Patient-defined posture states for posture responsive therapy

• US 9,592,387 B2
• Filed: 04/30/2009
• Issued: 03/14/2017
• 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., Sahasrabudhe, Rajeev
• Primary Examiner(s): Patel, Niketa
• Assistant Examiner(s): Hankins, Lindsey G
• Application Number:
  US12/433,840
• Publication Number:
  US 20100010573A1
• Time in Patent Office: 2,875 Days
• Field of Search: 600/481, 600/529, 600/544, 600/546, 607/17, 607/30, 607/62
• US Class Current: 1/1
• 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 memory that stores a set of pre-established posture state definitions for delivery of posture state-responsive therapy to a patient, an external programmer comprising a user interface that receives a request from a user to update the set of pre-established posture state definitions, and a processor that updates the set of pre-established posture state definitions in response to the request.

Claims

1. A method comprising:

storing a set of pre-established posture state definitions for delivery of posture state-responsive neurostimulation therapy to a patient, wherein the set of pre-established posture state definitions define one or more existing posture states;

receiving a posture state definition update request, from the patient via an external programmer, to update the set of pre-established posture state definitions to include a new posture state in addition to the one or more existing posture states, wherein receiving the posture state definition update request comprises receiving, from the patient via the external programmer when the patient assumes a position, an indication of the position as a boundary of the new posture state; and

updating, by at least one processor, the set of pre-established posture state definitions to include the new posture state in response to receiving the posture state definition update request.

2. The method of claim 1, wherein updating the set of pre-established posture state definitions comprises defining, in response to the request for the new posture state.

3. The method of claim 2, further comprising receiving, from the patient, a graphical representation of a location of the new posture state within a posture state space.

4. The method of claim 1, wherein the position is a first position and the boundary is a first boundary, and wherein receiving the posture update definition request further comprises receiving, from the patient via the external programmer when the patient assumes a second position, an indication of the second position as a second boundary of the new posture state within a posture state space, wherein the first boundary and the second boundary at least partially define the new posture state within the posture state space.

5. The method of claim 1, wherein one or more boundaries of the new posture state within a posture state space are at least one of predefined or defined by an algorithm.

6. The method of claim 1, further comprising associating one or more therapy parameter values with the new posture state, wherein the one or more therapy parameter values were used to deliver the posture responsive therapy to the patient when the new posture state was defined.

7. The method of claim 1, further comprising:

associating a set of therapy parameter values with the new posture state;

subsequently detecting the new posture state; and

delivering the posture responsive therapy to the patient according to the set of therapy parameter values associated with the new posture state in response to the detection.

8. The method of claim 1, further comprising receiving a request to modify a definition of at least one existing posture state of the one or more existing posture states, the set of pre-established posture state definitions comprising the definition of the at least one existing posture state, and wherein updating the set of posture state definitions comprises modifying the definition of the at least one existing posture state in response to the request to modify the at least one existing posture state.

9. The method of claim 8, wherein modifying the definition of the at least one existing posture state comprises at least one of modifying a location or a boundary of the at least one existing posture state within a posture state space.

10. The method of claim 1, wherein the external programmer comprises a patient programmer configured to be primarily used by the patient, wherein the patient programmer is different from a clinician programmer configured to be primarily used by a clinician.

11. An external programmer comprising:

a user interface configured to receive a posture state definition update request from a patient to update a set of pre-established posture state definitions to include a new posture state for delivery of posture responsive neurostimulation therapy to the patient, wherein;

the set of pre-established posture state definitions define one or more existing posture states,

the new posture state is in addition to the one or more existing posture states, and

the user interface is configured to receive, from the patient when the patient assumes a position, an indication of the position as a boundary of the new posture state; and

a processor configured to update the set of pre-established posture state definitions to include the new posture state in response to receiving the posture state definition update request.

12. The external programmer of claim 11, wherein the processor is configured to define, in response to the request for the new posture state, the new posture state.

13. The external programmer of claim 12, wherein the user interface is configured to receive, from the patient, a graphical representation of a location of the new posture state within a posture state space.

14. The external programmer of claim 11, wherein the position is a first position and the boundary is a first boundary, and wherein the user interface is configured to receive, from the patient when the patient assumes a second position, an indication of the second position as a second boundary of the new posture state within a posture state space, wherein the first boundary and the second boundary at least partially define the new posture state within the posture state space.

15. The external programmer of claim 11, wherein one or more boundaries of the new posture state within a posture state space are at least one of predefined or defined by an algorithm.

16. The external programmer of claim 11, wherein the processor is configured to associate one or more therapy parameter values with the new posture state, and

wherein the one or more therapy parameter values were used to deliver the posture responsive therapy to the patient when the new posture state was defined.

17. The external programmer of claim 11, wherein the user interface is configured to receive a request to modify a definition of at least one existing posture state of the one or more existing posture states, the set of pre-established posture state definitions comprising the definition of the at least one existing posture state, and wherein the processor is configured to modify the definition of the at least one existing posture state in response to the request to modify the at least one existing posture state.

18. The external programmer of claim 17, wherein the processor is configured to modify at least one of a location or a boundary of the at least one existing posture state within a posture state space.

