Collecting posture information to evaluate therapy

• US 8,447,401 B2
• Filed: 08/13/2010
• Issued: 05/21/2013
• 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:
  US12/856,255
• Publication Number:
  US 20100305665A1
• Time in Patent Office: 1,012 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 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 movement of the patient; and

a processor that;

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

identifies a plurality of movement events 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 movement events in the plurality of movement events that occur during the delivery of the therapy to the patient according that individual therapy parameter set with that individual therapy parameter set, and,

for each therapy parameter set in the plurality of therapy parameter sets, determines a value of a metric based on the movement events associated with that individual therapy parameter set, wherein the value of the metric indicates an efficacy of that individual therapy parameter set.

2. The medical system of claim 1, wherein at least one of the plurality of movement events comprises a movement indicative of at least one of tremor, Parkinson'"'"'s disease, or an epileptic seizure.

3. The medical system of claim 1, wherein the signal comprises a signal generated by the sensor as a function of movement of one or more extremity of the patient.

4. The medical system of claim 1, wherein the medical device delivers at least one of a movement disorder therapy, psychological disorder therapy, or deep brain stimulation.

5. The medical system of claim 1, wherein the medical device delivers at least one of a tremor therapy, a Parkinson'"'"'s disease therapy, and an epilepsy therapy.

6. The medical system of claim 1, further comprising a computing device that includes a display, wherein the computing device presents a list of the plurality of therapy parameter sets and metric values associated with the therapy parameter sets via the display.

7. The medical system of claim 6, wherein the computing device orders the list of therapy parameter sets according to the associated metric values.

8. The medical system of claim 7, wherein the processor determines a value of each of a plurality of metrics for each of a plurality of therapy parameter sets based on movement events associated with the therapy parameter sets, and the computing device orders the list according to a user selected one of the metrics.

9. The medical system of claim 1, further comprising a computing device that includes the display, wherein the computing device presents a graphical representation of the identified movement events via the display.

10. The medical system of claim 9, wherein the computing device presents at least one of a trend diagram, a histogram, or a pie chart based on the identified movement events.

13. The medical system of claim 1, wherein the value of the metric represents an activity level of the patient.

14. The medical system of claim 1, wherein the medical device is an implantable medical device.

15. The medical system of claim 1, wherein the medical device includes implantable lead including electrodes, wherein the medical device delivers the therapy to the patient via the electrodes.

16. The medical system of claim 1, wherein the medical device delivers deep brain stimulation.

17. The medical system of claim 1, wherein the medical device delivers spinal cord stimulation therapy.

18. The medical system of claim 1, wherein the medical device delivers pain therapy.

19. The medical system of claim 1, wherein the medical device delivers movement disorder therapy.

11. A medical system comprising:

means for delivering a therapy to a patient according to therapy parameters that change over time according to a plurality of therapy parameter sets;

means for monitoring a signal generated by a sensor as a function of movement of a patient during the delivery of the therapy to the patient;

means for identifying a plurality of movement events based on the signal during the delivery of the therapy to the patient;

means for associating, for each therapy parameter set in the plurality of therapy parameter sets each of the movement events in the plurality of movement events that occur during the delivery of the therapy to the patient according that individual therapy parameter set with that individual therapy parameter set; and

means for determining, for each therapy parameter set in the plurality of therapy parameter sets, a value of a metric based on the movement events associated with that individual therapy parameter set, wherein the value of the metric indicates an efficacy of that individual therapy parameter set.

12. The medical system of claim 11, wherein the value of the metric represents an activity level of the patient.

20. 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 movement of the patient; and

a processor that;

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

identifies a plurality of movement events 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 movement events in the plurality of movement events that occur during the delivery of the therapy to the patient according that individual therapy parameter set with that individual therapy parameter set, and,

for each therapy parameter set in the plurality of therapy parameter sets, determines a value of a metric based on the movement events associated with that individual therapy parameter set, wherein the value of the metric indicates an objective efficacy of that individual therapy parameter set.