US005941837A
`5,941,837
`[11] Patent Number:
`United States Patent 19
`Amanoetal.
`[45] Date of Patent:
`Aug. 24, 1999
`
`
`[75]
`
`[54] HEALTH MANAGEMENTDEVICE AND
`EXERCISE SUPPORT DEVICE
`Inventors: Kazuhiko Amano, Suwa; Kazuo
`Uebaba, Yokohama; Hitoshi Ishiyama,
`Toride, all of Japan
`[73] Assignee: Seiko Epson Corporation, Tokyo,
`Japan
`
`FOREIGN PATENT DOCUMENTS
`5793036
`6/1982
`Japan .
`aera 1900 Teoan ,
`2-55035
`2/1990
`Japan .
`6-105829
`4/1994
`Japan .
`7-88092
`4/1995
`Japan .
`7-213499
`8/1995
`Tapan .
`8-10234
`1/1996
`Japan.
`
`[21] Appl. No.:
`
`08/894,457
`
`[22]
`
`PCT Filed:
`
`Dec. 18, 1996
`
`.
`:
`:
`Primary Examiner—Max Hindenburg
`Attorney, Agent, or Firm—Eric B. Janofsky
`
`[86]
`
`PCT/JP96/03674
`PCT No.:
`Oct. 14, 1997
`§ 371 Date:
`§ 102(e) Date: Oct. 14, 1997
`
`ABSTRACT
`[57]
`A health management device is provided, which enables the
`user himself to make a determination of the quality of his
`state of health, without the presence of a physician or nurse
`specialist. However, this device may of course be employed
`to receive measurement directives from, or provide notifi-
`cation to, a third party. Pulse sensor 4 measures the user’s
`fingertip pulse wave. Acceleration sensor calculates an
`acceleration value from the user’s body. These outputs are
`converted to digital signals at sensor interface 6. CPU1
`determines whetheror notthe user is exercising based on the
`acceleration value read out from sensorinterface 6. Based on
`this result, CPU]takes up the user’s pulse waves before and
`after exercise, and determines the acceleration pulse wave.
`CPU1then calculates the amplituderatio of inflection points
`included in the acceleration pulse waveform, evaluates the
`exercise performed by the user based on the pre-exercise and
`post-exercise amplitude ratios, and displays this result on
`display device 7.
`U.S. PATENT DOCUMENTS
`4,432,374—2/1984 Osani oo. cee eeeeseeeneeeeeeeenee 128/694
`5,479,939
`1/1996 OgiN0 voces sees 128/782
`21 Claims, 27 Drawing Sheets
`
`[87]
`
`PCT Pub. No.: WO97/22295
`.
`PCT Pub. Date: Jun. 26, 1997
`[30]
`Foreign Application Priority Data
`Dec. 18,1995
`[JP]
`Japan weessseeeeee ear
`Mar. 12,1996
`Japan ssesscessrserscsernsrserneen S591
`[JP]
`
`
`[51]
`Tint, Cho oicccccsssssssseeeecesssssseeeeen A61B 5/00
`[52] U.S. Ch ou...
`600/595; 600/503
`
`[58] Field of Search
`600/502, 503
`— 600587 505
`,
`
`[56]
`
`References Cited
`
`604
`
`
`
`605
`
`MEMORY MEANS
`
`608
`
`
`
`CALCULATING
`MEANS
`
`
`
`
`
`
`NOTIFYING
`MEANS
`
`
`
`L
`CONTROL MEANS
`
`
`
`
`
`
`
`
`
`
`WAVEFORM MEASURING MEANS
`. EVALUATION MEANS i |
`
`
`
`
`BODY MOVEMENT MEASURING MEANS
`
`
`WAVEFORM MEASUREMENT
`DIRECTIVE DETECTION MEANS
`
`
`
`607
`
`606
`
`
`
`APPLE 1103
`
`APPLE 1103
`
`1
`
`

`

`U.S. Patent
`
`Aug.24, 1999
`
`Sheet 1 of 27
`
`5,941,837
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`U.S. Patent
`
`Aug.24, 1999
`
`Sheet 2 of 27
`
`5,941,837
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`
`
`GOOD _HEALT H
`STATE
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`HEALTH STATE
`BEGINNING TO
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`5,941,837
`
`Aug.24, 1999
`
`Sheet 3 of 27
`
`U.S. Patent
`
`FIG. 3A
`
`4
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`

