Programmable Programmable Biofeedback Chest Biofeedback Chest

ExerciserExerciserGroup 23:Group 23:

Eileen Bock, Lauren Cassell, Eileen Bock, Lauren Cassell, Margaret Gipson, Laurie McAlexanderMargaret Gipson, Laurie McAlexander

Advisors:Advisors:Douglas Sawyer, M.D., Ph.D.Douglas Sawyer, M.D., Ph.D.

Paul King, Ph.D.Paul King, Ph.D.John Newman, M.D.John Newman, M.D.

Heart Failure and Its Heart Failure and Its TreatmentTreatment

StatisticsStatistics Affects 5 million AmericansAffects 5 million Americans 50% mortality rate within 4 50% mortality rate within 4

years of diagnosisyears of diagnosis

PathologyPathologyHeart doesn’t pump nutrients Heart doesn’t pump nutrients to to tissues efficientlytissues efficientlyHeart can’t develop pressure Heart can’t develop pressure toto eject needed stroke volumeeject needed stroke volume

•Benefits of exercise as Benefits of exercise as treatmenttreatment

•Improves vascular functionImproves vascular function•Improves muscle functionImproves muscle function•Reduces arrythmia riskReduces arrythmia risk

•Benefits of deep breathing Benefits of deep breathing as as exerciseexercise

•Targets muscles of chest Targets muscles of chest wallwall•Not as difficult for patientsNot as difficult for patients

Other Possible ApplicationsOther Possible Applications

Device may not be able to generate Device may not be able to generate enough force to exercise chest wallenough force to exercise chest wall

Suggested to look into other applicationsSuggested to look into other applications Exercise monitorExercise monitor Breathing monitorBreathing monitor

Patient-specific usePatient-specific use 46 yo female experiences sudden drops in P 46 yo female experiences sudden drops in P

O2 – stops breathingO2 – stops breathing Breathing patterns normal while sleepingBreathing patterns normal while sleeping Dr. Newman wants to use device to remind Dr. Newman wants to use device to remind

patient to breathepatient to breathe

Current DevicesCurrent Devices Incentive SpirometerIncentive Spirometer

Blow into mouthpieceBlow into mouthpiece Cost: $10 -$1000 Cost: $10 -$1000 Problems: Problems:

Must be stationary Must be stationary

during useduring use Large, awkward shapeLarge, awkward shape

PneumotracePneumotrace Measures chest expansionMeasures chest expansion Cost: $200Cost: $200 Problems:Problems:

Must be lying down for useMust be lying down for use Very complex deviceVery complex device

Current DevicesCurrent Devices

RESPeRATERESPeRATE Tells patient when to breathe Tells patient when to breathe via headphonesvia headphones Cost: $330Cost: $330 Problems:Problems:

Must wear headphonesMust wear headphones Must carry additional deviceMust carry additional device

VivoMetrics LifeShirtVivoMetrics LifeShirt Measures chest expansion and Measures chest expansion and heart rateheart rate Cost: Not Available for saleCost: Not Available for sale Problems:Problems:

Large DeviceLarge Device Uncomfortable to wearUncomfortable to wear Very conspicuousVery conspicuous

Vandy RExVandy REx

Measures chest expansionMeasures chest expansion Cost: less than $100 without PDACost: less than $100 without PDA

$14 for stretch sensor$14 for stretch sensor $18 for batteries and op amps$18 for batteries and op amps

Why it’s better:Why it’s better: No additional devicesNo additional devices Comfortable to wearComfortable to wear Small and inconspicuousSmall and inconspicuous

ApproachApproach

BridgeBridge Differential Differential

amplifieramplifier Bend SensorBend Sensor Voltage threshold Voltage threshold

detectordetector

RRss/R/R22=R=R33/R/R11

DesignDesign

Adjustable inelastic Adjustable inelastic bandband

Elastic sectionElastic section Strain gauge/bend Strain gauge/bend

sensorsensor PDA for digital PDA for digital

outputoutput DAQ systemDAQ system Motor for vibrationMotor for vibration

Acquired Acquired components:components:

