Posture state redefinition based on posture data and therapy adjustments

• US 8,437,861 B2
• Filed: 04/30/2009
• Issued: 05/07/2013
• 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): Koharski, Christopher D
• Assistant Examiner(s): EDWARDS, PHILIP CHARLES
• Application Number:
  US12/433,858
• Publication Number:
  US 20100010574A1
• Time in Patent Office: 1,468 Days
• Field of Search: 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 5/1116 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: A61B 5/7435 Displaying user selection data, e.g. icons in a graphical user interface
• CPC Class Codes: A61N 1/36135 using physiological parameters
• 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 1/37247 User interfaces, e.g. input or presentation means
• CPC Class Codes: G16H 10/60 for patient-specific data, e.g. for electronic patient records
• CPC Class Codes: G16H 20/30 relating to physical therapies or activities, e.g. physiotherapy, acupressure or exercising
• CPC Class Codes: G16H 40/63 for local operation
• 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

The disclosure is directed towards posture-responsive therapy. To avoid interruptions in effective therapy, an implantable medical device may include a posture state module that detects the posture state of the patient and automatically adjusts therapy parameter values according to the detected posture state. A system may include a posture state module that records a current posture of a patient, a user interface that receives a therapy adjustment, a processor that associates a posture that the posture state module recorded when the user interface received the therapy adjustment with the therapy adjustment, determines whether the posture falls within a defined posture state, compares the therapy adjustment to therapy information associated with the defined posture state, and updates the set of posture state definitions based on the determination and comparison.

Claims

1. A system comprising:

a posture state module configured to record a current posture of a patient;

a user interface configured to receive a therapy adjustment to a therapy parameter;

a processor configured to associate a posture that the posture state module recorded when the user interface received the therapy adjustment with the therapy adjustment, determine whether the posture falls within a defined posture state, compare the therapy adjustment to therapy parameter information associated with the defined posture state, and update at least one posture state definition based on the determination and the comparison.

2. The system of claim 1, further comprising a memory configured to store the at least one posture state definition and associated therapy information.

3. The system of claim 2, further comprising an external programmer that comprises at least one of the memory, posture state module, user interface, or processor.

4. The system of claim 3, wherein the external programmer comprises at least one of a patient programmer or a clinician programmer.

5. The system of claim 2, further comprising a medical device that comprises at least one of the memory, posture state module, or processor.

6. The system of claim 5, wherein the medical device comprises an implantable medical device.

7. The system of claim 1, wherein the processor is configured to determine that the posture falls within the posture state and determine whether to at least one of merge the posture state with an adjacent posture state and split the posture state into multiple posture states.

8. The system of claim 7, wherein the processor is configured to determine whether a difference between an adjusted therapy parameter value corresponding to the therapy adjustment and an associated therapy parameter value associated with the posture state is less than a threshold difference.

9. The system of claim 8, wherein, if the difference is greater than the threshold difference, the processor is configured to analyze one or more previous therapy adjustments associated with postures that fall within the posture state and split the posture state into two or more new posture states based on the analysis.

10. The system of claim 8, wherein, if the difference is less than the threshold difference, the processor is configured to determine whether a distance between the posture state and an adjacent posture states is below a threshold distance, determine whether a difference between the adjusted therapy parameter value corresponding to the therapy adjustment and an adjacent therapy parameter value associated with the adjacent posture state is less than the threshold difference, and merge the posture state and adjacent postures state based on the determinations.

11. The system of claim 1, wherein the processor is configured to determine that the posture falls outside of the posture state and determine whether to at least one of expand the posture state to include the posture or create a new posture state that includes the posture.

12. The system of claim 1, further comprising an external programmer that comprises the posture state module, the user interface, and the processor.

13. The system of claim 1, further comprising:

telemetry circuitry configured to receive the therapy adjustment; and

an implantable medical device that comprises the posture state module, the processor, and the telemetry circuitry.

