Automated calibration of posture state classification for a medical device

• US 9,622,700 B2
• Filed: 10/01/2015
• Issued: 04/18/2017
• Est. Priority Date: 01/08/2010
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Sahasrabudhe, Rajeev M., Davenport, Lynn A., Davis, Jon P., Dewing, Wende L., Fehrmann, Elizabeth A., Goetz, Steven M., Gokaldas, Shyam L., Panken, Eric J.
• Primary Examiner(s): CAREY, MICHAEL JAMES
• Application Number:
  US14/872,390
• Publication Number:
  US 20160095546A1
• Time in Patent Office: 565 Days
• Field of Search: 607 59, 607 62, 607 63
• CPC Class Codes: A61B 2560/0223 of calibration, e.g. protocols for calibrating sensors
• CPC Class Codes: A61B 2560/0475 Special features of memory means, e.g. removable memory cards
• CPC Class Codes: A61B 5/021 Measuring pressure in heart or blood vessels A61B5/0205 takes precedence
• CPC Class Codes: A61B 5/024 Detecting, measuring or recording pulse rate or heart rate A61B5/0205, A61B5/021 take precedence
• CPC Class Codes: A61B 5/1116 Determining posture transitions
• CPC Class Codes: A61B 5/1118 Determining activity level
• CPC Class Codes: A61B 5/14532 for measuring glucose, e.g. by tissue impedance measurement
• CPC Class Codes: A61B 5/369 Electroencephalography [EEG] devices for psychotechnics A61B5/16
• CPC Class Codes: A61B 5/389 Electromyography [EMG]
• CPC Class Codes: A61B 5/4839 combined with drug delivery
• CPC Class Codes: A61B 5/686 Permanently implanted devices, e.g. pacemakers, other stimulators, biochips A61B5/6861 takes precedence
• CPC Class Codes: A61B 5/7264 Classification of physiological signals or data, e.g. using neural networks, statistical classifiers, expert systems or fuzzy systems neural networks per se G06N3/00; expert systems per se G06N5/00
• CPC Class Codes: A61B 5/7282 Event detection, e.g. detecting unique waveforms indicative of a medical condition A61B5/4094, A61B5/4818, A61B5/349, A61B5/0823 take precedence
• CPC Class Codes: A61B 5/742 using visual displays A61B5/339 takes precedence
• CPC Class Codes: A61B 5/7475 User input or interface means, e.g. keyboard, pointing device, joystick
• CPC Class Codes: A61N 1/36071 Pain
• CPC Class Codes: A61N 1/36535 controlled by body position or posture
• CPC Class Codes: A61N 1/37247 User interfaces, e.g. input or presentation means
• CPC Class Codes: G16H 20/30 relating to physical therapies or activities, e.g. physiotherapy, acupressure or exercising
• 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

Techniques relate to operating a medical device by classifying a detected posture state of a patient. This classification may be performed by comparing the detected posture state of the patient to posture state definitions available within the system. Each definition may be described in terms of a parameter (e.g., vector) indicative of a direction in three-dimensional space. The posture state definitions may be calibrated by automatically estimating values for these parameters, thereby eliminating the need for the patient to assume each posture state during the calibration process to capture actual parameter values. According to another aspect, the estimated parameter values may be updated as the patient assumes various postures during a daily routine. For instance, estimated vectors initially used to calibrate the posture state definitions may be changed over time to more closely represent posture states the patient actually assumes, and to further adapt to changes in a patient'"'"'s condition.

Claims

1. A method for controlling a medical device, comprising:

associating, via a processor, a posture state with at least one therapy parameter value;

sensing, via a posture state sensor, a first physiological signal indicative of the posture state of a patient;

sensing, via a second sensor, a second physiological signal indicative of an electrical signal originating from the patient; and

delivering, via a therapy delivery module, therapy to the patient according to the at least one therapy parameter value in response to determining that the patient is in the associated posture state based on the first physiological signal,

wherein associating, via the processor, the posture state with the at least one therapy parameter value is based, at least in part, on the second physiological signal.

2. The method of claim 1, wherein the second physiological signal is an EEG signal.

3. The method of claim 1, wherein the second physiological signal is an EMG signal.

4. The method of claim 1, wherein the second physiological signal triggers associating the posture state and the at least one therapy parameter value.

5. The method of claim 1, wherein the posture state is a lying posture state.

6. The method of claim 1, wherein associating the posture state with the at least one therapy parameter value comprises storing an indication of the posture state that is obtained based on the first physiological signal.

7. The method of claim 6, further comprising updating the association between the posture state and the at least one therapy parameter value based on the second physiological signal.

8. The method of claim 1, wherein associating, via the processor, the posture state with the at least one therapy parameter value comprises associating the posture state with at least one therapy parameter value based on obtaining at least one of the first and the second physiological signal during a programming session.

9. The method of claim 1, further comprising defining the posture state during a programming session based on the first physiological signal.

30. The method of claim 1, wherein delivering, via the therapy module, therapy to the patient comprises:

determining the patient is in the posture state based on the first physiological signal;

responsive to determining the patient is in the posture state, determining the at least one therapy parameter value that was previously associated with the determined posture state; and

delivering, via the therapy module, therapy to the patient according to the at least one therapy parameter value that was previously associated with the determined posture state.

