MEDICAL DEVICE THERAPY BASED ON POSTURE AND TIMING

• US 20100280500A1
• Filed: 04/30/2009
• Published: 11/04/2010
• Est. Priority Date: 04/30/2009
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Davis, Jon P., Denison, Timothy J., Skelton, Dennis M.
• Granted Patent: US 9,327,070 B2
• Time in Patent Office: Days
• US Class Current: 604/891.1
• CPC Class Codes: A61B 2562/0219 Inertial sensors, e.g. accelerometers, gyroscopes, tilt switches
• CPC Class Codes: A61B 5/11 Measuring movement of the entire body or parts thereof, e.g. head or hand tremor, mobility of a limb for measuring pulse A61B5/02 ;A61B5/1038 takes precedence; motion detection to correct for motion artifacts in physiological signals A61B5/721
• CPC Class Codes: A61B 5/1116 Determining posture transitions
• CPC Class Codes: A61B 5/7475 User input or interface means, e.g. keyboard, pointing device, joystick
• CPC Class Codes: A61M 2005/14208 with a programmable infusion control system, characterised by the infusion program
• CPC Class Codes: A61M 2210/0693 Brain, cerebrum
• CPC Class Codes: A61M 2210/1053 Stomach
• CPC Class Codes: A61M 2210/1078 Urinary tract
• CPC Class Codes: A61M 2230/62 Posture
• CPC Class Codes: A61M 5/14276 specially adapted for implantation
• CPC Class Codes: A61N 1/36071 Pain
• CPC Class Codes: A61N 1/36139 with automatic adjustment
• CPC Class Codes: A61N 1/37247 User interfaces, e.g. input or presentation means

Abstract

This disclosure describes techniques implemented by a medical device, such as an implantable medical device (IMD). The IMD may be configured to detect a posture state of a patient, and deliver posture-responsive therapy. In particular, the IMD not only detects the posture state of a patient, but also detects timing associated with the detected posture state, such as the time of day, the day of the week, or a specific time of day associated with a specific day. In this way, the posture-responsive therapy delivered by the IMD may be dependent not only on the posture state of the patient, but also on the timing associated with the posture state. The same posture state, therefore, may result in different types of therapy to the patient if the same posture occurs at different times of the day.

Claims

1. A method comprising:

detecting a posture state of a patient via a medical device;

detecting timing associated with the detected posture state;

selecting therapy parameters for the medical device based on both the detected posture state and the timing associated with the detected posture state; and

delivering therapy to the patient via the medical device according to the selected therapy parameters.

2. The method of claim 1, wherein detecting the posture state comprises detecting a posture transition from a first posture state to a second posture state.

3. The method of claim 1, wherein detecting the posture state comprises selecting among a plurality of pre-defined posture states.

4. The method of claim 3, wherein the plurality of pre-defined posture states includes a first posture state defining a first posture and a second posture state defining the first posture in conjunction with an activity.

5. The method of claim 3, wherein the plurality of pre-defined posture states includes a first posture state defining a first posture and a second posture state defining a second posture.

6. The method of claim 1, wherein detecting timing comprises detecting a time of day, wherein the medical device defines different therapies for different times of day for at least one posture state of a plurality of posture states

7. The method of claim 1, wherein detecting timing comprises detecting a day of the week and a time of the day, wherein the medical device defines different therapies for similar times of different days for at least one posture state of a plurality of posture states.

8. The method of claim 1, wherein detecting timing comprises detecting a time interval, wherein the medical device defines different therapies for different time intervals of one or more days.

9. The method of claim 8, further comprising:

receiving input from a user defining a new time interval;

receiving input from the user defining a particular posture state and a new set of therapy parameters for the new time interval and the particular posture state; and

automatically adjusting the medical device to deliver the new set of therapy parameters upon detecting the particular posture state during the new time interval.

