JP7212948B2 - Systems and methods for monitoring subject movement - Google Patents

Description

The present invention relates to systems and methods for monitoring movement of a subject.

Patent Literature 1 describes that the calorie consumption of a subject during exercise with a change in altitude is calculated by the following formula (1) based on the outputs of a triaxial acceleration sensor and an air pressure sensor attached to the subject.
Cal=W・(k1・Itotal+k2・(Ha+k6)+k3・(Hd+k7)+k4)・k5
... (1)
However, W: body weight of subject, Itotal: cumulative acceleration, Ha: amount of increase gained, Hd: amount of decrease acquired, k1: coefficient for converting cumulative acceleration to oxygen intake, k2: correction of oxygen intake by amount of increase acquired. k3: coefficient for correcting oxygen uptake by the amount of descent acquired; k4: oxygen uptake at rest; k5: calorie conversion factor for converting oxygen uptake into calories; k6: amount of increase acquired and k7: a coefficient for correcting the acquired descent amount.

JP 2008-220517

Exercise therapy is one of the treatments for heart failure. Current exercise regimens first determine the patient's maximal oxygen uptake and ventilatory threshold. To do so, gradually increase the load using a bicycle ergometer or treadmill and determine the maximum oxygen uptake (maximum oxygen uptake) and the ventilation threshold observed at 60% of the exercise intensity. . Exercise training is performed at an intensity above this ventilation threshold using a bicycle ergometer for 30 minutes a day, 4 days or more a week. This is the international standard exercise training method.

However, the current situation is that it is difficult to say that standard exercise training methods are generally implemented. The reason for this is that the number of facilities and staff cannot keep up with the large number of patients, and that families need to drive patients to and from the hospital in order to exercise, which is a heavy burden. . As a result, it was clarified that long-term exercise training did not significantly improve maximal oxygen uptake and cardiac function.

Therefore, it is an object of the present invention to provide a system and method suitable for exercise prescription that can be performed even at home based on regional core hospitals.

One aspect of the present invention is a first acquisition unit (function) that acquires exercise information including oxygen uptake estimated based on the output of an acceleration sensor that captures the motion of the subject, and at least one of the heart rate and electrocardiogram of the subject. a second acquisition unit (function) for acquiring cardiac information comprising: and real-time monitoring of the subject's cardiac information to the subject's monitoring agency when the oxygen uptake value relative to the subject's peak oxygen uptake reaches a predetermined value; is a system comprising a unit (function) that initiates the

In this system, the first acquisition unit can estimate oxygen uptake for determining exercise intensity based on the output of the acceleration sensor. For this reason, even without using equipment for exercise for rehabilitation, rehabilitation can be performed with exercises that can be easily performed at home, such as brisk walking and cycling. On the other hand, the location-independent nature of exercise training may not be well monitored by physicians, physical therapists, or hospital staff. For this reason, real-time monitoring is forcibly started when the oxygen uptake value relative to the maximum oxygen uptake of the subject reaches a predetermined value, that is, when the exercise intensity exceeds a predetermined value such as 70%. By doing so, monitoring during exercise training can be performed reliably. In addition, since oxygen uptake can be estimated by a parameter different from heart rate, exercise intensity and information about the heart can be monitored independently. Therefore, if an abnormality should occur in the heart during exercise training, the symptom can be quickly detected.

Typically, a monitoring organization for subjects who are exercise training subjects (patients) is a doctor, a medical institution, or its staff, and is a centralized monitoring organization that monitors a plurality of subjects. The system may also have a terminal that includes a first acquisition unit, a second acquisition unit, and a communication unit (function) for transmitting motion and cardiac information to a centralized monitoring facility. Since multiple subjects can be monitored at the required timing via terminals, exercise training can be carried out efficiently even when the number of medical personnel is small. Further, the centralized monitoring institution may be an institution or staff, such as medical personnel, remotely located with respect to the subject. The subject's monitoring agency may be an artificial intelligence or expert system comparable to that of medical personnel, and may be implemented in distributed terminals.

