Associating therapy adjustments with posture states using a stability timer

• US 8,504,150 B2
• Filed: 03/23/2012
• Issued: 08/06/2013
• Est. Priority Date: 07/11/2008
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Skelton, Dennis M.
• Primary Examiner(s): Patel, Niketa
• Assistant Examiner(s): Hankins, Lindsey G
• Application Number:
  US13/428,890
• Publication Number:
  US 20120179071A1
• Time in Patent Office: 501 Days
• Field of Search: 600/481, 600/529, 600/544, 600/546, 607/17, 607/30, 607/62
• US Class Current: 607/17
• CPC Class Codes: A61B 2560/0219 of externally powered implanted units
• CPC Class Codes: A61B 2562/0219 Inertial sensors, e.g. accelerometers, gyroscopes, tilt switches
• CPC Class Codes: A61B 5/103 Detecting, measuring or recording devices for testing the shape, pattern, colour, size or movement of the body or parts thereof, for diagnostic purposes A61B5/08 takes precedence; measuring aids for tailors A41H1/00; measuring instruments specially adapted for dentistry A61C19/04
• CPC Class Codes: A61B 5/1116 Determining posture transitions
• CPC Class Codes: A61B 5/686 Permanently implanted devices, e.g. pacemakers, other stimulators, biochips A61B5/6861 takes precedence
• CPC Class Codes: A61B 5/743 Displaying an image simultaneously with additional graphical information, e.g. symbols, charts, function plots
• CPC Class Codes: A61B 5/744 Displaying an avatar, e.g. an animated cartoon character
• CPC Class Codes: A61N 1/3605 Implantable neurostimulators for stimulating central or peripheral nerve system
• CPC Class Codes: A61N 1/36071 Pain
• CPC Class Codes: A61N 1/36535 controlled by body position or posture
• 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: A61N 1/37264 Changing the program; Upgrading firmware
• CPC Class Codes: G16H 20/30 relating to physical therapies or activities, e.g. physiotherapy, acupressure or exercising
• CPC Class Codes: G16H 20/40 relating to mechanical, radiation or invasive therapies, e.g. surgery, laser therapy, dialysis or acupuncture
• CPC Class Codes: G16H 40/60 for the operation of medical equipment or devices
• CPC Class Codes: G16H 40/63 for local operation
• CPC Class Codes: G16Z 99/00 Subject matter not provided for in other main groups of this subclass

Abstract

The disclosure describes techniques for associating therapy adjustments with posture states using a timer. The techniques may include detecting a patient adjustment to electrical stimulation therapy delivered to the patient, sensing a posture state of the patient, and associating the detected adjustment with the sensed posture state if the sensed posture state is sensed within a first period following the detection of the adjustment and if the sensed posture state does not change during a second period following the sensing of the sensed posture state.

Claims

1. A method comprising:

detecting an adjustment to one or more parameters of electrical stimulation therapy delivered to a patient;

sensing a posture state of the patient; and

associating, by a processor, the detected adjustment with the sensed posture state when the sensed posture state does not change within a period of time subsequent to the detected adjustment, wherein the period of time is tracked by a single timer.

2. The method of claim 1, wherein associating the detected adjustment with the sensed posture state comprises associating the detected adjustment with the sensed posture state when both the sensed posture state and the detected adjustment do not change within the period of time tracked by the single timer.

3. The method of claim 1, further comprising starting the single timer in response to one of the detected adjustment or a change to the sensed posture state.

4. The method of claim 1, further comprising restarting the single timer when a change to the sensed posture state is detected before the end of the period.

5. The method of claim 1, further comprising restarting the single timer when a subsequent adjustment to the one or more parameters is detected before the end of the period.

6. The method of claim 1, wherein:

detecting the adjustment to one or more parameters comprises detecting and recording one or more adjustments to the parameters;

sensing the posture state comprises sensing and recording one or more posture states of the patient;

associating the detected adjustment with the sensed posture state comprises associating the detected adjustment with the sensed posture state when no adjustments to one or more parameters and no changes to the sensed posture states have occurred within the period of time; and

the single timer is a rolling window defined by the period of time.

7. The method of claim 1, further comprising storing the association in a memory of at least one of an implantable medical device or an external programmer.

8. The method of claim 1, wherein the sensed posture state is one of a plurality of predetermined posture states detectable by a posture state module, and wherein each of the plurality of predetermined posture states define respective areas of a three-dimensional posture state space indicative of an orientation of the patient.

9. The method of claim 1, wherein the posture state of the patient is defined by a predetermined posture cone within a three-dimensional posture state space.

10. The method of claim 1, wherein the sensed posture state corresponds to at least one of an activity and a posture undertaken by the patient.

