Posture state redefinition based on posture data and therapy adjustments

• US 8,588,929 B2
• Filed: 04/08/2013
• Issued: 11/19/2013
• 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., Davis, Jon P.
• Primary Examiner(s): Koharski, Christopher D
• Assistant Examiner(s): EDWARDS, PHILIP CHARLES
• Application Number:
  US13/858,348
• Publication Number:
  US 20130231716A1
• Time in Patent Office: 225 Days
• Field of Search: 607/62
• US Class Current: 607/62
• 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 5/1116 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 5/7435 Displaying user selection data, e.g. icons in a graphical user interface
• CPC Class Codes: A61N 1/36135 using physiological parameters
• 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: G16H 10/60 for patient-specific data, e.g. for electronic patient records
• 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

Abstract

The disclosure is directed towards posture-responsive therapy. To avoid interruptions in effective therapy, an implantable medical device may include a posture state module that detects the posture state of the patient and automatically adjusts therapy parameter values according to the detected posture state. A system may include a posture state module that records a current posture of a patient, a user interface that receives a therapy adjustment, a processor that associates a posture that the posture state module recorded when the user interface received the therapy adjustment with the therapy adjustment, determines whether the posture falls within a defined posture state, compares the therapy adjustment to therapy information associated with the defined posture state, and updates the set of posture state definitions based on the determination and comparison.

Claims

1. A method comprising:

recording a posture of a patient and a therapy adjustment to a therapy parameter, wherein the therapy adjustment corresponds to the posture of the patient;

determining, by one or more processors, whether the posture falls within a defined posture state;

comparing, by the one or more processors, the therapy adjustment to therapy parameter information associated with the defined posture state; and

updating, by the one or more processors and based on the determination and the comparison, at least one posture state definition.

2. The method of claim 1, further comprising, responsive to determining that the posture falls within the defined posture state, updating the at least one posture state definition by merging the defined posture state with an adjacent posture state.

3. The method of claim 1, further comprising, responsive to determining that the posture falls within the defined posture state, updating the at least one posture state definition by splitting the defined posture state into multiple posture states.

4. The method of claim 1, wherein comparing the therapy adjustment to therapy parameter information associated with the defined posture state comprises determining whether a difference between an adjusted therapy parameter value corresponding to the therapy adjustment and an associated therapy parameter value associated with the defined posture state is less than a threshold difference.

5. The method of claim 4, further comprising, in response to determining that the difference is greater than the threshold difference, analyzing one or more previous therapy adjustments associated with postures that fall within the defined posture state and splitting, based on the analysis, the defined posture state into two or more new posture states.

6. The method of claim 4, further comprising, in response to determining that the difference is less than the threshold difference:

determining whether a distance between the posture state and an adjacent posture states is below a threshold distance;

determining whether a difference between the adjusted therapy parameter value corresponding to the therapy adjustment and an adjacent therapy parameter value associated with the adjacent posture state is less than the threshold difference; and

merging, based on the determinations, the defined posture state and adjacent posture state into a new posture state.

7. The method of claim 1, wherein updating the at least one posture state definition comprises, in response to determining that the posture falls outside of the defined posture state, updating the at least one posture state definitions by expanding the defined posture state to include the posture.

8. The method of claim 1, wherein updating the at least one posture state definition comprises, in response to determining that the posture falls outside of the defined posture state, updating the at least one posture state definitions by creating a new posture state that includes the posture.

9. The method of claim 1, further comprising associating the therapy adjustment with one of one or more posture states defined by the updated at least one posture state definition.

10. The method of claim 1, further comprising associating the posture that was recorded when the therapy adjustment was recorded with the therapy adjustment.

11. The method of claim 1, wherein an external programmer comprises the one or more processors.

12. The method of claim 1, wherein an implantable medical device comprises the one or more processors.

13. A non-transitory computer-readable storage medium comprising instructions that, when executed, cause one or more processors to:

record a posture of a patient and a therapy adjustment to a therapy parameter, wherein the therapy adjustment corresponds to the posture of the patient;

determine whether the posture falls within a defined posture state;

compare the therapy adjustment to therapy parameter information associated with the defined posture state; and

update, based on the determination and the comparison, at least one posture state definition.

14. The non-transitory computer-readable storage medium of claim 13, further comprising instructions that, when executed, cause the one or more processors to, responsive to determining that the posture falls within the defined posture state, update the at least one posture state definition by one of merging the defined posture state with an adjacent posture state or splitting the defined posture state into multiple posture states.

15. The non-transitory computer-readable storage medium of claim 13, wherein the instructions that, when executed, cause the one or more processors to compare the therapy adjustment to therapy parameter information associated with the defined posture state comprise instructions that, when executed, cause the one or more processors to determine whether a difference between an adjusted therapy parameter value corresponding to the therapy adjustment and an associated therapy parameter value associated with the defined posture state is less than a threshold difference.

16. The non-transitory computer-readable storage medium of claim 15, further comprising instructions that, when executed, cause the one or more processors to, in response to determining that the difference is greater than the threshold difference, analyze one or more previous therapy adjustments associated with postures that fall within the defined posture state and split, based on the analysis, the defined posture state into two or more new posture states.

17. The non-transitory computer-readable storage medium of claim 15, further comprising instructions that, when executed, cause one or more processors to, in response to determining that the difference is less than the threshold difference:

determine whether a distance between the posture state and an adjacent posture states is below a threshold distance;

determine whether a difference between the adjusted therapy parameter value corresponding to the therapy adjustment and an adjacent therapy parameter value associated with the adjacent posture state is less than the threshold difference; and

merge, based on the determinations, the defined posture state and adjacent posture state into a new posture state.

18. The non-transitory computer-readable storage medium of claim 13, wherein the instructions that, when executed, cause the one or more processors to update the at least one posture state definition comprise instructions that, when executed, cause the one or more processors to, in response to determining that the posture falls outside of the defined posture state, update the at least one posture state definitions by one of expanding the defined posture state to include the posture or creating a new posture state that includes the posture.

19. The non-transitory computer-readable storage medium of claim 13, further comprising instructions that, when executed, cause the one or more processors to associate the therapy adjustment with one of one or more posture states defined by the updated at least one posture state definition.

20. A method comprising:

recording a current posture of a patient;

receiving a therapy adjustment to a therapy parameter;

associating a posture that the posture state module recorded when the user interface received the therapy adjustment with the therapy adjustment;

determining, by a processor, whether the posture falls within a defined posture state;

comparing the therapy adjustment to therapy parameter information associated with the defined posture state; and

updating at least one posture state definition based on the determination and the comparison.