Heart rate regulation during cycle-ergometer exercise via event-driven biofeedback

© 2016, International Federation for Medical and Biological Engineering. This paper is devoted to the problem of regulating the heart rate response along a predetermined reference profile, for cycle-ergometer exercises designed for training or cardio-respiratory rehabilitation. The controller designed in this study is a non-conventional, non-model-based, proportional, integral and derivative (PID) controller. The PID controller commands can be transmitted as biofeedback auditory commands, which can be heard and interpreted by the exercising subject to increase or reduce exercise intensity. However, in such a case, for the purposes of effectively communicating to the exercising subject a change in the required exercise intensity, the timing of this feedback signal relative to the position of the pedals becomes critical. A feedback signal delivered when the pedals are not in a suitable position to efficiently exert force may be ineffective and this may, in turn, lead to the cognitive disengagement of the user from the feedback controller. This note examines a novel form of control system which has been expressly designed for this project. The system is called an “actuator-based event-driven control system”. The proposed control system was experimentally verified using 24 healthy male subjects who were randomly divided into two separate groups, along with cross-validation scheme. A statistical analysis was employed to test the generalisation of the PID tunes, derived based on the average transfer functions of the two groups, and it revealed that there were no significant differences between the mean values of root mean square of the tracking error of two groups (3.9 vs. 3.7 bpm, p= 0.65). Furthermore, the results of a second statistical hypothesis test showed that the proposed PID controller with novel synchronised biofeedback mechanism has better performance compared to a conventional PID controller with a fixed-rate biofeedback mechanism (Group 1: 3.9 vs. 5.0 bpm, Group 2: 3.7 vs. 4.4 bpm, p< 0.05)

A framework for optimal actuator/sensor selection in a control system

© 2017, © 2017 Informa UK Limited, trading as Taylor & Francis Group. When dealing with large-scale systems, manual selection of a subset of components (sensors/actuators), or equivalently identification of a favourable structure for the controller, that guarantees a certain closed-loop performance, is not very feasible. This paper is dedicated to the problem of concurrent optimal selection of actuators/sensors which can equivalently be considered as the structure identification for the controller. In the context of a multi-channel H 2 dynamic output feedback controller synthesis, we formulate and analyse a framework in which we incorporate two extra terms for penalising the number of actuators and sensors into the variational formulations of controller synthesis problems in order to induce a favourable controller structure. We then develop an explicit scheme as well as an iterative process for the purpose of dealing with the multi-objective problem of controller structure and control law co-design. It is also stressed that the immediate application of the proposed approach lies within the fault accommodation stage of a fault tolerant control scheme. By two numerical examples, we demonstrate the remarkable performance of the proposed approach

Effect of seasonal variation on clinical outcome in patients with chronic conditions: Analysis of the commonwealth scientific and industrial research organization (csiro) national telehealth trial

©Ahmadreza Argha, Andrey Savkin, Siaw-Teng Liaw, Branko George Celler. Background: Seasonal variation has an impact on the hospitalization rate of patients with a range of cardiovascular diseases, including myocardial infarction and angina. This paper presents findings on the influence of seasonal variation on the results of a recently completed national trial of home telemonitoring of patients with chronic conditions, carried out at five locations along the east coast of Australia. Objective: The aim is to evaluate the effect of the seasonal timing of hospital admission and length of stay on clinical outcome of a home telemonitoring trial involving patients (age: mean 72.2, SD 9.4 years) with chronic conditions (chronic obstructive pulmonary disease coronary artery disease, hypertensive diseases, congestive heart failure, diabetes, or asthma) and to explore methods of minimizing the influence of seasonal variations in the analysis of the effect of at-home telemonitoring on the number of hospital admissions and length of stay (LOS). Methods: Patients were selected from a hospital list of eligible patients living with a range of chronic conditions. Each test patient was case matched with at least one control patient. A total of 114 test patients and 173 control patients were available in this trial. However, of the 287 patients, we only considered patients who had one or more admissions in the years from 2010 to 2012. Three different groups were analyzed separately because of substantially different climates: (1) Queensland, (2) Australian Capital Territory and Victoria, and (3) Tasmania. Time series data were analyzed using linear regression for a period of 3 years before the intervention to obtain an average seasonal variation pattern. A novel method that can reduce the impact of seasonal variation on the rate of hospitalization and LOS was used in the analysis of the outcome variables of the at-home telemonitoring trial. Results: Test patients were monitored for a mean 481 (SD 77) days with 87% (53/61) of patients monitored for more than 12 months. Trends in seasonal variations were obtained from 3 years’ of hospitalization data before intervention for the Queensland, Tasmania, and Australian Capital Territory and Victoria subgroups, respectively. The maximum deviation from baseline trends for LOS was 101.7% (SD 42.2%), 60.6% (SD 36.4%), and 158.3% (SD 68.1%). However, by synchronizing outcomes to the start date of intervention, the impact of seasonal variations was minimized to a maximum of 9.5% (SD 7.7%), thus improving the accuracy of the clinical outcomes reported. Conclusions: Seasonal variations have a significant effect on the rate of hospital admission and LOS in patients with chronic conditions. However, the impact of seasonal variation on clinical outcomes (rate of admissions, number of hospital admissions, and LOS) of at-home telemonitoring can be attenuated by synchronizing the analysis of outcomes to the commencement dates for the telemonitoring of vital signs. Trial Registration: Australian New Zealand Clinical Trial Registry ACTRN12613000635763; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=364030&isReview=true (Archived by WebCite at http://www.webcitation.org/ 6xLPv9QDb