The terminal may further comprise a unit (function) for notifying the centralized monitoring agency of the commencement of exercise in which the subject's oxygen uptake value relative to the maximal oxygen uptake exceeds a predetermined value. Monitors can check the condition of the heart before starting exercise. The terminal may further include a unit (function) that notifies the subject of an exercise program created so that the value of oxygen uptake with respect to the maximum oxygen uptake of the subject exceeds a predetermined value. The centralized monitoring facility may further include a unit (function) that develops an exercise program based on subject attributes, symptoms, conditions monitored by the centralized monitoring facility, and/or the environment in which the exercise is scheduled.

The first acquisition unit may estimate said oxygen uptake based on the output of an acceleration sensor as well as the output of an altitude sensor that detects the subject's ascent and descent speed. Exercise in which the value of oxygen uptake relative to the maximum oxygen uptake of the subject exceeds a predetermined value is typically exercise for cardiac rehabilitation.

Another aspect of the invention is a method that includes monitoring a subject remotely using a terminal. The terminal includes a first acquisition unit that acquires exercise information including oxygen uptake estimated based on the output of an acceleration sensor that captures motion of the subject, and heart information that includes at least one of heart rate and electrocardiogram of the subject. and a communication unit for transmitting motion information and said cardiac information. The method comprises the subject's monitoring agency initiating real-time monitoring of the subject's cardiac information when the subject's oxygen uptake value relative to the subject's peak oxygen uptake reaches a predetermined value.

The method may further comprise the terminal notifying the monitoring agency that the subject's oxygen uptake value for maximal oxygen uptake exceeds a predetermined value to initiate exercise. The terminal may further comprise notifying the subject of an exercise program created such that the oxygen uptake value for the subject's maximal oxygen uptake exceeds a predetermined value. The monitoring agency may further comprise creating the exercise program based on subject attributes, symptoms, monitoring status by the monitoring agency, and/or the environment in which the exercise is planned.

Exercise in which the value of oxygen uptake relative to the subject's maximal oxygen uptake exceeds a predetermined value may typically include brisk walking. The method may further comprise the terminal obtaining the subject's peak oxygen uptake by walking the subject at the maximum speed the subject is capable of. The exercise in which the value of oxygen uptake relative to the maximum oxygen uptake of the subject exceeds a predetermined value may be exercise for cardiac rehabilitation.

The figure which shows the outline|summary of the system for rehabilitation. 4 is a flowchart showing an outline of processing in a rehabilitation application;

In the following, the present invention will be described by taking as an example a safe and inexpensive at-home/remote rehabilitation system based on exercise prescription for patients with mild heart failure. Currently, there are 1,720,000 heart disease patients, of which 300,000 are diagnosed with heart failure, 80% of which are aged 65 or older. Furthermore, the number of hospitalized patients with this disease is increasing by 10,000 every year. On the other hand, exercise therapy is one of the treatments for heart failure, and its effectiveness is well known. Exercise regimen criteria first determine the patient's maximal oxygen uptake and ventilatory threshold. That is, gradually increase the load using a bicycle ergometer or treadmill and determine the maximum oxygen uptake (maximum oxygen uptake) and the ventilation threshold observed at 60% of the exercise intensity. . Exercise training is performed at least 30 minutes a day, 4 days a week or more using a bicycle ergometer at an intensity above this ventilation threshold. This is the international standard in cardiac rehabilitation (American College of Sports Medicine).

However, in reality, the exercise prescription currently being carried out in general public hospitals in Japan is limited to 30 minutes per patient per day, once per week. The reason for this is that the number of facilities and staff cannot keep up with the large number of patients, and that families need to drive patients to and from the hospital in order to exercise, which is a heavy burden. . As a result, even if exercise training is carried out for 10 months, it is difficult to achieve remarkable improvements in maximum oxygen uptake and cardiac function.