`

`U.S. Patent
`
`Aug.24, 1999
`
`Sheet 4 of 27
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`5,941,837
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`
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`5
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`

`

`U.S. Patent
`
`5,941,837
`
`Aug.24, 1999
`
`Sheet 5 of 27
`
`FIG. 5A
`
`6
`
`

`

`U.S. Patent
`
`Aug.24, 1999
`
`Sheet 6 of 27
`
`5,941,837
`
`FIG. 6
`
`
`
`7
`
`

`

`U.S. Patent
`
`Aug.24, 1999
`
`Sheet 7 of 27
`
`5,941,837
`
`FIG. 7
`
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`8
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`

`

`U.S. Patent
`
`Aug.24, 1999
`
`Sheet 8 of 27
`
`5,941,837
`
`FIG. 8
`
`RATEOFCHANGEINd/a(%)
`
`LESS <> MORE
`EXERCISE AMOUNT
`
`9
`
`

`

`U.S. Patent
`
`Aug.24, 1999
`
`Sheet 9 of 27
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`U.S. Patent
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`Aug. 24, 1999
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`Sheet 10 of 27
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`U.S. Patent
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`Aug.24, 1999
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`Sheet 11 of 27
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`5,941,837
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`U.S. Patent
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`Aug.24, 1999
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`Sheet 12 of 27
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`5,941,837
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`U.S. Patent
`
`Aug.24, 1999
`
`Sheet 13 of 27
`
`5,941,837
`
`FIG. 13
`
`FIG. 14A
`PRIOR ART
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`i F
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`PRIOR ART
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`14
`
`

`

`U.S. Patent
`
`Aug.24, 1999
`
`Sheet 14 of 27
`
`5,941,837
`
`FIG. 15
`PRIOR ART
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`FIG. 17
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`BASE LINE
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`15
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`

`

`U.S. Patent
`
`Aug.24, 1999
`
`Sheet 15 of 27
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`5,941,837
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`U.S. Patent
`
`Aug.24, 1999
`
`Sheet 16 of 27
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`5,941,837
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`

`U.S. Patent
`
`Aug.24, 1999
`
`Sheet 17 of 27
`
`5,941,837
`
`FIG. 20
`
`TARGET VALUE FOR MAXIMAL OXYGEN UPTAKE (mi /kg/min)
`po 0~29 30~39 40~49 50~59 60~69
`
`FEMALE
`
`MALE
`
`FIG. 21
`
`REQUIRED AMOUNT OF EXERCISE
`TO CREATE A STATE OF HEALTH
`
`20~29 30~39 40~49 50~59 60~69
`
`(beats/min)
`
`180min
`
`170min
`
`160min
`
`min
`
`min
`
`TOTAL NUMBER
`
`OF EXERCISE
`
`PER WEEK
`
`TARGET
`HEART RATE
`
`18
`
`18
`
`

`

`U.S. Patent
`
`Aug.24, 1999
`
`Sheet 18 of 27
`
`5,941,837
`
`(%)
`
`A 50
`FIG. 22 40
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`

`

`U.S. Patent
`
`Aug.24, 1999
`
`Sheet 19 of 27
`
`5,941,837
`
`
`
`20
`
`20
`
`

`

`U.S. Patent
`
`Aug.24, 1999
`
`Sheet 20 of 27
`
`5,941,837
`
`
`
`21
`
`

`

`U.S. Patent
`
`Aug.24, 1999
`
`Sheet 21 of 27
`
`5,941,837
`
`FIG. 26
`
`
`
`22
`
`22
`
`

`

`U.S. Patent
`
`Aug.24, 1999
`
`Sheet 22 of 27
`
`5,941,837
`
`FIG. 27A
`
`230A
`
`266
`
`FIG. 27B
`
`
`
`23
`
`23
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`

`

`U.S. Patent
`
`Aug.24, 1999
`
`Sheet 23 of 27
`
`5,941,837
`
`FIG. 28A
`
`260
`
`a
`
`FIG. 28B
`
`
`
`24
`
`24
`
`

`

`U.S. Patent
`
`Aug.24, 1999
`
`Sheet 24 of 27
`
`5,941,837
`
`FIG. 29A
`
`280
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`286
`
`286
`
`286
`
`FIG. 29B
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`25
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`

`

`U.S. Patent
`
`Aug.24, 1999
`
`Sheet 25 of 27
`
`5,941,837
`
`FIG. 30A
`
`503
`
`a.
`
`FIG. 30B
`
`
`
`26
`
`26
`
`

