United States Patent [19]
`Jimenez et :11.
`
`[54]
`
`[75]
`
`I 1731
`[21]
`[22]
`
`[51] '
`[52]
`
`1581 A
`
`APPARATUS FOR TESTING PHYSICAL
`CONDITION OF A SUBJECT
`‘Inventors: Oscar Jimenez, Miami; Frank J.
`*
`Bianco, Pembroke Pines, botliof Fla.
`Assignee: Biotechnology, Inc., Miami, Fla.
`Appl. No.: 145,765
`' Filed:
`Apr. 30, 1980
`
`Int. C1.3 .............................................. .. A61B 5/02
`US. Cl. .................................. .. 128/689; 128/706;
`'
`128/707; 128/782
`Field of Search ...................... .. 128/668, 670-672,
`128/639, 644, 687-691, 706-707, 702-704, 718,
`779, 782; 364/410, 413, 415, 417
`' References Cited
`U.S. PATENT DOCUMENTS
`
`' ' ' '
`
`‘ 3,395,698 8/1968 Morehouse ....................... .. 128/707
`3,518,985 7/1970 Quinton ......... ..
`128/707
`3,534,727 10/1970 Roman
`123/644
`' ' ' ' ' ' ' '
`g’gg'ggg
`S3535,
`128/69o
`‘ 3’978’849 9/1976 Gina]; 8' '
`128 A570
`4:Os3:951 10/1977 nudspet?'gtngi: """""
`128/687
`4,101,071 7/1978 Brejnik et al. ..
`128/706
`4,108,166 8/1978 Schmid .............. ..
`l28/707
`4,112,928 9/1978 Putsch ........... ..
`4,144,568 3/1979 Hiller et a1. ............... .. 364/410
`i’igé’égg
`$1233” et a1‘
`4’202’350 5/1980 wglton """"" ‘f """""" " 128/690
`4,216,956 8/1980 Yamamura et al.
`272/70
`
`4,220,996 9/1980 Searcy . . . . . . . . .
`
`. . . . . . .. 364/561
`
`4,223,211 9/ 1980 Allsen et a1. ................ .. 235/92 DN
`
`11-11
`1451
`
`4,367,752
`Jan. 11, 1983
`
`OTHER PUBLICATIONS
`Kato, S. et al., “Application of Micro-Computer to
`Integrated Sleep Monitor”, Euromicro (Netherlands)
`V3, #4, Oct. 1927.
`Primary Examiner-Kyle L. Howell
`Assistant Examiner—~Francis J. .laworski
`Attorney, Agent, or Firm-Lowe, King, Price & Becker
`[57]
`ABSTRACT
`The physical condition of a subject is tested by a trans
`ducer mounted on the subject which derives a ?rst
`signal indicative of heart activity. An electronic instru
`ment. housing carried by the subject includes terminals
`responsive to the first signal and (a) an inertial member
`for monitoring the quantity of repetitive actions taken
`by a limb of the subject and for deriving a second signal
`indicative of the quantity, -(b) a keyboard for enabling
`signals to be derived indicative of numerical quantities
`associated with plural physiological parameters of the
`subject, (c) a clock source for deriving timing signals,
`(d) a digital computer responsive to the ?rst, second,
`timing and keyboard signals for deriving plural digital
`output signals indicative of different physical activities
`of the tested Subject, (1%) a visual digital indicator, (0
`plural key switches, each associated with a different one
`of the physical activities, and (g) circuitry responsive to
`activation of the plural key Switches for selectively
`coupling different ones of the plural output signals to
`the visual mdlcator so only one of the output slgnals is
`SuPPhed t° the mdlcator at a ‘"1119
`
`53 Claims, 15 Drawing Figures
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`U.S. Patent Jan. 11, 1983
`US. Patent
`Jan. 11, 1983
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`4,367,752
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`US. Patent
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`U.S. Patent Jan. 11, 1983
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`US. Patent Jan. 11, 1983
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`

`1
`
`APPARATUS FOR TESTING PHYSICAL
`‘ CONDITION OF A SUBJECT
`
`BACKGROUND ART
`
`TECHNICAL FIELD
`‘ The present invention vrelates generally to apparatus
`for testing the physical condition of a subject and, more
`particularly, to an apparatus for testing the physical
`condition of a subject in response to signals indicative of 10
`heart activity of the subject and of the distance tra
`versed by a limb of the subject during a timed testing
`period to provide a ?tness indication of the cardiovas
`cular system of the subject and/or parametric data re
`lated to exercise. ‘
`
`15
`
`4,367,752
`2
`oxygen ‘to various parts of the body of a subject. Exer
`cises ‘which typically fall into the category of aerobics
`are walking, jogging, running, hiking, climbing, tennis,
`cycling, weight lifting and swimming. Diligent pursuit
`of any of these exercises results in improved physical
`condition of a subject.
