Posture-responsive therapy control based on patient input

• US 8,175,720 B2
• Filed: 04/30/2009
• Issued: 05/08/2012
• Est. Priority Date: 04/30/2009
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Skelton, Dennis M., Davis, Jon P., Malekkhosravi, Shahram, Bucalo, Antonio N.
• Primary Examiner(s): Layno, Carl H
• Assistant Examiner(s): Stice, Paula J
• Application Number:
  US12/433,599
• Publication Number:
  US 20100280440A1
• Time in Patent Office: 1,104 Days
• Field of Search: 607/46, 607 60- 62
• US Class Current: 607/62
• CPC Class Codes: A61B 5/1116 Determining posture transitions
• CPC Class Codes: A61B 5/1118 Determining activity level
• CPC Class Codes: A61B 5/7475 User input or interface means, e.g. keyboard, pointing device, joystick
• CPC Class Codes: A61N 1/36132 using patient feedback
• CPC Class Codes: A61N 1/36535 controlled by body position or posture
• CPC Class Codes: A61N 1/37247 User interfaces, e.g. input or presentation means

Abstract

Patient efficacy inputs are received over a period of time during which posture-responsive therapy is delivered to the patient while the patient occupies a plurality of posture states. The patient inputs are correlated with the times at which the inputs were received, a sensed posture state of the patient, and a therapy program defining therapy delivery at each of the times the posture state was sensed. Posture-responsive therapy is adjusted based on the historical posture-responsive therapy information correlating the patient input, patient input time, sensed posture state, and therapy program.

Claims

1. A method comprising:

receiving a plurality of inputs from a patient via a programming device, wherein the plurality of inputs are indicative of an efficacy of therapy delivered to the patient by a medical device over a period of time, and wherein the medical device delivers posture-responsive therapy to the patient;

correlating, with at least one of the programming device or the medical device, each of the patient inputs to a patient input time, the patient input time being a time at which the respective patient input was received, a sensed posture state of the patient, and a therapy program defining therapy delivered by the medical device when the patient occupied the sensed posture state;

presenting the patient inputs and the correlated sensed posture states, therapy programs, and patient input times as a function of time to a user via a display device; and

adjusting the posture-responsive therapy delivered by the medical device based on one or more of the correlations between the patient inputs, the patient input times, the sensed posture states, and the therapy programs.

2. The method of claim 1, wherein presenting the patient inputs and correlated sensed posture states, therapy programs, and patient input times as a function of time to a user comprises presenting a step function graph of the patient inputs and correlated sensed posture states, therapy programs, and patient input times as a function of time.

3. The method of claim 2, wherein the step function graph comprises a first step function plot of patient posture states as a function of time and a second step function plot of therapy programs as a function of time.

4. The method of claim 3, wherein each of the patient inputs are represented by substantially vertical lines connecting a patient posture state on the first step function plot to a therapy program on the second step function plot at a time at which the patient input was received, the posture state of the patient was sensed, and therapy defined by the therapy program was delivered.

5. The method of claim 4, wherein each of the vertical lines is annotated with a symbol indicative of one of a range of efficacy levels.

6. The method of claim 5, wherein the range of efficacy levels comprises a satisfactory level and a spectrum of levels above and below the satisfactory level.

7. The method of claim 1, wherein adjusting the posture-responsive therapy delivered by the medical device comprises determining which patient input of the patient inputs correlated with a particular posture state comprises a relatively highest level of efficacy for the particular posture state and associating a therapy program correlated to the patient input with the relatively highest level of efficacy for the particular posture state with the particular posture state, wherein the medical device delivers therapy to the patient according to the therapy program when the particular posture state is detected.

8. The method of claim 1, wherein adjusting the posture-responsive therapy delivered by the medical device comprises determining which patient input of the plurality of patient inputs comprises a relatively highest level of efficacy for all the posture states and associating a therapy program correlated to the patient input with the relatively highest level of efficacy for all the posture states with a particular posture state.

9. The method of claim 1, wherein adjusting the posture-responsive therapy delivered by the medical device comprises determining which patient input correlated with a particular patient input time comprises a relatively highest level of efficacy for the particular patient input time and selecting a subsequent therapy program to be delivered at a subsequent time to be a therapy program correlated to the patient input with the relatively highest level of efficacy for the particular patient input time, wherein the particular patient input time is similar to the subsequent time.

10. The method of claim 9, wherein patient input time comprises a time of day.

11. The method of claim 1, wherein adjusting the posture-responsive therapy delivered by the medical device comprises adjusting a plurality of therapy programs associated with a plurality of respective posture states based on one correlation between a patient input, patient input time, sensed posture state, and therapy program.

12. The method of claim 1, wherein adjusting the posture-responsive therapy delivered by the medical device comprises adjusting a plurality of therapy programs associated with a particular posture state based on one correlation between a patient input, patient input time, sensed posture state, and therapy program.