14. The system of claim 1, wherein:

the user interface is configured to receive, as the therapy adjustment, an adjustment from a first value of the therapy parameter to a second value of the therapy parameter; and

the processor is configured to compare the second value of the therapy parameter to a third value of the therapy parameter, the therapy parameter information comprising the third value of the therapy parameter.

15. The system of claim 1, wherein the therapy parameter information has been previously associated with the defined posture state.

16. A system comprising:

means for recording a therapy adjustment to a therapy parameter and a posture of a patient corresponding to the therapy adjustment;

means for determining whether the posture falls within a defined posture state;

means for comparing the therapy adjustment to therapy parameter information associated with the defined posture state; and

means for updating at least one posture state definition based on the determination and the comparison.

17. The system of claim 16, wherein the means for updating the at least one posture state definition comprises means for at least one of merging the posture state with an adjacent posture state or splitting the posture state into multiple posture states if the posture falls within the posture state.

18. The system of claim 17, wherein the means for comparing the therapy adjustment to therapy information associated with the defined posture state comprises means for determining whether a difference between an adjusted therapy parameter value corresponding to the therapy adjustment and an associated therapy parameter value associated with the posture state is less than a threshold difference.

19. The system of claim 18, further comprising means for analyzing, if the difference between an adjusted therapy parameter value corresponding to the therapy adjustment and an associated therapy parameter value associated with the posture state is greater than the threshold difference, one or more previous therapy adjustments associated with postures that fall within the posture state and splitting the posture state into two or more new posture states based on the analysis.

20. The system of claim 18, further comprising:

means for determining, if the difference between an adjusted therapy parameter value corresponding to the therapy adjustment and an associated therapy parameter value associated with the posture state is less than the threshold difference, whether a distance between the posture state and an adjacent posture states is below a threshold distance;

means for determining, if the difference between an adjusted therapy parameter value corresponding to the therapy adjustment and an associated therapy parameter value associated with the posture state is less than the threshold difference, whether a difference between the adjusted therapy parameter value corresponding to the therapy adjustment and an adjacent therapy parameter value associated with the adjacent posture state is less than the threshold difference; and

means for merging the posture state and adjacent posture state based on the determinations.

21. The system of claim 16, wherein, if the posture falls outside of the posture state, the means for updating the set of posture state definitions comprises means for at least one of expanding the posture state to include the posture or creating a new posture state that includes the posture.

22. The system of claim 16, further comprising means for associating the therapy adjustment with a posture of the at least one updated posture state definition.

23. The system of claim 16, further comprising an implantable medical device comprising the means for recording the therapy adjustment and the posture of a patient corresponding to the therapy adjustment, the means for determining whether the posture falls within the defined posture state, the means for comparing the therapy adjustment to therapy parameter information associated with the defined posture state, and the means for updating the at least one posture state definition based on the determination and the comparison.

24. The system of claim 23, further comprising an external programmer comprising means for receiving the therapy adjustment from the patient.

25. The system of claim 16, further comprising an external programmer comprising the means for recording the therapy adjustment and the posture of a patient corresponding to the therapy adjustment, the means for determining whether the posture falls within the defined posture state, the means for comparing the therapy adjustment to therapy parameter information associated with the defined posture state, and the means for updating the at least one posture state definition based on the determination and the comparison.

26. A device comprising:

a posture state module configured to record a current posture of a patient; and

a processor configured to receive a therapy adjustment to a therapy parameter, associate a posture that the posture state module recorded when the processor received the therapy adjustment with the therapy adjustment, determine whether the posture falls within a defined posture state, compare the therapy adjustment to therapy parameter information associated with the defined posture state, and update at least one posture state definition based on the determination and the comparison.

27. The device of claim 26, wherein the device is an implantable medical device configured to be implanted within the patient.

28. An external programmer comprising:

a user interface configured to receive a therapy adjustment to a therapy parameter; and

a processor configured to record a current posture of a patient, associate the posture that the processor recorded when the user interface received the therapy adjustment with the therapy adjustment, determine whether the posture falls within a defined posture state, compare the therapy adjustment to therapy parameter information associated with the defined posture state, and update at least one posture state definition based on the determination and the comparison.