`As previously indicated, the previously developed
`devices provide an indication of physical condition by
`relying primarily upon one of two variables, namely
`heart rate during exercise or distance traveled by a limb
`in exercise. Because heart rate is a prime indicator of
`physical stress, it is valuable to constantly monitor heart
`rate during exercise of a subject. Maximum heart rate in
`human subjects is dependent on age. Clinical evidence
`exists to indicate that optimum bene?t from aerobic
`exercise is obtained when the cardiovascular system of
`the subject is exercised at a target heart rate range of
`between 75% to 85% of maximum heart rate for a par
`ticular subject for at least twelve minutes. However,
`clinical evidence developed by Dr. Azorides R. Mo
`rales, reported in September 1979, Medical World
`News, pps. 37 and 38, also exists to indicate that certain
`individuals, due to physical defects or condition, cannot
`use the standard 75% to 85% of maximum heart rate for
`their age, to calculate the target rate, without risk of
`heart damage to the subject. Certain of the prior art
`devices rely almost exclusively upon the heart rate
`monitoring to provide an indication of the physical
`condition of the subject. The other class of devices
`relies upon a measurement of distance and rate of dis
`tance covered to indicate the physical condition of the
`subject. These two classes of devices, however, have
`not generally provided the subject or physician with a
`complete analysis of the physical condition of a subject.
`
`40
`
`50
`
`DISCLOSURE OF THE INVENTION
`In accordance with a basic concept of the present
`invention, parameters concerning physiological param
`eters of an exercising subject, e. g. the physical condition
`and calorie consumption of the subject, are tested by
`monitoring heart activity of the subject during an exer
`cise period and the distance traversed by a limb of the ‘
`subject during testing. A computer means responds to
`the heart activity and distance traversed signals, as well
`as a timing signal from a clock source and a signal indic
`ative of at least one predetermined constant physiolog
`ical parameter of the subject, to derive a signal indica
`tive of the physical activity of the subject being tested.
`An‘ indicator responds to the physical activity signal to
`provide visual and/ or aural signals to a subject or physi
`cian.
`In the preferred embodiment, the physiological pa
`rameters determined by the computer are, heart rate,
`speed of the subject, ?tness, and calories consumed of
`the exercise. Distance is determined directly from indi
`cations of number of cycles the limb moves and a
`known, i.e., constant, predetermined physiological
`input parameter relating each cycle of limb movement
`to traversed distance; for a runner or walker the number
`of strides is counted and the stride length is the known
`input. From measurements of elapsed time and distance
`traveled, speed is calculated. Fitness is computed from
`distance traveled over a relatively long interval, eg 12
`minutes, of maximum exercise, based on data published
`in Cooper’s books, and is therefore a measure of oxygen
`uptake by the subject. Calorie consumption is computed
`in response to exercise, weight of the subject, sex of the
`
`25
`
`30
`
`35
`
`, Numerous devices have been devised, and some actu
`ally employed, for testing the physical condition of a
`human subject. The devices are employed for medical
`purposes, as well as to apprise an athlete of his physical
`condition during training. In a typical medical device,
`utilized in stress tests for physiological purposes, an
`electrocardiogram of a subject being tested is continu
`ously taken. In addition, blood pressure is intermittently
`monitored, and in some instances respiration rate is
`measured. The oxygen transfer to the lungs of the sub
`ject is also measured. Other devices have been devel
`oped wherein elapsed time of a test is combined with
`heart beat pulses to derive an indication of a heart beat
`rate, as well as caloric consumption and total calories
`expended. Other devices which base calorie consump
`tion only on heart rate are quite inaccurate because they
`do not take into consideration data required to calculate
`calorie consumption in accordance with variables
`which are known to effect calorie consumption viz:
`distance traveled, length of exercise time, resting heart
`rate, resting and exercise heart rate, weight of subject,
`change in heart rate in MET (multiples of metabolic
`need for sitting quietly) and oxygen consumed per min
`ute per pound. Other systems have been devised
`wherein physical exertion parameters of a subject are
`determined as a function of the age of a subject, in com
`bination with heart pulse frequency, to determine the
`stress on the heart.