FIG. 1 shows an example of a rehabilitation system capable of exercise training at home. This rehabilitation system (system) 1 includes a terminal 10 equipped with a function 11 capable of performing exercise training for improving physical strength at home and an electrocardiogram monitor function 12, a regional central hospital 35 serving as a monitoring base 30, and and a server unit 40 that stores information. A function 11 capable of performing exercise training functions as a first acquisition unit for acquiring information (exercise information) 61 during exercise of a subject (patient, subject) 2 who is exercising. It functions as a second acquisition unit for acquiring cardiac information (cardiac monitoring information) 62 including two heart rates and/or an electrocardiogram.

The terminal 10 is, for example, a mobile terminal (smartphone) worn and carried by the subject (patient) 2, and has a communication function (communication unit) 18 and various sensors. Examples of sensors include, but are not limited to, GPS 21, triaxial accelerometer 22, altitude sensor 23 such as a barometer, pulse/electrocardiograph 24, thermometer, and the like. These sensors may be integrated into the terminal 10, or may be provided separately from the terminal 10 as wearable parts or devices and connected to the terminal 10 by wire or wirelessly.

The altitude sensor 23 may be a sensor capable of accurately measuring relative altitude displacement (altitude change) accompanying movement, or may be a barometer. The terminal 10 may be a wristwatch-type terminal that can be worn on the arm to easily detect the pulse, and is a wristwatch-type terminal having functions as a pulse monitor and/or an electrocardiograph and Bluetooth (registered trademark) (Bluetooth). It may also be a mobile terminal that can be connected by short-range wireless communication such as the mobile terminal.

One of the applications 15 implemented in the terminal 10 is a rehabilitation application 50 including a function 11 for performing exercise training and a function 12 for monitoring an electrocardiogram. In this example, a rehabilitation application 50 that uses interval walking as exercise training will be described. The application (app) 50 includes an activity amount (consumed energy amount) monitoring function (monitor, activity amount monitor) 51 . Based on the data obtained from the accelerometer 22, the barometer 23, the GPS 21, etc., the activity monitor 51 detects the type of activity of the user 2, such as walking, cycling (while traveling by bicycle), private car, or others. and an oxygen intake amount estimation unit (VO2 unit) 51b for estimating the oxygen intake _eVO2 by a predetermined estimation formula based on the activity type. , an energy consumption estimation unit (CAL unit) 51c that obtains energy consumption using the estimated oxygen uptake, and measurement data (exercise information ) 61 and a unit 51d that outputs . Data such as oxygen uptake eVO ₂ included in exercise information 61 are used in other functions of app 50 and are also provided to server system 40 via communication unit 18 .

The VO2 unit 51b calculates oxygen intake per unit time during cycling using an oxygen intake estimation formula set for cycling when the activity mode (movement mode) is determined to be moving by bicycle (during cycling). The amount eVO ₂ C is obtained, and when walking is determined, the oxygen uptake per unit time eVO ₂ W during walking is obtained using an oxygen uptake estimation formula set for walking.

Based on the research by the inventors of the present application, the oxygen uptake (oxygen consumption) eVO ₂ W during walking is measured by the triaxial acceleration sensor 22 that measures the acceleration of the person (subject) 2 to be measured per unit time. The cumulative acceleration (vector norm) VM per unit time, the amount of ascent (ascending speed) Hu per unit time of the person to be measured 2 measured by the altitude sensor 23, and the amount of descent (falling speed) Hd of the person to be measured per unit time are It can be estimated by the following formula (2) including: For example, Yamazaki T, Gen-no H, Kamijo Y, Okazaki K, Masuki S, and Nose H. A new device to estimate VO2 during incline walking by accelerometry and barometry. Med Sci Sports Exerc, 41 : 2213-2219, 2009".
eVO ₂ W=w1·VM+w2·Hu+w3·Hd (2)
The unit of oxygen uptake eVO ₂ W is ml/kg/min, the unit of cumulative acceleration VM is G/min, the unit of ascending amount Hu is m/min, the unit of descending amount Hd is m/min, and the unit of coefficient w1. is ml/kg/G, the units of coefficients w2 and w3 are ml/kg/m. An example of each coefficient is as shown in the following equations (3) to (5).
0.022≤w1≤0.070 (3)
0.770≤w2≤1.886 (4)
0.098≤w3≤1.082 (5)
The lower limit of the coefficient w1 may be 0.030 or 0.038, and the upper limit may be 0.062 or 0.054. The lower limit of the coefficient w2 may be 0.956 or 1.142, and the upper limit may be 1.700 or 1.514. The lower limit of the coefficient w3 may be 0.262 or 0.426, and the upper limit may be 0.918 or 0.754.

