Defining therapy parameter values for posture states

• US 8,751,011 B2
• Filed: 04/30/2009
• Issued: 06/10/2014
• 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., Nolan, Joseph J., Sahasrabudhe, Rajeev, Gokaldas, Shyam
• Primary Examiner(s): Patel, Niketa
• Assistant Examiner(s): LEVICKY, WILLIAM J
• Application Number:
  US12/433,854
• Publication Number:
  US 20100010580A1
• Time in Patent Office: 1,867 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 an external programmer comprising a user interface that receives user input defining therapy parameter values for delivery of therapy to a patient, and user input associating one or more of the therapy parameter values with a plurality of posture states based on user input, a processor that automatically defines therapy parameter values for delivery of therapy to a patient when the patient occupies the posture states based on the association, and an implantable medical device that delivers the therapy to the patient in response to detection of the posture states.

Claims

1. A method comprising:

defining a plurality of posture states for a patient including a first posture state and a second posture state;

defining a value of a first therapy parameter for the first posture state, a value of a second therapy parameters for a first posture state, and a value of the second therapy parameter for the second posture state, wherein a value of the first therapy parameter for the second posture state is initially undefined following the definition of the second posture state;

determining, while the value of the first therapy parameter for the second posture state is undefined and the value of the second therapy parameter for the second posture state is defined, that the patient transitioned from the first posture state to the second posture state;

controlling the delivery, prior to defining the value of the first therapy parameter for the second posture state, of a therapy to the patient while the patient occupies the second posture state based on the determination, wherein the therapy delivered while that patient occupies the second posture state is delivered based on the value of the first therapy parameter defined for the first posture state and the value of the second therapy parameter defined for the second posture state;

receiving, subsequent to the delivery of the therapy, patient input indicating a value for the undefined value of the first therapy parameter for the second posture state while the patient is in the second posture state or transitioning to the second posture state; and

defining, in response to the receipt of the patient input, the value of the first therapy parameter for the second posture state based on the patient input.

2. The method of claim 1, wherein the value of the undefined first therapy parameter comprises at least one of an amplitude value, a pulse width value, a pulse rate value, an electrode combination, or an electrode polarity.

3. The method of claim 1, further comprising requesting that the patient confirm that the value of the first therapy parameter for the second posture state should be defined for the second posture state based on the patient input, and wherein defining the value of the first therapy parameter value for the second posture state based on the patient input comprises defining the value of the first therapy parameter for the second posture state based on receipt of both the patient input and the patient confirmation.

4. The method of claim 1, wherein defining the value of the first therapy parameter comprises automatically defining the value of the first therapy parameter for the second posture state in response to the receipt of the patient input.

5. The method of claim 1, further comprising:

subsequently determining that the patient occupies the second posture state; and

controlling delivery of therapy to the patient, while occupying the second posture state, according to the value of the first therapy parameter and the value of the second therapy parameter defined for the second posture state in response to the determination that the patient occupies the second posture state.

6. The method of claim 5, wherein controlling delivery of therapy comprises controlling delivery of electrical stimulation therapy to the patient via an implantable medical device.

7. An external programmer for an implantable medical device, the programmer comprising:

a memory that stores a definition of a plurality of posture states for a patient including a first posture state and a second posture state;

a user interface that receives patient input; and

a processor that;

defines a value of a first therapy parameter for the first posture state, a value of a second therapy parameters for a first posture state, and a value of the second therapy parameter for the second posture state, wherein a value of the first therapy parameter for the second posture state is initially undefined following the definition of the second posture state,

programs the implantable medical device to determine, while the value of the first therapy parameter for the second posture state is undefined and the value of the second therapy parameter for the second posture state is defined, that the patient transitioned from the first posture state to the second posture state,

programs the implantable medical device to deliver, prior to defining the value of the first therapy parameter for the second posture state, a therapy to the patient while the patient occupies the second posture state based on the determination, wherein the therapy delivered while that patient occupies the second posture state is delivered based on the value of the first therapy parameter defined for the first posture state and the value of the second therapy parameter defined for the second posture state,

receives, subsequent to the delivery of therapy, patient input via the user interface indicating a value for the undefined value of the first therapy parameter for the second posture state while the patient is in the second posture state or transitioning to the second posture state, and

defines, in response to the receipt of the patient input, the value of the first therapy parameter for the second posture state based on the patient input.