`Other devices have been proposed for monitoring
`physical condition of a subject in response to a signal
`derived from an electromechanical sensor adapted to
`generate an electrical pulse in response to each step
`taken by an individual while walking, running or jog
`ging. In one particular system of this type, a computer
`counts the number of steps taken by the subject and, in
`response to a timing signal from a clock source, mea
`sures the rate at which the steps are taken. The com
`puter continuously integrates the number of steps taken
`multiplied by the step rate over a time interval while the
`subject is being tested. The computer supplies signals to
`aural and visual outputs, to provide indications of the
`physical condition of the subject, and to apprise the
`subject as to whether he is achieving or exceeding pre
`determined levels associated with his physical parame
`ters.
`These prior art devices are frequently based upon
`information derived from two books written by Dr.
`Kenneth H. Cooper entitled “Aerobics”, M. Evans and
`Company, Inc., NewYork, NY. (1968) and “The New
`65
`Aerobics”, M. Evans,‘ and "Company, Inc., New York,
`NY. (1970). Dr. Cooper, in these books, de?nes the
`word aerobics as exercises'that increase the supply of
`
`9
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`

`5
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`20
`
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`4,367,752
`4
`3
`subject, the change in heart rate per MET (multiples of
`the differential ampli?er means includes a buffer ampli
`metabolic need for sitting quietly) and the milliliters of
`?er for the voltages applied to the two leads and a dif
`ferential ampli?er responsive to the output voltages of
`oxygen consumed by the subject per minute per pound
`the two buffer ampli?ers. The differential ampli?er is
`of the subject. Resting heart rate is set into the computer
`referenced to ground to provide the common mode
`from measurements on the subject at the time of awak
`rejection for voltages generated by the electrodes.
`ening, while exercising heart rate is measured continu
`An alternative arrangement for monitoring heart
`ally during the exercise. Heart beats per MET and oxy
`beats employs photo-plethysmography wherein infra
`gen per minute per pound are determined from a calcu
`red absorption properties by capillaries in the skin of the
`lation by the computer as being directly proportional to
`computed ?tness or from table look-ups stored in a
`subject are monitored by an infra red source and detec
`memory of the computer or from printed tables. If ?t
`tor. The detector derives a pulse for each heart beat and
`avoids the necessity for a harness carrying electrodes
`ness has not been previously computed, it can also be
`and the accompanying circuitry.
`determined from a printed table. All data derived from
`The visual indicator is preferably a liquid crystal
`printed tables can be entered into the computer.
