Sensory-Motor Systems Lab, Department of Health Science and Technologies (HEST), Institute of Robotics and Intelligent Systems (IRIS), ETH Zurich, Tannenstrasse 1, 8092, Zurich, Switzerland.
Med Biol Eng Comput. 2014 Jan;52(1):53-64. doi: 10.1007/s11517-013-1119-5. Epub 2013 Oct 7.
Cardiovascular deconditioning has long been recognized as a characteristic of the physiological adaptation to long-term bed rest in patients. The process is thought to contribute to orthostatic intolerance and enhance secondary complications in a significant way. Mobilization is a cost-effective and simple method to maintain the cardiovascular parameters (i.e., blood pressure, heart rate) stable, counter orthostatic intolerance and reduce the risk of secondary problems in patients during long-term immobilization. The aim of this project is to control the cardiovascular parameters such as heart rate and blood pressure of bed rest patients via automated leg mobilization and body tilting. In a first step, a nonlinear model predictive control strategy was designed and evaluated on five healthy subjects and 11 bed rest patients. In a next step, a clinically feasible study was conducted on two patients. The mean values differed on average less than 1 bpm from the predetermined heart rate and less than 2.5 mmHg from the desired blood pressure values. These results of the feasibility study are promising, although heterogeneous disease etiologies and individual medication strongly influence the mechanically induced reactions. The long-term goal is an automation of the control of physiological signals and the mobilization of bed rest patients in an early phase of the rehabilitation process. Therefore, this new approach could help to strengthen the cardiovascular system and prevent secondary health problems arising from long-term bed rest.
心血管功能减退长期以来被认为是患者长期卧床休息时对生理适应的特征。该过程被认为以显著的方式导致直立不耐受，并增强次要并发症。动员是一种经济有效的简单方法，可以维持心血管参数（即血压、心率）稳定，对抗直立不耐受，并降低患者在长期固定期间发生继发性问题的风险。本项目的目的是通过自动腿部运动和身体倾斜来控制卧床休息患者的心血管参数，如心率和血压。在第一步中，针对五名健康受试者和 11 名卧床休息患者设计并评估了非线性模型预测控制策略。在下一步中，对两名患者进行了一项临床可行的研究。平均心率与预定心率相差不到 1 bpm，平均血压值与期望血压值相差不到 2.5 mmHg。尽管异质性疾病病因和个体用药强烈影响机械诱导反应，但这些可行性研究的结果很有希望。长期目标是在康复过程的早期阶段自动控制生理信号和卧床休息患者的动员。因此，这种新方法可以帮助增强心血管系统，预防长期卧床休息引起的继发性健康问题。