10. The method of claim 1, wherein delivering therapy via the medical device comprises one of:

delivering stimulation pulses via an implantable stimulation device, and

delivering drug therapy via an implantable drug pump

11. The method of claim 1, wherein the medical device stores a lookup table that maps posture states and timings of the postures states with therapy parameters, wherein selecting the therapy parameters comprises performing a lookup in the lookup table.

12. The method of claim 1, further comprising:

receiving input from a user that defines a therapy adjustment;

determining a particular posture state of the patient at a time associated with the therapy adjustment;

recording the time associated with the therapy adjustment; and

associating a new therapy defined by the therapy adjustment with the particular posture state and the time associated with the therapy adjustment.

13. The method of claim 12, wherein the time associated with the therapy adjustment comprises a time of day, the method further comprising:

automatically adjusting the medical device to deliver the new therapy defined by the therapy adjustment in a subsequent day in response to detecting the particular posture state and the time on the subsequent day.

14. The method of claim 12, further comprising:

presenting an indicator to the user identifying an automatic adjustment to the new therapy at the time of day for one or more subsequent days.

15. The method of claim 1, further comprising:

receiving input from a user defining a new time period;

detecting a particular posture state of the patient via the medical device during the new time period;

receiving a selection of new therapy parameters;

associating the new therapy parameters with both the particular posture state during the new time period and a time of day defined by the new time period; and

automatically delivering therapy to the patient via the medical device according to the selected new therapy parameters during the new time period for one or more subsequent days upon detecting the particular posture state without any input from the user to select or adjust the therapy parameters for the medical device.

16. The method of claim 1, wherein selecting the therapy parameters comprises adjusting the therapy parameters.

17. The method of claim 1, wherein the medical device is an implantable medical device and the method is performed by the implantable medical device.

18. The method of claim 1, wherein the medical device comprises an implantable medical device and wherein the method is performed by an implantable medical device system that includes the implantable medical device and a programmer for the implantable medical device.

19. The method of claim 1, wherein the detected timing is associated with a defined activity that occurs at a particular time of a particular day.

20. The method of claim 1, wherein the detected timing is associated with a particular type of day defined by the patient.

21. The method of claim 1, wherein the medical device defines a set of posture states for a particular time, and wherein the posture states in the set of posture states for the particular time define different sets of therapy parameters for the particular time.

22. The method of claim 1, wherein a manner in which the medical device detects the posture state is dependent upon the detected timing.

23. A medical device system comprising:

a therapy delivery unit configured to deliver therapy to a patient;

a posture state module configured to detect a posture state of the patient;

a timing unit configured to detect timing associated with the detected posture state; and

a processor configured to select therapy parameters for a medical device based on both the detected posture state and the timing associated with the detected posture state, wherein the processor causes the therapy delivery unit to deliver therapy to the patient according to the selected therapy parameters.

24. The medical device system of claim 23, wherein the posture state module detects a posture transition from a first posture state to a second posture state.

25. The medical device system of claim 23, wherein the posture state module detects the posture state from a plurality of pre-defined posture states.

26. The medical device system of claim 25, wherein the plurality of posture states includes a first posture state defining a first posture and a second posture state defining the first posture in conjunction with an activity.

27. The medical device system of claim 25, wherein the plurality of posture states includes a first posture state defining a first posture and a second posture state defining a second posture.

28. The medical device system of claim 23, wherein the timing unit detects a time of day and the processor selects different therapies for different times of day for at least one posture state of a plurality of posture states.

29. The medical device system of claim 23, wherein the timing unit detects a day of the week and a time of the day and the processor defines different therapies for similar times of different days for at least one posture state of a plurality of posture states.

30. The medical device system of claim 23, wherein the timing unit detects a time interval and the processor defines different therapies for different time intervals of one or more days.

