PROGRAMMING POSTURE RESPONSIVE THERAPY

• US 20100010585A1
• Filed: 04/30/2009
• Published: 01/14/2010
• Est. Priority Date: 07/11/2008
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Davis, Jon P., Skelton, Dennis M., Gokaldas, Shyam, Sahasrabudhe, Rajeev
• Granted Patent: US 9,440,084 B2
• Time in Patent Office: Days
• US Class Current: 607/62
• CPC Class Codes: A61B 2562/0219 Inertial sensors, e.g. accelerometers, gyroscopes, tilt switches
• CPC Class Codes: A61B 5/1116 Determining posture transitions
• CPC Class Codes: A61B 5/1118 Determining activity level
• CPC Class Codes: A61N 1/36071 Pain
• CPC Class Codes: A61N 1/36132 using patient feedback
• CPC Class Codes: A61N 1/36135 using physiological parameters
• CPC Class Codes: A61N 1/36542 controlled by body motion, e.g. acceleration
• CPC Class Codes: A61N 1/37247 User interfaces, e.g. input or presentation means
• CPC Class Codes: G16H 20/10 relating to drugs or medications, e.g. for ensuring correct administration to patients
• CPC Class Codes: G16H 20/30 relating to physical therapies or activities, e.g. physiotherapy, acupressure or exercising
• CPC Class Codes: G16H 40/63 for local operation
• CPC Class Codes: G16H 40/67 for remote operation
• CPC Class Codes: G16H 50/20 for computer-aided diagnosis, e.g. based on medical expert systems
• CPC Class Codes: G16H 80/00 ICT specially adapted for facilitating communication between medical practitioners or patients, e.g. for collaborative diagnosis, therapy or health monitoring

Abstract

A programming session for an implantable medical device that includes a posture responsive therapy mode includes at least two phases. In a first phase, a first set of therapy parameter values are modified while the posture responsive therapy mode is deactivated. In the posture responsive therapy mode, the medical device automatically selects one or more therapy parameter values that define therapy delivered to a patient based on a detected posture state. In a second phase, the posture responsive therapy mode is activated and a second set of therapy parameter values are adjusted after observing a patient response to the posture responsive therapy delivered with the first set of therapy parameter values selected during the first phase. The second set of therapy parameter values may, for example, define the patient posture states or the modification profiles with which the medical device adjusts therapy upon detecting a posture state transition.

Claims

1. A method comprising:

programming one or more therapy parameters of a medical device during a programming session while the medical device is in a first mode;

during the programming session, activating a second mode of the medical device to deliver posture responsive therapy to a patient, wherein the posture responsive therapy is suspended while the medical device is in the first mode; and

programming one or more therapy parameters of the medical device based on efficacy of the posture responsive therapy delivered to the patient while the second mode of the medical device is activated.

2. The method of claim 1, further comprising receiving input indicative of the efficacy of the posture responsive therapy delivered to the patient while the second mode of the medical device is activated.

3. The method of claim 2, wherein receiving input comprises at least one of receiving patient input or input from one or more sensors indicative of a physiological effect of the therapy.

4. The method of claim 2, further comprising modifying values for the one or more therapy parameter based on efficacy of the posture responsive therapy delivered to the patient while the second mode of the medical device is activated.

5. The method of claim 1, wherein programming one or more therapy parameters while the medical device is in the first mode comprises programming a first therapy parameter with which the medical device delivers therapy to the patient.

6. The method of claim 5, wherein the first therapy parameter value comprises at least one of an amplitude, a frequency, a signal duration, an electrode combination, or a posture state definition with which the medical device automatically determines a patient posture state.

7. The method of claim 5, wherein programming one or more therapy parameters based on efficacy of the posture responsive therapy delivered to the patient while the second mode of the medical device is activated comprises programming a second therapy parameter that differs from the first therapy parameter.

8. The method of claim 7, wherein the second therapy parameter value comprises a modification profile with which the medical device transitions between therapy parameter settings in response to detecting a posture state transition.

9. The method of claim 8, wherein the modification profile defines at least one of a dwell time duration between a detection of the posture state transition by the medical device and a modification to the therapy parameter settings made by the medical device, a rate of change of a therapy parameter implemented by the medical device upon detecting the patient posture transition, or a transition period of time over which the medical device adjusts a therapy parameter upon detecting the posture state transition.

10. The method of claim 8, wherein the modification profile defines a dwell time duration between the posture state transition by the patient and a modification to the therapy parameter settings made by the medical device.

11. The method of claim 7, wherein the second therapy parameter value comprises a posture state definition with which the medical device automatically determines a patient posture state.

12. The method of claim 1, further comprising:

receiving input indicative of an efficacy of therapy delivered to the patient while the medical device is in the first mode;

modifying a first therapy parameter value based on the input indicative of the efficacy of therapy, wherein programming one or more therapy parameters of the medical device based on efficacy of the posture responsive therapy delivered to the patient while the second mode of the medical device is activated comprises modifying a second therapy parameter value based on the efficacy of the posture responsive therapy, wherein the second therapy parameter value is not modified based on the efficacy of the therapy delivered to the patient while the medical device is in the first mode.