`

`U.S. Patent
`
`Aug.24, 1999
`
`Sheet 26 of 27
`
`5,941,837
`
`FIG. 31
`
`
`
`27
`
`27
`
`

`

`U.S. Patent
`
`Aug.24, 1999
`
`Sheet 27 of 27
`
`5,941,837
`
`909109
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`

`5,941,837
`
`1
`HEALTH MANAGEMENT DEVICE AND
`EXERCISE SUPPORT DEVICE
`
`BACKGROUND OF THE INVENTION
`
`1. Technical Field
`
`2
`capillaries is the examination of the fingertip plethysmo-
`gram. However,the fingertip plethysmogram itself displays
`a gently undulating waveform. Accordingly, it was consid-
`ered difficult to interpret very fine changes in the waveform.
`Further, there has also been the problem that changes in
`circulation are very small, and are sensitive to changes in the
`organism s environment.
`However,if the second derivative of the fingertip plethys-
`mogram waveform is obtained, to convert the waveform to
`a double differential plethysmogram (i.e., the acceleration
`plethysmogram waveform),
`it
`then becomes possible to
`enlarge and extract the information on circulation, and to
`display the circulation condition in a form whichis easy to
`understand. FIG. 14(a)
`is one example of the original
`waveform obtained at the fingertip plethysmogram; FIG.
`14(b) shows the waveform of the velocity plethysmogram
`obtained by taking the first derivative of the waveform
`shown in FIG. 14(a); FIG. 14(c) shows the waveform of the
`acceleration plethysmogram obtained by taking the second
`derivative of the waveform shown in FIG. 14(a).
`diseases. As one example of these factors, evidence has been
`FIG. 15 shows an example in which one waveform of a
`found which suggests that insufficient circulation can cause
`typical acceleration plethysmogram has been extracted. As
`health problems. Whencirculation is insufficient, cells and
`shownin this figure, there are three peaks and twovalleys
`tissues do not receive the necessary amount of oxygen and
`in one waveform of an acceleration plethysmogram.
`nutrients. When this situation persists for a long period of
`Namely, there is an initial peak a, followed by valley b, peak
`time, organic pathological changes begin to occur in organs
`c, valley d, and peak e. The waveform is roughly flat from
`and tissues. Once these changes have progressedto a certain
`peak e until the next peak a. Further, if peak a is excluded,
`extent, symptoms can appear quite suddenly.
`then each point does not form a peak or valley, but rather
`Accordingly, various attempts have been made to prevent
`simply becomesa point of inflection.
`such diseases before there is significant progression in
`The significance of the amplitudes of each of the afore-
`organic pathological change, by determining the quality of
`mentioned peaks and valleys will now be described. To
`circulation,
`the basis for
`these pathological changes.
`begin with, peakais a signal that the blood pumped out from
`Accordingly,it has been the practice until now to determine
`the heart has reached the capillaries in the fingertip. Valley
`the quality of circulation by focusing on risk factors such as
`b relates to the heart’s stroke volume. The larger the stroke
`blood pressure, changes in the electrocardiogram, blood
`volume the deeper valley b falls.
`cholesterol, neutral fat concentration, and the like.
`Peak c is related to venal return, and, from the view of
`However,
`in reality,
`it
`is not uncommon for cerebral
`circulation,
`indicates whether or not
`there is excessive
`apoplexy or heart failure to occur even in an individual with
`pooling of blood by appropriate contraction of venules.
`low blood pressure, while there are examples of elderly
`When the venal return is good, peak c is near or above the
`persons whohavehigh blood pressure butstill are in good
`base line. In contrast, when blood pooling in venules is
`health. Similarly,
`there are numerous instances where a
`increasing, peak c ceasesto rise, but ratherfalls below valley
`substantial organic pathological change has occurred, but
`nothing is observed in the electrocardiogram, etc. While
`examination equipment may discover this change if it
`progresses further,
`this is not acceptable because of the
`additional delay.
`Accordingly, the discovery that acceleration pulse wave-
`forms can be useful as an indicator of the quality of
`circulation has gained attention in recent years. A brief
`explanation of acceleration pulse wave as a measure of
`circulation will now be provided. Namely,as is well known,
`circulation basically involves the heart pumping out blood,
`which flows through the arteries to the capillaries of the
`tissues and organs, and then returns through the veins.
`The supply of oxygen and nutrients takes place at the
`capillaries, so that the quality of circulation is correlated to
`the behavior of the blood in the smallest vessels.
`Accordingly,transitions in the amount of blood contained in
`the capillaries may be viewedto serve as a good measure of
`circulation. Namely, a slight difference in arterial and venal
`blood pressure giverise to fine differences in nutrient supply
`and gas exchangeat the capillary level. It is for this reason