Novel frameworks for the design of fault-tolerant control using optimal sliding-mode control

Copyright © 2018 John Wiley & Sons, Ltd. This paper describes 2 schemes for a fault-tolerant control using a novel optimal sliding-mode control, which can also be employed as actuator redundancy management for overactuated uncertain linear systems. By using the effectiveness level of the actuators in the performance indexes, 2 schemes for redistributing the control effort among the remaining (redundant or nonfaulty) set of actuators are constructed based on an H2-based optimal sliding-mode control. In contrast to the current sliding-mode fault-tolerant control design methods, in these new schemes, the level of control effort required to maintain sliding is penalised. The proposed optimal sliding-mode fault-tolerant control design schemes are implemented in 2 stages. In the first stage, a state feedback gain is derived using an LMI-based scheme that can assign a number of the closed-loop eigenvalues to a known value whilst satisfying performance specifications. The sliding function matrix related to the particular state feedback derived in the first stage is obtained in the second stage. The difference between the 2 schemes proposed for the sliding-mode fault-tolerant control is that the second one includes a separate control allocation module, which makes it easier to apply actuator constraints to the problem. Moreover, it will be shown that, with the second scheme, we can deal with actuator faults or even failures without controller reconfiguration. We further discuss the advantages and disadvantages of the 2 schemes in more details. The effectiveness of the proposed schemes are illustrated with numerical examples

Designing adaptive integral sliding mode control for heart rate regulation during cycle-ergometer exercise using bio-feedback

© 2015 IEEE. This paper considers our developed control system which aims to regulate the exercising subjects' heart rate (HR) to a predefined profile. The controller would be an adaptive integral sliding mode controller. Here it is assumed that the controller commands are interpreted as biofeedback auditory commands. These commands can be heard and implemented by the exercising subject as a part of the control-loop. However, transmitting a feedback signal while the pedals are not in the appropriate position to efficiently exert force may lead to a cognitive disengagement of the user from the feedback controller. To address this problem this paper will employ a different form of control system regarding as 'actuator-based event-driven control system'. This paper will claim that the developed event-driven controller makes it possible to effectively regulate HR to a predetermined HR profile

Heart rate regulation during cycle-ergometer exercise via bio-feedback

© 2015 IEEE. This paper explains our developed control system which regulates the heart rate (HR) to track a desired trajectory. The controller is indeed a non-conventional non-model-based proportional, integral and derivative (PID) controller. The controller commands are interpreted as biofeedback auditory commands. These commands can be heard and implemented by the exercising subject as a part of the control-loop. However, transmitting a feedback signal while the pedals are not in the appropriate position to efficiently exert force may lead to a cognitive disengagement of the user from the feedback controller. This note explains a novel form of control system regarding as 'actuator-based event-driven control system', designed specifically for the purpose of this project. We conclude that the developed event-driven controller makes it possible to precisely regulate HR to a predetermined HR profile

Patient adherence to scheduled vital sign measurements during home telemonitoring: Analysis of the intervention arm in a before and after trial

