Closed-loop therapy adjustment

• US 7,957,797 B2
• Filed: 12/01/2006
• Issued: 06/07/2011
• Est. Priority Date: 12/02/2005
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Bourget, Duane, Miesel, Keith A.
• Primary Examiner(s): Bockelman; Mark W
• Assistant Examiner(s): Dinga; Roland
• Application Number:
  US11/607,426
• Publication Number:
  US 20070150026A1
• Time in Patent Office: 1,649 Days
• Field of Search: 607/17, 607/30, 607/62, 600/481, 600/529, 600/544, 600/546
• US Class Current: 607/2
• CPC Class Codes: A61N 1/36071 Pain
• CPC Class Codes: A61N 1/37211 Means for communicating with stimulators
• CPC Class Codes: A61N 1/37247 User interfaces, e.g. input or presentation means
• CPC Class Codes: A61N 1/37252 Details of algorithms or data aspects of communication system, e.g. handshaking, transmitting specific data or segmenting data
• CPC Class Codes: G16H 20/30 relating to physical therapies or activities, e.g. physiotherapy, acupressure or exercising
• CPC Class Codes: G16H 20/70 relating to mental therapies, e.g. psychological therapy or autogenous training
• CPC Class Codes: G16H 40/63 for local operation

Abstract

Techniques for detecting a value of a sensed patient parameter, and automatically delivering therapy to a patient according to therapy information previously associated with the detected value, are described. In exemplary embodiments, a medical device receives a therapy adjustment from the patient. In response to the adjustment, the medical device associates a sensed value of a patient parameter with therapy information determined based on the adjustment. Whenever the parameter value is subsequently detected, the medical device delivers therapy according to the associated therapy information. In this manner, the medical device may “learn” to automatically adjust therapy in the manner desired by the patient as the sensed parameter of the patient changes. Exemplary patient parameters that may be sensed for performance of the described techniques include posture, activity, heart rate, electromyography (EMG), an electroencephalogram (EEG), an electrocardiogram (ECG), temperature, respiration rate, and pH.

Claims

1. A method comprising:

using one or more processors;

receiving a therapy adjustment and a subsequent confirmation from a user;

determining therapy information based on the therapy adjustment;

determining a value of a sensed parameter of a patient, wherein the sensed parameter of the patient is sensed via a sensor;

delivering therapy to the patient according to the therapy information in response to receiving the therapy adjustment, wherein the subsequent confirmation from the user is received after the therapy is delivered to the patient according to the therapy information;

associating the therapy information with the value of the sensed parameter of the patient in response to the subsequent confirmation;

subsequently detecting the value of the sensed parameter; and

automatically delivering therapy to the patient according to the therapy information associated with the value in response to the subsequent detection.

2. The method of claim 1, further comprising prompting the user to confirm that the therapy information should be associated with the value in response to the delivery of therapy to the patient according to the therapy information determined in response to receiving the therapy adjustment, wherein receiving a subsequent confirmation comprises receiving the confirmation in response to the prompting.

3. The method of claim 1, further comprising:

receiving one of a plurality of therapy adjustments and subsequent confirmations from the user whenever the user adjusts the therapy;

for each of the therapy adjustments, determining respective therapy information based on the therapy adjustment, and associating the respective therapy information with a respective value of the sensed parameter in response to the respective confirmation;

subsequently detecting the plurality of values of the sensed parameter over time; and

automatically delivering therapy to the patient according to the respective therapy information associated with the detected values of the sensed parameter.

4. The method of claim 3, wherein the patient assumes each of a plurality of at least one of postures or activities, and receiving one of a plurality of therapy adjustments comprises receiving one of the plurality of therapy adjustments for each of the postures or activities.

5. The method of claim 4, further comprising directing the patient to assume the plurality of at least one of postures or activities.

6. The method of claim 5, wherein the at least one of postures or activities are predetermined.

7. The method of claim 5, wherein directing the patient to assume the plurality of at least one of postures or activities comprises directing the patient via a programming device.

8. The method of claim 3, further comprising:

detecting a rate of change of the sensed parameter value that exceeds a threshold; and

delivering the therapy according to predetermined default therapy information for a predetermined period of time in response to the detection.

9. The method of claim 8, wherein delivering the therapy according to predetermined default therapy information comprises suspending the therapy for the predetermined period of time.

10. The method of claim 3, further comprising maintaining a data structure, wherein associating the sensed parameter values with the respective therapy information comprises storing the associated parameter values and therapy information as respective records within the data structure.

11. The method of claim 1, wherein the value of the sensed parameter indicates at least one of patient posture or patient activity.

12. The method of claim 1, wherein therapy comprises stimulation and the therapy information comprises values for a plurality of stimulation parameters.

13. The method of claim 1, wherein the user is the patient.

14. The method of claim 1, wherein the therapy adjustment comprises an adjustment of a value of at least one parameter of the therapy delivered by a medical device to the patient.

15. The method of claim 14, wherein the therapy comprises electrical stimulation therapy, and wherein the at least one parameter of the therapy comprises at least one stimulation parameter.

16. The method of claim 15, wherein the at least one stimulation parameter includes at least one of amplitude, pulse width, pulse rate, or electrode configuration.

17. A system comprising:

a medical device configured to deliver a therapy to a patient;

a sensor configured to sense a parameter of the patient;

a user interface; and

a processor configured to;

receive a therapy adjustment and subsequent confirmation from a user via the user interface,

determine therapy information based on the therapy adjustment,

determine a value the sensed parameter of the patient via the sensor,

deliver therapy to the patient according to the therapy information in response to receiving the therapy adjustment, wherein the subsequent confirmation from the user is received after the therapy is delivered to the patient according to the therapy information,

associate the value of the sensed parameter detected via the sensor with the therapy information in response to the subsequent confirmation,

subsequently detect the value of the sensed parameter via the sensor, and

automatically control the medical device to deliver therapy to the patient according to the therapy information associated with the value in response to the subsequent detection.

