rate wherein reached is related to walking distance, and heart strain rate and heart rate restore all to be the dynamic of heartThe direct digital representation of state function.Therefore, to carry out risk stratification using heart adaptability to changes series index more scientific, objectiveIt sees.
The formulation of exercise prescription
Exercise prescription includes four aspects, it may be assumed that the movement frequency, exercise intensity, type of sports, movement duration.According to dangerIt is layered result and the wish of patient, we can determine whether the movement frequency, type of sports, movement durations.For example, danger low for onePatient, we can suggest him once a day, move 20-30 minutes, have warming-up exercise in 10 minutes before movement, there is 10 points after movementClock reactivates.He can choose skelp, excercises, taijiquan etc..
Exercise intensity metabolic equivalent and target heart rate metering.After smoothly completing digital cardiopulmonary gait test, if also selectedThe training mode to skelp is selected, it can be directly using the heart strain limit reached in digital cardiopulmonary gait test, namely mostBig heart rate.By target heart rate selection, the 80-100% of maximum heart rate can in gait test.
On the other hand, since gait test form limits the performance of locomitivity, we can be adopted in the following methodTo determine exercise intensity, the target heart rate of the heart strain rate calculating personalization measured is used.
The first step carries out risk stratification according to cardiac rehabilitation guide, according to risk stratification as a result, determining movement deposit: lowEndanger 7MET, middle danger 6MET, high-risk 5MET；
Second step, recommending exercise intensity is the 60%-80% of movement deposit, it may be assumed that 4-5.5MET of low danger, middle danger 3.5-4.5MET, high-risk 3.0-4.0MET.For rigid setting in motion trainer, lower amount of exercise is taken, it is then incremental, it increasesAmount of exercise.
Third step calculates personalized target heart rate according to recommendation exercise intensity and heart adaptability to changes series index.Here, the heart is answeredVariability varies with each individual, and is to calculate us to be illustrated with an example:
Have a low danger patient, setting in motion for a period of time, we prefer that movement is 5MET by force；
Target heart rate is calculated according to the resting heart rate (75BPM) of measurement and heart strain rate (13B/MET):
HRexerc=75+13* (5-1)=127BPM
4th step, risk stratification and exercise prescription are inputted in the case database of the patient.
Fig. 3 is in the embodiment of the present invention by the knot of the rehabilitation training of sports apparatus and formulation optimization (CRIM) system 300Structure schematic diagram.After cardio-pulmonary function assessment, risk stratification and exercise prescription setting, the case of the patient in case big dataThe necessary data for carrying out cardiac rehabilitation is had been provided with, patient can setting in motion rehabilitation training.By sports apparatusRehabilitation training and formulation optimization (CRIM) system 300 equipment in hospital or recovery centre, and with case big data intelligent management systemSystem 100 is connected.By the rehabilitation training of sports apparatus and formulation optimization (CRIM) system 300 include doctor workstation module 310,Sports apparatus and control module 320, body monitoring modular 330.
After patient comes hospital or recovery centre, doctor or rehabilitation are an apprentice of in case big data intelligent management system 100 and are adjustedThe rehabilitation prescription and corresponding data of the patient out generates this rehabilitation programme, issues disease according to prescription, data and patient's wishPeople's rehabilitation training hand-held intelligent equipment 321.And with 321 brush doctor workstation module of rehabilitation training intelligent rehabilitation equipment, 310 screenThe rehabilitation training plans of the patient are passed in his rehabilitation training intelligent rehabilitation equipment 321 by two dimensional code on curtain.The drill programInclude him using which kind of sports apparatus, do how long warming-up exercise, on the instrument with which kind of speed movement how long,Monitoring index and alarm setting when exercise rehabilitation training.Meanwhile doctor or rehabilitation teacher issue the wearable monitoring device of patient330, including electrocardioscanner 331, sphygmomanometer 332, BOLD contrast 333.It is real-time by bluetooth that all monitoring devices will acquire dataIt is transmitted to patients ' recovery training hand-held intelligent equipment 321.
Patients ' recovery training hand-held intelligent equipment 321 by hand-held intelligent communicate and calculate equipment (be often used smart phone orTablet computer) and be mounted above APP composition.The APP of patients ' recovery training hand-held intelligent equipment 321 has a two big functions: oneIt is to remind and manage the implementation of patients ' recovery drill program according to exercise rehabilitation training plan.The a certain sports apparatus of patient selectionAfterwards, it is communicated by bluetooth with the foundation of sports apparatus 322, and its classification and parameter is obtained with the two dimensional code of the instrument.According to movementRehabilitation programme sends control instruction (being then speed and the gradient if it is treadmill) to sports apparatus 322, while sending out to othersSend verbal cue.Such as: " now beginning to move, please be ready ".
The second largest function of the APP of patients ' recovery training hand-held intelligent equipment 321 is to receive electrocardio, blood pressure and blood oxygen numberAccording to being handled and analyzed in real time, data and processing result are uploaded to doctor workstation module 310.Pass through when noting abnormalitiesDoctor workstation module 310 is alarmed Xiang doctor and rehabilitation teacher.Simultaneously with presetting, adjust automatically sports apparatus speed is remindedPatient pays attention to.Patients ' recovery training hand-held intelligent equipment 321 is wirelessly connected with doctor workstation module 310 by wifi.
