Programming posture responsive therapy

• US 9,440,084 B2
• Filed: 04/30/2009
• Issued: 09/13/2016
• Est. Priority Date: 07/11/2008
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Davis, Jon P., Skelton, Dennis M., Gokaldas, Shyam, Sahasrabudhe, Rajeev
• Primary Examiner(s): Porter, Jr., Allen
• Application Number:
  US12/433,551
• Publication Number:
  US 20100010585A1
• Time in Patent Office: 2,693 Days
• Field of Search: 607/59, 607/62
• US Class Current: 1/1
• 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 5/1118 Determining activity level
• CPC Class Codes: A61N 1/36071 Pain
• CPC Class Codes: A61N 1/36132 using patient feedback
• CPC Class Codes: A61N 1/36135 using physiological parameters
• 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 20/10 relating to drugs or medications, e.g. for ensuring correct administration to patients
• 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
• CPC Class Codes: G16H 80/00 ICT specially adapted for facilitating communication between medical practitioners or patients, e.g. for collaborative diagnosis, therapy or health monitoring

Abstract

A programming session for an implantable medical device that includes a posture responsive therapy mode includes at least two phases. In a first phase, a first set of therapy parameter values are modified while the posture responsive therapy mode is deactivated. In the posture responsive therapy mode, the medical device automatically selects one or more therapy parameter values that define therapy delivered to a patient based on a detected posture state. In a second phase, the posture responsive therapy mode is activated and a second set of therapy parameter values are adjusted after observing a patient response to the posture responsive therapy delivered with the first set of therapy parameter values selected during the first phase. The second set of therapy parameter values may, for example, define the patient posture states or the modification profiles with which the medical device adjusts therapy upon detecting a posture state transition.

Claims

1. A method comprising:

programming a first set of one or more therapy parameter values of a medical device during a programming session while the medical device is in a first mode, the first set of one or more therapy parameter values being associated with a posture state, wherein programming the first set of one or more therapy parameter values while the medical device is in the first mode comprises programming a first value of a first therapy parameter with which the medical device delivers therapy to the patient;

during the programming session, activating a second mode of the medical device to deliver posture responsive therapy to a patient, wherein the posture responsive therapy is suspended while the medical device is in the first mode, and wherein, while the medical device is in the second mode, the medical device delivers posture responsive therapy to the patient by at least delivering therapy to the patient in accordance with the first set of one or more therapy parameter values in response to detecting the posture state; and

programming a second set of one or more therapy parameter values of the medical device based on efficacy of the posture responsive therapy delivered to the patient with therapy parameter values including the first set of one or more therapy parameter values while the second mode of the medical device is activated,

wherein programming the second set of one or more therapy parameter values based on efficacy of the posture responsive therapy delivered to the patient while the second mode of the medical device is activated comprises programming a second therapy parameter that differs from the first therapy parameter.

2. The method of claim 1, further comprising receiving input indicative of the efficacy of the posture responsive therapy delivered to the patient while the second mode of the medical device is activated.

3. The method of claim 2, wherein receiving input comprises at least one of receiving patient input or input from one or more sensors indicative of a physiological effect of the therapy.

4. The method of claim 2, wherein programming the second set of one or more therapy parameter values comprises modifying at least one therapy parameter value of the first set of one or more therapy parameter values based on efficacy of the posture responsive therapy delivered to the patient while the second mode of the medical device is activated.

5. The method of claim 1, wherein the first therapy parameter comprises at least one of an amplitude, a frequency, a signal duration, an electrode combination, or a posture state definition with which the medical device automatically determines a patient posture state.

6. The method of claim 1, wherein the second therapy parameter comprises a modification profile with which the medical device transitions between therapy parameter settings in response to detecting a posture state transition.

7. The method of claim 6, wherein the modification profile defines at least one of a dwell time duration between a detection of the posture state transition by the medical device and a modification to the therapy parameter settings made by the medical device, a rate of change of a therapy parameter implemented by the medical device upon detecting the patient posture transition, or a transition period of time over which the medical device adjusts a therapy parameter upon detecting the posture state transition.

8. The method of claim 6, wherein the modification profile defines a dwell time duration between the posture state transition by the patient and a modification to the therapy parameter settings made by the medical device.

9. The method of claim 1, wherein the second therapy parameter comprises a posture state definition with which the medical device automatically determines a patient posture state.

10. The method of claim 1, further comprising:

receiving input indicative of an efficacy of therapy delivered to the patient while the medical device is in the first mode; and

modifying the first therapy parameter value based on the input indicative of the efficacy of therapy, wherein programming the second set of one or more therapy parameters of the medical device based on efficacy of the posture responsive therapy delivered to the patient while the second mode of the medical device is activated comprises modifying the second therapy parameter value based on the efficacy of the posture responsive therapy, wherein the second therapy parameter value is not modified based on the efficacy of the therapy delivered to the patient while the medical device is in the first mode.

