Associating therapy adjustments with patient posture states

• US 8,315,710 B2
• Filed: 04/30/2009
• Issued: 11/20/2012
• 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.
• Primary Examiner(s): Gedeon, Brian T
• Application Number:
  US12/433,750
• Publication Number:
  US 20100010588A1
• Time in Patent Office: 1,300 Days
• Field of Search: 607/19, 607/45, 607/46, 607/62
• US Class Current: 607/62
• 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

The disclosure provides a method for associating a detected therapy adjustment to a posture state and storing the association with a plurality of associations for the posture state. In a record mode, an implantable medical device is configured to store therapy adjustments for each posture state and allow a user to find efficacious therapy based upon review of the associations made during therapy. The system may determine the associations through implementation of a posture search timer and a posture stability timer. These timers allow the system to correctly associate therapy adjustments to posture states when the patient anticipates the posture change by adjusting therapy before engaging in the desired posture state. An external programmer may present a range of the therapy adjustments for each posture state to allow a user to review the therapy adjustments that have been made during the therapy.

Claims

1. A method comprising:

detecting a plurality of patient adjustments to electrical stimulation therapy delivered to a patient during multiple instances of a sensed posture state;

associating, by at least one processor, the detected patient adjustments with the sensed posture state of the patient; and

storing the associations of the detected patient adjustments with the sensed posture state in a memory, wherein at least two of the associations are maintained in the memory for the sensed posture state.

2. The method of claim 1, the method further comprising:

detecting a plurality of patient adjustments to electrical stimulation therapy delivered to a patient during multiple instances of a plurality of sensed posture states;

associating some of the detected patient adjustments with each of the sensed posture states; and

storing the associations of the detected adjustments with the respective sensed posture states in the memory.

3. The method of claim 2, further comprising defining a range of the detected adjustments for each of the posture states, and presenting the range of adjustments for at least one of the sensed posture states to a user via an output device.

4. The method of claim 2, further comprising presenting maximum and minimum values of the detected adjustments for each of the sensed posture states via an output device, wherein the detected adjustments include stimulation amplitudes.

5. The method of claim 2, further comprising:

quantifying a number of the detected adjustments associated with each of the sensed posture states; and

presenting the quantified number of the detected adjustments associated with each of the sensed posture states to a user via an output device.

6. The method of claim 2, wherein the memory is located within at least one of an implantable medical device that delivers the electrical stimulation to the patient or an external programmer that receives the detected adjustments and controls the implantable medical device.

7. The method of claim 2, further comprising sensing the posture states via an implantable medical device that delivers the electrical stimulation, wherein detecting adjustments includes detecting the adjustments via an external programmer for the implantable medical device, and wherein associating includes associating the detected adjustments with the sensed posture states of the patient via one of the implantable medical device or the external programmer.

8. The method of claim 2, wherein associating each of the detected adjustments with one of the sensed posture states comprises associating each of the detected adjustments with the sensed posture state if the sensed posture state is sensed within a first period following the detection of the adjustment and if the sensed posture state does not change during a second period following the sensing of the sensed posture state.

9. The method of claim 8, further comprising:

starting a posture search timer to time the first period in response to the detection of each of the adjustments; and

starting a posture stability timer to time the second period in response to the sensing of each of the posture states.

10. The method of claim 2, wherein the patient adjustments include adjustments to electrical stimulation therapy parameters associated with multiple programs delivered to the patient as a group of programs, and wherein associating further comprises associating the detected patient adjustments with one of the sensed posture states and one of the programs.

11. The method of claim 2, further comprising delivering the electrical stimulation via an implantable medical device, and receiving the adjustments from the patient via an external programmer that controls the implantable medical device.

12. A system comprising:

an input device that receives a plurality of patient adjustments to electrical stimulation therapy delivered to a patient during multiple instances of a sensed posture state;

a processor that associates the received patient adjustments with the sensed posture state of the patient; and

a memory that stores the associations of the received patient adjustments with the sensed posture state, wherein at least two of the associations are maintained in the memory for the sensed posture state.

13. The system of claim 12, wherein:

the input device receives a plurality of patient adjustments to electrical stimulation therapy delivered to a patient during multiple instances of a plurality of sensed posture states,

the processor associates some of the received patient adjustments with each of the sensed posture states, and

the memory stores the associations of the received patient adjustments with the respective sensed posture states in the memory.

14. The system of claim 12, wherein the processor defines a range of the received adjustments for each of the posture states, the system further comprising an output device that presents the range of adjustments for at least one of the sensed posture states to a user.