31. The medical device system of claim 30, wherein the system comprises an implantable medical device and a programmer device, wherein:

the programmer device receives input from a user defining a new time interval, receives input from the user defining a particular posture state and a new set of therapy parameters for the new time interval and the particular posture state, and programs the implantable medical device based on the inputs; and

in response to being programmed by the programmer device, the implantable medical device automatically delivers the new set of therapy parameters upon detecting the particular posture state during the new time interval.

32. The medical device system of claim 23, wherein the medical device system comprises one or more of:

an implantable stimulation device, and

an implantable drug pump.

33. The medical device system of claim 32, wherein the medical device system further comprises at least one programmer device.

34. The medical device system of claim 23, wherein the medical device system includes a memory that stores a lookup table that maps a set of posture states and timings of the postures states with different sets of therapy parameters, wherein in selecting the therapy parameters, the medical device system performs a lookup in the lookup table.

35. The medical device system of claim 23, wherein the system comprises an implantable medical device and a programmer device, wherein:

the programmer device receives input from a user that defines a therapy adjustment and programs the implantable medical device to apply a new therapy, and

the processor determines a particular posture state of the patient at a time associated with the therapy adjustment, records the time associated with the therapy adjustment, and associates a new therapy defined by the therapy adjustment with the particular posture state and the time associated with the therapy adjustment.

36. The medical device system of claim 35, wherein the time associated with the therapy adjustment comprises a time of day, wherein the processor:

automatically adjusts the medical device system to deliver the new therapy defined by the therapy adjustment in a subsequent day in response to detecting the particular posture state and the time on the subsequent day.

37. The medical device system of claim 36, wherein the programmer device presents an indicator to the user identifying an automatic adjustment to the new therapy at the time of day for one or more subsequent days.

38. The medical device system of claim 23, wherein the system comprises an implantable medical device and the posture state module, the timing unit and the processor all reside within the implantable medical device.

39. The medical device system of claim 23, wherein the system comprises an implantable medical device and a programmer, wherein the posture state module and the timing unit reside in the implantable medical device, and the processor resides in the programmer.

40. The medical device system of claim 23, wherein the system comprises an implantable medical device and a programmer device, wherein:

the programmer device receives input from a user defining a new time period, receives a selection of new therapy parameters, and programs the implantable medical device for the new time period,

the posture state module detects a particular posture state of the patient during the new time period, and

the processor associates the new therapy parameters with both the particular posture during the new time period and a time of day defined by the new time period, and causes the therapy unit to automatically deliver therapy to the patient according to the selected new therapy parameters during the new time period for one or more subsequent days upon detecting the particular posture without any input from the user to select or adjust the therapy parameters for the implantable medical device.

41. The medical device system of claim 23, wherein the system comprise an implantable medical device.

42. The medical device system of claim 23, wherein the system comprise an implantable medical device and at least one programmer device.

43. The medical device system of claim 23, wherein the detected timing is associated with a defined activity that occurs at a particular time of a particular day.

44. The medical device system of claim 23, wherein the detected timing is associated with a particular type of day defined by the patient.

45. The medical device system of claim 23, wherein the medical device defines a set of posture states for a particular time, and wherein the posture states in the set of posture states for the particular time define different sets of therapy parameters for the particular time.

46. The medical device system of claim 23, wherein a manner in which the medical device detects the posture state is dependent upon the detected timing.

47. A system comprising:

means for detecting a posture state of a patient via a medical device;

means for detecting timing associated with the detected posture state;

means for selecting therapy parameters for the medical device based on both the detected posture state and the timing associated with the detected posture state; and

means for delivering therapy to a patient via the medical device according to the selected therapy parameters.

48. A computer-readable storage medium comprising instructions that when executed in a medical device system cause the medical device system to:

detect a posture state of a patient via a medical device of the medical device system;

detect timing associated with the detected posture state;

select therapy parameters for the medical device based on both the detected posture state and the timing associated with the detected posture state; and

deliver therapy to a patient via the medical device according to the selected therapy parameters.