31. The method of claim 30, wherein determining the at least one therapy parameter that was previously associated with the determined posture state comprises retrieving the at least one therapy parameter value from memory after determining the patient is in the posture state.

32. The medical system of claim 30, wherein the one or more processors are further configured to:

determine the patient is in the posture state based on the first physiological signal;

responsive to determining the patient is in the posture state, determine the at least one therapy parameter value that was previously associated with the determined posture state; and

control delivery of therapy to the patient according to the at least one therapy parameter value that was previously associated with the determined posture state.

33. The medical system of claim 32, wherein the one or more processors are further configured to determine the at least one therapy parameter value that was previously associated with the determined posture state by retrieving the at least one therapy parameter value from memory after determining the patient is in the posture state.

10. A medical system, comprising:

a memory configured to store an association between a posture state and at least one therapy parameter value;

a posture state sensor configured to sense a first physiological signal indicative of at least one of an activity and a posture of a patient;

a second sensor configured to sense a second physiological signal indicative of electrical activity sensed from tissue of the patient; and

one or more processors configured to control delivery of therapy to the patient according to the at least one therapy parameter value in response to determining that the patient is in the posture state based on the first physiological signal, and wherein the association between the posture state and the at least one therapy parameter value is formed based, at least in part, on the second physiological signal.

11. The medical system of claim 10, wherein the one or more processors are configured to store the association between the posture state and the at least one therapy parameter value based, at least in part, on the second physiological signal.

12. The medical system of claim 10, further comprising an implantable medical device comprising at least one of the one or more processors.

13. The medical system of claim 10, further comprising a programmer comprising at least one of the one or more processors.

14. The medical system of claim 10, wherein the second sensor is configured to sense neural activity originating from tissue of the patient.

15. The medical system of claim 10, wherein the second sensor is configured to sense electrical activity originating from muscle of the patient.

16. The medical system of claim 10, wherein the memory is configured to store multiple associations, each between a respective posture state and at least one respective therapy parameter value, wherein at least one of the one or more processors is configured to receive the first physiological signal from the posture state sensor and to control therapy delivery to the patient according to the multiple associations based on the first physiological signal.

17. The medical system of claim 16, wherein at least one of the one or more processors is configured to update at least one of the multiple associations based, at least in part, on the second physiological signal.

18. The medical system of claim 17, wherein the at least one of the one or more processors is configured to update at least one of an indication of the posture state or an indication of the respective at least one therapy parameter value for the at least one of the multiple associations.

19. The medical system of claim 17, wherein the at least one of the one or more processors is configured to update at least one of an indication of the posture state or an indication of the respective at least one therapy parameter value for the at least one of the multiple associations based on a time indicated by the second physiological signal.

20. The medical system of claim 16, wherein at least one of the one or more processors is configured to update at least one therapy parameter value for at least one of the associations based on one or more therapy parameter values stored for different ones of the multiple associations.

21. The medical system of claim 10, wherein at least one of the one or more processors is configured to associate the posture state with the at least one therapy parameter value based on at least one of the first and the second physiological signal received from the patient during a programming session.

22. The medical system of claim 21, further comprising a user interface configured to receive input from a user, and wherein the at least one of the one or more processors is configured to associate the posture state with the at least one therapy parameter based upon the input received from the user.

23. A medical device, comprising:

a memory configured to store one or more posture state definitions, each indicating a posture state and at least one therapy parameter value used to control delivery of therapy to a patient when the patient is determined to be in the posture state;

a posture state sensor configured to sense a first physiological signal indicative of a posture state of the patient;

a second sensor configured to sense a second physiological signal, wherein the second physiological signal is an electrical signal originating from tissue of the patient; and

a processor configured to receive the first physiological signal from the posture state sensor, determine the posture state of the patient based on the first physiological signal and the one or more posture state definitions, determine the at least one therapy parameter associated with the determined posture state of the patient in the memory, and control delivery of therapy to the patient according to the at least one therapy parameter determined to be associated with the determined posture state of the patient, wherein at least one of the one or more posture state definitions is stored, based at least in part, on the second physiological signal.

24. The medical device of claim 23, wherein the processor is configured to store an indication of the posture state for the at least one of the one or more posture state definitions based, at least in part, on the second physiological signal.

25. The medical device of claim 23, wherein the second sensor is configured to determine neural electrical activity of the patient.

26. The medical device of claim 23, wherein the second sensor is an EEG sensor.

27. The medical device of claim 23, wherein the second sensor is configured to determined muscular electrical activity of the patient.

28. The medical device of claim 23, wherein the second sensor is an EMG sensor.

29. A medical system, comprising:

memory means for storing one or more posture state definitions, each indicating a posture state and at least one therapy parameter value used to control delivery of therapy to a patient when the patient is determined to be in the posture state;

posture state sensor means for sensing a first physiological signal indicative of a posture state of the patient;

second sensor means for sensing a second physiological signal, wherein the second physiological signal is an electrical signal originating from tissue of the patient; and

processing means for receiving the first physiological signal from the posture state sensing means, for determining the posture state of the patient based on the first physiological signal and the one or more posture state definitions, for determining the at least one therapy parameter associated with the determined posture state of the patient in the memory means, and for controlling delivery of therapy to the patient according to the at least one therapy parameter determined to be associated with the determined posture state of the patient, wherein at least one of the one or more posture state definitions is stored, based at least in part, on the second physiological signal.