19. A system comprising:

a memory configured to store a set of pre-established posture state definitions for delivery of posture state-responsive neurostimulation therapy to a patient, wherein the set of pre-established posture state definitions define one or more existing posture states;

an external programmer comprising a user interface configured to receive a posture state definition update request from the patient to update the set of pre-established posture state definitions to include a new posture state in addition to the one or more existing posture states, wherein the user interface is configured to receive, from the patient when the patient assumes a position, an indication of the position as a boundary of the new posture state; and

a processor configured to update the set of pre-established posture state definitions to include the new posture state in response to receiving the posture state definition update request.

20. The system of claim 19, wherein the processor is configured to define, in response to receiving the posture state definition update request, the new posture state.

21. The system of claim 20, wherein the user interface is configured to receive, from the patient, a graphical representation of a location of the new posture state within a posture state space.

22. The system of claim 19, wherein the position is a first position and the boundary is a first boundary, and wherein the user interface is configured to receive, from the patient when the patient assumes a second position, an indication of the second position as a second boundary of the new posture state within a posture state space, wherein the first boundary and the second boundary at least partially define the new posture state within the posture state space.

23. The system of claim 19, wherein one or more boundaries of the new posture state within a posture state space is at least one of predefined or defined by an algorithm.

24. The system of claim 19, further comprising a medical device configured to deliver the posture-responsive neurostimulation therapy to the patient according to a set of therapy parameter values, wherein the processor is configured to associate one or more therapy parameter values with the new posture state, and wherein the one or more therapy parameter values were used to deliver neurostimulation therapy to the patient when the new posture state was defined.

25. The system of claim 19, wherein the processor is configured to:

associate a set of therapy parameter values with the new posture state;

subsequently detect the new posture state; and

deliver the posture state-responsive neurostimulation therapy to the patient according to the set of therapy parameter values associated with the new posture state in response to the detection.

26. The system of claim 19, wherein the user interface is configured to receive a request to modify a definition of at least one existing posture state of the one or more existing posture states, the set of pre-established posture state definitions comprising the definition of the at least one existing posture state, and wherein the processor is configured to modify the definition of the at least one existing posture state in response to receiving the posture state definition update request.

27. The system of claim 26, wherein the processor is configured to modify at least one of a location or a boundary of the at least one existing posture state within a posture state space.

28. The system of claim 19, wherein the external programmer comprises the processor.

29. The system of claim 19, further comprising a medical device configured to deliver posture-responsive neurostimulation therapy to the patient, wherein the medical device comprises the processor.

30. A system comprising:

means for storing a set of pre-established posture state definitions for delivery of posture responsive neurostimulation therapy to a patient, wherein the set of pre-established posture state definitions define one or more existing posture states;

means for receiving a posture state definition update request from the patient to update the set of pre-established posture state definitions to include a new posture state in addition to the one or more existing posture states, wherein the means for receiving the posture state definition update request comprises means for receiving, from the patient when the patient assumes a position, an indication of the position as a boundary of the new posture state; and

means for updating the set of pre-established posture state definitions to include the new posture state in response to receiving the posture state definition update request.

31. A non-transitory computer-readable medium comprising instructions that cause a programmable processor to:

store a set of pre-established posture state definitions for delivery of posture responsive neurostimulation therapy to a patient, wherein the set of pre-established posture state definitions define one or more existing posture states;

receive a posture state definition update request from the patient to update the set of pre-established posture state definitions for delivery of posture responsive neurostimulation therapy to the patient to include a new posture state in addition to the one or more existing posture states, wherein receiving the posture state definition update request comprises receiving, from the patient when the patient assumes a position, an indication of the position as a boundary of the new posture state; and

update the set of pre-established posture state definitions to include the new posture state in response to receiving the posture state definition update request.

32. A method comprising:

receiving a posture state definition update request from a patient via an external programmer, to add a new posture state to a set of posture state definitions for delivery of posture responsive therapy to the patient;

receiving, from the patient and via the external programmer, a graphical representation of a location of the new posture state from the patient; and

defining, by at least one processor, the new posture state based on the location in response to receiving the posture state definition update request.

33. An implantable medical device comprising:

a housing configured to be implantable within a patient;

a memory that stores a set of pre-established posture state definitions for delivery of posture state-responsive neurostimulation therapy to the patient, wherein the set of pre-established posture state definitions define one or more existing posture states; and

a processor within the housing and configured to;

receive a signal from an external programmer, the signal being representative of a posture state definition update request from the patient to update the set of pre-established posture state definitions to include a new posture state in addition to the one or more existing posture states, wherein the signal is also representative of receiving, from the patient via the external programmer when the patient assumes a position, an indication of the position as a boundary of the new posture state; and

update the set of pre-established posture state definitions to include the new posture state in response to receiving the signal.

34. The implantable medical device of claim 33, wherein the processor, to update the set of pre-established posture state definitions, is configured to define, in response to the signal, the new posture state.

35. The implantable medical device of claim 33, further comprising a stimulation generator, wherein:

the processor is configured to associate a set of therapy parameter values with the new posture state and subsequently detect the new posture state; and

the stimulation generator is configured to deliver neurostimulation therapy to the patient according to the set of therapy parameter values associated with the new posture state in response to the detection.

36. The implantable medical device of claim 33, wherein the signal is representative of a request to modify a definition of at least one existing posture state of the existing posture states, the set of pre-established posture state definitions comprising the definition of the at least one existing posture state, and wherein the processor is configured to modify the definition of the at least one existing posture state in response to the signal.

37. The implantable medical device of claim 36, wherein the processor is configured to modify at least one of a location or a boundary of the at least one existing posture state.