`that it is believed that organic pathological changes may
`occur in tissues and organsif the difference in arterial and
`venal blood pressure expands over a long period of time.
`Accordingly, one widely used method for observing
`changes over time in the amount of blood contained in the
`
`Valley d is related to the load on the heart. When the load
`on the heart is increasing, valley d falls sharply. Peak e
`corresponds to the position of the rise in the fingertip
`plethysmogram after a contraction, however the concrete
`significance of this is not yet understood.
`It is known that poor circulation as ascertained from
`acceleration plethysmograms as described above can be
`improved by jogging or other forms of endurance training.
`A temporary improvement may be noted from just a single
`training session, while a sustained improvement can be
`confirmed if training is continued. On the other hand, if
`training is suspended, circulation again deteriorates.
`Accordingly, it is possible to know the degree of improve-
`ment in circulation by analyzing the acceleration plethys-
`mogram.
`Japanese Patent Application First Publication No. Hei
`8-10234 (Title: Device for Measuring Exercise Quantity)
`may be cited as one example of a technology which applies
`the above-described acceleration plethysmograms in exer-
`cise. This reference cites the use of a treadmill or bicycle
`ergometer for performing exercise to increase the health of
`the patient, with the exercise’s effect on the patient mea-
`sured. For this purpose, information referred to as “wave-
`form representative values”, which are calculated from the
`
`The present invention relates to a device for measuring
`physical state in a patient based on the condition of circu-
`lation. More specifically, the present invention relates to a
`health management device for monitoring the user’s state of
`health based on information obtained from the condition of
`
`circulation in the user’s body, and to an exercise support
`device which provides appropriate suggestions and guidance
`to the user, or provides an exercise plan deemed appropriate
`to create a state of health in the user.
`
`2. Background of the Invention
`With the rapid aging of society in recent years, the health
`issues of middle aged and elderly persons, geriatric diseases
`being chief among these, have been a topic of much dis-
`cussion. Various factors have been cited as causes of such
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`acceleration plethysmogram waveform, are measured before
`and after exercise, and the difference in these waveform
`representative values is displayed. Further, during exercise,
`the waveform representative values at each pointin time are
`comparedto predetermined waveform representative values.
`When the difference in the measured and predetermined
`waveform representative values reaches a value whichis the
`patient’s load limit, for example, then exercise is halted.
`Japanese Patent Application First Publication No.
`57-93036 may be cited as one example of an invention
`which attempts to determine circulation quality in a patient
`by analyzing the acceleration plethysmograms. Varioussites
`such as the fingertip, earlobe, and the like may be considered
`for measuring the plethysmogram. However, the aforemen-
`tioned reference specifically measures the fingertip plethys-
`mogram. This is because the movement of blood from the
`arteries to the veins can be obtained at the fingertip, and
`because this is the site where the capillaries are most
`developed and the amount of blood contained therein is
`great. Moreover, the fingertip is ordinarily exposed, so that
`it may be freely brought near the plethysmogram measure-
`ment device. Accordingly, this enables a more simplified
`structure for the device.
`
`The structure of the acceleration plethysmograph accord-
`ing to the invention in the above-cited reference is shown in
`FIG. 16. This device is formed by means of the cascade
`connection of a fingertip plethysmogram pick-up 200, pre-
`amplifier 201, operational amplifier 202, characteristic
`extraction circuit 203 which has two analog differentiating
`circuits utilizing CR circuits, and an oscillograph 204.
`Fingertip plethysmogram pick-up 200 is comprised of an
`opening 206 into which the patient inserts his finger, a light
`source 207, and a photoelectric element 208.
`Three types of plethysmogram waveform graphs are
`displayed on oscillograph 204:
`the plethysmogram waveform, and the first and second
`derivative waveforms of the plethysmogram which are
`calculated by characteristic extraction circuit 203.
`Accordingly, based on the acceleration plethysmo-
`grams shown on oscillograph 204,
`it is possible to
`determine the quality of circulation in the patient.
`To begin with,as a first method for this determination, the
`acceleration plethysmogram waveform is typed according to
`the depths of valleys b and d into three categories: valley
`bevalley d, valley b=valley d, or valley b<valley d. Next, the
`thus-type patterns are further typed into three categories
`based on the height of peak c relative to the base line. The
