ASSOCIATING THERAPY ADJUSTMENTS WITH PATIENT POSTURE STATES

• US 20100010432A1
• Filed: 04/30/2009
• Published: 01/14/2010
• 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.
• Granted Patent: US 8,150,531 B2
• Time in Patent Office: Days
• US Class Current: 604/66
• 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 5/103 Detecting, measuring or recording devices for testing the shape, pattern, colour, size or movement of the body or parts thereof, for diagnostic purposes A61B5/08 takes precedence; measuring aids for tailors A41H1/00; measuring instruments specially adapted for dentistry A61C19/04
• 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: A61N 1/36071 Pain
• CPC Class Codes: A61N 1/36139 with automatic adjustment
• 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 20/40 relating to mechanical, radiation or invasive therapies, e.g. surgery, laser therapy, dialysis or acupuncture
• CPC Class Codes: G16H 40/63 for local operation

Abstract

A therapy adjustment received from a patient is associated with a sensed patient posture state. Thereafter, a stability indication can be associated with the sensed posture state to indicate that a therapy adjustment specific to the sensed posture state was received and implemented. In addition, therapy parameter values associated with related patient posture states are updated based on the therapy adjustment. In some examples, only the related posture states that are not associated with respective stability indications are updated based on the therapy adjustment. The absence of a stability indication indicates that the patient has not inputted a therapy adjustment specific to the respective related posture state. As a result, the therapy parameter values associated with the related posture states that are not associated with stability indications may float until the patient adjusts the therapy parameter value associated with the respective related posture state.

Claims

1. A method comprising:

receiving user input indicating an adjustment to a first therapy parameter value that defines therapy delivered to a patient by a medical device;

associating the adjustment with a sensed posture state of the patient; and

based on the adjustment, automatically updating a second therapy parameter value associated with at least one patient posture state related to the sensed posture state and not associated with a respective stability indication.

2. The method of claim 1, further comprising associating the sensed patient posture state with a stability indication.

3. The method of claim 1, further comprising:

starting a posture search timer having a search period upon receiving the user input; and

starting a posture stability timer having a stability period, wherein associating the adjustment with the sensed posture state occurs only when the sensed posture state begins within the search period and does not change during the stability period.

4. The method of claim 3, wherein the search period is between about thirty seconds and about thirty minutes and the stability period is between about thirty seconds and about thirty minutes.

5. The method of claim 3, wherein the search period about three minutes and the stability period is about three minutes.

6. The method of claim 1, wherein the adjustment to the first therapy parameter value indicates a net change to the first therapy parameter value, and updating the second therapy parameter value comprises adjusting the second therapy parameter value based on the net change.

7. The method of claim 6, wherein updating the second therapy parameter value comprises adjusting the second therapy parameter value based on the net change comprises updating the second therapy parameter value to maintain a predetermined ratiometric balance between the first and second therapy parameter values.

8. The method of claim 1, wherein updating the second therapy parameter value comprises adjusting the second therapy parameter value to be substantially equal to the first therapy parameter value.

9. The method of claim 1, wherein updating the second therapy parameter value comprises:

determining a lowest, highest or average therapy parameter value of a group of therapy parameter values associated with the related posture states and associated with stability indications in a memory; and

updating the second therapy parameter value based on the lowest, highest or average therapy parameter value.

10. The method of claim 9, wherein the related posture states comprise related lying posture states and determining the lowest, highest or average therapy parameter value of a group of therapy parameter values comprises determining the lowest or average therapy parameter value, and updating the second therapy parameter value based on the lowest, highest or average therapy parameter value comprises updating the second therapy parameter value based on the lowest or average therapy parameter value.

11. The method of claim 9, wherein the related posture states comprise related upright posture states and determining the lowest, highest or average therapy parameter value of a group of therapy parameter values comprises determining the highest or average therapy parameter value, and updating the second therapy parameter value based on the lowest, highest or average therapy parameter value comprises updating the second therapy parameter value based on the highest or average therapy parameter value.

12. The method of claim 1, further comprising storing the adjustment and the sensed posture state in a memory.

13. The method of claim 12, wherein a memory associates the sensed posture state with the at least one posture state related to the sensed posture state.

14. The method of claim 13, wherein the sensed posture state comprises a first lying posture state and the at least one posture state posture state related to the sensed posture state comprises a second lying posture state.

15. The method of claim 13, wherein the sensed posture state comprises one of an upright posture state or an upright and active posture state, and the at least one posture state related to the sensed posture state comprises another upright posture or upright and active posture state.

