Medical device for determining the posture of patient

• US 8,790,254 B2
• Filed: 06/29/2005
• Issued: 07/29/2014
• Est. Priority Date: 06/29/2005
• Status: Expired due to Fees

• Current Assignee: St. Jude Medical AB (Abbott Laboratories Incorporated)
• Original Assignee: St. Jude Medical AB (Abbott Laboratories Incorporated)
• Inventors: hlander, Malin, Holmstrm, Nils, Norn, Kjell
• Primary Examiner(s): Jackson, Gary
• Assistant Examiner(s): SORIANO, BOBBY GILES
• Application Number:
  US11/993,254
• Publication Number:
  US 20100113961A1
• Time in Patent Office: 3,317 Days
• Field of Search: 600/300, 600/301, 600/534, 600/537, 607/17
• US Class Current: 600/300
• CPC Class Codes: A61B 5/0031 Implanted circuitry
• CPC Class Codes: A61B 5/01 Measuring temperature of body parts ; Diagnostic temperature sensing, e.g. for malignant or inflamed tissue clinical contact thermometers G01K13/20
• CPC Class Codes: A61B 5/029 Measuring or recording blood output from the heart, e.g. minute volume A61B8/065 takes precedence
• CPC Class Codes: A61B 5/053 Measuring electrical impedance or conductance of a portion of the body
• CPC Class Codes: A61B 5/0816 Measuring devices for examining respiratory frequency measuring frequency of electric signals G01R23/00
• CPC Class Codes: A61B 5/1116 Determining posture transitions
• CPC Class Codes: A61B 5/4561 Evaluating static posture, e.g. undesirable back curvature A61B5/1116 takes precedence
• CPC Class Codes: A61B 5/686 Permanently implanted devices, e.g. pacemakers, other stimulators, biochips A61B5/6861 takes precedence
• CPC Class Codes: G16H 20/30 relating to physical therapies or activities, e.g. physiotherapy, acupressure or exercising

Abstract

In a method and a device for determining the posture of a patient, a bio-impedance measurement device, having a number of electrodes configured to interact with the patient in a number of different electrode configurations, is operated to initiate a patient posture determining session by measuring an impedance value of the patient with the electrodes in at least one configuration among the number of configurations. A reference impedance value from among a number of stored reference impedance values for the at least one configuration is selected. The number of stored reference impedance values are respectively associated with different postures of the patient, and the posture associated with the selected reference impedance value represents a candidate posture. The measured impedance value is compared with the selected reference impedance value, thereby obtaining a comparison result. Dependent on said comparison result, it is automatically determined whether the current posture of the patient conforms to the candidate posture.

Claims

1. A method for determining the posture of a patient comprising the steps of:

with a bio-impedance measurement device having a plurality of electrodes configured to interact with the patient in a plurality of different electrode configurations, initiating a patient posture determining session by measuring an impedance value of the patient with said electrodes in at least one configuration among said plurality of configurations;

selecting a reference impedance value from among a plurality of stored reference impedance values for said at least one configuration, said plurality of stored reference impedance values being respectively associated with different postures of the patient, and the posture associated with the selected reference impedance value representing a candidate posture;

comparing the measured impedance value with the selected reference impedance value, thereby obtaining a comparison result; and

dependent on said comparison result, automatically electronically determining whether the current posture of the patient conforms to the candidate posture.

2. A method as claimed in claim 1 comprising:

obtaining said reference impedance values for each of a predetermined number of said electrode configurations for each of a predetermined number of different postures for each of a predetermined number of said electrode configurations; and

storing the reference impedance values in a reference value matrix representing each reference impedance value associated with each electrode configuration and each posture.

3. A method as claimed in claim 2 comprising:

sensing a breathing rate of the patient; and

determining said impedance value as an average value over a duration selected from the group consisting of a predetermined number of breaths, a predetermined number of breathing cycles, and a predetermined period of time.

4. A method as claimed in claim 3 comprising synchronizing the respective impedance measurement sessions with said breathing rate.

5. A method as claimed in claim 1 comprising:

automatically determining whether a difference between said measured impedance value for said at least one configuration and the reference value for said at least one configuration is within a predetermined interval; and

if said difference is outside of said interval for a predetermined number of posture determining sessions, updating the stored reference impedance values by using the measure impedance value of said predetermined number of posture determining sessions.

6. A method as claimed in claim 1 wherein the step of comparing said measured impedance value with said stored reference impedance value comprises calculating a deviation factor, as said comparison result, for the posture associated with said reference impedance value, and determining whether said current posture conforms to said candidate posture using said deviation factor.

7. A method as claimed in claim 6 comprising calculating said deviation factor as a squared difference sum of said measured impedance values and stored reference impedance value for said candidate posture.