`measured acceleration plethysmogram waveform is then set
`to whichever of these patterns it most closely resembles.
`A second method of determination makes use of the
`
`height of peak c and the depth of peak d from the base line.
`As shown in FIG. 17, the depth of valley b is divided into
`four equal parts, for example, with the each partitioned area
`assigned a number 0, 1, ... 5, in order from the base line.
`The numberof points corresponding to the height of peak c,
`the depth of peak d, etc., are then determined from the
`positions thereof.In this way, the quality of circulation in the
`patient can be rendered as a numeric value.
`This reference provides several working examples,
`including: 1) a device wherein,in place of a CR circuit, the
`measured value of the plethysmogramis digitalized using an
`A/D converter, and the acceleration plethysmogram is cal-
`culated by meansof digital processing using a microcom-
`puter; 2) a device wherein the third derivative waveform is
`obtained by taking the derivative of the acceleration plethys-
`mogram waveform, and a microcomputer is used to obtain
`the position of the valleys and peaks; and 3) a device which
`
`4
`corrects for fluctuations in the time interval of the plethys-
`mogram dueto respiratory action, by carrying out statistical
`processing, such as obtaining the arithmetic average for
`pairs of corresponding peaks and valleys, on the repeating
`waveform of a plurality of individual plethysmograms.
`Japanese Patent Application First Publication No.: Hei
`2-55035 discloses an invention which develops the above-
`described technology. The structure of the acceleration
`plethysmograph according to this reference is shown in FIG.
`18. As shown in this figure, plethysmogram detector 300
`includes a lamp 301 whichis provided opposite the center of
`a concavity into which the fingertip is inserted, and a light
`detector comprising a photoelectric element 302. Photoelec-
`tric element 302 is formed of resistors 303 to 306 and a
`
`bridge circuit. The output from this bridge circuit is ampli-
`fied by differential amplifier 307. Further, the brightness of
`lamp 301 can be adjusted with a switch S so that the bridge
`circuit is balanced. In this figure, the symbol V is the voltage
`of the electric source.
`
`The output of differential amplifier 307 is amplified
`further by amplifier 308. Waveform correcting circuit 309
`then modifies the amplified output to a rectangular wave-
`form by clipping voltages which exceed a prefixed standard
`voltage. This output is differentiated at differentiating circuit
`310, with micropulses generated in the negative direction by
`rectifier 311 to trigger one-shot multivibrator 312. As a
`result, a rectangular wave of duration T, is obtained in the
`output of one-shot multivibrator 312.
`In addition, the output of differential amplifier 307 passes
`through gate circuit 313 during an interval of the aforemen-
`tioned duration Tj. The output signal of gate circuit 313
`passes through differentiating circuits 314, 315, with the
`output of the second derivative of the plethysmogram signal
`obtained in the output of differential circuit 315. Waveform
`correcting circuit 316 generates a sampling pulse for the
`output at each point in time where a valley b, peak c, and
`valley d appear. In accordance with this sampling pulse,
`sampling circuit 317 samples the output from differential
`circuit 315, which has passed through delay circuit 318, and
`stores the result in successive recording circuit 319. Maxi-
`mum value detection circuit 320 reads out the contents of
`successive recording circuit 319, and records the maximum
`value from among the amplitudes for valley b, peak c, and
`valley d. The output of maximum value detection circuit 320
`is divided at voltage dividing circuit 321, with each divided
`voltage then output.
`Control circuit 322 successively outputs the voltages of
`valley b, peak c, and valley d, which are the output of
`successive recording circuit 319. This output is input into
`pulse height analyzer 323 which employsthe output value of
`the voltage dividing circuit 321 as a comparison voltage,
`and, based on the voltages of valley b, peak c, and valley d,
`outputs values in which these voltages have been standard-
`ized (for example,ratios c/b, d/b,or ratios b/a, c/a, d/a, etc.)
`to output terminal OP.
`A microcomputer or similar device determines which
`waveform pattern from among the pre-typed acceleration
`plethysmogram waveforms the waveform output at output
`terminal OPis associated with, and displays this result.
`When makingthis determination of the waveform pattern,
`a determination is first made as to which ofthe voltage zones
`classified by voltage dividing circuit 321,
`the levels of
`standardized valley b, peak c, and valley d are associated
`with. For each of the separate voltage zones with which
`valley b, peak c, and valley d are associated, the measured
`plethysmogram is typed as one of the aforementioned
`patterns, based on the respective size relationship, and on the
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`5
`vertical relationship with respect to the baseline of valley b,
