Medical device therapy based on posture and timing

• US 9,327,070 B2
• Filed: 04/30/2009
• Issued: 05/03/2016
• Est. Priority Date: 04/30/2009
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Skelton, Dennis M., Davis, Jon P., Denison, Timothy J.
• Primary Examiner(s): Mehta, Bhisma
• Assistant Examiner(s): Thomas, Jr., Bradley G
• Application Number:
  US12/433,501
• Publication Number:
  US 20100280500A1
• Time in Patent Office: 2,560 Days
• Field of Search: 604/891.1, 604/890.1, 604/19, 607/17, 607/62, 607/46, 128/898
• US Class Current: 1/1
• CPC Class Codes: A61B 2562/0219 Inertial sensors, e.g. accelerometers, gyroscopes, tilt switches
• CPC Class Codes: A61B 5/11 Measuring movement of the entire body or parts thereof, e.g. head or hand tremor, mobility of a limb for measuring pulse A61B5/02 ;A61B5/1038 takes precedence; motion detection to correct for motion artifacts in physiological signals A61B5/721
• CPC Class Codes: A61B 5/1116 Determining posture transitions
• CPC Class Codes: A61B 5/7475 User input or interface means, e.g. keyboard, pointing device, joystick
• CPC Class Codes: A61M 2005/14208 with a programmable infusion control system, characterised by the infusion program
• CPC Class Codes: A61M 2210/0693 Brain, cerebrum
• CPC Class Codes: A61M 2210/1053 Stomach
• CPC Class Codes: A61M 2210/1078 Urinary tract
• CPC Class Codes: A61M 2230/62 Posture
• CPC Class Codes: A61M 5/14276 specially adapted for implantation
• CPC Class Codes: A61N 1/36071 Pain
• CPC Class Codes: A61N 1/36139 with automatic adjustment
• CPC Class Codes: A61N 1/37247 User interfaces, e.g. input or presentation means

Abstract

This disclosure describes techniques implemented by a medical device, such as an implantable medical device (IMD). The IMD may be configured to detect a posture state of a patient, and deliver posture-responsive therapy. In particular, the IMD not only detects the posture state of a patient, but also detects timing associated with the detected posture state, such as the time of day, the day of the week, or a specific time of day associated with a specific day. In this way, the posture-responsive therapy delivered by the IMD may be dependent not only on the posture state of the patient, but also on the timing associated with the posture state. The same posture state, therefore, may result in different types of therapy to the patient if the same posture occurs at different times of the day.

Claims

1. A medical device system comprising:

an implantable medical device that includes;

a therapy delivery unit that delivers therapy to a patient,

a posture state module that detects a posture state of the patient,

a timing unit that detects timing associated with the detected posture state, and

a processor; and

a programmer device, wherein the programmer device;

receives input from a user defining a time interval, a particular posture state, and a new set of therapy parameters for the time interval and the particular posture state, and

programs the implantable medical device based on the inputs,

wherein, in response to the implantable medical device being programmed based on the inputs and by the programmer device, the processor causes the therapy delivery unit to deliver therapy to the patient according to the new set of therapy parameters upon subsequently detecting the particular posture state during the time interval.

2. The medical device system of claim 1, wherein the posture state module detects a posture transition from a first posture state to a second posture state.

3. The medical device system of claim 1, wherein the posture state module detects the posture state from a plurality of pre-defined posture states.

4. The medical device system of claim 3, wherein the plurality of posture states includes a first posture state defining a first posture and a second posture state defining the first posture in conjunction with an activity.

5. The medical device system of claim 3, wherein the plurality of posture states includes a first posture state defining a first posture and a second posture state defining a second posture.

6. The medical device system of claim 1, wherein the timing unit detects a time of day.

7. The medical device system of claim 1, wherein the timing unit detects a day of the week and a time of the day and the processor defines different therapies for similar times of different days for at least one posture state of a plurality of posture states.

8. The medical device system of claim 1, wherein the timing unit detects a time interval and the processor defines different therapies for different time intervals of one or more days.

9. The medical device system of claim 1, wherein the medical device system comprises one or more of:

an implantable stimulation device, and

an implantable drug pump.

