Collecting gait information for evaluation and control of therapy

Patent metadata

Field	Value
Publication number	US-9592379-B2
Application number	US-201414278821-A
Country	US
Kind code	B2
Filing date	May 15, 2014
Priority date	Mar 24, 2006
Publication date	Mar 14, 2017
Grant date	Mar 14, 2017

Abstract

A medical device delivers a therapy to a patient. The medical device or another device may periodically determine an activity level or gait parameter of the patient, and associate each determined level or parameter with a current therapy parameter set. A value of at least one activity metric is determined for each of a plurality of therapy parameter sets based on the activity levels or parameters associated with that therapy parameter set. Whether the patient is currently experiencing or anticipated to experience gait freeze caused by their neurological disorder, such as Parkinson's disease, may also be determined. Gait freeze events may be associated with current therapy parameters and used to determine activity metric values. In some examples, the activity metric associated with certain therapy parameters may be presented to a user.

First claim

What is claimed is:

1. A method comprising:
monitoring, with an implantable medical device, a physiological signal of a patient based on a signal generated by an implantable sensor within the patient;
predicting, with the implantable medical device, a gait freeze event based on the signal prior to onset of the gait freeze event; and
providing stimulation therapy to the patient from the implantable medical device in response to the predicted gait freeze event to mitigate the gait freeze event.

2. The method of claim 1 ,
wherein the signal generated by the implantable sensor includes an electromyogram (EMG) signal, and
wherein predicting, with the implantable medical device, the gait freeze event based on the signal includes predicting the gait freeze event based on irregular EMG activity in the EMG signal.

3. The method of claim 1 ,
wherein the signal generated by the implantable sensor includes an electroencephalogram (EEG) signal, and
wherein predicting, with the implantable medical device, the gait freeze event based on the signal includes predicting the gait freeze event based on irregular EEG activity in the EEG signal.

4. The method of claim 1 , wherein predicting, with the implantable medical device, the gait freeze event based on the signal includes:
monitoring a gait of the patient based on the signal generated by the implantable sensor; and
anticipating, with the implantable medical device, the gait freeze event based on the signal.

5. The method of claim 1 , wherein predicting, with the implantable medical device, the gait freeze event based on the signal includes:
monitoring a gait of the patient based on the signal generated by the implantable sensor; and
detecting, with the implantable medical device, the gait freeze event based on the signal.

6. The method of claim 1 , wherein providing the stimulation therapy to the patient from the implantable medical device in response to the predicted gait freeze event to mitigate the gait freeze event includes delivering stimulation via one or more electrodes to the brain of the patient.

7. The method of claim 1 , further comprising providing audible gait cues to the patient in response to the predicted gait freeze event to mitigate the gait freeze event.

8. The method of claim 1 , wherein providing the stimulation therapy to the patient from the implantable medical device in response to the predicted gait freeze event to mitigate the gait freeze event includes delivering rhythmic electrical stimulation perceivable by the patient.

9. The method of claim 1 , wherein monitoring the physiological signal of the patient includes monitoring the physiological signal of the patient with one or more electrodes of the implantable sensor.

10. The method of claim 1 , wherein monitoring the physiological signal of the patient includes sensing activity via an activity sensor.

11. The method of claim 1 , wherein providing the stimulation therapy to the patient from the implantable medical device in response to the predicted gait freeze event to mitigate the gait freeze event includes modifying at least one of a movement disorder therapy, Parkinson's disease therapy, epilepsy therapy, tremor therapy, or deep brain stimulation being delivered to the patient.

12. A system comprising:
an implantable sensor configured to generate a signal that varies as a function of activity of a patient;
a processor configured to monitor a physiological signal of a patient based on the signal generated by the implantable sensor and predicts a gait freeze event based on the signal prior to onset of the gait freeze event; and
a therapy module configured to provide stimulation therapy to the patient in response to the predicted gait freeze event to mitigate the gait freeze event.

13. The system of claim 12 ,
wherein the signal generated by the implantable sensor includes an electromyogram (EMG) signal, and
wherein the processor is configured to predict the gait freeze event based on irregular EMG activity in the EMG signal.

14. The system of claim 12 ,
wherein the signal generated by the implantable sensor includes an electroencephalogram (EEG) signal, and
wherein the processor is configured to predict the gait freeze event based on irregular EEG activity in the EEG signal.

15. The system of claim 12 , wherein the therapy module is configured to deliver rhythmic electrical stimulation perceivable by the patient in response to the predicted gait freeze event to mitigate the gait freeze event.

16. The system of claim 12 , wherein the therapy module is configured to modify at least one of a movement disorder therapy, Parkinson's disease therapy, epilepsy therapy, tremor therapy, or deep brain stimulation being delivered to the patient in response to the predicted gait freeze event to mitigate the gait freeze event.

17. A non-transitory computer-readable storage medium comprising instructions that cause a processor to:
monitor a physiological signal of a patient based on a signal generated by an implantable sensor within the patient;
predict a gait freeze event based on the signal prior to onset of the gait freeze event; and
issue instructions to a therapy module to provide stimulation therapy to the patient from the therapy module in response to the predicted gait freeze event to mitigate the gait freeze event.

18. The non-transitory computer-readable storage medium of claim 17 , wherein the instructions to the therapy module to provide stimulation therapy to the patient from the therapy module in response to the predicted gait freeze event to mitigate the gait freeze event include instructions to deliver rhythmic electrical stimulation perceivable by the patient.

19. The non-transitory computer-readable storage medium of claim 17 , wherein the instructions to the therapy module to provide stimulation therapy to the patient from the therapy module in response to the predicted gait freeze event to mitigate the gait freeze event include instructions to modify at least one of a movement disorder therapy, Parkinson's disease therapy, epilepsy therapy, tremor therapy, or deep brain stimulation being delivered to the patient.

Assignees

• Medtronic Inc

Inventors

• Heruth Kenneth T
• Miesel Keith A
• Molnar Gregory F

Classifications

• A61N1/36082

  Cognitive or psychiatric applications, e.g. dementia or Alzheimer's disease · CPC title

• A61B5/7282

  Event detection, e.g. detecting unique waveforms indicative of a medical condition (cough events A61B5/0823; seizures A61B5/4094; sleep apnoea A61B5/4818) · CPC title

• A61B5/1123

  Discriminating type of movement, e.g. walking or running (A61B5/1116, A61B5/112 take precedence) · CPC title

• A61B5/7405

  using sound · CPC title

• A61B2562/0219

  Inertial sensors, e.g. accelerometers, gyroscopes, tilt switches · CPC title