11. The method of claim 1, wherein the one or more therapy parameters comprise at least one of an amplitude, a pulse rate, a pulse width, an electrode combination, and an electrode polarity.

12. A system comprising:

a posture state module configured to detect an adjustment to one or more parameters of electrical stimulation therapy delivered to a patient and sense a posture state of the patient; and

a processor configured to associate the detected adjustment with the sensed posture state when the sensed posture state does not change within a period of time subsequent to the detected adjustment, wherein the period of time is tracked by a single timer.

13. The system of claim 12, wherein the processor is configured to associate the detected adjustment with the sensed posture state when both the sensed posture state and the detected adjustment do not change within the period of time tracked by the single timer.

14. The system of claim 12, further comprising a sensor configured to sense the posture state of the patient.

15. The system of claim 12, wherein the processor is configured to start the single timer in response to the posture state module detecting one of the adjustment or a change to the sensed posture state.

16. The system of claim 12, wherein the processor is configured to restart the single timer when a change to the sensed posture state is detected before the end of the period.

17. The system of claim 12, wherein the processor is configured to restart the single timer when a subsequent adjustment to the one or more parameters is detected before the end of the period.

18. The system of claim 12, wherein:

the posture state module is configured to detect one or more adjustments to the parameters and sense one or more posture states of the patient;

the processor is configured to record the one or more adjustments and the one or more posture states and associate the detected adjustment with the sensed posture state when no adjustments to one or more parameters and no changes to the sensed posture states have occurred within the period of time; and

the single timer is a rolling window defined by the period of time.

19. The system of claim 12, further comprising a medical device configured to deliver the stimulation therapy, wherein the processor is configured to store the association in a memory of at least one of the medical device or an external programmer for the medical device, and wherein the processor is located in the external programmer.

20. The system of claim 12, further comprising an implantable medical device configured to deliver the stimulation therapy, wherein the processor is configured to store the association in a memory of at least one of the implantable medical device or an external programmer, and wherein the processor is located in the implantable medical device.

21. A system comprising:

means for detecting an adjustment to one or more parameters of electrical stimulation therapy delivered to the patient;

means for sensing a posture state of a patient; and

means for associating the detected adjustment with the sensed posture state when the sensed posture state does not change within a period of time subsequent to the detected adjustment, wherein the period of time is tracked by a single timer.

22. The system of claim 21, wherein the means for associating the detected adjustment with the sensed posture state comprises means for associating the detected adjustment with the sensed posture state when both the sensed posture state and the detected adjustment do not change within the period of time tracked by the single timer.

23. The system of claim 21, further comprising:

means for starting the single timer to time the period in response to detecting one of the adjustment or a change to the sensed posture state.

24. The system of claim 21, further comprising means for restarting the single timer when a change to the sensed posture state is detected before the end of the period.

25. The system of claim 21, further comprising means for restarting the single timer when a subsequent adjustment to the one or more parameters is detected before the end of the period.

26. A programmer comprising:

a user interface configured to receive an adjustment to one or more therapy parameters that define stimulation therapy delivered to a patient by a medical device;

a telemetry interface configured to receive a sensed posture state from the medical device and transmit the received adjustment to the medical device;

a processor configured to;

detect an adjustment to one or more parameters of electrical stimulation therapy delivered to the patient;

sense a posture state of a patient;

associate the detected adjustment with the sensed posture state when the sensed posture state does not change within a period of time subsequent to the detected adjustment; and

employ a single timer that tracks the period of time subsequent to the detected adjustment; and

a memory configured to store the association.

27. An implantable medical device comprising:

a stimulation generator configured to deliver stimulation therapy to a patient;

a telemetry interface configured to receive a change to one or more therapy parameters, wherein the one or more therapy parameters define the stimulation therapy;

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

a processor configured to;

detect an adjustment to one or more parameters of electrical stimulation therapy delivered to the patient;

sense a posture state of a patient;

associate the detected adjustment with the sensed posture state when the sensed posture state does not change within a period of time subsequent to the detected adjustment; and

employ a single timer that tracks the period of time subsequent to the detected adjustment; and

a memory configured to store the association.

28. A method comprising:

sensing a posture state of a patient; and

associating, by a processor, the sensed posture state with a parameter of electrical stimulation therapy currently delivered to the patient when both the sensed posture state and the parameter do not change within a period of time subsequent to sensing the posture state, wherein the period of time is tracked by a single timer.