`peak c, and valley d, to make a determination of the quality
`of circulation.
`
`As explained above, maintaining good circulation is nec-
`essary to create a state of health. One important factor to
`accomplishing this is performing the appropriate level of
`exercise, to maintain a good circulation state for as long a
`period as possible. However, use of devices such as dis-
`closed in the above-cited references present a problem.
`Namely, it is knownto be extremely difficult to accurately
`measure plethysmogram waveforms during exercise.
`Accordingly, using acceleration plethysmograms measured
`during exercise as a basis for controlling the exercise
`performed by a patient is not very successful, so that, as a
`result,
`the goal of carrying out
`the appropriate level of
`exercise is not achieved. Moreover, the present inventors
`carried out experiments using devices having the structures
`disclosed in the aforementioned references, and confirmed
`that plethysmograms could not be correctly measured. The
`same conclusion was reached even in the case where a
`sensor was attached to a patient’s hand and the hand was
`held in place while the subject exercised on a tread mill, for
`example.
`In devices such as those described above, information
`extracted from the acceleration plethysmogram is simply
`displayed to the patient. Thus, a doctor or nurse with special
`training is required to interpret these results. However, if
`numerouspatients are exercising each day, and doctors and
`nurses must analyze the results and then direct the next
`exercise plan for each patient, then this creates a consider-
`able burden on hospital personnel, and does not benefit the
`patient’s treatment.
`However, it is extremely troublesome and inconvenient
`for the user of the device himself to make a determination of
`the quality of circulation, without the assistance of a doctor
`or nurse. Moreover,
`there is no assurance that a patient
`exercising without a doctor present will be able to perform
`exercise of the same quality as would have been carried out
`if a doctor were present to provide guidance. Accordingly,
`when carrying out
`interval
`training or physical
`rehabilitation, various problems may occur, such as the
`exercise proving ineffective because it was too mild, or the
`exercise having an effect opposite that desired because it was
`overly strenuous.
`On the other hand, guidance could be provided to the
`patient once every twoor three weeks, butthis is bothersome
`since it necessitates a visit to the doctor’s office. Moreover,
`exercise of the same quality as if regular guidance were
`being provided still may not be carried out in this case.
`Accordingly, there have been grave doubts that effective
`exercise guidance could be carried out in the case where
`conventional devices were employed.
`SUMMARYOF THE INVENTION
`
`The present invention was conceived in consideration of
`the aforementioned circumstances, and hasasits first objec-
`tive the provision of a device for accurately measuring
`conditions in a patient based on the circulation state and
`body movement.
`It is a second objective of the present invention to provide
`a health management device which monitors the user’s state
`of health based on the state of circulation which is obtained
`from pulse waveforms, and provides appropriate sugges-
`tions and guidance to the user, this device moreover being
`easy to use.
`It is a third objective of the present invention to provide
`a health management device which has a simple structure
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`and which can proscribe an exercise plan deemed appropri-
`ate for creating a state of health in the user after taking the
`user’s physical condition into consideration.
`the
`In order to achieve the above-stated objectives,
`present invention is characterized in the provision of a pulse
`wave measuring means which measures the user’s pulse
`waves, and a body movement measuring means which
`measurers the movement of the user’s body.
`As onepreferred embodiment, the present invention com-
`poses a pulse wave measuring means for measuring the
`user’s pulse waves, a body movement measuring means
`which measures the user’s body movement, a calculating
`means which obtains an indicator showing the state of
`circulation in the user from the pulse waveform when the
`measured results of the body movement measuring means
`are below a prespecified value, and a notifying means which
`notifies the user of the aforementioned indicator.
`
`this embodiment composes a pulse
`More specifically,
`wave measuring means for measuring the user’s pulse
`waveforms, a pulse wave measurement directive detection
`means which detects a directive by the user to measure pulse
`waves, a calculating means which obtains an indicator
`showing the state of circulation in the user from the pulse
`waveform during the time that a plethysmogram measure-
`mentdirective is being output, and a notifying means which
`notifies the user of the aforementioned indicator.
`
`The aforementioned calculating means obtains the accel-
`eration plethysmogram pulse waveform, selects two peaks