Motor pattern and amount of exercise monitoring and adjustment
Using sports apparatus exercise rehabilitation training need optimize be motor pattern, exercise intensity and move duration choosingIt selects.In exercise prescription, exercise intensity is usually there are two types of objective representation method, first is that the exercise intensity indicated with metabolic equivalent,Another kind is indicated with target heart rate.Since heart strain rate varies with each individual, for same exercise intensity, the target heart rate of different people is notThe same.Meanwhile some variations can also occur for same person's different time and different conditions, heart strain rate.Heart strain rateVariation leads to the variation of target heart rate.Therefore, it is usually transported in the case where being difficult to real-time measurement exercise intensity with target heart rate to controlDynamic training strength.When using sports apparatus, we can know exercise intensity in real time, should control exercise prescription with exercise intensityImplementation preferably.If exercise prescription is indicated with target heart rate, the heart that can be used in heart adaptability to changes series index is answeredTarget heart rate is converted into the exercise intensity of metabolic equivalent expression by variability and resting heart rate.Here, heart strain rate is to contact generally to transportThe index of fatigue resistance and personalized target heart rate；Resting heart rate corresponds to the stationary state that metabolic equivalent is one.
We use trapezoidal motion mode.The exercise intensity according to determined by sport training plan and movement duration, precedingRespectively add Motor preparation and the exercise recovery stage of certain time length afterwards.For example, the sport training plan of a certain patient is strong with 5METDegree movement 20 minutes.The formula given according to American Society of Sports Medicine, can calculate the gradient and speed on a treadmill, andStart before plus 2 minutes accelerators, after plus 2 minutes moderating process.In entire motion process, as long as no electrocardio, bloodPressure, blood oxygen are abnormal, just maintain former design sport training plan, the adjustment of speed of not taking exercises and movement duration.Doctor workstationModule 310 calculates heart adaptability to changes series for according to the variation of electrocardio, blood pressure and blood oxygen parameter in entire sport training processIndex, heart rate variability, blood pressure and blood oxygen running parameter, and provide training report.Sometimes, in order to improve rehabilitation training effect,It, can be with certain regular varying motion intensity in entire movement duration.
Fig. 4 is the structure of guidance and monitoring (SCRA) system 400 of walking and other free movements in the embodiment of the present inventionSchematic diagram.Guidance and monitoring (SCRA) system 400 and case big data intelligent management system 100 of walking and other free movementsIt is connected, including 420 module of rehabilitation assistant and rehabilitation service client modules 410.Rehabilitation service client modules 410 further wrapInclude medical and nursing work station 411-1, doctor's mobile client 411-2, family members' client 412 and professional service client 413.Patient steps onThere are two types of situations using rehabilitation assistant progress cardiac rehabilitation for note: one is during phase rehabilitation in hospital, body is more weak, can onlyBedside movement is done, needs to carry out real-time monitoring using rehabilitation assistant；Second is that starting the house rehabilitation of three phases.Patient begins to use rehabilitationBefore helper module 420 carries out rehabilitation training, need to be registered by medical and nursing work station 411-1: case is an apprentice of in doctor or rehabilitationThe patient data is recalled in big data intelligent management system 100, rehabilitation implementation plan is generated according to doctor's advice, with what is scanned the two-dimensional codeForm, will be in the smart phone APP 422 of patient related information input rehabilitation assistant.Rehabilitation assistant wearing is allotted to patient simultaneouslyEquipment 421.
Rehabilitation helper module 420 reminds according to the big prescription of rehabilitation 5 and doctor's advice and patient is assisted to implement rehabilitation training, and canTo carry out intellectual monitoring, provide rehabilitation training report.Rehabilitation helper module 420 includes wearable device 421 and smart phone APP422.Wearable device 421 measures electrocardio and motor message simultaneously, is sent to smart phone APP 422 by bluetooth.Smart phone APP422 processing in real time and analysis electrocardio and motor message.By handling and analyze electrocardiosignal, heart rate is accurately obtained, monitoring premature beat,The anomalous ecgs such as atrial fibrillation, arrhythmia cordis；By handling and analyzing motor message, i.e., 3 dimension acceleration signals and 3 dimension gyroscope lettersNumber, accurately it is inferred to body posture: lies, sits, stands, walks, runs, falls down；Cadence, step-length when estimation is left and run, to surveyCalculate speed and exercise intensity.
The recovery function that smart phone APP 422 is provided includes: to remind patient's medication according to quantity on time；Patient is reminded to open on timeBeginning exercise rehabilitation training, electrocardio, breathing, type of sports and the intensity of real-time monitoring patient, position, at the movement of settingSide, reminds the insufficient or excessive of amount of exercise；Remind dyskinesia (such as falling down) and anomalous ecg；All data are recorded, according to needIt uploads or saves；Report is automatically generated, is referred to for doctor.
Smart phone APP 422 also has the function of sleep monitor, it integrate heart rate variability characteristic measure (time domainNN50, SDSD, VLF, LF and HLF relative value and motion state of frequency domain, 3 kinds of sleep states of classifying: waking up, shallowly sleep, sound sleep, andFurther heart rate variability of the assessment under these different conditions provides personalized sleep quality and health state evaluation reportIt accuses.
Smart phone APP also detects movement of getting up, and points out and slow down movement, fall prevention.This is outstanding for the elderlyIts is important.
By family members' client 412, user can consult the case data of related patient, can also be to case big data intelligenceIt can management system customization report or timing Real-time Monitoring Data.For example, family members can customize: 8 points of every night, push patient thisThe case where one day 5 big prescription of execution and exercise rehabilitation training report；Anomalous ecg and while falling down, send Hot Report immediately.
The technical means disclosed in the embodiments of the present invention is not limited only to technological means disclosed in above embodiment, further includesTechnical solution consisting of any combination of the above technical features.It should be pointed out that for those skilled in the artFor, various improvements and modifications may be made without departing from the principle of the present invention, these improvements and modifications are also considered asProtection scope of the present invention.