11. The method of claim 1, wherein programming the first set of one or more therapy parameter values while the medical device is in the first mode and programming the second set of one or more therapy parameter values based on efficacy of the posture responsive therapy delivered to the patient while the second mode of the medical device is activated comprises programming values for one or more common therapy parameters.

12. The method of claim 1, wherein the patient is present at a clinic during the programming session and activating the second mode of the programming session of the medical device comprises temporarily activating a chronic therapy delivery mode of the medical device while the patient is present at the clinic.

13. The method of claim 1, further comprising automatically deactivating the second mode of the medical device after a predetermined duration of time.

14. A system comprising:

a medical device that includes a first mode and a second mode in which the medical device automatically delivers posture responsive therapy to a patient, wherein the posture responsive therapy is suspended when the medical device is in the first mode; and

a processor that, during a programming session, programs a first set of one or more therapy parameter values of the medical device while the medical device is in the first mode, the first set of one or more therapy parameter values being associated with a posture state, and activates the second mode of the medical device to activate posture responsive therapy delivery to the patient, wherein, while the medical device is in the second mode, the medical device delivers posture response therapy to the patient by at least delivering therapy to the patient in accordance with the first set of one or more therapy parameter values in response to detecting the posture state, and wherein the processor programs a second set of one or more therapy parameter values of the medical device based on efficacy of the posture responsive therapy delivered to the patient with therapy parameter values including the first set of therapy parameter values while the second mode of the medical device is activated,

wherein the processor programs the first set of one or more therapy parameter values of the medical device while the medical device is in the first mode by at least programming a first value of a first therapy parameter with which the medical device delivers therapy to the patient, and

wherein the processor programs the second set of one or more therapy parameter values of the medical device based on efficacy of the posture responsive therapy delivered to the patient while the second mode of the medical device is activated by at least programming a second therapy parameter that differs from the first therapy parameter.

15. The system of claim 14, wherein the processor automatically deactivates the second mode of the medical device after a predetermined duration of time.

16. The system of claim 14, wherein the processor receives input indicative of the efficacy of the posture responsive therapy delivered to the patient while the second mode of the medical device is activated and determines the efficacy of the posture responsive therapy based on the input.

17. The system of claim 16, wherein the processor receives the input from a user.

18. The system of claim 16, comprising one or more sensors that sense one or more physiological parameters of the patient, wherein the processor receives the input indicative of the efficacy of therapy from the one or more sensors.

19. The system of claim 16, wherein the processor programs the second set of one or more therapy parameter values by at least modifying at least one therapy parameter value of the first set of one or more therapy parameter values based on efficacy of the posture responsive therapy delivered to the patient while the second mode of the medical device is activated.

20. The system of claim 14, wherein the first therapy parameter comprises at least one of an amplitude, a frequency, a signal duration, an electrode combination, or a posture state definition with which the medical device automatically determines a patient posture.

21. The system of claim 14, wherein the second therapy parameter comprises a modification profile with which the medical device transitions between therapy parameter settings in response to detecting a posture state transition.

22. The system of claim 14, wherein the second therapy parameter comprises a posture state definition with which the medical device automatically determines a patient posture state.

23. The system of claim 14, wherein the processor activates the second mode of the medical device by at least temporarily activating a chronic therapy delivery mode of the medical device.

24. The system of claim 14, further comprising a medical device programmer that comprises the processor.

25. The system of claim 14, wherein the medical device comprises the processor.

26. A system comprising:

means for programming a first set of one or more therapy parameter values of a medical device during a programming session while the medical device is in a first mode, the first set of one or more therapy parameter values being associated with a posture state, wherein the means for programming the first set of one or more therapy parameter values while the medical device is in the first mode programs a first value of a first therapy parameter with which the medical device delivers therapy to the patient;

means for activating a second mode of the medical device to deliver posture responsive therapy to a patient during the programming session, wherein the posture responsive therapy is suspended while the medical device is in the first mode, and wherein, while the medical device is in the second mode, the medical device delivers posture response therapy to the patient by at least delivering therapy to the patient in accordance with the first set of one or more therapy parameter values in response to detecting the posture state; and

means for programming a second set of one or more therapy parameter values of the medical device based on efficacy of the posture responsive therapy delivered to the patient with therapy parameter values including the first set of one or more therapy parameter values while the second mode of the medical device is activated, wherein the means for programming the second set of one or more therapy parameter values based on efficacy of the posture responsive therapy delivered to the patient while the second mode of the medical device is activated programs a second therapy parameter that differs from the first therapy parameter.

27. The system of claim 26, further comprising:

means for determining an efficacy of therapy delivered to the patient while the medical device is in the first mode.