`and valleys from among the plurality of peaks and valleys
`appearing in the acceleration plethysmogram, obtains an
`amplitude ratio for the selected peaks and valleys, and
`defines this ratio as the aforementioned indicator.
`
`In this embodiment, notification of the state of circulation
`is provided to the user based on the measurement of his
`pulse waves. Accordingly it is possible for the user to know
`the state of his own circulation at all
`times, with the
`exception of during exercise. Thus, advanced notice of such
`diseases as ischemic heart disease or cerebrovascular disease
`can be obtained.
`
`The following four arrangements may be considered for
`the aforementioned calculating means.
`(1) The aforementioned indicator is defined as the value
`obtained by dividing the amplitude value of the second
`valley by the amplitude value of the first peak in the
`acceleration pulse waves.
`In this arrangement, the amplitude value of the spectral
`component obtained from a spectral analysis of change
`across the time period of adjacent pulse wavesis defined as
`the indicator. As a result, it is possible to ascertain and
`managethe state of health based on an indicator which well
`displays the activity of the sympathetic and parasympathetic
`nervous systems.
`(2) The time interval between adjacent pulse waves is
`calculated, spectral analysis is conducted on change over
`this time interval, and the amplitude value of the spectral
`componentwhichis obtained from this analysis is defined
`as the aforementioned indicator.
`
`In this arrangement, the ratio of the amplitudes of the low
`frequency and high frequency spectral components which
`are obtained from spectral analysis on changes overthe time
`interval between adjacent pulse waves is defined as the
`indicator. Therefore, variation in the indicator which arises
`due to differences between individuals can be eliminated.
`
`in addition to managing the state of health,
`Thus,
`possible to provide objective data for determination.
`(3) The time interval between adjacent pulse waves is
`calculated, spectral analysis is conducted on change over
`
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`this time interval, the ratio of the amplitude of the low
`frequency spectral component and the high frequency
`spectral component obtained from this analysis is
`calculated, and defined as the indicator.
`In this arrangement, the number of times the amount of
`change in the time interval between adjacent pulse waves
`exceeds a prespecified time is set as the indicator. Thus,
`health state can be ascertained and managed based on a
`indicator which well expresses conditions of arousal or
`sedation in the body.
`(4) The time interval between adjacent pulse waves is
`calculated, and the numberof time in which the amount
`of change in continuoustimeintervals exceeds a prespeci-
`fied time is defined as the indicator.
`
`In another embodiment, the health management device
`has a pulse measurement means for measuring the pulse rate
`of the user. When the measuredresult of the body movement
`measuring means exceeds a prespecified value, the notifying
`means notifies the user of the measured pulse rate.
`This health management device is provided with an
`evaluation means which measures an indicator when the
`
`measured result of the body movement measuring meansis
`below a prespecified value, and measuresthe indicator again
`after the measured result of the body movement measuring
`means exceedsthe prespecified value and then again returns
`below that prespecified value. The evaluation means then
`carries out an evaluation of the exercise performed by the
`user based on the difference in these indicators. Thereafter,
`the notifying means notifies the user of the results of this
`evaluation.
`
`In this embodiment, the user is informed of his pulse rate
`while he is exercising. Thus, even during exercise,
`it is
`possible to adjust the amount of exercise appropriately, so
`that a more desirable training effect can be achieved.
`In another embodiment, a pulse measuring means for
`measuring the user’s pulse rate, and a pulse measurement
`directive detection means, for detecting a directive from the
`user to measure pulse rate, are provided. As a result, the
`notifying meansnotifies the user of the pulse rate measure-
`ment result during the time that a pulse measurement
`directive is being output.
`In this embodiment, an evaluation means is provided
`which takes up the indicator obtained when the user issued
`a pulse measurementdirective prior to the start of exercise,
`and the indicator obtained when the user issued a pulse
`measurementdirective after the completion of exercise, and
`then carries out an evaluation of the exercise performed by
`the user based on the difference in these indicator values.
`Thereafter,
`the notifying means notifies the user of the
`results of this evaluation.
`
`Since the exercise evaluation is made based on the change
`in the indicator before and after exercise, it is possible to
`know whether the exercise carried out at each interval in
`interval training, for example, is