13. The method of claim 1, wherein programming one or more therapy parameters while the medical device is in a first mode and programming one or more therapy parameters based on efficacy of the posture responsive therapy delivered to the patient while the second mode of the medical device is activated comprises programming one or more common therapy parameters.

14. The method of claim 1, wherein the patient is present at a clinic during the programming session and activating the second mode of the programming session of the medical device comprises temporarily activating a chronic therapy delivery mode of the medical device while the patient is present at the clinic.

15. The method of claim 1, further comprising automatically deactivating the second mode of the medical device after a predetermined duration of time.

16. A system comprising:

a medical device that includes a first mode and a second mode in which the medical device automatically delivers posture responsive therapy to a patient, wherein the posture responsive therapy is suspended when the medical device is in the first mode; and

a processor that, during a programming session, programs one or more therapy parameters of the medical device while the medical device is in the first mode, activates the second mode of the medical device to activate posture responsive therapy delivery to the patient, and programs one or more therapy parameters of the medical device based on efficacy of the posture responsive therapy delivered to the patient while the second mode of the medical device is activated.

17. The system of claim 16, wherein the processor automatically deactivates the second mode of the medical device after a predetermined duration of time.

18. The system of claim 16, wherein the processor receives input indicative of the efficacy of the posture responsive therapy delivered to the patient while the second mode of the medical device is activated and determines the efficacy of the posture responsive therapy based on the input.

19. The system of claim 18, wherein the processor receives the input from a user.

20. The system of claim 18, comprising one or more sensors that sense one or more physiological parameters of the patient, wherein the processor receives the input indicative of the efficacy of therapy from the one or more sensors.

21. The system of claim 18, wherein the processor modifies values for the one or more therapy parameters based on efficacy of the posture responsive therapy delivered to the patient while the second mode of the medical device is activated.

22. The system of claim 16, wherein the processor programs the one or more therapy parameters of the medical device while the medical device is in the first mode by at least programming a first therapy parameter value with which the medical device delivers therapy to the patient.

23. The system of claim 22, wherein the first therapy parameter value comprises at least one of an amplitude, a frequency, a signal duration, an electrode combination, or a posture state definition with which the medical device automatically determines a patient posture.

24. The system of claim 22, wherein the processor programs the one or more therapy parameters of the medical device based on efficacy of the posture responsive therapy delivered to the patient while the second mode of the medical device is activated by at least programming a second therapy parameter that differs from the first therapy parameter.

25. The system of claim 24, wherein the second therapy parameter value comprises a modification profile with which the medical device transitions between therapy parameter settings in response to detecting a posture state transition.

26. The system of claim 24, wherein the second therapy parameter value comprises a posture state definition with which the medical device automatically determines a patient posture state.

27. The system of claim 16, wherein the processor activates the second mode of the medical device by at least temporarily activating a chronic therapy delivery mode of the medical device.

28. The system of claim 16, further comprising a medical device programmer that comprises the processor.

29. The system of claim 16, wherein the medical device comprises the processor.

30. A system comprising:

means for programming one or more therapy parameters of a medical device during a programming session while the medical device is in a first mode;

means for activating a second mode of the medical device to deliver posture responsive therapy to a patient during the programming session, wherein the posture responsive therapy is suspended while the medical device is in the first mode; and

means for programming one or more therapy parameters of the medical device based on efficacy of the posture responsive therapy delivered to the patient while the second mode of the medical device is activated.

31. The system of claim 30, further comprising:

means for determining an efficacy of therapy delivered to the patient while the medical device is in the first mode; and

means for programming a first therapy parameter value based on the efficacy of the therapy determined while the first mode of the medical device is activated, wherein the means for programming one or more therapy parameters of the medical device based on efficacy of the posture responsive therapy delivered to the patient while the second mode of the medical device is activated programs a second therapy parameter value that differs from the first therapy parameter value.

32. A method comprising:

receiving input selecting a first therapy parameter value of a medical device while the medical device is in a first mode, wherein the medical device includes a second mode in which the medical device automatically delivers posture responsive therapy to a patient and the first mode in which the posture responsive therapy mode is suspended;

transmitting a first signal to the medical device that causes the medical device to deliver therapy according to the first therapy parameter value;

during the programming session, transmitting a second signal to the medical device that activates the posture responsive therapy mode of the medical device;

transmitting a third signal to the medical device that causes the medical device to deliver posture responsive therapy to the patient according to a second therapy parameter value; and

during the programming session, modifying the second therapy parameter value based on an efficacy of the posture responsive therapy delivered to the patient.

33. The method of claim 32, further comprising receiving input indicating the efficacy of the posture responsive therapy delivered to the patient, wherein modifying the second therapy parameter value comprises modifying the second therapy parameter value based on the input.