Collecting posture and activity information to evaluate therapy

• US 8,688,221 B2
• Filed: 02/21/2012
• Issued: 04/01/2014
• Est. Priority Date: 04/14/2004
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Miesel, Keith A., Heruth, Kenneth T., Molnar, Gregory F.
• Primary Examiner(s): Schaetzle, Kennedy
• Application Number:
  US13/401,348
• Publication Number:
  US 20120150258A1
• Time in Patent Office: 770 Days
• Field of Search: None
• US Class Current: 607/45
• CPC Class Codes: A61B 5/0205 Simultaneously evaluating both cardiovascular conditions and different types of body conditions, e.g. heart and respiratory condition
• 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 5/4094 Diagnosing or monitoring seizure diseases, e.g. epilepsy
• CPC Class Codes: A61B 5/6804 Garments; Clothes
• 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: A61N 1/0529 Electrodes for brain stimulation
• 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 1/36585 controlled by two or more physical parameters
• CPC Class Codes: A61N 1/37235 Aspects of the external programmer

Abstract

A medical device, programmer, or other computing device may determine values of one or more activity and, in some embodiments, posture metrics for each therapy parameter set used by the medical device to deliver therapy. The metric values for a parameter set are determined based on signals generated by the sensors when that therapy parameter set was in use. Activity metric values may be associated with a postural category in addition to a therapy parameter set, and may indicate the duration and intensity of activity within one or more postural categories resulting from delivery of therapy according to a therapy parameter set. A posture metric for a therapy parameter set may indicate the fraction of time spent by the patient in various postures when the medical device used a therapy parameter set. The metric values may be used to evaluate the efficacy of the therapy parameter sets.

Claims

1. A method for evaluating a neurostimulation therapy delivered to a patient by an implantable medical device system, the method comprising:

monitoring a plurality of signals, each of the signals generated by at least one sensor of the implantable medical device system as a function of at least one of activity or posture of the patient;

determining whether the patient is in a target posture based on at least one of the signals;

periodically determining an activity level of the patient based on at least one of the signals when the patient is in the target posture;

periodically determining values of at least one activity metric based on the activity levels determined when the patient was in the target posture; and

displaying for a user the determined activity metric values in a manner that is indicative of efficacy of the neurostimulation therapy delivered to the patient.

2. The method of claim 1, wherein the target posture is upright.

3. The method of claim 1, wherein the target posture is standing.

4. The method of claim 1, wherein the target posture is lying down.

5. The method of claim 1, wherein displaying for the user the determined activity metric values comprises displaying a trend diagram of activity over time based on the activity metric values determined over time.

6. The method of claim 1, wherein displaying for the user the determined activity metric values comprises displaying a graphical representation of percentages of time that the activity metric values were within each of a plurality of ranges.

7. The method of claim 1, wherein displaying for the user the determined activity metric values in a manner that is indicative of efficacy of the neurostimulation therapy delivered to the patient comprises displaying for the user the determined activity metric values in a manner that is indicative of an amount of time that the patient was upright and active.

8. The method of claim 1,

further comprising associating each of the determined activity levels with a therapy parameter set, selected from among a plurality of therapy parameter sets, according to which the implantable medical device delivered the neurostimulation therapy to the patient when the activity levels were determined,

wherein displaying for the user the determined activity metric values comprises displaying the determined activity metric values in a manner that is indicative of the relative efficacy of the plurality of therapy parameter sets.

9. The method of claim 1, further comprising:

determining an average number of posture transitions over a period of time; and

displaying for the user the determined average number of posture transitions over the period of time in a manner that is indicative of efficacy of the neurostimulation therapy delivered to the patient.

10. The method of claim 1, wherein the neurostimulation 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:

one or more sensors, each of the sensors generating a signal as a function of at least one of activity or posture of a patient;

an implantable medical device that delivers a neurostimulation therapy to a patient; and

a processor that;

determines whether the patient is in a target posture based on at least one of the signals,

periodically determines an activity level of the patient based on at least one of the signals when the patient is in the target posture, and

periodically determines values of at least one activity metric based on the activity levels determined when the patient was in the target posture; and

a computing device that displays for a user the determined activity metric values in a manner that is indicative of efficacy of the neurostimulation therapy delivered to the patient.

12. The medical system of claim 11, wherein the target posture is upright.

13. The medical system of claim 11, wherein the target posture is standing.

14. The medical system of claim 11, wherein the target posture is lying down.

15. The medical system of claim 11, wherein the computing device displays a trend diagram of activity over time based on the activity metric values determined over time.

16. The medical system of claim 11, wherein the computing device displays a graphical representation of percentages of time that the activity metric values were within each of a plurality of ranges.

17. The medical system of claim 11, wherein the computing device displays for the user the determined activity metric values in a manner that is indicative of an amount of time that the patient was upright and active.

18. The medical system of claim 11,

wherein the processor further comprising associates each of the determined activity levels with a therapy parameter set, selected from among a plurality of therapy parameter sets, according to which the implantable medical device delivered the neurostimulation therapy to the patient when the activity levels were determined, and

wherein the computing device displays the determined activity metric values in a manner that is indicative of the relative efficacy of the plurality of therapy parameter sets.

19. The medical system of claim 11,

wherein the processor further determines an average number of posture transitions over a period of time, and

wherein the computing device displays for the user the determined average number of posture transitions over the period of time in a manner that is indicative of efficacy of the neurostimulation therapy delivered to the patient.

20. A medical system comprising:

means for monitoring a plurality of signals, each of the signals generated as a function of at least one of activity or posture of the patient;

means for determining whether the patient is in a target posture based on at least one of the signals;

means for periodically determining an activity level of the patient based on at least one of the signals when the patient is in the target posture;

means for periodically determining values of at least one activity metric based on the activity levels determined when the patient was in the target posture; and

means for presenting the determined activity metric values to a user in a manner that is indicative of efficacy of a neurostimulation therapy delivered to the patient.

21. A non-transitory computer-readable medium comprising instructions that cause a processor to:

monitor a plurality of signals, each of the signals generated by a sensor of the implantable medical device system as a function of at least one of activity or posture of the patient;

determine whether the patient is in a target posture based on at least one of the signals;

periodically determine an activity level of the patient based on at least one of the signals when the patient is in the target posture;

periodically determine values of at least one activity metric based on the activity levels determined when the patient was in the target posture; and

cause display of the determined activity metric values for a user in a manner that is indicative of efficacy of a neurostimulation therapy delivered to the patient.