Programming posture responsive therapy

Patent metadata

Field	Value
Publication number	US-9440084-B2
Application number	US-43355109-A
Country	US
Kind code	B2
Filing date	Apr 30, 2009
Priority date	Jul 11, 2008
Publication date	Sep 13, 2016
Grant date	Sep 13, 2016

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.

First claim

The invention claimed is:

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 processo

Assignees

• Davis Jon P
• Skelton Dennis M
• Gokaldas Shyam
• Sahasrabudhe Rajeev
• Medtronic Inc

Inventors

• Davis Jon P
• Skelton Dennis M
• Gokaldas Shyam
• Sahasrabudhe Rajeev

Classifications

• G16H80/00

  ICT specially adapted for facilitating communication between medical practitioners or patients, e.g. for collaborative diagnosis, therapy or health monitoring · CPC title

• A61B5/1116

  Determining posture transitions · CPC title

• A61N1/36135

  using physiological parameters · CPC title

• G16H50/20

  for computer-aided diagnosis, e.g. based on medical expert systems · CPC title

• A61N1/36132

  using patient feedback · CPC title