Collecting posture information to evaluate therapy

• US 8,396,554 B2
• Filed: 01/31/2012
• Issued: 03/12/2013
• Est. Priority Date: 03/16/2004
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Miesel, Keith A., Heruth, Kenneth T.
• Primary Examiner(s): Holmes, Rex R
• Application Number:
  US13/362,785
• Publication Number:
  US 20120130286A1
• Time in Patent Office: 406 Days
• Field of Search: 607 17- 19, 607/45, 607/49
• US Class Current: 607/19
• 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 5/4082 Diagnosing or monitoring movement diseases, e.g. Parkinson, Huntington or Tourette
• CPC Class Codes: A61B 5/4848 Monitoring or testing the effects of treatment, e.g. of medication
• CPC Class Codes: A61B 5/6825 Hand
• CPC Class Codes: A61B 5/686 Permanently implanted devices, e.g. pacemakers, other stimulators, biochips A61B5/6861 takes precedence
• CPC Class Codes: A61M 5/14276 specially adapted for implantation
• CPC Class Codes: A61N 1/0531 Brain cortex electrodes
• CPC Class Codes: A61N 1/0534 Electrodes for deep brain stimulation
• CPC Class Codes: A61N 1/36071 Pain
• CPC Class Codes: A61N 1/36082 Cognitive or psychiatric applications, e.g. dementia or Alzheimer's disease
• CPC Class Codes: A61N 1/36514 controlled by a physiological quantity other than heart potential, e.g. blood pressure controlled by two or more physical parameters A61N1/36585
• CPC Class Codes: A61N 1/36521 the parameter being derived from measurement of an electrical impedance
• 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 1/36557 controlled by chemical substances in blood
• CPC Class Codes: A61N 1/37235 Aspects of the external programmer

Abstract

A medical device delivers a therapy to a patient. Posture events are identified, e.g., a posture of the patient is periodically determined and/or posture transitions by the patient are identified, and each determined posture event is associated with a current therapy parameter set. A value of at least one posture metric is determined for each of a plurality of therapy parameter sets based on the posture events associated with that therapy parameter set. A list of the therapy parameter sets is presented to a user, such as a clinician, for evaluation of the relative efficacy of the therapy parameter sets. The list may be ordered according to the one or more posture metric values to aid in evaluation of the therapy parameter sets. Where values are determined for a plurality of posture metrics, the list may be ordered according to the one of the posture metrics selected by the user.

Claims

1. A method comprising:

monitoring at least one signal generated by a sensor as a function of at least one of activity or posture of a patient during delivery of a therapy to a patient from a medical device according to therapy parameters that change over time according to a plurality of therapy parameter sets;

periodically identifying a posture of the patient based on the at least one signal;

for each therapy parameter set in the plurality of therapy parameter sets, associating each of the identified postures that occurred during the delivery of the therapy to the patient according to that individual therapy parameter set with that individual therapy parameter set; and

for each therapy parameter set in the plurality of therapy parameter sets, displaying for a user the postures identified during the delivery of the therapy to the patient according to that individual therapy parameter set in a manner that is indicative of efficacy of that individual therapy parameter set.

2. The method of claim 1, wherein displaying the therapy parameter sets comprises presenting a list of the therapy parameter sets and identified postures associated with the therapy parameter sets.

3. The method of claim 2, further comprising ordering the list of therapy parameter sets based on the identified postures to illustrate relative efficacy of the therapy parameter sets.

4. The method of claim 1, wherein displaying the therapy parameter sets associated with the postures identified during their use comprises presenting, for one or more of the therapy parameter sets, a graphical representation of the postures identified during their use.

5. The method of claim 4, wherein presenting a graphical representation comprises presenting at least one of a trend diagram, a histogram or a pie chart illustrating the postures identified during use of the one or more therapy parameter sets.

6. The method of claim 1, wherein displaying the therapy parameter sets associated with the postures identified during their use comprises illustrating, for one or more of the therapy parameter sets, percentages of time that the patient assumed certain postures during use of the therapy parameter set.

7. The method of claim 1, wherein displaying the therapy parameter sets associated with the postures identified during their use comprises illustrating, for one or more of the therapy parameter sets, durations of time that the patient assumed certain postures during use of the therapy parameter set.

8. The method of claim 1, further comprising determining, for the therapy parameter sets, numbers of posture transitions that occurred during use of the therapy parameter sets based on the postures identified during use of the therapy parameter sets, wherein displaying for the user the postures identified during the delivery of the therapy to the patient according to that individual therapy parameter set in a manner that is indicative of efficacy of that individual therapy parameter set comprises displaying that individual therapy parameter set associated with the numbers of posture transitions.