8. The external programmer of claim 7, wherein the value of the undefined first therapy parameter comprises at least one of an amplitude value, a pulse width value, a pulse rate value, an electrode combination, or an electrode polarity.

9. The external programmer of claim 7, wherein the user interface generates a request that the patient confirm that the value of the first therapy parameter for the second posture state should be defined for the second posture state based on the patient input, and the processor defines the value of the first therapy parameter for the second posture state based on receipt of both the patient input and the patient confirmation.

10. The external programmer of claim 7, wherein the processor automatically defines the value of the first therapy parameter for the second posture state in response to the receipt of the patient input.

11. The external programmer of claim 7, wherein the programmer programs the implantable medical device to subsequently determine that the patient occupies the second posture state, and deliver therapy to the patient, while occupying the second posture state, according to the value of the first therapy parameter and the value of the second therapy parameter defined for the second posture state in response to the determination that the patient occupies the second posture state.

12. A system comprising:

a memory that stores a definition of a plurality of posture states for a patient including a first posture state and a second posture state;

an external programmer comprising a user interface that receives patient input;

one or more processors that;

define a value of a first therapy parameter for the first posture state, a value of a second therapy parameters for a first posture state, and a value of the second therapy parameter for the second posture state, wherein a value of the first therapy parameter for the second posture state is initially undefined following the definition of the second posture state,

determine, while the value of the first therapy parameter for the second posture state is undefined and the value of the second therapy parameter for the second posture state is defined, that the patient transitioned from the first posture state to the second posture state,

control delivery, prior to defining the value of the first therapy parameter for the second posture state, of a therapy to the patient via a medical device while the patient occupies the second posture state based on the determination, wherein the therapy delivered while that patient occupies the second posture state is delivered based on the value of the first therapy parameter defined for the first posture state and the value of the second therapy parameter defined for the second posture state,

receive, subsequent to the delivery of therapy, patient input via the user interface indicating a value for the undefined value of the first therapy parameter for the second posture state while the patient is in the second posture state or transitioning to the second posture state,

define, in response to the receipt of the patient input, the value of the first therapy parameter for the respective posture state based on the patient input,

subsequently determine the patient occupies the second posture state, and

control delivery of therapy via the medical device to the patient, while the patient occupies the second posture state, based on the value of the first therapy parameters and the value of the second therapy parameter defined for the second posture state based on the subsequent determination.

13. The system of claim 12, wherein the value of the undefined first therapy parameter comprises at least one of an amplitude value, a pulse width value, a pulse rate value, an electrode combination, or an electrode polarity.

14. The system of claim 12, wherein the user interface generates a request that the patient confirm that the value of the first therapy parameter for the second posture state should be defined for the second posture state based on the patient input, and the processor defines the value of the first therapy parameter for the second posture state based on receipt of both the patient input and the patient confirmation.

15. The system of claim 12, wherein the one or more processors automatically define the value of the first therapy parameter for the second posture state in response to the receipt of the patient input.

16. The system of claim 12, wherein the medical device comprises at least one of the one or more processors.

17. The system of claim 12, wherein the external programmer comprises the at least one of the one or more processors.

18. The system of claim 12, wherein the external programmer comprises at least one of a patient programmer or a clinician programmer.

19. The system of claim 12, wherein the therapy delivered by the medical device comprises electrical stimulation therapy.

