Collecting posture information to evaluate therapy

• US 8,792,982 B2
• Filed: 05/20/2013
• Issued: 07/29/2014
• 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:
  US13/898,197
• Publication Number:
  US 20130253380A1
• Time in Patent Office: 435 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 for evaluating therapy comprising:

monitoring, with a processor, a signal generated by a sensor as a function of movement of a patient during the delivery of a therapy to the patient by a medical device that delivers the therapy to the patient according to therapy parameters that change over time according to a plurality of therapy parameter sets;

identifying 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, associating each of the movement events in the plurality of movement events that occur during the delivery of the therapy to the patient according to that particular therapy parameter set with that particular therapy parameter set;

for each therapy parameter set in the plurality of therapy parameter sets, determining a value of a metric based on the movement events associated with that particular therapy parameter set, the value of the metric indicating an efficacy of that particular therapy parameter set; and

storing, for each therapy parameter set in the plurality of therapy parameter sets, the value of the metric based on the movement events associated with that particular therapy parameter set in a computer-readable memory.

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

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

4. The method of claim 1, wherein the therapy comprises at least one of a movement disorder therapy, psychological disorder therapy, or deep brain stimulation.

5. The method of claim 4, wherein the therapy comprises at least one of a tremor therapy, a Parkinson'"'"'s disease therapy, and an epilepsy therapy.

6. The method of claim 1, further comprising presenting a list of the plurality of therapy parameter sets and metric values associated with the therapy parameter sets.

7. The method of claim 6, further comprising ordering the list of therapy parameter sets according to the associated metric values.

8. The method of claim 7, wherein determining a value of a metric comprises determining 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 ordering the list comprises ordering the list according to a user selected one of the metrics.

9. The method of claim 1, further comprising presenting a graphical representation of the identified movement events.

10. The method of claim 9, wherein presenting a graphical representation comprises presenting at least one of a trend diagram, a histogram and a pie chart based on the identified movement events.

11. The method of claim 1, wherein the value of the metric represents an activity level of the patient.

12. The method of claim 1, wherein the medical device is an implantable medical device.

13. The method of claim 1, wherein the medical device includes implantable lead including electrodes, the method further comprising delivering the therapy to the patient via the electrodes.

14. The method of claim 1, wherein the therapy includes deep brain stimulation, the method further comprising delivering the deep brain stimulation with the medical device.

15. The method of claim 1, wherein the therapy includes spinal cord stimulation therapy, the method further comprising delivering the spinal cord stimulation therapy with the medical device.

16. The method of claim 1, wherein the therapy includes pain therapy, the method further comprising delivering the pain therapy with the medical device.

17. The method of claim 1, wherein the therapy includes movement disorder therapy, the method further comprising delivering the movement disorder therapy with the medical device.

23. The method of claim 1, further comprising displaying, for each therapy parameter set in the plurality of therapy parameter sets, the value of the metric based on the movement events associated with that particular therapy parameter on a display.

18. A method for evaluating therapy comprising:

monitoring, with a processor, a signal generated by a sensor as a function of movement of a patient;

identifying a plurality of movement events based on the signal;

associating each of the movement events with a therapy parameter set that was used by a medical device to deliver a therapy to the patient when the movement event was identified;

for each of a plurality of therapy parameter sets, determining a value of a metric based on the movement events associated with the therapy parameter set, the value of the metric indicating an efficacy of the therapy parameter set; and

storing, for each therapy parameter set in the plurality of therapy parameter sets, the value of the metric based on the movement events associated with that particular therapy parameter set in a computer-readable memory.

19. The method of claim 18, wherein identifying a plurality of movement events comprises identifying a movement indicative of at least one of tremor, Parkinson'"'"'s disease, or an epileptic seizure.

22. The method of claim 18, further comprising displaying, for each therapy parameter set in the plurality of therapy parameter sets, the value of the metric based on the movement events associated with that particular therapy parameter on a display.

20. A method for evaluating therapy comprising:

monitoring, with a processor, a signal generated by a sensor as a function of movement of a patient during the delivery of a therapy to the patient by a medical device that delivers the therapy to the patient according to therapy parameters that change over time according to a plurality of therapy parameter sets;

identifying 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, associating each of the movement events in the plurality of movement events that occur during the delivery of the therapy to the patient according to that particular therapy parameter set with that particular therapy parameter set;

for each therapy parameter set in the plurality of therapy parameter sets, determining a value of a metric based on the movement events associated with that particular therapy parameter set, the value of the metric indicating an objective efficacy of that particular therapy parameter set; and

storing, for each therapy parameter set in the plurality of therapy parameter sets, the value of the metric based on the movement events associated with that particular therapy parameter set in a computer-readable memory.

21. The method of claim 20, further comprising displaying, for each therapy parameter set in the plurality of therapy parameter sets, the value of the metric based on the movement events associated with that particular therapy parameter on a display.