The oxygen uptake eVO ₂ C while traveling by bicycle can be estimated by the following equation (6).
eVO ₂ C=c1·VM+c2·Hu+c3·Hd (6)
0.048≤c1≤0.210 (7)
0.463≤c2≤2.605 (8)
0.020≦c3≦0.602 (9)
The unit of oxygen uptake eVO ₂ C is ml/kg/min, the unit of coefficient c1 is ml/kg/G, and the unit of coefficients c2 and c3 is ml/kg/m. The lower limit of coefficient c1 may be 0.075 or 0.102, and the upper limit may be 0.183 or 0.156. The lower limit of coefficient c2 may be 0.820 or 1.177, and the upper limit may be 2.248 or 1.891. The lower limit of coefficient c3 may be 0.117 or 0.214, and the upper limit may be 0.505 or 0.408.

The energy consumption CAL per unit time can be obtained by the following equation (10) including the oxygen uptake eVO ₂ W or eVO ₂ C and the weight W of the subject.
CAL=k1·W·eVO ₂ W (or eVO ₂ C) (10)
However, the unit of energy consumption CAL is kcal/min, the unit of body weight W is kg, and the unit of calorie conversion coefficient k1 is kcal/ml. An example of the calorie conversion factor k1 is 4.825.

The rehabilitation application 50 further has a function (physical strength measurement unit) 52 for measuring physical fitness, and a function (fast walking determination unit) for determining whether or not the user is exercising at a predetermined exercise intensity, that is, whether the person is walking fast. 53, a function (exercise program execution unit) 54 that causes the subject (user) 2 to exercise according to a predetermined exercise program, and a hospital 35 that is a monitoring institution 30 that starts real-time monitoring when it is determined that the exercise program has started. and a function (notification unit, monitoring unit) 55 for notifying and starting.

The physical fitness measurement unit 52 can obtain the maximum oxygen uptake (maximum oxygen uptake) VO2peak using the activity monitor 51 . That is, as disclosed in the inventors' patent No. 4500184, etc., there is a correlation between the cumulative acceleration (impulse) VM during walking at maximum speed and endurance (maximum oxygen uptake) VO2peak. or for a predetermined period of time, the subject 2 wears the terminal 10 and walks at maximum speed, so that the physical strength measurement unit 52 estimates the maximum load oxygen uptake (maximum oxygen uptake) VO2peak of the subject 2. can be done. In addition, the inventors have obtained the viewpoint that there is a correlation between the heart rate of the subject 2 immediately before the start of spontaneous exercise and the maximum oxygen uptake VO2peak. The maximum oxygen uptake VO2peak may be estimated from the timing and the pulsometer 24 value. The physical fitness measurement result 52a including the maximum oxygen uptake VO2peak is recorded in the memory 17, sent also to the server 40, and stored in the physical fitness measurement result DB42.

When the value (exercise intensity, ventilation threshold) of the oxygen uptake eVO ₂ W or eVO ₂ C obtained by the activity monitor 51 with respect to the maximum oxygen uptake VO2peak reaches a predetermined value, for example, 60%, the fast walking determining unit 53 It is determined that a predetermined training (exercise program) has started. For example, in the case of exercise training including brisk walking, it is determined that brisk walking has started. For example, in the “interval brisk walking (registered trademark)” training advocated by the inventors, whose main purpose is to improve physical strength, a brisk walk at 70% or more of the individual's maximum oxygen intake and a slow walk at 40% are alternated for three minutes each. Repeatedly, 30 minutes a day, 4 days a week. By practicing this training for 5 months, it was found that the physical strength improved by 5-20%, and the lifestyle-related disease index improved by 5-10%.