9. The method of claim 1, wherein the therapy comprises electrical stimulation.

10. The method of claim 1, wherein the therapy comprises at least one of spinal cord stimulation, a movement disorder therapy, a psychological disorder therapy, deep brain stimulation, a tremor therapy, a Parkinson'"'"'s disease therapy, or an epilepsy therapy.

11. A medical system comprising:

a medical device that delivers a therapy to a patient according to therapy parameters that change over time according to a plurality of therapy parameter sets;

a sensor that generates at least one signal as a function of at least one of activity or posture of the patient;

a processor that;

monitors the at least one signal during the delivery of the therapy to the patient,

periodically identifies a posture of the patient based on the at least one signal, and

for each therapy parameter set in the plurality of therapy parameter sets, associates each of the identified postures that occurred during the delivery of the therapy to the patient according to that individual therapy parameter set with that individual therapy parameter set; and

an electronic device that displays for a user, for each therapy parameter set in the plurality of therapy parameter sets, the postures identified during the delivery of the therapy to the patient according to that individual therapy parameter set in a manner that is indicative of efficacy of that individual therapy parameter set.

12. The medical system of claim 11, wherein the electronic device presents a list of the therapy parameter sets and identified postures associated with the therapy parameter sets.

13. The medical system of claim 12, wherein the electronic device orders the list of therapy parameter sets based on the identified postures to illustrate relative efficacy of the therapy parameter sets.

14. The medical system of claim 11, wherein the electronic device presents, for one or more of the therapy parameter sets, a graphical representation of the postures identified during their use.

15. The medical system of claim 14, wherein the electronic device presents at least one of a trend diagram, a histogram or a pie chart illustrating the postures identified during use of the therapy parameter set.

16. The medical system of claim 11, wherein the electronic device presents, for one or more of the therapy parameter sets, percentages of time that the patient assumed certain postures during use of the therapy parameter set.

17. The medical system of claim 11, wherein the electronic device presents, for one or more of the therapy parameter sets, durations of time that the patient assumed certain postures during use of the therapy parameter set.

18. The medical system of claim 11,

wherein the processor determines, for the therapy parameter sets, numbers of posture transitions that occurred during use of the therapy parameter sets based on the postures identified during use of the therapy parameter sets,

wherein the electronic device displays the therapy parameter sets associated with the numbers of posture transitions.

19. The medical system of claim 11, wherein the medical device delivers electrical stimulation therapy.

20. The medical system of claim 11, wherein the medical device delivers at least one of spinal cord stimulation, a movement disorder therapy, a psychological disorder therapy, deep brain stimulation, a tremor therapy, a Parkinson'"'"'s disease therapy, or an epilepsy therapy.

21. The medical system of claim 11, wherein the medical device comprises an implantable medical device.

22. The medical system of claim 11, wherein the processor comprises a processor of the medical device.

23. The medical system of claim 11, wherein the processor comprises a processor of the electronic device.

24. The medical system of claim 23, wherein the electronic device comprises a programming device configured to program the medical device.

25. A medical system comprising:

means for monitoring at least one signal generated by a sensor as a function of at least one of activity or posture of a patient during delivery of a therapy to a patient from a medical device according to therapy parameters that change over time according to a plurality of therapy parameter sets;

means for periodically identifying a posture of the patient based on the at least one signal;

means for associating each of the identified postures with the therapy parameter set of the plurality of therapy parameter sets that was used by the medical device to deliver the therapy to the patient when the posture was identified; and

means for displaying for a user the postures associated with each of the therapy parameter sets in a manner that is indicative of efficacy of each of the therapy parameter sets.

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

monitor at least one signal generated by a sensor as a function of at least one of activity or posture of a patient during delivery of a therapy to a patient from a medical device according to therapy parameters that change over time according to a plurality of therapy parameter sets;

periodically identify a posture of the patient based on the at least one signal;

associate each of the identified postures with the therapy parameter set of the plurality of therapy parameter sets that was used by the medical device to deliver the therapy to the patient when the posture was identified; and

cause display of the postures associated with each of the therapy parameter sets in a manner that is indicative of efficacy of each of the therapy parameter sets.

27. A medical system comprising:

a medical device that delivers a therapy to a patient according to therapy parameters that change over time according to a plurality of therapy parameter sets;

a sensor that generates a signal as a function of at least one of activity or posture of the patient;

a processor that;

monitors the signal generated by the sensor during the delivery of the therapy to the patient,

periodically identifies a posture of the patient based on the signal during the delivery of the therapy to the patient,

for each therapy parameter set in the plurality of therapy parameter sets, associates each of the identified postures that occurred during the delivery of the therapy to the patient according to that individual therapy parameter set with that individual therapy parameter set; and

a computing device that displays for a user, for each therapy parameter set in the plurality of therapy parameter sets, the postures identified during the delivery of the therapy to the patient according to that individual therapy parameter set in a manner that is indicative of efficacy of that individual therapy parameter set.