`display (LCD) or a light emitting diode (LED) display
`In one embodiment, the heart activity of the subject is
`for digital numeral indicating signals derived by the
`indicated by monitoring the number of heartbeats of the
`computer. Different signals are applied to the visual
`subject. Preferably, the heart beats are detected by
`indicator on a selective basis to enable the subject and
`electrodes on the subject which derive an electrocar
`/or physician to be apprised of various aspects of the
`diogram signal. As is well known, an electrocardiogram
`physical condition of the subject. If the subject is run
`signal includes several pulses referred to as p, q, r, s and
`ning, walking, or jogging, the signal indicative of dis
`t pulses, all of which are derived each time the heart
`tance traversed by a limb of the subject is derived by a
`beats. The r pulse has a relatively large magnitude,
`considerably larger than the remaining pulses, and is
`pedometer. In this case, the indicator is selectively re
`sponsive to signals indicative of heart beats per minute,
`detected in a preferred embodiment of the invention to
`elapsed time of the exercise interval, the distance tra
`indicate the number of heart beats. The r pulses are
`versed by the subject, the number of calories used by
`detected by a band pass ?lter which passes the r pulses
`the subject during the interval, the rate of speed of the
`and feeds the passed r pulses to a clamping circuit for
`subject during the interval, and a ?tness factor which is
`the peaks of the r pulses. A full wave recti?er is pro
`a function of maximum oxygen uptake. The distance
`vided for the r pulses so that r pulses of only one polar
`transversed, consumption of calories and ?tness factor
`ity are applied to the clamping means, regardless of
`connections of the electrodes to the r pulse detecting
`are calculated by the computer in response to entry on
`circuitry. To prevent possible high amplitude artifact
`a keyboard of the physiological parameters of sex, age,
`resting heart rate, weight, and stride of the subject.
`noise in the electrocardiogram signal from being erro
`The aural indicator signals heart beat rate to the sub
`neously detected as r pulses, the heart activity signal is
`ject in response to entry on the keyboard of minimum
`not coupled to the computer in response to a pair of
`35
`heart rate and can provide the subject with an indica
`adjacent detected r pulses occurring in less than a pre
`determined interval which is less than the possible per
`tion that he is exercising at an excessive rate in response
`to entry on the keyboard of maximum heart rate. In
`iod between adjacent beats of a heart of a subject.
`particular, the aural indicator is pulsed in response to
`In a preferred embodiment, three electrodes are pro
`each heart beat when the computer is responsive to at
`vided on the subject and are carried by a garment that
`least a predetermined number of heart beats in a prede
`presses the electrodes against the skin of the subject.
`termined interval. The aural indicator is continuously
`The garment may be a chest strap, or in the case of a
`activated in response to the heart beat rate exceeding a
`female athlete, a brassiere. One of the electrodes is
`predetermined level, as indicated by the computer
`adapted to abut on skin against the rib cage, in the vicin
`ity of the heart of the subject, a second of the electrodes
`means.
`In accordance with a further feature of the invention,
`is adapted to abut on skin against the sternum of the
`the computer means includes a memory that is supplied
`subject, while a third electrode is adapted to abut on
`with signals indicative of the predetermined, constant
`skin just below the right chest quadrant of the subject.
`physiological parameters. By activating a power down
`To provide a low electrical conductance path be
`key on the keyboard the memory continues to store the
`tween the skin of the subject and the electrodes for the
`electrocardiogram signals generated by the subject,
`signals indicative of the predetermined, constant physi
`ological parameters even when a DC power supply for
`each of the electrodes includes a highly electrically
`each of the computer means, signal deriving means and
`conductive gel which adheres to the skin of the subject
`indicator means is decoupled from the remainder of the
`while moistened. Moistening of the gel can occur by
`computer means, as well as signal deriving means and
`applying water from an external source, or in response
`indicator means. It is, however, possible to supply new
`to perspiration from the subject. In a preferred embodi
`signals to the computer memory indicative of the prede
`ment, the gel includes karaya gum and glycerin.
`termined, constant physiological parameters of the sub
`Associated with each electrode is a lead wire and a
`ject, as desired.
`shield for the lead wire or a common shield for all of the
`In a preferred con?guration, the signal deriving
`lead wires. Because the three lead wires and the shield
`means, visual and aural indicators, computer means and
`are connected to three sets of input terminals of an
`pedometer are all located in an electronic instrument
`electronic instrument housing, there is a tendency for
`housing adapted to be mounted on the subject. The
`the grounded shield voltage to vary relative to ground
`electronic instrument housing includes a keyboard for
`of the housing. To obviate this problem, a common
`enabling derivation of signals indicative of numerical
`mode rejection circuit includes a ground terminal for
`65
`quantities associated with a plurality of physiological
`the lead of one of the electrodes. The lead wires for the
`parameters of the subject, as well as plural key switches,
`other two electrodes are connected to a differential
`ampli?er arrangement. In the preferred con?guration,
`each associated with a different one of the physical
`
`40
`
`45
`
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`
`10
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`

`

`4,367,752
`5
`activities. Thus‘, the‘electro'nic instrument housing con
`tains all of the structure,'except for the electrodes, nec
`essary to'provide Ithe‘subje'ct and/or physician with an
`indication of the physical condition of the‘ subject. The
`instrument housing can be connected by a jack to ‘a
`conventional‘EKG monitoring device.’