© Branko Celler, Ahmadreza Argha, Marlien Varnfield, Rajiv Jayasena. Background: In a home telemonitoring trial, patient adherence with scheduled vital signs measurements is an important aspect that has not been thoroughly studied and for which data in the literature are limited. Levels of adherence have been reported as varying from approximately 40% to 90%, and in most cases, the adherence rate usually dropped off steadily over time. This drop is more evident in the first few weeks or months after the start. Higher adherence rates have been reported for simple types of monitoring and for shorter periods of intervention. If patients do not follow the intended procedure, poorer results than expected may be achieved. Hence, analyzing factors that can influence patient adherence is of great importance. Objective: The goal of the research was to present findings on patient adherence with scheduled vital signs measurements in the recently completed Commonwealth Scientific and Industrial Research Organisation (CSIRO) national trial of home telemonitoring of patients (mean age 70.5 years, SD 9.3 years) with chronic conditions (chronic obstructive pulmonary disease, coronary artery disease, hypertensive diseases, congestive heart failure, diabetes, or asthma) carried out at 5 locations along the east coast of Australia. We investigated the ability of chronically ill patients to carry out a daily schedule of vital signs measurements as part of a chronic disease management care plan over periods exceeding 6 months (302 days, SD 135 days) and explored different levels of adherence for different measurements as a function of age, gender, and supervisory models. Methods: In this study, 113 patients forming the test arm of a Before and After Control Intervention (BACI) home telemonitoring trial were analyzed. Patients were required to monitor on a daily basis a range of vital signs determined by their chronic condition and comorbidities. Vital signs included noninvasive blood pressure, pulse oximetry, spirometry, electrocardiogram (ECG), blood glucose level, body temperature, and body weight. Adherence was calculated as the number of days during which at least 1 measurement was taken over all days where measurements were scheduled. Different levels of adherence for different measurements, as a function of age, gender, and supervisory models, were analyzed using linear regression and analysis of covariance for a period of 1 year after the intervention. Results: Patients were monitored on average for 302 (SD 135) days, although some continued beyond 12 months. The overall adherence rate for all measurements was 64.1% (range 59.4% to 68.8%). The adherence rates of patients monitored in hospital settings relative to those monitored in community settings were significantly higher for spirometry (69.3%, range 60.4% to 78.2%, versus 41.0%, range 33.1% to 49.0%, P<.001), body weight (64.5%, range 55.7% to 73.2%, versus 40.5%, range 32.3% to 48.7%, P<.001), and body temperature (66.8%, range 59.7% to 73.9%, versus 55.2%, range 48.4% to 61.9%, P=.03). Adherence with blood glucose measurements (58.1%, range 46.7% to 69.5%, versus 50.2%, range 42.8% to 57.6%, P=.24) was not significantly different overall. Adherence rates for blood pressure (68.5%, range 62.7% to 74.2%, versus 59.7%, range 52.1% to 67.3%, P=.04), ECG (65.6%, range 59.7% to 71.5%, versus 56.5%, range 48.7% to 64.4%, P=.047), and pulse oximetry (67.0%, range 61.4% to 72.7%, versus 56.4%, range 48.6% to 64.1%, P=.02) were significantly higher in males relative to female subjects. No statistical differences were observed between rates of adherence for the younger patient group (70 years and younger) and older patient group (older than 70 years). Conclusions: Patients with chronic conditions enrolled in the home telemonitoring trial were able to record their vital signs at home at least once every 2 days over prolonged periods of time. Male patients maintained a higher adherence than female patients over time, and patients supervised by hospital-based care coordinators reported higher levels of adherence with their measurement schedule relative to patients supervised in community settings. This was most noticeable for spirometry

On heart rate regulation in cycle-ergometer exercise

© 2014 IEEE. In this paper, we have focused on the issue of regulating the human heart rate (HR) to a predefined reference trajectory, especially for cycle-ergometer exercise used for training or rehabilitation. As measuring HR is relatively easy compared to exercise intensity, it has been used in the wide range of training programs. The aim of this paper is to develop a non-model-based control strategy using proportional, integral and derivative (PID) controller/relay controller to regulate the HR to track a desired trajectory. In the case of using PID controller, the controller output signal is interpreted as a voice or auditory command, referred to as biofeedback, which can be heard by the exercising subject as a part of the control-loop. Alternatively, the relay controller output signals can be converted to some special words which can be recognised by the exerciser. However, in both cases, to effectively communicate to the user a change in exercise intensity, the timing of this feedback signal relative to the positions of the pedals becomes quite critical. A feedback signal delivered when the pedals are not in a suitable position to efficiently exert force may be ineffective and may lead to a cognitive disengagement of the user form the feedback controller. In this paper we examine the need and the consequence of synchronising the delivery of the feedback signal with an optimal and user specific placement of the pedal

Online auto-calibration of triaxial accelerometer with time-variant model structures

© 2017 Elsevier B.V. In this paper, an online auto-calibration method for MicroElectroMechanical Systems (MEMS) triaxial accelerometer (TA) is proposed, which can simultaneously identify the time-dependent model structure and its parameters during the changes of the operating environment. Firstly, the model as well as its associated cost function is linearized by a new proposed linearization approach. Then, exploiting an online sparse recursive least square (SPARLS) estimation, the unknown parameters are identified. In particular, the online sparse recursive method is based on an L1-norm penalized expectation-maximum (EM) algorithm, which can amend the model automatically by penalizing the insignificant parameters to zero. Furthermore, this method can reduce computational complexity and be implemented in a low-cost Micro-Controller-Unit (MCU). Based on the numerical analysis, it can be concluded that the proposed recursive algorithm can calculate the unknown parameters reliably and accurately for most MEMS triaxial accelerometers available in the market. Additionally, this method is experimentally validated by comparing the output estimations before and after calibration under various scenarios, which further confirms its feasibility and effectiveness for online TA calibration