8. A method as claimed in claim 7 comprising identifying a candidate posture, among said postures respectively associated with the stored reference impedance values, having a lowest squared difference sum and determining said current posture as being said candidate posture having said lowest squared difference sum.

9. A method as claimed in claim 7 comprising determining whether said squared difference sum for said candidate posture is within a predetermined interval, and determining said current posture to be said candidate posture if said squared difference sum is within said predetermined interval.

10. A method as claimed in claim 1 comprising sensing a physiological feature of said patient selected from the group consisting of heart rate, activity level, body temperature and cardiac output, and initiating said patient posture determining session only when said physiological feature is at a predetermined level.

11. A method as claimed in claim 1 comprising generating an updating indication signal indicating that said reference impedance values require updating, if a current posture is not determined in said patient posture determining session within a predetermined period of time.

12. A device for determining the posture of a patient comprising the steps of:

a bio-impedance measurement device having a plurality of electrodes configured to interact with the patient in a plurality of different electrode configurations, that initiates a patient posture determining session by measuring an impedance value of the patient with said electrodes in at least one configuration among said plurality of configurations;

a memory containing for said at least one configuration, a plurality of stored reference impedance values respectively associated with different postures of the patient;

a processor that selects a reference impedance value from said memory, the posture associated with the selected reference impedance value representing a candidate posture;

said processor comprising a comparator that compares the measured impedance value with the selected reference impedance value to obtain a comparison result; and

said processor dependent on said comparison result, automatically determining whether the current posture of the patient conforms to the candidate posture.

13. A device as claimed in claim 12 wherein said memory contains reference impedance values for each of a predetermined number of said electrode configurations for each of a predetermined number of different postures for each of a predetermined number of said electrode configurations and wherein the reference impedance values are stored in the memory in a reference value matrix representing each reference impedance value associated with each electrode configuration and each posture.

14. A device as claimed in claim 13 comprising:

a breathing rate sensor that senses a breathing rate of the patient; and

wherein said processor determines said impedance value as an average value over a duration selected from the group consisting of a predetermined number of breaths, a predetermined number of breathing cycles, and a predetermined period of time.

15. A device as claimed in claim 14 comprising a control unit that synchronizes the respective impedance measurement sessions with said breathing rate.

16. A device as claimed in claim 12 wherein said processor automatically determines whether a difference between said measured impedance value for said at least one configuration and the reference value for said at least one configuration is within a predetermined interval and, if said difference is outside of said interval for a predetermined number of posture determining sessions, updates the stored reference impedance values by using the measure impedance value of said predetermined number of posture determining sessions.

17. A device as claimed in claim 12 wherein said comparator compares said measured impedance value with said stored reference impedance value by calculating a deviation factor, as said comparison result, for the posture associated with said reference impedance value, and wherein said processor determines whether said current posture conforms to said candidate posture using said deviation factor.

18. A device as claimed in claim 17 wherein said comparator calculates said deviation factor as a squared difference sum of said measured impedance values and stored reference impedance values for said candidate posture.

19. A device as claimed in claim 18 wherein said processor identifies a candidate posture, among said postures having a lowest squared difference sum and determining said current posture as being said candidate posture having said lowest squared difference sum.

20. A device as claimed in claim 18 wherein said processor determines whether said squared difference sum for said candidate posture is within a predetermined interval, and determines said current posture to be said candidate posture to said squared difference sum is within said predetermined interval.

21. A device as claimed in claim 12 comprising a sensing arrangement that detects a physiological feature of said patient selected from the group consisting of heart rate, activity level, body temperature and cardiac output, and comprising a control unit that initiates said patient posture determining session only when said physiological feature is at a predetermined level.

22. A device as claimed in claim 12 wherein said processor generates an updating indication signal indicating that said reference impedance values require updating, if a current posture is not determined in said patient posture determining session within a predetermined period of time.

23. A computer-readable medium encoded with programming instructions for determining the posture of a patient for use with a bio-impedance measurement device having a plurality of electrodes configured to interact with the patient in a plurality of different electrode configurations, said programming instructions causing a computerized circuit to:

operate said bio-impedance measurement device to initiate a patient posture determining session by measuring an impedance value of the patient with said electrodes in at least one configuration among said plurality of configurations;

select a reference impedance value from among a plurality of stored reference impedance values for said at least one configuration, said plurality of stored reference impedance values being respectively associated with different postures of the patient, and the posture associated with the selected reference impedance value representing a candidate posture;

compare the measured impedance value with the selected reference impedance value, thereby obtaining a comparison result; and

dependent on said comparison result, determine whether the current posture of the patient conforms to the candidate posture.