Closed-loop therapy adjustment

• US 20070150029A1
• Filed: 12/01/2006
• Published: 06/28/2007
• Est. Priority Date: 12/02/2005
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Bourget, Duane, Miesel, Keith
• Granted Patent: US 7,957,809 B2
• Time in Patent Office: Days
• US Class Current: 607/62
• CPC Class Codes: A61N 1/36021 for treatment of pain
• CPC Class Codes: A61N 1/36071 Pain
• CPC Class Codes: A61N 1/37247 User interfaces, e.g. input or presentation means
• CPC Class Codes: A61N 1/37252 Details of algorithms or data aspects of communication system, e.g. handshaking, transmitting specific data or segmenting data

Abstract

Techniques for detecting a value of a sensed patient parameter, and automatically delivering therapy to a patient according to therapy information previously associated with the detected value, are described. In exemplary embodiments, a medical device receives a therapy adjustment from the patient. In response to the adjustment, the medical device associates a sensed value of a patient parameter with therapy information determined based on the adjustment. Whenever the parameter value is subsequently detected, the medical device delivers therapy according to the associated therapy information. In this manner, the medical device may “learn” to automatically adjust therapy in the manner desired by the patient as the sensed parameter of the patient changes. Exemplary patient parameters that may be sensed for performance of the described techniques include posture, activity, heart rate, electromyography (EMG), an electroencephalogram (EEG), an electrocardiogram (ECG), temperature, respiration rate, and pH.

Claims

1. A method comprising:

receiving a plurality of therapy adjustments from a user over time;

determining therapy information for each of the therapy adjustments based on the therapy adjustment;

automatically associating the therapy information with a value of a sensed parameter of a patient for each of the therapy adjustments in response to the therapy adjustment;

subsequently detecting the values of the sensed parameter; and

for each of the detected values, automatically delivering therapy to the patient according to the therapy information associated with the value in response to the detection.

2. The method of claim 1, wherein the patient assumes each of a plurality of at least one of postures or activities, and receiving a plurality of therapy adjustments comprises receiving one of the plurality of therapy adjustments for each of the postures or activities.

3. The method of claim 2, further comprising directing the patient to assume the plurality of at least one of postures or activities.

4. The method of claim 3, wherein the at least one of postures or activities are predetermined.

5. The method of claim 3, wherein directing the patient to assume the plurality of at least one of postures or activities comprises directing the patient via a programming device.

6. The method of claim 1, further comprising:

detecting a rate of change of the sensed parameter that exceeds a threshold; and

delivering the therapy according to predetermined default therapy information for a predetermined period of time in response to the detection.

7. The method of claim 6, wherein delivering the therapy according to predetermined default therapy information comprises suspending the therapy for the predetermined period of time.

8. The method of claim 1, further comprising maintaining a data structure, wherein associating the therapy information with a value of a sensed parameter of a patient for each of the therapy adjustments comprises storing the associated parameter values and therapy information as respective records within the data structure.

9. The method of claim 1, wherein the sensed parameter comprises at least one of posture or activity.

10. The method of claim 1, wherein therapy comprises stimulation and the therapy information comprises a plurality of stimulation parameters.

11. The method of claim 1, wherein the user is the patient.

12. A system comprising:

a medical device that delivers a therapy to a patient;

a sensor that senses a parameter of the patient;

a user interface; and

a processor that receives a plurality of therapy adjustments over time from a user via the user interface, determines therapy information for each of the therapy adjustments based on the therapy adjustment, automatically associates the therapy information with a value of a sensed parameter of a patient for each of the therapy adjustments in response to the therapy adjustment, subsequently detects the values of the sensed parameter, and, for each of the detected values, automatically controls the medical device to deliver therapy to the patient according to the therapy information associated with the value in response to the detection.

13. The system of claim 12, wherein the patient assumes each of a plurality of at least one of postures or activities, and the processor receives one of the plurality of therapy adjustments via the user interface for each of the postures or activities.

14. The system of claim 13, wherein processor directs the patient to assume the plurality of at least one of postures or activities via the user interface.

15. The system of claim 12, wherein the processor detects a rate of change of the sensed parameter that exceeds a threshold, and controls the medical device to deliver the therapy according to predetermined default therapy information for a predetermined period of time in response to the detection.

16. The system of claim 15, wherein the processor causes the medical device to suspend delivery of therapy for the predetermined period of time based on the predetermined default therapy information.

17. The system of claim 12, further comprising a memory, wherein the processor stores the associated parameter values and therapy information as respective records within a data structure within the memory.

18. The system of claim 12, wherein medical device delivers stimulation, and the therapy information comprises a plurality of stimulation parameters.

19. The system of claim 12, wherein the medical device comprises the processor, and at least one of includes or is coupled to the sensor.

20. The system of claim 12, wherein the medical device is implantable within the patient.

21. The system of claim 12, wherein medical device delivers pain therapy to the patient.

22. The system of claim 12, wherein the medical device delivers spinal cord stimulation therapy to the patient.

23. A system comprising:

means for receiving a plurality of therapy adjustments from a user over time;

means for determining therapy information for each of the therapy adjustments based on the therapy adjustment;

means for automatically associating the therapy information with a value of a sensed parameter of a patient for each of the therapy adjustments in response to the therapy adjustment;

means for subsequently detecting the values of the sensed parameter; and

means for automatically delivering therapy to the patient according to the therapy information associated with the value in response to each of the detected values.

24. The system of claim 23, wherein the patient assumes each of a plurality of at least one of postures or activities, and the means for receiving a plurality of therapy adjustments comprises means for receiving one of the plurality of therapy adjustments for each of the postures or activities.

25. The system of claim 23, further comprising:

means for detecting a rate of change of the sensed parameter that exceeds a threshold; and

means for delivering the therapy according to predetermined default therapy information for a predetermined period of time in response to the detection.