13. The method of claim 1, wherein adjusting the posture-responsive therapy delivered by the medical device comprises receiving a selection input from the user selecting a therapy program correlated to patient input, patient input time, and sensed posture state and associating the selected therapy program with one or more posture states.

14. The method of claim 1, wherein receiving a plurality of inputs from a patient indicative of an efficacy of therapy delivered to the patient by a medical device over a period of time comprises receiving a plurality of inputs from a patient indicative of an efficacy of one or more parameters included in one or more therapy programs that define the therapy delivered to the patient by the medical device over the period of time.

15. The method of claim 1, wherein correlating patient inputs to patient input times, sensed posture states, and therapy programs comprises correlating each of the patient inputs to a time at which the input was received, a sensed posture state of the patient at the time the patient input was received, and a therapy program defining therapy delivered by the medical device when the patient occupied the sensed posture state.

16. The method of claim 1, wherein correlating patient inputs to patient input times, sensed posture states, and therapy programs comprises correlating each of the patient inputs to a time at which the input was received, a sensed posture state of the patient at a time other than the time the patient input was received, and a therapy program defining therapy delivered by the medical device when the patient occupied the sensed posture state.

17. The method of claim 1, wherein the programming device and the display device are separate devices.

18. The method of claim 1, wherein the programming device comprises the display device.

19. A non-transitory computer-readable medium comprising instructions for causing a programmable processor to carry out a method comprising:

receiving a plurality of inputs from a patient indicative of an efficacy of therapy delivered to the patient by a medical device over a period of time, wherein the medical device delivers posture-responsive therapy to the patient;

correlating each of the patient inputs to a patient input time, the patient input time being a time at which the respective patient input was received, a sensed posture state of the patient, and a therapy program defining therapy delivered by the medical device when the patient occupied the sensed posture state;

presenting the patient inputs and the correlated sensed posture states, therapy programs, and patient input times as a function of time to a user via a display device; and

adjusting the posture-responsive therapy delivered by the medical device based on one or more of the correlations between the patient inputs, the patient input times, the sensed posture states, and the therapy programs.

20. The non-transitory computer-readable medium of claim 19, wherein the instructions cause the programmable processor to present the patient inputs and correlated sensed posture states, therapy programs, and patient input times as a function of time to a user by at least presenting a step function graph of the patient inputs and correlated sensed posture states, therapy programs, and patient input times as a function of time.

21. The non-transitory computer-readable medium of claim 20, wherein the step function graph comprises a first step function plot of patient posture states as a function of time and a second step function plot of therapy programs as a function of time.

22. The non-transitory computer-readable medium of claim 21, wherein each of the patient inputs are represented by substantially vertical lines connecting a patient posture state on the first step function plot to a therapy program on the second step function plot at a time at which the patient input was received, the posture state of the patient was sensed, and therapy defined by the therapy program was delivered.

23. The non-transitory computer-readable medium of claim 22, wherein each of the patient input vertical lines is annotated with a symbol indicative of one of a range of efficacy levels.

24. The non-transitory computer-readable medium of claim 19, wherein the instructions cause the programmable processor to adjust the posture-responsive therapy delivered by the medical device by at least determining which one of the patient inputs for a particular posture state comprises a relatively highest level of efficacy for the particular posture state and associating a therapy program correlated to the patient input with the relatively highest level of efficacy for the particular posture state with the particular posture state, wherein the medical device delivers therapy to the patient according to the therapy program when the particular posture state is detected.

25. The non-transitory computer-readable medium of claim 19, wherein the instructions cause the programmable processor to adjust the posture-responsive therapy delivered by the medical device by at least determining which one of the patient inputs comprises a relatively highest level of efficacy for all the posture states and associating a therapy program correlated to the patient input with the relatively highest level of efficacy for all the posture states with a particular posture state.

26. The non-transitory computer-readable medium of claim 19, wherein the instructions cause the programmable processor to adjust the posture-responsive therapy delivered by the medical device by at least determining a patient input for a particular patient input time comprising a relatively highest level of efficacy for the particular patient input time and selecting a subsequent therapy program to be delivered at a subsequent time to be a therapy program correlated to the patient input with the relatively highest level of efficacy for the particular patient input time, wherein the particular patient input time is similar to the subsequent time.

27. The non-transitory computer-readable medium of claim 19, wherein the instructions cause the programmable processor to adjust the posture-responsive therapy delivered by the medical device by at least adjusting a plurality of therapy programs associated with a plurality of respective posture states based on one correlation between a patient input, patient input time, sensed posture state, and therapy program.

28. The non-transitory computer-readable medium of claim 19, wherein the instructions cause the programmable processor to adjust the posture-responsive therapy delivered by the medical device by at least adjusting a plurality of therapy programs associated with a particular posture state based on one correlation between a patient input, patient input time, sensed posture state, and therapy program.

29. The non-transitory computer-readable medium of claim 19, wherein the instructions cause the programmable processor to adjust the posture-responsive therapy delivered by the medical device by at least receiving a selection input from the user selecting a therapy program correlated to patient input, patient input time, and sensed posture state and associating the selected therapy program with one or more posture states.

