Manual Pulse Research Articles

Continuous Piezoelectric Pulse-Sensor Monitoring of Peripheral Vascular Reconstructions

Postoperative assessment of vascular surgical reconstructive procedures is most commonly performed by means of Doppler flowmetry or manual pulse palpation. Because these techniques are intermittent and can be subjective, the authors have investigated the application of a piezoelectric pulse sensor in monitoring distal pulses continuously in patients undergoing limb revascularization. By placing a piezoelectric sensor on the skin overlying an artery, systolic displacement of the underlying vessel wall and tissue is converted into a graphically displayed real-time waveform. Hardcopies of the waveforms (n = 90) were obtained at hourly postoperative intervals from a total of 10 patients undergoing vascular surgery for occlusive disease. In all cases, continuous monitoring confirmed ongoing patency of the reconstructions, despite impalpable distal pulses in 60% of the patients. The amplitudes of the waveforms increased (mean = 18%, range = 6% to 33%) during the first eight postoperative hours. Because of the small size and sensitivity of the sensor, this technique was especially useful in patients with foot lesions requiring occlusive dressings, or where sequential stenoses prevented accurate assessment of postoperative circulation by manual palpation or Doppler examination. The authors conclude that continuous postoperative piezoelectric pulse monitoring allows accurate, continuous assessment of limb revascularization and alleviates the subjective, time-consuming observations by physicians and ancillary personnel.

The arterial pulse analyzer as a potential replacement for manual pulse palpation in Oriental medicine.

Application of the arterial pulse analyzer now makes it possible to automatically diagnose such geriatric disorders as arteriosclerosis by using simple electrocardiograms and radial, carotid and posterior tibial artery pressure pulse wave charts. If the arterial pulse analyzer is adopted for use in Oriental medical clinics, there will no longer be a need for manual pulse palpation. In brief, applying the arterial pulse analyzer to the 8 key pulses of Oriental medicine yields the following results: 1) 'Slow' or 'rapid' pulses can be defined by the S-S interval (almost identical to the R-R interval of the ECG). 2) 'Slippery' or 'hesitant' pulses can be defined by the S-P time and the Dh/Ch% (P time & Incisura) ratio. 3) 'Floating' or 'submerged' pulses can be defined by the Ph/Ch% (pressure pulse wave to height) ratio. 4) 'Scattered' or 'moderate' pulses can be defined by the S-C- time (E time). Thus, by employing the arterial pulse analyzer, subjectivity problems inherent in the manual pulse palpation used by Oriental medicine for over 1500 years can be analyzed objectively.

Heart rate monitoring and exercise

Heart rate after exercise is compared using a manual and telemetry method. The manual measurement gave lower values than the 5 s post exercise value measured by telemetry (p < 0.001). This indicates that manual methods underestimate the immediate post–exercise heart rate. Although no significant differences existed between the manual method and the telemetry measurements at 10, 15 and 20 s, the correlations were poor (r = 0.543, 0.472, and 0.431 respectively).The telemetry-measured 25 and 30 s values were significantly lower (p < 0.05, p < 0.01). There is logic therefore in reducing the manual pulse recording time to as little as possible while retaining accuracy. This can only be achieved using a system such as telemetry. Predicted maximal heart rates correlated poorly with telemetry-measured heart rates (r = 0.502). The correlation improved after an aerobic training programme (r = 0.70.

Data encoder for an electronic musical instrument

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