20. A system comprising:

means for defining a plurality of posture states for a patient including a first posture state and a second posture state;

means for defining a value of a first therapy parameter for the first posture state, a value of a second therapy parameters for a first posture state, and a value of the second therapy parameter for the second posture state, wherein a value of the first therapy parameter for the second posture state is initially undefined following the definition of the second posture state;

means for determining, while the value of the first therapy parameter for the second posture state is undefined and the value of the second therapy parameter for the second posture state is defined, that the patient transitioned from the first posture state to the second posture state;

means for controlling the delivery, prior to defining the value of the first therapy parameter for the second posture state, of a therapy to the patient while the patient occupies the second posture state based on the determination, wherein the therapy delivered while that patient occupies the second posture state is delivered based on the value of the first therapy parameter defined for the first posture state and the value of the second therapy parameter defined for the second posture state;

means for receiving, subsequent to the delivery of the therapy, patient input indicating a value for the undefined value of the first therapy parameter for the second posture state while the patient is in the second posture state or transitioning to the second posture state; and

means for defining, in response to the receipt of the patient input, the value of the first therapy parameter for the second posture state based on the patient input.

21. The system of claim 20, wherein the value of the undefined first therapy parameter comprises at least one of an amplitude value, a pulse width value, a pulse rate value, an electrode combination, or an electrode polarity.

22. The system of claim 20, further comprising means for requesting that the patient confirm that the value of the first therapy parameter for the second posture state should be defined for the second posture state based on the patient input, and wherein the means for defining the value of the first therapy parameter value for the second posture state based on the patient input comprises means for defining the value of the first therapy parameter for the second posture state based on receipt of both the patient input and the patient confirmation.

23. The system of claim 20, wherein the means for defining the value of the first therapy parameter comprises means for automatically defining the value of the first therapy parameter for the second posture state in response to the receipt of the patient input.

24. The system of claim 20, further comprising:

means for subsequently determining that the patient occupies the second posture state; and

means for delivering therapy to the patient, while occupying the second posture state, according to the value of the first therapy parameter and the value of the second therapy parameter defined for the second posture state in response to the determination that the patient occupies the second posture state.

25. The system of claim 24, wherein the means for delivering therapy comprises means for delivering electrical stimulation therapy to the patient via an implantable medical device.

26. A medical device comprising:

a memory that stores a definition of a plurality of posture states for a patient including a first posture state and a second posture state; and

one or more processors configured to;

define a value of a first therapy parameter for the first posture state, a value of a second therapy parameters for a first posture state, and a value of the second therapy parameter for the second posture state, wherein a value of the first therapy parameter for the second posture state is initially undefined following the definition of the second posture state,

determine, while the value of the first therapy parameter for the second posture state is undefined and the value of the second therapy parameter for the second posture state is defined, that the patient transitioned from the first posture state to the second posture state,

control delivery, prior to defining the value of the first therapy parameter for the second posture state, of a therapy to the patient via a medical device while the patient occupies the second posture state based on the determination, wherein the therapy delivered while that patient occupies the second posture state is delivered based on the value of the first therapy parameter defined for the first posture state and the value of the second therapy parameter defined for the second posture state,

receive, subsequent to the delivery of therapy, patient input via the user interface indicating a value for the undefined value of the first therapy parameter for the second posture state while the patient is in the second posture state or transitioning to the second posture state, and

define, in response to the receipt of the patient input, the value of the first therapy parameter for the respective posture state based on the patient input.

27. The medical device of claim 26, wherein the value of the undefined first therapy parameter comprises at least one of an amplitude value, a pulse width value, a pulse rate value, an electrode combination, or an electrode polarity.

28. The medical device of claim 26, wherein the one or more processors are configured to receive patient confirmation from an external programmer indicating that the value of the first therapy parameter for the second posture state should be defined for the second posture state based on the user input, and define the value of the first therapy parameter the second posture state based on receipt of both the patient input and the patient confirmation.

29. The medical device of claim 26, wherein the one or more processors automatically define the value of the first therapy parameter for the second posture state in response to the receipt of the patient input.

30. The medical device of claim 26, wherein the one or more processors are configured to subsequently determine that the patient occupies the second posture state, and control delivery of therapy to the patient, while occupying the second posture state, according to the value of the first therapy parameter and the value of the second therapy parameter defined for the second posture state in response to the subsequent determination that the patient occupies the second posture state.

31. The medical device of claim 26, further comprising an therapy module configured to deliver electrical stimulation therapy to the patient, and wherein the one or more processors are configured to control the therapy module to deliver electrical stimulation therapy to the patient according to the detected posture state.