30. The non-transitory computer-readable medium of claim 19, wherein the instructions cause the programmable processor to adjust the posture-responsive therapy delivered by the medical device by at least receiving a selection input from the user indicating that a plurality of subsequent therapy programs should be set to one of the therapy programs correlated to patient input, patient input time, and sensed posture state.

31. The non-transitory computer-readable medium of claim 19, wherein the instructions cause the programmable processor to receive a plurality of inputs from a patient indicative of an efficacy of therapy delivered to the patient by a medical device over a period of time by at least receiving a plurality of inputs from a patient indicative of an efficacy of one or more parameters included in one or more therapy programs that define the therapy delivered to the patient by the medical device over the period of time.

32. The non-transitory computer-readable medium of claim 19, wherein the instructions cause the programmable processor to correlate patient inputs to patient input times, sensed posture states, and therapy programs by at least correlating each of the patient inputs to a time at which the input was received, a sensed posture state of the patient at the time the patient input was received, and a therapy program defining therapy delivered by the medical device when the patient occupied the sensed posture state.

33. The non-transitory computer-readable medium of claim 19, in the instructions cause the programmable processor to correlate patient inputs to patient input times, sensed posture states, and therapy programs by at least correlating each of the patient inputs to a time at which the input was received, a sensed posture state of the patient at a time other than the time the patient input was received, and a therapy program defining therapy delivered by the medical device when the patient occupied the sensed posture state.

34. An implantable medical system configured to deliver posture-responsive therapy to a patient, the system comprising:

an implantable medical device (IMD) that senses patient posture states and delivers therapy to the patient by adjusting one or more therapy parameter values based on a sensed patient posture state;

a user interface;

one or more processors that receive a plurality of inputs from the patient via the user interface, where the plurality of inputs are indicative of an efficacy of therapy delivered to the patient by the IMD over a period of time, correlate each of the patient inputs to a patient input time, the patient input comprising a time at which the respective patient input was received, a sensed posture state of the patient, and a therapy program defining therapy delivered by the IMD when the patient occupied the sensed posture state, present the patient inputs and the correlated sensed posture states, therapy programs, and patient input times as a function of time to a user via the user interface, and adjust the posture-responsive therapy delivered by the IMD based on one or more of the correlations between the patient inputs, the patient input times, the sensed posture states, and the therapy programs.

35. The system of claim 34, wherein the implantable medical device comprises the one or more processors.

36. The system of claim 34, further comprising an external programmer that includes the one or more processors and the user interface.

37. The system of claim 34, wherein the implantable medical device comprises at least one of the one or more processors, the system further comprising an external programmer that includes at least one of the one or more processors.

38. The system of claim 37, wherein the external programmer includes the user interface, and the at least one of the one or more processors included in the external programmer receives the plurality of inputs from the patient, and presents the patient inputs and correlated sensed posture states, therapy programs, and patient input times as a function of time to the user via the user interface.

39. The system of claim 34, wherein the one or more processors present the patient inputs and correlated sensed posture states, therapy programs, and patient input times as a function of time to a user by at least presenting a step function graph of the patient inputs and correlated sensed posture states, therapy programs, and patient input times as a function of time.

40. The system of claim 34, wherein the one or more processors adjust the posture-responsive therapy by at least determining which one of the patient inputs for a particular posture state comprises a relatively highest level of efficacy for the particular posture state and associating a therapy program correlated to the patient input with the relatively highest level of efficacy for the particular posture state with the particular posture state, wherein the implantable medical device delivers therapy to the patient according to the therapy program when the particular posture state is detected.

41. The system of claim 34, wherein the one or more processors adjust the posture-responsive therapy by at least determining which one of the patient inputs comprises a relatively highest level of efficacy for all the posture states and associating a therapy program correlated to the patient input with the relatively highest level of efficacy for all the posture states with a particular posture state.

42. The system of claim 34, wherein the one or more processors adjust the posture-responsive therapy by at least determining a patient input for a particular patient input time comprising a relatively highest level of efficacy for the particular patient input time and selecting a subsequent therapy program to be delivered at a subsequent time to be a therapy program correlated to the patient input with the relatively highest level of efficacy for the particular patient input time, wherein the particular patient input time is similar to the subsequent time.

43. The system of claim 34, wherein the one or more processors adjust the posture-responsive therapy by at least adjusting a plurality of therapy programs associated with a plurality of respective posture states based on one correlation between a patient input, patient input time, sensed posture state, and therapy program.

44. The system of claim 34, wherein the one or more processors adjust the posture-responsive therapy by at least adjusting a plurality of therapy programs associated with a particular posture state based on one correlation between a patient input, patient input time, sensed posture state, and therapy program.

45. The system of claim 34, wherein the one or more processors adjust the posture-responsive therapy by at least receiving a selection input from the user via the user interface, the selection input selecting a therapy program correlated to patient input, patient input time, and sensed posture state, and associating the selected therapy program with one or more posture states.