10. The medical device system of claim 1, wherein the medical device system includes a memory that stores a lookup table that maps a set of posture states and timings of the postures states with different sets of therapy parameters, wherein upon detecting the particular posture state during the time interval, the medical device system performs a lookup in the lookup table.

11. The medical device system of claim 1, wherein the posture state module, the timing unit and the processor all reside within the implantable medical device.

12. The medical device system of claim 1, wherein the posture state module and the timing unit reside in the implantable medical device, and the processor resides in the programmer device.

13. The medical device system of claim 1, wherein the detected timing is associated with a defined activity that occurs at a particular time of a particular day.

14. The medical device system of claim 1, wherein the detected timing is associated with a particular type of day defined by the patient.

15. The medical device system of claim 1, wherein the medical device defines a set of posture states for a particular time, and wherein the posture states in the set of posture states for the particular time define different sets of therapy parameters for the particular time.

16. The medical device system of claim 1, wherein a manner in which the medical device detects the posture state is dependent upon the detected timing.

17. The medical device system of claim 1, wherein the time interval is defined as at least one of a specific time of a day, a specific day of a week, and a specific day of a month.

18. The medical device system of claim 1, wherein the time interval is defined as at least one of a plurality of pre-defined time slots.

19. A medical device system comprising:

an implantable medical device comprising;

a therapy delivery unit that delivers therapy to a patient,

a posture state module that detects a posture state of the patient,

a timing unit that detects timing associated with the detected posture state, and

a processor; and

a programmer device, wherein the programmer device;

receives input from a user that defines a therapy adjustment, and programs the processor to apply a new therapy defined by the therapy adjustment,

wherein the processor determines a particular posture state of the patient at a time associated with the therapy adjustment, records the time associated with the therapy adjustment, and subsequently associates the new therapy defined by the therapy adjustment with the particular posture state and the time associated with the therapy adjustment.

20. The medical device system of claim 19, wherein the time associated with the therapy adjustment comprises a time of day, wherein the processor:

automatically adjusts the medical device system to deliver the new therapy defined by the therapy adjustment in a subsequent day in response to detecting the particular posture state and the time on the subsequent day.

21. The medical device system of claim 20, wherein the programmer device presents an indicator to the user identifying an automatic adjustment to the new therapy at the time of day for one or more subsequent days.

22. A medical device system comprising

an implantable medical device comprising:

a therapy delivery unit that delivers therapy to a patient,

a posture state module that detects a posture state of the patient,

a timing unit that detects timing associated with the detected posture state, and

a processor; and

a programmer device, wherein the programmer device;

receives input from a user defining a time period,

receives a selection of new therapy parameters, and

programs the implantable medical device for the time period, wherein the posture state module detects a particular posture state of the patient during the time period, and

wherein the processor associates the new therapy parameters with both the particular posture state during the time period and a time of day defined by the time period, and causes the therapy unit to automatically deliver therapy to the patient according to the selected new therapy parameters during the time period for one or more subsequent days upon subsequently detecting the particular posture state without any input from the user to select or adjust the therapy parameters for the implantable medical device.

23. A system comprising:

means for detecting a posture state of a patient;

means for detecting timing associated with the detected posture state;

means for delivering therapy to a patient device;

means for receiving input from a user defining a time interval, a particular posture state, and a new set of therapy parameters for the time interval and the particular posture state;

means for programming a medical device based on the inputs, wherein, in response to being programmed based on the inputs and by the means for programming, the medical device delivers therapy to the patient according to the new set of therapy parameters upon subsequently detecting the particular posture state during the time interval.

24. A method comprising:

detecting, via a posture state module of a medical device system, a posture state of a patient;

detecting, via a timing unit of the medical device system, timing associated with the detected posture state;

receiving, via a programmer device of the medical system, input from a user defining a time interval, a particular posture state, and a new set of therapy parameters for the time interval and the particular posture state; and

delivering, via a therapy delivery unit of the medical device system, therapy to the patient according to the new set of therapy parameters upon subsequently detecting the particular posture state and the time interval.

25. The method of claim 24, wherein detecting the posture state comprises detecting a posture transition from a first posture state to a second posture state.

26. The method of claim 24, wherein detecting the posture state comprises selecting among a plurality of pre-defined posture states.

