1.1. Cardiorespiratory Endurance
With the rapid development of the economy, manual labor work has been replaced by a large number of machines, resulting in an inactive state of life. The World Health Organization points out that inadequate physical activity has become the fourth most important risk factor for global mortality, more than 2 million deaths can be attributed to physical inactivity. About 60–85% of adults in the world live a static life, and two-thirds of children have insufficient physical activity, which will affect their health and cause public health problems in the future [
1,
2]. From a health perspective, people who have good heart and lung endurance can exercise longer, not get tired as quickly, and avoid all kinds of cardiorespiratory diseases. Improving cardiorespiratory endurance is an important issue for maintaining good health [
3,
4,
5].
To eliminate the need to refer to a chart of the modular standard to decide the fitness category, A back-propagation neural network (BPNN) was adopted to accesses the subject’s physical fitness (PF). Data collected included five parameters required for the PF passport: subject’s age, body mass index (BMI), performance in the sit-and-reach test, 1-min bent-leg curl-ups, and cardiorespiratory endurance [
6].
The appropriate exercise level varies for each elderly person because there are great individual differences. To remain healthy by exercising, and to provide appropriate exercise levels for elderly people, a fuzzy system is designed for adjusting the cycle ergometer workload to each individual’s physical work capacity. For the basic data collection, the respiratory gas exchange and the blood lactate every minute were simultaneously measured to determine the anaerobic threshold (AT) and the lactate threshold (LT). The results showed that periodical customization of the fuzzy system for individuals was important because of changes in the muscular fatigue properties and the differences between the objective and subjective representations of fatigue [
7].
In the investigation of the associations between cardiovascular function and both BMI and PF in Korean men, the VO
2max was obtained from YMCA submaximal test using a cycle erogometer. The muscular strength, muscular endurance, flexibility, power, agility, and balance were evaluated by grip strength (kg), sit-ups (reps/min), sit and reach (cm), vertical jump (cm), side steps (reps/30 s), and standing on one leg with eyes closed (s), respectively. This study found that an obese person exhibits lower fitness level and weaker cardiovascular function than a normal person [
8].
Tadeusz et al. presented a fuzzy system to evaluate the health related physical fitness (H-RF) based on the European Test of Physical Fitness (EUROFIT) battery tests. The basis of the system is the EUROFIT calculator which converts absolute results of individual trials to standardized values and the fuzzy inference system for four H-RF components (Morphological, cardiorespiratory, musculoskeletal and motor fitness). The system allows one to assess the results of EUROFIT tests in relation to the national reference systems as well as enables their linguistic classification based on the concept of H-RF [
9].
The ergoracer bicycle was also used in [
10], where a proportional-Integral (PI) fuzzy controller was applied to control the applied physical stress to ensure the predefined target heart rate is not exceeded to ensure safety. The controller accepts two inputs, the first is the error between the subject’s heart rate and the predefined target heart rate (e (t)), while the second is the change of error (Δe (t)). The output is the appropriate physical stress that corresponds to the subject’s current heart rate.
In a similar study [
11], physical activity (PA) was assessed by a self-reported questionnaire; cardiorespiratory fitness (CRF) was assessed by VO
2max during a symptom-limited maximal exercise test on a cycle ergometer. This study demonstrated that CRF has greater association with the prevalence of metabolic syndrome compared with PA in Chinese midlife women.
A survey to assess cardiorespiratory fitness levels in US youth aged 12 to 19 years was reported in [
12]. The estimated VO
2max was determined by a submaximal treadmill exercise test. Blood pressure, rating of perceived exertion, and heart rate were obtained during each of the stages. The Jackson non-exercise test formula was used to predict each participant’s fitness level prior to the treadmill test, based on age, sex, BMI, and self-reported physical activity level.
In [
13], the cardiovascular system is defined by the following parameters: heart rate (HR, at rest and maximal), stroke volume (SV, at rest and maximal), cardiac output (Q, at rest and maximal), heart volume, blood volume, systolic blood pressure (at rest and maximal), and diastolic blood pressure (at rest and maximal). A fuzzy algorithm evaluates the physiologic effort capacity of an individual based on these physiologic parameters.