29. The method of claim 28, further comprising:

tracking a delay period from the sensed posture state;

adjusting, with a processor, the parameter from a first parameter value associated with the sensed posture state when the delay period elapses to a second parameter value, wherein;

associating the sensed posture state with the parameter of electrical stimulation therapy currently delivered to the patient comprises associating the sensed posture state with the second parameter value of electrical stimulation therapy currently delivered to the patient when the period of time is one of equal to or greater than the delay period.

30. The method of claim 28, further comprising starting the single timer in response to sensing the posture state.

31. The method of claim 28, further comprising:

detecting a change to the sensed posture state; and

in response to the detection, restarting the single timer.

32. The method of claim 28, further comprising:

detecting an adjustment to the parameter before the end of the period of time; and

in response to the detection, restarting the single timer.

33. The method of claim 28, wherein the sensed posture state is one of a plurality of predetermined posture states detectable by a posture state module, and wherein each of the plurality of predetermined posture states define respective areas of a three-dimensional posture state space indicative of an orientation of the patient.

34. The method of claim 28, wherein the parameter comprises at least one of an amplitude, a pulse rate, a pulse width, an electrode combination, and an electrode polarity.

35. A system comprising:

a posture state module configured to sense a posture state of a patient; and

a processor configured to associate the sensed posture state with a parameter of electrical stimulation therapy currently delivered to the patient when both the sensed posture state and the parameter do not change within a period of time subsequent to sensing the posture state, wherein the period of time is tracked by a single timer.

36. The system of claim 35, wherein the processor is configured to:

track a delay period from the sensed posture state;

adjust the parameter from a first parameter value associated with the sensed posture state when the delay period elapses to a second parameter value; and

associate the sensed posture state with the second parameter value of electrical stimulation therapy currently delivered to the patient when the period of time is one of equal to or greater than the delay period.

37. The system of claim 35, wherein the processor is configured to start the single timer in response to receiving an indication of the sensed posture state.

38. The system of claim 35, wherein the processor is configured to:

detect a change to the sensed posture state; and

in response to the detection, restart the single timer.

39. The system of claim 35, wherein the processor is configured to:

detect an adjustment to the parameter before the end of the period of time; and

in response to the detection, restart the single timer.

40. The system of claim 35, wherein the sensed posture state is one of a plurality of predetermined posture states detectable by the posture state module, and wherein each of the plurality of predetermined posture states defines respective areas of a three-dimensional posture state space indicative of an orientation of the patient.

41. The system of claim 35, wherein the parameter comprises at least one of an amplitude, a pulse rate, a pulse width, an electrode combination, and an electrode polarity.

42. The system of claim 35, further comprising an implantable medical device that comprises the posture state module and the processor.

43. The system of claim 35, further comprising an external programmer that comprises the processor.

44. The system of claim 43, further comprising an implantable medical device that comprises the posture state module, wherein the external programmer comprises a telemetry module configured to receive an indication of the sensed posture state from the implantable medical device.

45. A system comprising:

means for sensing a posture state of a patient; and

means for associating the sensed posture state with a parameter of electrical stimulation therapy currently delivered to the patient when both the sensed posture state and the parameter do not change within a period of time subsequent to sensing the posture state, wherein the period of time is tracked by a single timer.

46. A non-transitory computer-readable medium comprising instructions that, when executed by a processor, cause the processor to:

sense a posture state of a patient; and

associate the sensed posture state with a parameter of electrical stimulation therapy currently delivered to the patient when both the sensed posture state and the parameter do not change within a period of time subsequent to sensing the posture state, wherein the period of time is tracked by a single timer.

47. A programmer for a medical device, the programmer comprising:

a telemetry interface configured to receive a sensed posture state of a patient from the medical device;

a processor configured to;

associate the sensed posture state with a parameter of electrical stimulation therapy currently delivered to the patient when both the sensed posture state and the parameter do not change within a period of time subsequent to sensing the posture state; and

employ a single timer that tracks the period of time; and

a memory configured to store the association.

48. The programmer of claim 47, further comprising a user interface configured to receive an adjustment to the parameter, wherein:

the telemetry interface is configured to transmit the adjusted parameter to the medical device; and

the electrical stimulation therapy currently delivered to the patient is at least partially defined by the adjusted parameter.

49. An implantable medical device comprising:

a stimulation generator configured to deliver electrical stimulation therapy to a patient;

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

a processor configured to;

associate the sensed posture state with a parameter of electrical stimulation therapy currently delivered to the patient when both the sensed posture state and the parameter do not change within a period of time subsequent to sensing the posture state; and

employ a single timer that tracks the period of time; and

a memory configured to store the association.

50. The implantable medical device of claim 49, further comprising a telemetry interface configured to receive, from a programmer, a change to the parameter, wherein the electrical stimulation therapy currently delivered to the patient is at least partially defined by the changed parameter.