Voltage sourceVoltage source Low power Low power

Operational Operational AmplifierAmplifier

TestingTesting

Part 1Part 1 10 subjects wear 10 subjects wear

the device for 1 the device for 1 hour eachhour each

Subject will Subject will perform breathing perform breathing exercises and exercises and various common various common activitiesactivities

Subject surveySubject survey

Part 2Part 2 Previous 10 Previous 10

subjects will return subjects will return and wear device and wear device for 3 hoursfor 3 hours

Subject surveySubject survey

TestingTestingPart 3Part 3 Clinical testing: requires another Clinical testing: requires another

IRB protocol submissionIRB protocol submission 2 control groups, 1 experimental 2 control groups, 1 experimental

groupgroup Measure improvement of negative Measure improvement of negative

inspiratory force with incentive inspiratory force with incentive spirometerspirometer

Tidal Volume ExperimentsTidal Volume Experiments

Determine Determine relationship between relationship between chest circumference chest circumference and lung volumeand lung volume

Determine the output Determine the output voltage of the device voltage of the device during a normal and during a normal and a deep breatha deep breath

Measurements used Measurements used to adjust resistor to adjust resistor ratings and gainratings and gain

Expected ResultsExpected Results

Output voltage correlates to lung volumeOutput voltage correlates to lung volume Deep breath threshold will correspond to Deep breath threshold will correspond to

a given output voltagea given output voltage If threshold not reach in a predetermined If threshold not reach in a predetermined

time period, alarm will soundtime period, alarm will sound Expect that the use of this device will Expect that the use of this device will

increase lung capacity and force of increase lung capacity and force of expiration from lungsexpiration from lungs

Tidal Volume ResultsTidal Volume Results

Graphs show relationship Graphs show relationship between exhaled air and between exhaled air and chest expansionchest expansion

Data from 2 group Data from 2 group membersmembers

Shows what constitutes Shows what constitutes deep breathsdeep breaths

May have to calibrate for May have to calibrate for each personeach person

Breath greater than 500 Breath greater than 500 mL needed for detectionmL needed for detection

y = 1.1539x + 0.3692

R2 = 0.8503

0

0.5

1

1.5

2

2.5

3

3.5

0 0.5 1 1.5 2

Chest Expansion (cm)

Exh

aled

Air

(L

)

y = 0.8493x + 0.6736

R2 = 0.842

0

0.5

1

1.5

2

2.5

3

3.5

4

0 0.5 1 1.5 2 2.5 3 3.5 4

Chest Expansion

Exh

aled

Air

(L

)

ResourcesResources

REST1 Impedance Pneumograph by UFI. REST1 Impedance Pneumograph by UFI. http://www.ufiservingscience.com/ DSRsp11.htmlhttp://www.ufiservingscience.com/ DSRsp11.html

"How to Use an Incentive Spirometer". The Cleveland Clinic "How to Use an Incentive Spirometer". The Cleveland Clinic Foundation. Foundation. <http://www.clevelandclinic.org/health/health-info/docs/0200/0239<http://www.clevelandclinic.org/health/health-info/docs/0200/0239.asp?index= 4302& src=news>. .asp?index= 4302& src=news>.

"Anaesthesia Products," Lifeline Systems Pvt. Ltd. "Anaesthesia Products," Lifeline Systems Pvt. Ltd. <http://www.lifelinedelhi.com/ catheter-mount.html><http://www.lifelinedelhi.com/ catheter-mount.html>

"RESPeRATE High Blood Pressure and Hypertension." Buyamag. "RESPeRATE High Blood Pressure and Hypertension." Buyamag. <http://www.buyamag.com/high_blood_pressure_hypertension.ph<http://www.buyamag.com/high_blood_pressure_hypertension.php>.p>.

"Smart textiles at Hightex 2005". Hightex 2005. "Smart textiles at Hightex 2005". Hightex 2005. <http://www.hightex2005.com/smart_textiles.htm>.<http://www.hightex2005.com/smart_textiles.htm>.

““Learning to Whistle”. November 2005. Learning to Whistle”. November 2005. <http://learningtowhistle.blogspot.com/2005_11_01_learningtowhi<http://learningtowhistle.blogspot.com/2005_11_01_learningtowhistle_archive.html>.stle_archive.html>.

http://www.answers.com/topic/lung http://www.answers.com/topic/lung