A fuzzy PID based on the classic PI control approach was confirmed in a system that included minimizing heart-rate deviations during a treadmill exercise [
14]. The controller was tested and validated using two nonlinear human-on-treadmill models [
15,
16].
The Physical Efficiency Index (PEI), proposed by Brouha et al., is a mathematical formula for determining a cardiovascular endurance index number [
17,
18]. Lee et al. analyzed the heart rates of Korean children during ski simulator exercise and the Harvard step test to evaluate the cardiopulmonary endurance by the PEI formula. This study showed that the ski simulator exercise can be effectively utilized as exercise equipment since it resulted in higher PEI levels than the Harvard step test [
19].
There was another similar survey in Taiwan for health-related physical fitness among junior high school students. Five health-related physical fitness measurements were taken according to the governmental guidelines indicated on the official website of the Taiwan Ministry of Education: body composition (BMI), muscle strength and endurance (bent-leg sit-ups), explosive power (standing long jump), flexibility (sit-and-reach), and cardiorespiratory endurance (800-/1600-m run). All data were processed using Statistical Package for the Social Science (SPSS) software (IBM, Armonk, NY, USA). This study assessed body composition on the basis of BMI. Despite its extensive use to define obesity status, BMI is not an accurate measure of the proportion of fat and fat-free tissue in the body. Percentage of body fat should be considered for precise measures [
20].
1.2. VO2max and Heart Rate
The heart rate is the most direct response to physiological indicators during quiet rest, exercise and after exercise. Maximal heart rate (MHR) refers to the fastest rate at which your heart will beat in one minute, and is commonly used in exercise physiology and clinical practice for preventive and diagnostic purposes [
21]. It is also used to develop exercise prescriptions, estimate aerobic fitness levels, and is often a criterion for achieving maximal exertion in the determination of maximal aerobic capacity. There are different formulas for MHR, in this paper we refer to many ways to provide a more accurate formulas as in Equation (1) to estimate MHR for different age groups [
22]:
Resting heart rate is the number of beats per minute of the human heart after a long rest, usually measured in the morning when you wake up and have not yet gotten out of bed. It is normally between 60 (beats per minute) and 100 (beats per minute). RHR can vary with one’s fitness level and with age, and the fitter one is, generally the lower the resting heart rate [
23]. This is due to the fact that the heart gets bigger and stronger with exercise, and becomes more efficient at pumping blood around the body, therefore fewer beats per minute are required. Heart rate recovery is the speed at which the heart rate returns to normal after exercise, and it can indicate physical cardiac condition and the risk of certain diseases. Studies often use the current heart rate after stopping the exercise minus the heart rate two minutes after stopping the exercise for measuring HRR, which is a way to tell whether an exercise program is effective. People in better cardiovascular condition tend to have lower heart rates during peak exercise, and return to their resting heart rate more quickly after physical activity [
24]. HRR may be an index of physiological age and actual age as illustrated in
Table 1.
A person’s VO
2max refers to the maximal amount of oxygen the individual can consume typically over one minute during an intense physical effort. The oxygen uptake of the human body is directly proportional to the exercise intensity. Therefore, the oxygen uptake of the human body is an indicator of the level of physical activity. Typically, VO
2max is measured directly by analyzing inspired and expired breathing gases in a laboratory setting during maximal exertion, and expressed either as absolute maximal amount of oxygen per minute (L/min) or as relative to the individual’s weight as the maximal milliliters of oxygen the person uses in one minute per kilogram of body weight (mL/kg/min) [
25,
26,
27,
28]. The 12-min run fitness test was developed by Cooper in 1968 as an easy way to measure aerobic fitness and provide an estimate of VO
2max for military personnel, but today it’s used by many different trainers to determine cardiovascular fitness and track fitness over time [
29]. This test requires the athlete to run as far as possible in 12 min, and the distance is measured. However, practice and pacing improve the result, so a swimmer or bicyclist with equal physical fitness would probably score lower. In 2003, the Finnish scholar Saalasti proposed using neural networks for heart rate time series analysis. The cardiopulmonary function instrument was used to collect data of experimenters’ VO
2 and heart rate (HR). By regression analysis of these data, a nonlinear relationship between VO
2 and heart rate level is demonstrated together with a polynomial fit to the data. The polynomial can be written as Equation (2) [
30]:
This study found a close relationship between oxygen consumption and heart rate. If laboratory testing is unavailable, then the individual’s age-predicted (estimated) maximal heart rate can be used as the basis for determining exercise intensity. The Karvonen method and percentage of maximal heart rate formulas provide practical intensity assignments basing them on age-predicted maximal heart rates, the relationship between VO
2max and MHR is shown in
Table 2 [
31].