In an exercise program for cardiac rehabilitation, the exercise intensity determined as fast walking by the fast walking determining unit 53 is often set to 40% to 60% depending on the condition of the subject 2 . Specifically, it is set for each subject 2 by a medical staff such as a doctor or a physical therapist.

The exercise program execution unit 54 guides the subject 2 to exercise (training) according to an exercise program 54a preset for each subject 2 using voice or the like. The execution unit 54 includes a start unit (start button, start icon) 56 that starts the exercise program 54a when operated by the subject 2, a guide unit 57 that instructs the subject 2 on the exercise content according to the exercise program 54a, and a history display unit 58 for displaying exercise (training) history. Based on the oxygen intake eVO ₂ W obtained from the activity monitor 51, the guide unit 57 adjusts the walking speed of the subject 2 so that the exercise intensity reaches a predetermined level and the change in the exercise intensity falls within a predetermined range. and so on.

When the start unit 56 is operated or the trot determination unit 53 determines that trot walking has started, the notification unit 55 notifies a real-time monitoring request 63 to the hospital 35 or the like registered as the monitoring institution 30 of the subject 2. do. When exercise information 61 including exercise history such as oxygen intake eVO ₂ W obtained from activity monitor 51 is sent from terminal 10 in real time to server 40 or monitoring agency 30, real-time monitoring request 63 is sent to server 40 or monitoring agency 30 .

The rehabilitation application 50 has the function of supporting the training of the subject 2 according to the exercise program 54a for rehabilitation as described above, and also monitors the state of the heart of the subject 2, such as the heart rate and electrocardiogram obtained from the electrocardiograph 24. It includes a cardiac monitoring function (monitoring unit) 54 that acquires information (cardiac information) 62 to monitor. When the notification unit 55 outputs the real-time monitoring instruction 63 or when the conditions for outputting the real-time monitoring instruction 63 are met, the communication unit 18 sends the exercise information 61 and the heart information 62 to the Internet (cloud) 9 or The information is provided to a hospital 35 or the like, which is a monitoring organization 30, through other communication means.

Even if the conditions for outputting the real-time monitoring instruction 63 are not met, the heart monitoring unit 12 may notify the monitoring institution 30 of the occurrence of an abnormality in the subject 2 if there is an abnormality in the heart rate or electrocardiogram. good. In addition to the GPS 21 information indicating the location of the subject 2, the notification of the abnormality may include exercise information 61 indicating the activity status of the subject 2 before and after the occurrence of the abnormality, and heart information 62 indicating the state of the heart.

A server unit 40 that accumulates information from the terminal 10 includes a user database (user DB) 41 that stores the attributes of the subject (user) 2 of the terminal 10, a physical strength measurement result DB 42 that stores physical strength measurement results, and a history DB 43 that stores the exercise history included in the exercise information 61 of . The history DB 43 may store information such as a pulse and an electrocardiogram included in the heart information 62 provided from the terminal 10, together with the exercise history, in association with the exercise history. The user DB 41 contains attributes of the subject 2 such as sex, age, height, weight, genetic background, home environment, underlying disease, symptoms such as heart failure severity, environment in which the exercise program 54a is executed, for example, area where fast walking is performed. height difference, road conditions, etc. may be registered in advance.

The hospital 35, which includes a function as a monitoring agency 30 that monitors the condition of the subject 2 during home rehabilitation in real time, has a doctor 39, a physical therapist, and other professional staff to perform rehabilitation exercise when there is a request for real-time monitoring. A monitoring function (monitoring service) 31 that monitors the execution status of the program 54a and the state of the heart in real time, and an exercise program creation function (exercise program creation service) 32 that creates an exercise program 54a suitable for the condition of the subject 2. , and a function (emergency response service) 33 for performing an emergency response in the unlikely event that an abnormality occurs in the subject 2 . A monitoring agency 30, such as a hospital 35, may provide these services for a fee.

