COLLECTING ACTIVITY INFORMATION TO EVALUATE THERAPY

• US 20080177355A1
• Filed: 01/22/2008
• Published: 07/24/2008
• Est. Priority Date: 03/16/2004
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Heruth, Kenneth T., Miesel, Keith A.
• Granted Patent: US 7,908,013 B2
• Time in Patent Office: Days
• US Class Current: 607/59
• CPC Class Codes: A61B 2562/0219 Inertial sensors, e.g. accelerometers, gyroscopes, tilt switches
• CPC Class Codes: A61B 5/0031 Implanted circuitry
• CPC Class Codes: A61B 5/02055 Simultaneously evaluating both cardiovascular condition and temperature
• CPC Class Codes: A61B 5/1118 Determining activity level
• CPC Class Codes: A61B 5/1455 using optical sensors, e.g. spectral photometrical oximeters
• CPC Class Codes: A61B 5/369 Electroencephalography [EEG] devices for psychotechnics A61B5/16
• CPC Class Codes: A61B 5/389 Electromyography [EMG]
• CPC Class Codes: A61B 5/6814 Head
• CPC Class Codes: A61B 5/6826 Finger
• CPC Class Codes: A61B 5/6831 Straps, bands or harnesses
• CPC Class Codes: A61B 5/6838 Clamps or clips
• CPC Class Codes: A61M 5/14276 specially adapted for implantation
• CPC Class Codes: A61M 5/1723 using feedback of body parameters, e.g. blood-sugar, pressure measurement of body parameters A61B5/00
• CPC Class Codes: A61N 1/36071 Pain
• CPC Class Codes: A61N 1/365 controlled by a physiological parameter, e.g. heart potential evoked response A61N1/371
• CPC Class Codes: A61N 1/36521 the parameter being derived from measurement of an electrical impedance
• CPC Class Codes: A61N 1/36542 controlled by body motion, e.g. acceleration
• CPC Class Codes: A61N 1/36557 controlled by chemical substances in blood

Abstract

A medical device delivers a therapy to a patient. The medical device may periodically determine an activity level of the patient, and associate each determined activity level with a current therapy parameter set. A value of at least one activity metric is determined for each of a plurality of therapy parameter sets based on the activity levels associated with that therapy parameter set. A list of the therapy parameter sets is presented to a user, such as a clinician, for evaluation of the relative efficacy of the therapy parameter sets. The list may be ordered according to the one or more activity metric values to aid in evaluation of the therapy parameter sets. Where values are determined for a plurality of activity metrics, the list may be ordered according to the one of the activity metrics selected by the user.

Claims

1. A medical system comprising:

an implantable medical device that that delivers a therapy to a patient, monitors a signal that varies as a function of patient activity, periodically determines an activity level of the patient based on the signal, and associates each of the determined activity levels with a current therapy parameter set; and

an external programming device including a display that receives information identifying a plurality of therapy parameter sets and associated activity levels from the implantable medical device via telemetry, determines a value of an activity metric for each of a plurality of therapy parameter sets based on activity levels associated with the therapy parameter sets, and presents a list of the plurality of therapy parameter sets and activity metric values associated with the therapy parameter sets via the display.

2. The medical system of claim 1, wherein the implantable medical device determines when the patient is awake, and periodically determines an activity level while the patient is awake.

3. The medical system of claim 1, wherein, for each of the therapy parameter sets, the external programming device determines at least one of a mean or a median of activity levels associated with the therapy parameter set, and determines the activity metric value based on the at least one of the mean or the median activity level.

4. The medical system of claim 3, wherein, for each of the therapy parameter sets, the external programming device compares the at least one of the mean or the median activity level to at least one threshold, and selects an activity metric value from a plurality of predetermined possible activity metric values based on the comparison.

5. The medical system of claim 1, wherein, for each of the therapy parameter sets, the external programming device compares each of the activity levels associated with the therapy parameter set to a threshold value, and determines as the activity metric value for the therapy parameter set at least one of a percentage of time above the threshold or a percentage of time below the threshold.

6. The medical system of claim 1, wherein, for each of the plurality of parameter sets, the external programming device compares each of the activity levels associated with the therapy parameter set to a threshold value, and determines as the activity metric value for the parameter set an average length of time that consecutively determined activity levels were above the threshold.

7. The medical system of claim 1, wherein an activity level comprises a number of activity counts.

8. The medical system of claim 7, wherein the external programming device determines the activity metric value for each of the therapy parameter sets as an average number of activity counts per a unit of time.

9. The medical system of claim 1, wherein the programming device orders the list of therapy parameter sets according to the associated activity metric values.

10. The medical system of claim 9, wherein the programming device determines a value of each of a plurality of activity metrics for each of the plurality of therapy parameter sets based on activity levels associated with the therapy parameter sets, receives a selection of one of the activity metrics from a user, and orders the list according to the user selected one of the activity metrics.

11. The medical system of claim 1, wherein the implantable medical device comprises at least one of an implantable neurostimulator or an implantable drug pump.

12. The medical system of claim 1, wherein the implantable medical device periodically determines an activity level by periodically determining a value of at least one physiological parameter of the patient.

13. The medical system of claim 12, wherein the implantable medical device periodically determines at least one of a heart rate, a respiration rate, a respiratory volume, a core temperature, or a muscular activity level.

14. A programming device comprising:

a telemetry circuit;

a user interface including a display; and

a processor that receives information identifying a plurality of therapy parameter sets and associated activity levels from an implantable medical device via the telemetry circuit, determines a value of an activity metric for each of a plurality of therapy parameter sets based on activity levels associated with the therapy parameter sets, and presents a list of the plurality of therapy parameter sets and activity metric values associated with the therapy parameter sets via the display.

15. The programming device of claim 14, wherein, for each of the therapy parameter sets, the processor determines at least one of a mean or a median of activity levels associated with the therapy parameter set, and determines the activity metric value based on the at least one of the mean or the median activity level.

16. The programming device of claim 15, wherein, for each of the therapy parameter sets, the processor compares the at least one of the mean or the median activity level to at least one threshold, and selects an activity metric value from a plurality of predetermined possible activity metric values based on the comparison.

17. The programming device of claim 14, wherein, for each of the therapy parameter sets, the processor compares each of the activity levels associated with the therapy parameter set to a threshold value, and determines as the activity metric value for the therapy parameter set at least one of a percentage of time above the threshold or a percentage of time below the threshold.

18. The programming device of claim 14, wherein, for each of the plurality of parameter sets, the processor compares each of the activity levels associated with the therapy parameter set to a threshold value, and determines as the activity metric value for the parameter set an average length of time that consecutively determined activity levels were above the threshold.

19. The programming device of claim 14, wherein an activity level comprises a number of activity counts, and the processor determines the activity metric value for each of the therapy parameter sets as an average number of activity counts per a unit of time.

20. The programming device of claim 14, wherein the processor orders the list of therapy parameter sets according to the associated activity metric values.

21. The programming device of claim 20, wherein the processor determines a value of each of a plurality of activity metrics for each of the plurality of therapy parameter sets based on activity levels associated with the therapy parameter sets, receives a selection of one of the activity metrics from a user via the user interface, and orders the list according to the user selected one of the activity metrics.

22. The programming device of claim 14, wherein, for each of the plurality of parameter sets, the processor determines a value of each of a plurality of activity metrics, and determines a value of an overall activity metric based on the plurality of activity metric values.