ABSTRACT
BACKGROUND: Home-based resistance training offers an alternative to traditional, hospital-based or rehabilitation center-based resistance training and has attracted much attention recently. However, without the supervision of a therapist or the assistance of an exercise monitoring system, one of the biggest challenges of home-based resistance training is that the therapist may not know if the patient has performed the exercise as prescribed. A lack of objective measurements limits the ability of researchers to evaluate the outcome of exercise interventions and choose suitable training doses. OBJECTIVE: To create an automated and objective method for segmenting resistance force data into contraction phase-specific segments and calculate the repetition number and time-under-tension (TUT) during elbow flexor resistance training. A pilot study was conducted to evaluate the performance of the segmentation algorithm and to show the capability of the system in monitoring the compliance of patients to a prescribed training program in a practical resistance training setting. METHODS: Six subjects (three male and three female) volunteered to participate in a fatigue and recovery experiment (5 min intermittent submaximal contraction (ISC); 1 min rest; 2 min ISC). A custom-made resistance band was used to help subjects perform biceps curl resistance exercises and the resistance was recorded through a load cell. The maximum and minimum values of the force-derivative were obtained as distinguishing features and a segmentation algorithm was proposed to divide the biceps curl cycle into concentric, eccentric and isometric contraction, and rest phases. Two assessors, who were unfamiliar with the study, were recruited to manually pick the visually observed cut-off point between two contraction phases and the TUT was calculated and compared to evaluate performance of the segmentation algorithm. RESULTS: The segmentation algorithm was programmatically implemented and the repetition number and contraction-phase specific TUT were calculated. During isometric, the average TUT (3.75 ± 0.62 s) was longer than the prescribed 3 s, indicating that most subjects did not perform the exercise as prescribed. There was a good TUT agreement and contraction segment agreement between the proposed algorithm and the assessors. CONCLUSION: The good agreement in TUT between the proposed algorithm and the assessors indicates that the proposed algorithm can correctly segment the contraction into contraction phase-specific parts, thereby providing clinicians and researchers with an automated and objective method for quantifying home-based elbow flexor resistance training. The instrument is easy to use and cheap, and the segmentation algorithm is programmatically implemented, indicating good application prospect of the method in a practical setting.
ABSTRACT
To improve or maintain the physical function of bedridden patients, appropriate and effective exercises are required during the patient's bed rest. Resistance training (RT) is an effective exercise for improving the physical function of bedridden patients, and the improvement of the physical function is caused by mechanical stimuli associated with RT. Currently, the measured mechanical stimuli are external variables which represent the synthetic effect of multiple muscles and body movements. Important features of stimuli experienced by muscles are of crucial importance in explaining muscular strength and power adaptation. This study describes an integrated system for assessing muscular states during elbow flexor resistance training in bedridden patients, and some experiments were carried out to test and evaluate this system. The integrated system incorporates an elbow joint angle estimation model (EJAEM), a musculoskeletal model (MSM), and a muscle-tendon model. The EJAEM enables real-time interaction between patient and MSM. The MSM is a three-dimensional model of the upper extremity, including major muscles that make up the elbow flexor and extensor, and was built based on public data. One set of concentric and eccentric contraction was performed by a healthy subject, and the results of the calculations were analyzed to show important features of mechanical stimuli experienced by muscles during the training. The integrated system provides a considerable method to monitor the body-level and muscle-level mechanical stimuli during elbow flexor resistance training in bedridden patients.