In this rehabilitation system 1, when there is a real-time monitoring request 63 from the terminal 10, or when conditions for real-time monitoring are satisfied by the exercise information 61 and the heart information 62 received in real time, the exercise information 61 and the heart information 62 are displayed. is monitored in real time by professional staff at the monitoring agency 30 . Therefore, the subject 2 can safely implement the exercise program 54a for rehabilitation in a place away from the monitoring facility 30, for example, in a home environment. Even when rehabilitation is performed in the hospital 35, the subject 2 can safely implement the exercise program 54a for rehabilitation by himself/herself without the need for one-on-one supervision of the subject 2 by specialized staff. In addition, when the subject 2 is not performing the exercise program 54a for rehabilitation, the monitoring by the specialist staff is unnecessary, so the burden on the specialist staff can be reduced. Furthermore, the subject 2 does not have to be conscious of being constantly monitored, and since constant monitoring services are unnecessary, the cost required for rehabilitation can be reduced.

Furthermore, in the monitoring institution 30, a small number of professional staff members monitor the implementation status of the exercise program 54a and the heart conditions of many subjects 2, as long as the number of subjects 2 to be monitored does not become too large. be able to. Therefore, by using the terminal 10 equipped with the application 50 for rehabilitation, the rehabilitation system 1 equipped with the institution 30 that centrally monitors the rehabilitation of many subjects 2 can be provided. Therefore, in this rehabilitation system 1, the burden on the medical staff involved in rehabilitation can be reduced. In addition, the burden on the family who takes the subject 2 to and from the hospital can be reduced, and the additional burden can be reduced.

Further, in this rehabilitation system 1, a real-time monitoring request 63 is output when exercise intensity reaches a predetermined value. Therefore, even if the subject 2 unintentionally takes an action that may place an excessive burden on the heart, the monitoring facility 30 automatically performs real-time monitoring. Therefore, it is also possible to reduce the risk in the subject's 2 daily life.

In this rehabilitation system 1, the monitor 30 monitors the exercise state including the oxygen uptake eVO ₂ W of the subject 2 who is executing the exercise program 54a for rehabilitation, and the heart state including the heart rate and electrocardiogram. Then, a professional staff such as a doctor 39 monitors in real time. For this reason, if any symptom leading to an abnormality in the state of the heart during execution of the exercise program 54a is observed, based on this, advice such as lowering the exercise intensity is given to the subject 2 who is exercising, and an abnormality occurs. can be prevented from occurring. It is also possible to recreate the exercise program 54a, even if it does not interfere with exercise (training). On the other hand, if there is no symptom leading to an abnormal heart condition during monitoring, the doctor 39 or the like can update the exercise program 54a executed by the subject 2 to one with a higher exercise intensity.

FIG. 2 shows an overview of the processing of the application 50 for rehabilitation in the form of a flowchart. First, in step 71, initialization is performed. In the initial setting, attributes of subject (user) 2 are set. Attributes include, for example, age, gender, height, and weight. Attributes may further include information such as genetics and underlying diseases. Further, at the time of initial setting, in step 72, physical fitness is measured and the maximum oxygen uptake (maximum oxygen uptake, endurance) VO2peak is set.

The application 50 may continuously acquire exercise information 61 including oxygen consumption eVO ₂ W in step 73 using the activity monitor 51 as the first acquisition unit 11 . Cardiac information 62 including heart rate and/or an electrocardiogram may also be acquired by the cardiac monitoring unit (second acquisition unit) 12 at step 74 . These information 61 and 62 may be used to determine behavior and abnormalities of the subject 2 within the application 50 and may be sent to the server unit 40 via the communication unit 18 in real time or intermittently. and/or transmitted to monitoring agency 30 .