18. The system of claim 17, wherein the processor prompts the user via the user interface to confirm that the therapy information should be associated with the value in response to the delivery of therapy to the patient according to the therapy information determined in response to receiving the therapy adjustment, and receives the confirmation via the user interface in response to the prompting.

19. The system of claim 17,

wherein the processor receives one of a plurality of therapy adjustments and subsequent confirmations from the user whenever the user adjusts the therapy via the user interface, and, for each of the therapy adjustments, determines respective therapy information based on the therapy adjustment, and associates the respective therapy information with a respective value of the sensed parameter in response to the respective confirmation,

wherein the processor subsequently detects the plurality of values of the sensed parameter via the sensor over time, and automatically controls the medical device to deliver therapy to the patient according to the respective therapy information associated with the detected values of the sensed parameter.

20. The system of claim 19, wherein the patient assumes each of a plurality of at least one of postures or activities, and the processor receives one of the plurality of therapy adjustments via the user interface for each of the postures or activities.

21. The system of claim 20, wherein processor directs the patient to assume the plurality of at least one of postures or activities via the user interface.

22. The system of claim 19, wherein the processor detects a rate of change of the sensed parameter value that exceeds a threshold, and controls the medical device to deliver the therapy according to predetermined default therapy information for a predetermined period of time in response to the detection.

23. The system of claim 22, wherein the processor causes the medical device to suspend delivery of therapy for the predetermined period of time based on the predetermined default therapy information.

24. The system of claim 19, further comprising a memory, wherein the processor stores the associated parameter values and therapy information as respective records within a data structure within the memory.

25. The system of claim 17, wherein medical device delivers stimulation, and the therapy information comprises values for a plurality of stimulation parameters.

26. The system of claim 17, wherein the medical device comprises the processor, and wherein the medical device comprises the sensor or is coupled to the sensor.

27. The system of claim 17, wherein the medical device is implantable within the patient.

28. The system of claim 17, wherein medical device delivers pain therapy to the patient.

29. The system of claim 17, wherein the medical device delivers spinal cord stimulation therapy to the patient.

30. The system of claim 17, wherein the therapy adjustment comprises an adjustment of a value of at least one parameter of the therapy delivered by a medical device to the patient.

31. The system of claim 30, wherein the therapy comprises electrical stimulation therapy, and wherein the at least one parameter of the therapy comprises at least one stimulation parameter.

32. The system of claim 31, wherein the at least one stimulation parameter includes at least one of amplitude, pulse width, pulse rate, or electrode configuration.

33. The system of claim 17, wherein the value of the sensed parameter indicates at least one of patient posture or patient activity.

34. A system comprising:

means for receiving a therapy adjustment and a subsequent confirmation from a user;

means for determining therapy information based on the therapy adjustment;

means for detecting a value of a sensed parameter of a patient;

means for delivering therapy to the patient according to the therapy information in response to receiving the therapy adjustment, wherein the means for receiving receives the confirmation from the user after the therapy is delivered to the patient according to the therapy information;

means for associating the therapy information with the value of the sensed parameter of the patient in response to the subsequent confirmation;

means for subsequently detecting the value of the sensed parameter; and

means for automatically delivering therapy to the patient according to the therapy information associated with the value in response to the subsequent detection.

35. The system of claim 34, further comprising means for prompting the user to confirm that the therapy information should be associated with the value in response to the delivery of therapy to the patient according to the therapy information determined in response to receiving the therapy adjustment, wherein the means for receiving a subsequent confirmation comprises means for receiving the confirmation in response to the prompting.

36. The system of claim 34,

wherein the means for receiving a therapy adjustment comprises means for receiving one of a plurality of therapy adjustments and subsequent confirmations from the user whenever the user adjusts the therapy,

wherein the means for determining therapy information comprises means for determining respective therapy information based on the therapy adjustment for each of the therapy adjustments,

wherein the means for associating comprises means for associating the respective therapy information with a respective value of the sensed parameter in response to the respective confirmation,

wherein the means for subsequently detecting comprises means for subsequently detecting the plurality of values of the sensed parameter over time, and

wherein the means for automatically delivering comprises means for automatically delivering therapy to the patient according to the respective therapy information associated with the detected values of the sensed parameter.

37. The system of claim 36, wherein the patient assumes each of a plurality of at least one of postures or activities, and the means for receiving one of a plurality of therapy adjustments comprises means for receiving one of the plurality of therapy adjustments for each of the postures or activities.

38. The system of claim 36, further comprising:

means for detecting a rate of change of the sensed parameter value that exceeds a threshold; and

means for delivering the therapy according to predetermined default therapy information for a predetermined period of time in response to the detection.

39. The system of claim 38, wherein the means for delivering the therapy according to predetermined default therapy information comprises means for suspending the therapy for the predetermined period of time.

40. The system of claim 34, wherein the therapy adjustment comprises an adjustment of a value of at least one parameter of the therapy delivered by a medical device to the patient.

41. The system of claim 40, wherein the therapy comprises electrical stimulation therapy, and wherein the at least one parameter of the therapy comprises at least one stimulation parameter.

42. The system of claim 41, wherein the at least one stimulation parameter includes at least one of amplitude, pulse width, pulse rate, or electrode configuration.

43. The system of claim 34, wherein the value of the sensed parameter indicates at least one of patient posture or patient activity.