Cardiovascular control and stabilization via inclination and mobilization during bed rest

• Published in: Medical & biological engineering & computing 2014, Vol.52 (1), p.53-64
• Main Authors: Wieser, Martin, Gisler, Stefan, Sarabadani, Amirehsan, Ruest, Rafael M., Buetler, Lilith, Vallery, Heike, Klamroth-Marganska, Verena, Hund-Georgiadis, Margret, Felder, Morena, Schoenberger, Josef L., Gutknecht, Clemens, Riener, Robert
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Analysis; Automation; Bed Rest - adverse effects; Beds; Bioengineering; Biomedical and Life Sciences; Biomedical Engineering and Bioengineering; Biomedicine; Blood pressure; Blood Pressure - physiology; Body mass index; Cardiovascular Deconditioning - physiology; Cardiovascular system; Cardiovascular System - physiopathology; Compression therapy; Computer Applications; Feasibility studies; Female; Females; Heart rate; Heart Rate - physiology; Human Physiology; Humans; Hypotension; Imaging; Legs; Male; Medical device industry; Middle Aged; Muscle strength; Original Article; Patients; Physiology; Radiology; Rehabilitation; Studies; Thromboembolism; Young Adult
• ISSN: 0140-0118; 1741-0444
• DOI: 10.1007/s11517-013-1119-5

Cardiovascular deconditioning has long been recognized as a characteristic of the physiological adaptation to long-term bed rest in patients. The process is thought to contribute to orthostatic intolerance and enhance secondary complications in a significant way. Mobilization is a cost-effective and simple method to maintain the cardiovascular parameters (i.e., blood pressure, heart rate) stable, counter orthostatic intolerance and reduce the risk of secondary problems in patients during long-term immobilization. The aim of this project is to control the cardiovascular parameters such as heart rate and blood pressure of bed rest patients via automated leg mobilization and body tilting. In a first step, a nonlinear model predictive control strategy was designed and evaluated on five healthy subjects and 11 bed rest patients. In a next step, a clinically feasible study was conducted on two patients. The mean values differed on average less than 1 bpm from the predetermined heart rate and less than 2.5 mmHg from the desired blood pressure values. These results of the feasibility study are promising, although heterogeneous disease etiologies and individual medication strongly influence the mechanically induced reactions. The long-term goal is an automation of the control of physiological signals and the mobilization of bed rest patients in an early phase of the rehabilitation process. Therefore, this new approach could help to strengthen the cardiovascular system and prevent secondary health problems arising from long-term bed rest.