Regarding the recording of electrocardiogram waveforms and transfer to the server, the electrocardiogram (electrocardiogram monitor) 24 is kept constant at any time in order to save the storage capacity of the electrocardiogram (electrocardiogram monitor) 24 and shorten the transfer speed from the mobile terminal 10 to the server 40. Record for a period of time, record the waveform for 5 seconds before and after the time when an abnormality in the RR interval (arrhythmia) was detected on the monitor 24 (200 Hz), transfer it to the mobile terminal 10 by Bluetooth, and further carry it. It may be transferred from the terminal 10 to the server 40 .

If, at step 75, cardiac monitoring unit 12 determines that the heart condition is abnormal, then at step 76, an alert is provided to monitoring agency 30 or other emergency response agency. The alarm may include position information of the GPS 21, exercise information 61, and heart information 62. FIG.

In step 77 , the subject 2 operates the exercise program execution unit 54 to start the exercise program 54 a , and in step 79 the notification unit 55 outputs the real-time monitoring request 63 . When the subject 2 operates the start of the exercise program execution unit 54, or alternatively, in step 78 starts the exercise program 54a or a comparable exercise, such as brisk walking, the brisk walking determination unit 53 determines the oxygen consumption eVO Based on ₂ W, it is determined that a preset brisk walk or an exercise with a comparable exercise intensity (value of oxygen uptake relative to maximal oxygen uptake) has started. As a result, in step 79, a real-time monitoring request 63 is output.

The terminal 10 may have a function of communicating with a training machine for cardiac rehabilitation, and when the subject 2 performs exercise using the training machine instead of exercise such as brisk walking or cycling, the training machine consumes oxygen. Information corresponding to the quantity eVO ₂ W may be obtained. In this case as well, when the exercise intensity exceeds a predetermined value, the application 50 outputs a real-time monitoring request 63, whereby the monitoring agency 30 may start real-time monitoring. The terminal 10 can notify the monitoring agency 30 that the subject ₂ will start exercising in which the value of the oxygen uptake eVO2 relative to the maximum oxygen uptake VO2peak exceeds a predetermined value.

When the real-time monitoring request 63 is output in step 79, the exercise information 61 and cardiac information 62 collected in steps 80 and 81 as in steps 73 and 74 are sent to the monitoring agency (step 82) via the communication unit 18. provided to a hospital 35 which is a monitoring facility 30 . As a result, in step 91, the condition of the subject 2 is monitored in real time at the hospital 35, which is the centralized monitoring facility 30. FIG. In step 83, in the application 50, the guide unit 57 notifies the subject 2 of the intensity and duration of brisk walking according to the preset rehabilitation program 54a, and monitors the progress. The terminal 10 notifies the subject 2 of the exercise program 54a created so that the value of the oxygen uptake eVO ₂ W with respect to the maximum oxygen uptake VO2peak of the subject 2 exceeds a predetermined value, and limits the predetermined training to the upper limit and It can be instructed to do it within the lower limit range.

When the prescribed training (exercise) defined in the exercise program 54a is completed in step 84, the centralized monitoring facility 30 is notified of the end of real-time monitoring in step 85, and the real-time monitoring in the centralized monitoring facility 30 is completed. Real-time monitoring may be performed at the monitoring institution 30 by artificial intelligence trained for monitoring or an expert system equipped with knowledge for monitoring instead of professional staff such as doctors 39 and physical therapists. If the artificial intelligence is compact enough to be installed in the terminal 10, the terminal may have the function of the monitoring agency 30.

If monitoring agency 30 provides a new exercise program 54 a at step 92 , terminal 10 updates the established exercise program 54 a at step 86 . Monitoring agency 30 may create or update exercise program 54a based on the results of real-time monitoring, subject attributes, symptoms, monitoring status by monitoring agency 30, and/or the environment in which exercise is scheduled.

With this cardiac rehabilitation system 1, it is possible to ensure safety during training using the portable terminal 10, and by performing this system 1 at home, it is possible to spread safe and inexpensive home-based cardiac rehabilitation. can. The widespread use of safe and inexpensive walking exercise prescriptions through mobile terminal applications will enable the construction of a large-scale DB. Using this, the training implementation rate and effect can be stratified by initial attributes such as age, gender, heart failure severity, underlying disease, and genetic background, or by environmental factors such as regional and seasonal differences in training effects. can be analyzed separately. It will contribute to the establishment of treatment methods including exercise prescription for heart failure patients.