`'
`l
`i
`I
`
`It is, accordingly, an object of the present invention
`to provide a new and improved apparatusfor testing the
`physical condition of a human subject. ,
`i
`_,
`"
`An additional object of the invention is to provide a
`new and improved apparatus for, indicating physical
`condition of a subject in response to signals indicative ‘of
`heart activity of thesubject and distance traversed by a
`
`limbrof a subjectduring testing‘; '
`
`.
`
`'
`
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`
`,
`
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`
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`
`Another object of the invention is to provide a new
`and improved programmable apparatusfor testing the
`physical condition of a subject,lwhich»apparatus can be
`worn on the subject- and provide the subject ‘and/0r. ,
`others with visual and- aural indications-of his physical
`condition and‘whether he ‘is exceeding his physical
`
`capabilities.
`
`" -
`
`.
`
`‘
`
`25
`
`Still another object of the invention is ‘to provide a
`portable‘ apparatus which can be worn by a jogger,
`walker, hiker, or runner, which apparatus provides the
`subject with an indication of his heart beat per minute,
`miles traversed, ‘speed of traversaL'length of exercise
`period, calorieconsumption, and, upon completion of
`12 minutes of maximumuactivity, his ?tness based on
`maximum oxygen uptake.
`‘
`i
`.
`The above )and,still further objects, features and ad
`vantages of the present invention will become apparent
`upon consideration of the following detailed description‘
`of several speci?c embodiments thereof, especially
`35
`when taken in considerationwith» the accompanying
`' drawings.
`
`BRIEF DESCRIPTION OF THE DRAWINGS ‘
`FIG. 1 is an illustration of a female jogger, runner,
`hiker or walker equipped with the apparatus of the
`
`present invention;
`I
`‘
`'
`I
`FIG. 2 is a diagram of a male jogger, runner, hiker or
`walker equipped with the'apparatus of the present in
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`vention;
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`FIG. 3 is a perspective view of electrodes mounted in
`garments worn by‘the test subjects of FIGS. 1 or 2;
`FIG. 4 is a generally front, perspective view of an
`electronic instrument housing for ‘aportion of the appa
`ratus‘ of the present invention; I‘
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`FIGS. 5 and 5a are back views of alternative embodi
`ments of the instrument housing illustrated in FIG. 4;
`FIGS. ,6‘, v7 and 8 are illustrations of various pedome
`ters that can be mounted in vthe (housing, of ‘FIGS. 4 and '
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`FIG. 9 is a perspective view of an electrode carrying
`chest strap in combination with a cable and thefinstru
`menthousingyrr.
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`FIG. ‘10 is_a circuit diagram of the, electrocardiogram
`ampli?er and‘ ?lter» circuitry, in the instrument housing
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`ofFIG.4;- ~
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`FIGS. 11a and 11b, together form a block diagram of
`‘the apparatus‘vcontained in- the instrument housing, as
`well as of the electrodes; and .
