How to Prevent Sports Injury & Sudden Death if Sports Watches Add ECG Function

“I don’t feel very good and get a little tired when I wake up this morning. ”
“Well, I still decide to stick to my running plan. ”
“I’m not a quitter. ”
“I believe that my mental perseverance can overcome my body. ”
If you're a runner , you may often say that to yourself.

According to the American Journal of Sports Medicine, 37%-56% of all runners have experienced injuries, of which 30%-90% have to undergo training suspension and 20%-70% have to undergo medical treatment. Each year, tens of millions of runners in the United States alone have to take a break from exercise or go to the hospital for treatment because of injuries based on this proportion. Incorrect running posture and excessive exercise are the main causes of sports injuries, 30%-90% of these injuries are due to excessive exercise.

And according to a survey by the world's leading running magazine-Runner's World, one out of every 50,000 runners who complete a marathon would die (including those who suffered sudden death within 24 hours after the race), one out of every two major marathons.

There are three main causes of sports injury caused by running: excessive exercise, wrong running posture and lack of core muscle strength; 90% Sudden death during exercise caused by heart problems. This paper mainly combines the new technology in the field of smart wearables to discuss how to solve the safety problems of sports by analyzing the causes and current situation of sudden death and prevention of injury in sports.

ECG Testing to Prevent Sports Injury

Studies have attempted to quantify the change of running form between rest and fatigue by measuring the asymmetrical running gait of the lower limbs. The results showed that the degree of intra-knee rotation and knee stiffness became asymmetrical with fatigue, increasing by 14% and 5.3%, respectively. The abnormal running posture in fatigue state makes every touchdown cause different degrees of wear on human joints such as feet and knees, and tens of thousands of impacts will eventually lead to sports injuries. Excessive exercise under the state of fatigue is one of the main causes of running injuries.

Sports injury caused by excessive exercise or fatigued exercise has been widely accepted, but how to judge excessive and tiring exercise is a problem that cannot be accurately measured and defined. Due to the great individual differences among different users, there is a great error in judging from the absolute amount of physical activity. The marathon champion trains 20 kilometers a day and still remains in good shape. But if an average person runs 5 kilometers a day, it can also cause sports injury; At the same time, individual subjective judgment of fatigue is affected by emotion and other factors.

The sports watch with ECG function mainly relies on accurate measurement of exercise heart rate and fatigue test to prevent running sports injury. Heart rate monitoring during exercise is used to check the intensity of exercise in real time, prevent sports injury and improve the efficiency of exercise. The fatigue test is used to assess the physical condition before exercise, further preventing injuries caused by excessive exercise.

1.HEART RATE VARIABILITY

Heart rate variability (HRV) may reflect the activity of autonomic nervous system and quantitatively evaluate the tension & balance of cardiac sympathetic nerve and vagus nerve so as to determine its condition and prevention of cardiovascular disease, which is a valuable predictor of sudden cardiac death and arrhythmia. The quantification of autonomic nervous system activity can be demonstrated by the degree of changes in heart rate. HRV can reflect the functional changes of autonomic nervous system caused by training and formulate individualized exercise prescription.

2.FATIGUE TEST

Through sports watch which configured in ECG chip to collect original electrocardiogram (ECG) data, and the ECG data can only be conducted by professional doctors since ordinary users don't understand. ECG data analysis combines with medical algorithm to calculate HRV value, then time domain indexes of HRV, Ln rMMSD, can be converted based on certain mathematics and medical backing, the users also easily interpret parameters and intuitively understand at the same time, finally the data obtained is defined as the fatigue and shown in hundred-mark system. The fatigue value interval is defined as follows. Generally, the higher the fatigue test value, the better the physical condition.
（1）80~100：In good condition；
（2）65~80：In general condition；
（3）50~65：In fatigued condition；
（4）0~50：In bad condition；

Fatigue Test by IWOWNFIT P1 Power Watch

After wearing the watch with ECG testing function, the user can test fatigue and judge his or her physical state intuitively based on the test value. HRV will be lowered after exercise or excessive fatigue, and the decrease or increase of HRV will directly change the value of fatigue, and HRV will also gradually decline with age. Users should compare the relative changes of personal fatigue data by combining the amount of exercise on the day.

The heart rate band can accurately calculate fatigue data by using ECG signal, but it is not easy to use and cannot be used for a long time during exercise. For runners, it would be more accurate to measure HRV data in the hospital if they want to obtain their HRV data, but they could not obtain persistent HRV values and could not independently get support of HRV special testing in a laboratory.

Wearing sports watches with ECG testing function can directly collect the ECG data and then calculate the HRV, finally convert to fatigue value. Therefore, the purpose of easy use & testing will be achieved on the premise of guaranteeing the accuracy for the majority of users, it is also an important difference between normal heart rate watches and watches with ECG testing.

3.SIGNIFICANCE OF FATIGUE TESTING

Exercise injuries are mostly caused by overtraining. Fatigue test is an effective tool to monitor training and restore balance. The fatigue test value can help you prevent overtraining, improve training efficiency and ensure exercise safety. The HRV measured in fatigue tests is a good indicator of autonomic nervous system disorders, and the excitement of the human sympathetic nervous system will be caused by fatigue or overtraining. Decreased HRV resulted in increased sympathetic tension, which was an unfavorable factor. Increased HRV resulted in increased parasympathetic tension, which was a protective factor.

HRV measurements can be influenced by some external factors, such as stress, sleep, underlying diseases, environmental changes (temperature, height) and so on, but long-term monitoring of HRV can help you optimize your training and prevent overtraining.