1.3. Training and Evaluation
An effective cardiorespiratory endurance training program must include an exercise prescription specifically developed for the individual athlete. It must carefully consider the strengths and weaknesses of the athletes to avoid potentially harmful training programs and cause sports injuries. According to the official guideline of cardiorespiratory endurance of the Sports Administration of Ministry of Education of Taiwan (SAMET), there are four essential components as follows [
32]:
Exercise frequency: At least three to five days of aerobic exercise per week.
Exercise intensity: 60–80% of the maximum heart rate is better.
Exercise type: Aerobic exercise is beneficial to the improvement of cardio endurance.
Exercise time: 20–50 min per exercise.
Before exercise, one must first understand one’s physical fitness level; the SAMET physical activity index table helps us to understand our physical condition. The way to do this is to convert the intensity, duration, and frequency of the exercise to a score, and then multiply, that is, the total score of the physical activity index, and then compared the result with
Table 3 below, so one can understand one’s physical condition.
Table 4 is the SAMET prescription for aerobic exercise. Users can adjust their exercise load according to their individual physical condition.
Aerobic exercise is beneficial to the improvement of cardiopulmonary fitness. Any aerobic exercise with rhythm, whole body involvement, long time and low intensity such as walking, jogging, aerobic dance, skipping, step exercise, swimming, and bicycle riding can contribute to the improvement of cardiopulmonary fitness. As a result of training, the most obvious physiological changes observed in humans involves their cardiovascular function, respiratory function, neuromuscular system, metabolism, and basic energy systems.
Evaluating these changes is not an easy task. It usually requires expensive equipment and controlled conditions. Besides, using classic training methods often does not ensure the necessary operating points to achieve the desired results, which may cause undesirable events such as under-training or over-training [
33]. In recent years, Internet of Things (IoT) technologies have grown rapidly providing an extension of internet connectivity into physical devices and everyday objects. Wearable devices allowing for continuous passive heart rate monitoring have become available [
34,
35]. The cloud is a huge, interconnected network of powerful servers that performs services for businesses and for people such as Google’s cloud services. Activities like data storage and processing take place in the cloud rather than on the device itself, which has had significant implications for IoT. Many IoT systems make use of large numbers of sensors to collect data and then make intelligent decisions.
In this paper, we propose a fuzzy system based on the human heart rate to provide an effective cardiorespiratory endurance training program and the evaluation of cardiorespiratory endurance levels, so that the trainers can respond correctly to obtain the desired training results and prevent undesirable events. The treadmill is an indoor sport that does not require a wide field and can avoid the effects of weather, and its exercise time and intensity can be controlled, which is suitable for this study. The treadmill training program refers to the 7333 method (exercise at least three times a week, 30 min each time, heartbeat up to 130 bpm). The fuzzy algorithm that is built in the Android mobile phone system receives the resting heart rate (RHR) from a device worn by the participants via Bluetooth before exercise to determine the suitable training speed mode for the individual. The computer-based fuzzy program takes RHR and heart rate recovery (HRR) after exercise as inputs to calculate the cardiorespiratory endurance level. A smart device with a built-in human machine interface (app) receives the training result through the cloud. The proposed fuzzy system not only allows the testers to have better cardio endurance, but also allows the fitness instructor to change the training mode more flexibly by referencing the cardiopulmonary endurance data that is stored in the cloud.