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`FIGS. '12 and 13 are‘ illustrations of alternative de
`vices for monitoring heart beats using photo-plethys
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`mography‘.‘
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`BEsr'MoDE FoR CARRYING OUT THE
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`‘INYENTION:
`Reference isnow;; made to FIGS. 1 and 2 wherein
`there are respectively illustrated female and male ath
`letes equipped with the present invention. The female
`and male athletes respectively wear garments 11 and 12,
`each carrying threeelectrodes13-‘15 which are pressed
`by the garments. against the skin of the athlete. Each
`athlete also wearsa waist band which carries electronic
`instrument housing17, connected to the electrodes by a
`suitable cable or lead wire arrangement. For the female
`athlete, the garment is a brassiere 11, preferably of the
`type known as a “running bra” which minimizes breast
`bouncing, skin irritation and collagen tissue breakdown
`of the breasts. For the male athlete, the garment is a
`chest strap 12, worn slightly above the vicinity of the
`male breast. Each of garments 11‘ and 12 carries three
`electrodes 13, 14 and 15 which are electrically con
`nected to the skin of the athlete, i.e., subject being tested
`for physical condition, to supply electrocardiogram
`voltages generated by the subject to leads which extend
`to electronic instrument housing 17, which is mounted
`on the waist band. Each of brassiere 11 and chest strap
`12 is provided with a fastener which ?rmly secures the
`brassiere or chest strap to the chest of the subject so that
`electrode 13 abuts on skin just below the right chest
`quadrant of the subject, electrode 14 abuts on skin
`against the sternum of the subject, in the center of the
`chest of the subject, and electrode 15 abuts on skin
`against the rib cage, in the vicinity of the heart of the
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`subject.
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`. A preferred con?guration for each of electrodes
`13-15 is illustrated in FIG. 3 and includes a generally
`square layer 21 of a gel which is highly electrically
`conductive and adheres to the skin of the subject while
`moistened. Layer 21 is ‘illustrated as being of generally
`square con?guration, but is is to be understood that it
`can take any’ suitable geometry, having suf?cient
`contact area on a face adapted to contact the skin of the
`subject. On the face of layer 21 opposite from the face
`adapted to contact the skin of the subject is a metal _
`mesh layer 22 of stainless steel or soft annealed brass
`carrying an impreganted ?lm of silver-silver chloride.
`Layer 22- includes a central button 23 which is secured
`to lead wire 24 of a shielded or unshielded cable that is
`connected to a reference potential (preferably zero or
`ground voltage) within instrument housing 17. Lead
`wire 24 for each of electrodes 13-15 has its own sepa
`rate shield in one embodiment, or, in another embodi
`ment, the lead wires for the various electrodes have a
`common shield in a single cable; however the latter
`con?guration may have deleterious results due to cross
`coupling of signals transduced by electrodes 13~15.
`In a preferred con?guration, gel layer 21 is composed
`of the following ingredients:
`Karaya gum, a hydrophilic gum which is carbohy
`drate polymer exuded from certain Indian trees of the
`genus sterculia, 33 percent by weight; ‘
`Glycerin, 60 percent by weight;
`Ethanol, ,1, percent by ‘weight; ,
`Methyl-p-hydroxybenzoate, 0.01 percent by weight;
`Propyl~p:hydroxybenzoate, 0.01 percent by weight;
`Sodium chloride, 4 percent by weight;
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`I Potassium chloride, 2 percent: by weight. .
`The Karaya gumforms a highly electrically'conductive
`translucent colloidal. gel. when mixed with the remain
`ing ingredients. Layer 21 has an area of approximately
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`11
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`15
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`20
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`35
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`four centimeters by four centimeters, and a two millime
`ter thickness. If desired 'or necessary, layers 21 are
`moistened with water or a saline solution prior to the
`subject securing brassiere 11 or chest strap 12 in place.
`Alternatively, layer 21 can remain dry prior to installa
`tion and can be moistened by perspiration from the skin
`of the subject.
`It is to be understood that other electrodes can be
`utilized in lieu of the electrodes speci?cally illustrated
`in FIG. 3. In particular, an In-Vivo Metric Systems type
`E221 electrode or a Beckman Instruments Company
`type 650437 electrode could be employed. If either of
`these electrodes is employed, however, an electrolyte
`gel must be employed to provide proper coupling of the
`electrocardiogram voltage to lead 24.
`Reference is now made to FIGS. 4 and 5 of the draw
`ings wherein there is illustrated the exterior of elec
`tronic instrument housing 17 which is carried on waist
`band 16. Inside of housing 17 is located electronic cir
`cuitry which is reponsive to signals derived from elec
`trodes 13-15, an instrument for deriving a signal indica
`tive of the distance traversed by a limb of the subject
`being tested (generally a pedometer which counts the
`number of strides taken by the subject), a clock source
`for deriving a timing signal, and digital computer means
`responsive to the electrode signals, the distance tra
`versed signal, the timing signal, as well as predeter
`mined physiological parameters of the subject. The
`computer means derives a signal which is indicative of
`the physical activity of the subject being tested and
`supplies the signal to an indicator, in the form of a liquid
`crystal digital display 31 mounted on the top face of
`housing 17. Housing 17 is shaped generally as a right
`parallelepiped, having approximately a six inch length,
`three inch width, and one inch thickness.