Heart failure is an advanced form of various lifestyle-related diseases, and is often accompanied by renal failure, dementia, depression, and cancer. Therefore, the establishment of home-type and remote-type exercise prescriptions for cardiac rehabilitation will lead to the development of rehabilitation medicine in general, and the improvement in patients' ADL and QOL brought about by it will bring about the effect of suppressing medical expenses, revitalizing the economy, and extending healthy life expectancy. It leads to the establishment of society.

1 rehabilitation system, 10 terminal 50 application for rehabilitation

Claims (13)

a first acquisition unit that acquires exercise information including oxygen uptake estimated based on the output of an acceleration sensor that captures movement of the subject;
a second acquisition unit for acquiring cardiac information including at least one of a heart rate and an electrocardiogram of the subject;
causing the subject's monitoring agency to initiate real-time monitoring of the cardiac information of the subject when the oxygen uptake value relative to the subject's peak oxygen uptake reaches a predetermined value. In claim 1,
the monitoring agency of the subject is a centralized monitoring agency that monitors a plurality of subjects;
The system further comprising a terminal including said first acquisition unit, said second acquisition unit, and a communication unit for transmitting said exercise information and said cardiac information to said centralized monitoring agency. In claim 2,
The system, wherein the terminal further includes a unit for notifying the centralized monitoring agency to initiate exercise when the oxygen uptake value for the subject's maximal oxygen uptake exceeds a predetermined value. In claim 2 or 3,
The system, wherein the terminal further includes a unit for notifying the subject of an exercise program created so that the value of the oxygen uptake relative to the maximum oxygen uptake of the subject exceeds a predetermined value. In claim 4,
The system, wherein the centralized monitoring agency further includes a unit for creating the exercise program based on at least one of the subject's attributes, symptoms, conditions monitored by the centralized monitoring agency, and an environment in which exercise is planned. In any one of claims 1 to 5,
The system, wherein the first acquisition unit estimates the oxygen uptake based on the output of the acceleration sensor as well as the output of an altitude sensor that detects the subject's ascent and descent rates. In any one of claims 1 to 6,
The system, wherein the exercise in which the oxygen uptake value exceeds a predetermined value relative to the maximum oxygen uptake of the subject is exercise for cardiac rehabilitation. A method comprising remotely monitoring a subject using a terminal, comprising:
The terminal includes a first acquisition unit that acquires exercise information including oxygen uptake estimated based on the output of an acceleration sensor that captures movement of the subject, and cardiac information including at least one of heart rate and an electrocardiogram of the subject. a communication unit for transmitting the exercise information and the heart information; and a notification unit for notifying a real-time monitoring request ;
The method is such that when the oxygen uptake value relative to the maximum oxygen uptake of the subject reaches a predetermined value, the notification unit of the terminal notifies the subject's monitoring organization of the real-time monitoring request to the subject. initiating real-time monitoring of the cardiac information of. In claim 8 ,
The method further comprising the terminal notifying the subject of an exercise program created such that the value of the oxygen uptake relative to the maximal oxygen uptake of the subject exceeds a predetermined value. In claim 9 ,
The method, wherein the exercise program is created by the monitoring agency based on at least one of the subject's attributes, symptoms, monitoring status by the monitoring agency, and an environment in which the exercise is planned. In any one of claims 8 to 10 ,
The method, wherein the exercise in which the oxygen uptake value exceeds a predetermined value relative to the maximal oxygen uptake of the subject includes brisk walking. In any one of claims 8 to 11 ,
The method further comprising the terminal obtaining the maximum oxygen uptake of the subject by walking the subject at the maximum speed the subject is capable of. In any one of claims 8 to 12 ,
The method, wherein the exercise in which the oxygen uptake value exceeds a predetermined value relative to the maximum oxygen uptake of the subject is exercise for cardiac rehabilitation.

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