For runners or sports enthusiasts, the most intuitive feedback from HRV is that the higher the HRV value, the stronger the aerobic endurance. Athletes can adjust the exercise training plan by regularly measuring the fatigue value with the ECG watch so as to prevent sports injuries caused by excessive exercise.

4.SPECIFIC APPLICATION OF FATIGUE

Overall, HRV changes can be used to judge the autonomic nervous function state before exercise and formulate individualized exercise prescription, so users can adjust exercise intensity based on daily fatigue value. However, please keep in mind that the HRV change also varies from person to person.

It is recommended to conduct the benchmark test first, you can continuously measure the fatigue for 4-6 days within 2 weeks, and the average value of the data can be used as the personal reference value. Daily exercise should be maintained during the 2 weeks of benchmark testing, not plenty of heavy exercise or complete rest. After the benchmark fatigue value is obtained in the test, the measured value of fatigue in a single session can be compared with the benchmark value of fatigue before starting to exercise in the later stage. The planning principle:
• Properly reduce the training intensity when the measured value of fatigue＜the benchmark value of fatigue;
• Properly increase the training intensity when the measured value of fatigue＞the benchmark value of fatigue;

Fatigue Value & Training Intensity

As shown in the figure above, the white curve represents the degree of fatigue and the bar graph represents the amount of exercise. On Tuesday, the test shows a high value of fatigue, indicating that the individual is in good condition and could increase the amount of exercise on the basis of regular exercise. On Wednesday, the test shows lower value, which means that the individual is not in good condition. Then it’s suggested to reduce the amount of exercise on the basis of daily routine.

Developing personalized training plans via HRV or fatigue value has been adopted by some professional athletes. With the convenience and accuracy of products measuring ECG and HRV data, more and more amateur athletes and the general public can also use fatigue data to guide their fitness activities. If used for a long time, it can reduce the risk of sports injury caused by overdose

ECG Testing to Prevent Exercise-related Sudden Death

As mentioned above, 90% Sudden death during exercise caused by heart problems. One might question whether an electrocardiogram survey of all athletes would be effective in reducing sudden death in exercising. The answer is yes. According to a report in 2006, Italian researchers found that screening, including electrocardiogram, relatively reduced 89% risk of death from heart disease.

Sudden Death During Exercise

Before the sudden death during exercise, the ECG of the sudden death will show abnormal changes. If the abnormal changes of ECG can be detected and treated in time, it will make a great contribution to the prevention of exercise-related sudden death. Regardless of medical resources and cost reasons, doctors and scientists generally agree that electrocardiogram tests are important in preventing sudden death from exercise.

The hospital usually uses the standard 12-lead ECG monitoring equipment to rapidly monitor the accurate ECG signal waveform, and can automatically analyze and diagnose the symptoms of various abnormal ECG signals. The equipment is usually a large fixed device with high purchase cost, which is mainly used in hospitals or other centralized medical service places.

12-lead ECG Monitoring Equipment

The smart watch can monitor the human single lead ECG at any time by adding the ECG chip. And the single lead ECG provides valuable references for arrhythmia, such as ventricular premature beats (VPB) and atrial fibrillation. At the same time, single lead electrocardiogram also has certain diagnostic value for myocardial ischemia. Single-lead ECG monitoring collects single-way ECG signal by using a pair of ECG electrodes, which is suitable for long-term ECG monitoring and single ECG measurement. Due to its small size, convenient to carry and high accuracy, the single-lead ECG monitoring tool is suitable for prevention and recording at home or outside. If the abnormal ECG data can be timely monitored and recorded through the watch built-in ECG chip and displayed in the APP by combining pictures and text when the athletes suffer from sudden heart palpitations, chest tightness, dizziness, chest pain or other symptoms, then it would provide some references for doctors to make a differential diagnosis.

ECG Shown on APP & Recorded ECG Curve

The state of heart discomfort is often transient and unpredictable. If the ECG data can be recorded in the first time when the heart becomes abnormal or unwell, then it is of great significance to the judgment and analysis of the heart early hidden problems. Although the 12-lead ECG monitoring equipment is accurate in measurement, it is unable to record in real time, resulting in the loss of data when sending abnormal heart conditions. The single-lead ECG test function on the sports watch is very convenient and economical. There is a certain difference in the diagnosis accuracy of diseases compared with the 12-lead ECG, but it can be collected data outside the hospital (Anywhere, Anytime, Anyone), and thus has great value for preventive medicine. The user can use the ECG watch for daily monitoring and abnormal warning. When the ECG data is abnormal, the user can go to the hospital for detailed ECG monitoring and detection.

Prevent Sudden Death in Exercising of Smart Watch Built-in ECG

Adding a high-quality ECG chip to a sports watch will cost a few dozens of yuan, and the difficulty of development will greatly increase accordingly. Since it would be of immense value for users to prevent such tragedies as sports injury and few sudden deaths in sports, IWOWNFIT still takes the risk of increasing costs and development difficulty to realize this function. After researching and developing more than one year and a half, the power sports watch P1 has added high-precision ECG chips, which can not only increase the accuracy of heart rate monitoring, provide fatigue test, but also capture and record the ECG data when cardiovascular events occur. It is of great value in medical use. As an advocate and pioneer of the concept of precision fitness, as well as the first participant in the field of intelligent wearables, IWOWNFIT will contribute more innovative and practical products & solutions in the field of sports & health in the future.

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