15. The system of claim 12, wherein the output device presents maximum and minimum values of the received adjustments for each of the sensed posture states, and wherein the received adjustments include stimulation amplitudes.

16. The system of claim 12, wherein the processor quantifies a number of the received adjustments associated with each of the sensed posture states, and the output device presents the quantified number of the received adjustments associated with each of the sensed posture states to a user via a user interface.

17. The system of claim 12, further comprising an implantable medical device that delivers the electrical stimulation to the patient and an external programmer including the output device, and wherein the memory is located within at least one of the implantable medical device and the external programmer.

18. The system of claim 12, further comprising an implantable medical device that is configured to deliver the electrical stimulation to the patient and an external programmer including the user interface, wherein the implantable medical device senses the posture state and the external programmer receives the adjustments, and the processor that associates the received adjustments with the sense posture state is located in one of the implantable memory device or the external programmer.

19. The system of claim 12, wherein the processor associates each of the adjustments with the sensed posture state if the sensed posture state is sensed within a first period following the receiving of the adjustment and if the sensed posture state does not change during a second period following the sensing of the sensed posture state.

20. The system of claim 19, wherein the processor starts a posture search timer to time the first period in response to the receiving of the adjustment, and starts a posture stability timer to time the second period in response to the sensing of the posture state.

21. The system of claim 12, wherein the patient adjustments includes adjustments to electrical stimulation therapy parameters associated with multiple programs delivered to the patient as a group of programs, and wherein the processor associates the received patient adjustments with one of the sensed posture states and one of the programs.

22. The system of claim 12, further comprising an implantable medical device that delivers the electrical stimulation, and an external programmer that transmits the adjustments to the implantable medical device.

23. A system comprising:

means for detecting a plurality of patient adjustments to electrical stimulation therapy delivered to a patient during multiple instances of a sensed posture state;

means for associating the detected patient adjustments with the sensed posture state of the patient; and

means for storing the associations of the detected patient adjustments with the sensed posture state, wherein at least two of the associations are maintained in the means for storing the associations for the sensed posture state.

24. The system of claim 23, further comprising:

means for detecting a plurality of patient adjustments to electrical stimulation therapy delivered to a patient during multiple instances of a plurality of sensed posture states;

means for associating some of the detected patient adjustments with each of the sensed posture states;

means for storing the associations of the detected adjustments with the respective sensed posture states, wherein at least two of the associations are maintained in the means for storing the associations for at least one of the respective sensed posture states.

25. The system of claim 24, further comprising means for defining a range of the detected adjustments for each of the posture states based upon the detected adjustments associated with the respective sensed posture states, and means for presenting the range of adjustments for at least one of the sensed posture states to a user.

26. The system of claim 24, further comprising means for presenting maximum and minimum values of the detected adjustments for each of the sensed posture states, wherein the detected adjustments include stimulation amplitudes.

27. The system of claim 24, further comprising:

means for quantifying a number of the detected adjustments associated with each of the sensed posture states; and

means for presenting the quantified number of the detected adjustments associated with each of the sensed posture states to a user.

28. The system of claim 24, wherein the means for associating each the detected adjustments with one of the sensed posture states comprises means for associating each of the detected adjustments with the sensed posture state if the sensed posture state is sensed within a first period following the detection of the adjustment and if the sensed posture state does not change during a second period following the sensing of the sensed posture state.

29. The system of claim 28, further comprising:

means for starting a posture search timer to time the first period in response to the detection of the adjustment; and

means for starting a posture stability timer to time the second period in response to the sensing of the posture state.

30. An external programmer for an implantable medical device, the programmer comprising:

an input device that receives a plurality of patient adjustments to electrical stimulation therapy delivered to the patient by the implantable medical device during multiple instances of a sensed posture state;

a telemetry interface that receives a sensed posture state from the implantable medical device and transmits the received patient adjustments to the implantable medical device;

a processor that associates the received patient adjustments with the sensed posture state of the patient; and

a memory that stores the associations of the received adjustments with the sensed posture state, wherein at least two of the associations are maintained in the memory for the sensed posture state.

31. An implantable medical device comprising:

a stimulation generator that delivers electrical stimulation therapy to a patient;

a posture sensing module that senses a posture state of the patient;

a telemetry interface that receives patient adjustments to the electrical stimulation therapy from an external programmer during multiple instances of a plurality of sensed postured states;

a processor that associates the received adjustments with a sensed posture state of the patient; and

a memory that stores the associations of the received adjustments with the sensed posture state, wherein at least two of the associations are maintained in the memory for the sensed posture state.