`Physiological data concerning the subject being
`tested are entered into the computer means with key
`board 32 on the back face of housing 17, i.e., the face of
`the housing which is remote from the body of the sub
`ject being tested. Keyboard 32 includes a matrix of keys
`which enable differing predetermined, constant physio
`logical parameters and differing numbers relative to
`some of these parameters to be entered into the com
`puter. Other keys and slide switch 33 are provided for
`functions associated with the types of indications (aural
`and/or visual) which are provided by housing 17 and
`data storage in a memory of the computer means in
`cluded in the housing. The predetermined, constant
`physiological functions which can be entered are age,
`sex, male, female, weight, ?tness factor, and stride of
`the subject, entries respectively associated with keys 34,
`35, 36, 37, 38 and 40. In addition, keys 41 and 42 are
`respectively associated with resting heart rate, low and
`high heart rates, in beats per minute, for the subject, as
`determined from a chart which is supplied to the tested
`subject or to a physician. Key 43 is for entry of a maxi
`mum beat rate of 150 beats per minute, which has been
`clinically found to be a maximum heart rate for a signi?
`cant (25%) of the population having a congenital heart
`defect.
`In general, an entry is made by depressing function
`key 45, then pressing a physiological key and keys asso
`ciated with the particular physiological factor (e. g., 0-9
`numeral keys 45 or a speci?c sex key 36 or 37), in turn
`followed by pressing enter key 44. For example, if the
`subject is known to have the congenital heart defect,
`function key 45 is pressed, followed by pressing of key
`43, in turn followed by pressing of enter key 44. After
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`depression of function key 45 and sex key 35, one of
`male or female keys 36 or 37 is pressed, in min followed
`by depression of enter key 44. After depression of func
`tion key 45 and one of keys 34 or 38-42, a numerical
`value is entered by depressing one or more of 0-9 nu
`meral keys 45, which is followed by depressing enter
`key 44.
`Keyboard 32 includes three additional keys 46, 47 and
`48, respectively labeled “power down”, “clear” and
`“heart rate”. Depression of “power down” key enables
`the physiological parameters associated with the sub
`ject to be stored in the memory of the computer means
`within housing 17 inde?nitely, even when power is
`decoupled from the remainder of the unit. If the physio
`logical parameters of the subject change or the device is
`used for a different subject, new parameters can be
`entered into the memory merely by pressing function
`key 45, the desired physiological key, the speci?c sex or
`numerical value keys, and enter key 44. Clear key 47 is
`depressed when it is desired to remove all entries from
`keyboard 32 and to clear display 31. Heart rate key 48 is
`depressed by the subject while he is in a rest condition
`and after brassiere 11 or chest strap 12 has been secured
`in place and leads 24 of electrodes 13-15 have been
`connected to input terminals of instrument housing 17.
`On the top face of instrument housing 17, in addition
`to liquid crystal digital display 31, are a liquid crystal
`display 51, in the form of a heart, and a cloth or other air
`pervious screen 52, which allows aural pulses and con
`tinuous aural tones to be coupled exteriorly of housing
`17. Liquid crystal display 51 is activated at the same rate
`as heart beats of the subject. With slide switch 33 in the
`upper, “audio” position, an aural pulsed tone is coupled
`through screen 52 each time the heart of the subject
`beats, when the heart beat rate is greater than the rate
`which is entered after depression of low rate key 41. A
`continuous aural tone is coupled through screen 52 in
`response to the heart beat rate of the subject exceeding
`a predetermined maximum, associated with entry of a
`numeral value, subsequent to depression of high rate
`key 42 or 150 rate key 43. The subject is advised to
`reduce his activity if he hears the continuous tone.
`On the upper face of hou