27. The method of claim 26, wherein the plurality of pre-defined posture states includes a first posture state defining a first posture and a second posture state defining the first posture in conjunction with an activity.

28. The method of claim 26, wherein the plurality of pre-defined posture states includes a first posture state defining a first posture and a second posture state defining a second posture.

29. The method of claim 24, wherein detecting timing comprises detecting a time of day.

30. The method of claim 24, wherein detecting timing comprises detecting a day of the week and a time of the day.

31. The method of claim 24, wherein detecting timing comprises detecting a time interval.

32. The method of claim 24, wherein delivering therapy comprises one of:

delivering, via an implantable stimulation device of the medical device system, stimulation pulses, and

delivering, via an implantable drug pump of the medical device system, drug therapy.

33. The method of claim 24, wherein a memory of the medical device system stores a lookup table that maps posture states and timings of the postures states with therapy parameters, wherein delivering therapy to the patient according to the new set of therapy parameters upon detecting the particular posture state and the time interval comprises performing a lookup in the lookup table.

34. The method of claim 24, wherein selecting the therapy parameters comprises adjusting the therapy parameters.

35. The method of claim 24, wherein the medical device system is an implantable medical device and the method is performed by the implantable medical device.

36. The method of claim 24, wherein the medical device system comprises an implantable medical device and a programmer device for the implantable medical device, wherein the method is performed by the implantable medical device and the programmer device for the implantable medical device.

37. The method of claim 24, wherein the detected timing is associated with a defined activity that occurs at a particular time of a particular day.

38. The method of claim 24, wherein the detected timing is associated with a particular type of day defined by the patient.

39. The method of claim 24, wherein the medical device system defines a set of posture states for a particular time, and wherein the posture states in the set of posture states for the particular time define different sets of therapy parameters for the particular time.

40. The method of claim 24, wherein a manner in which the posture state module detects the posture state is dependent upon the detected timing.

41. A method comprising:

detecting, via a posture state module of a medical device system, a posture state of a patient;

detecting, via a timing unit of the medical device system, timing associated with the detected posture state;

receiving, via a programmer device of the medical device system, input from a user that defines a therapy adjustment;

determining, via a processor of the medical device system, a particular posture state of the patient at a time associated with the therapy adjustment;

recording, via the processor, the time associated with the therapy adjustment; and

associating, subsequent to the determining and the recording and via the processor, a new therapy defined by the therapy adjustment with the particular posture state and the time associated with the therapy adjustment.

42. The method of claim 41, wherein the time associated with the therapy adjustment comprises a time of day, the method further comprising:

automatically adjusting, via the processor, the therapy delivery unit to deliver the new therapy defined by the therapy adjustment in a subsequent day in response to detecting the particular posture state and the time on the subsequent day.

43. The method of claim 41, further comprising:

presenting, via the programmer device, an indicator to the user identifying an automatic adjustment to the new therapy at the time of day for one or more subsequent days.

44. A method comprising:

detecting, via a posture state module of a medical device system, a posture state of a patient;

detecting, via a timing unit of the medical device system, timing associated with the detected posture state;

receiving, via a programmer device of the medical device system, input from a user defining a time period;

detecting, via the posture state module, a particular posture state of the patient during the time period;

receiving, via the programmer device, a selection of new therapy parameters;

associating, via a processor of the medical device system, the new therapy parameters with both the particular posture state during the time period and a time of day defined by the time period; and

automatically delivering, via a therapy delivery unit of the medical device system, therapy to the patient according to the selected new therapy parameters during the time period for one or more subsequent days upon subsequently detecting the particular posture state without any input from the user to select or adjust the therapy parameters for the medical device.

45. A computer-readable storage medium comprising instructions that when executed in a medical device system cause the medical device system to:

detect a posture state of a patient via a posture state module of a medical device of the medical device system;

detect timing associated with the detected posture state via a timing unit of the medical device of the medical device system;

receive, via a programmer device of the medical device system, input from a user defining a time interval, a particular posture state, and a new set of therapy parameters for the time interval and the particular posture state;

program a processor of the medical device system via the programmer device based on the inputs; and

deliver therapy to a patient via the medical device according to the new set of therapy parameters upon subsequently detecting the posture state and the time interval via the medical device of the medical device system.