16. The method of claim 1, further comprising determining the at least one patient posture state related to the sensed posture state by at least determining whether any posture states stored in the memory are associated with similar posture state definitions, similar therapy parameter values or similar patient conditions.

17. The method of claim 1, further comprising receiving input via a user interface of a medical device programmer that indicates the at least one patient posture state that is related to the sensed posture state.

18. A system comprising:

a posture state sensor that generates a signal indicative of a patient posture state;

a user input mechanism that receives user input indicating an adjustment to a first therapy parameter value that defines therapy delivered to a patient; and

a processor that associates the adjustment with a sensed posture state of the patient determined based on the signal from the posture state sensor, and based on the adjustment, updates a second therapy parameter value associated with at least one patient posture state related to the sensed posture state and not associated with a respective stability indication.

19. The system of claim 18, further comprising a memory, wherein the processor stores the adjustment and the sensed posture state in the memory.

20. The system of claim 18, wherein the processor associates the sensed patient posture state with a stability indication.

21. The system of claim 18, wherein the processor starts a posture search timer having a search period upon receiving the user input, and starts a posture stability timer having a stability period, and wherein the processor associates the adjustment with the sensed posture state only when the sensed posture state begins within the search period and does not change during the stability period.

22. The system of claim 21, wherein the search period is between about thirty seconds and about thirty minutes and the stability period is between about thirty seconds and about five minutes.

23. The system of claim 18, wherein the adjustment to the first therapy parameter value indicates a net change to the first therapy parameter value, and the processor updates the second therapy parameter value by at least adjusting the second therapy parameter value by the net change.

24. The system of claim 18, wherein the processor updates the second therapy parameter value by at least adjusting the second therapy parameter value to substantially equal the first therapy parameter value.

25. The system of claim 18, wherein the processor updates the second therapy parameter value by at least determining a lowest, highest or average therapy parameter value of a group of therapy parameter values associated with the related posture states and associated with stability indications in the memory, and updating the second therapy parameter value based on the lowest, highest or average therapy parameter value.

26. The system of claim 25, wherein the related posture states comprise related lying posture states and the processor determines the lowest or average therapy parameter value of the group of therapy parameter values and updates the second therapy parameter value based on the lowest or average therapy parameter value.

27. The system of claim 25, wherein the related posture states comprise related upright posture states and the processor determines the highest or average therapy parameter value of the group of therapy parameter values and updates the second therapy parameter value based on the highest or average therapy parameter value.

28. The system of claim 18, further comprising a memory that associates the sensed posture state with the at least one posture state related to the sensed posture state.

29. The system of claim 28, wherein the sensed posture state comprises a first lying posture state and the at least one posture state posture state related to the sensed posture state comprises a second lying posture state.

30. The system of claim 28, wherein the sensed posture state comprises one of an upright posture state or an upright and active posture state, and the at least one posture state related to the sensed posture state comprises another upright posture or upright and active posture state.

31. The system of claim 28, wherein the memory is located within at least one of an implantable medical device that delivers therapy to the patient or an external programmer that receives the therapy adjustment.

32. The system of claim 28, further comprising a user interface that receives input from a user indicating the at least one posture state related to the sensed posture state.

33. The system of claim 18, wherein the processor automatically determines the at least one patient posture state related to the sensed posture state by at least determining whether any posture states stored in the memory are associated with similar posture state definitions, similar therapy parameter values or similar patient conditions.

34. A computer-readable medium comprising instructions that cause a programmable processor to:

receive user input indicating an adjustment to a first therapy parameter value that defines therapy delivered to a patient;

associate the adjustment with a sensed posture state of the patient;

based on the adjustment, update a second therapy parameter value associated with at least one patient posture state related to the sensed posture state and not associated with a respective stability indication; and

control a medical device to deliver therapy to the patient according to the adjusted first therapy parameter value and the updated second therapy parameter value.

35. The computer-readable medium of claim 34, further comprising instructions that cause the programmable processor to associate the sensed patient posture state with a stability indication in a memory.

36. A system comprising:

means for receiving user input indicating an adjustment to a first therapy parameter value that defines therapy delivered to a patient;

means for associating the adjustment with a sensed posture state of the patient; and

means for updating a second therapy parameter value associated with at least one patient posture state related to the sensed posture state and not associated with a respective stability indication based on the adjustment.

37. The system of claim 36, further comprising means for associating the sensed patient posture state with a stability indication.