Automatic therapy adjustments

Abstract

A medical device detects a previously defined event, and controls delivery of therapy to a patient according to therapy information associated with the previously defined event. In exemplary embodiments, the medical device enters a learning mode in response to a command received from a user, e.g., the patient or a clinician. In such embodiments, the medical device defines the event, collects the therapy information, and associates the therapy information with the defined event while operating in the learning mode. In some embodiments, the medical device defines the event based on the output of a sensor that indicates a physiological parameter of the patient during the learning mode. The sensor may be an accelerometer, which generates an output that reflects motion and/or posture of the patient. The medical device may collect therapy information by recording therapy changes made by the user during the learning mode.

1 - 18 . (canceled) 
     
     
         19 : A method comprising:
 storing a set of pre-established posture state definitions for delivery of posture state-responsive neurostimulation therapy to a patient;   receiving a posture state definition update request, from the patient via an external programmer, to update the set of pre-established posture state definitions; and   updating, by at least one processor, the set of pre-established posture state definitions in response to receiving the posture state definition update request.   
     
     
         20 : The method of  claim 19 , wherein the set of pre-established posture state definitions defines one or more existing posture states, wherein the posture state definition update request comprises a request for a new posture state, and wherein updating the set of pre-established posture state definitions comprises defining, in response to the request for the new posture state, the new posture state, the new posture state being in addition to the one or more existing posture states. 
     
     
         21 : The method of  claim 20 , further comprising receiving, from the patient, a location of the new posture state within a posture state space. 
     
     
         22 : The method of  claim 21 , wherein receiving the location of the new posture state comprises receiving an indication that the patient is positioned in the new posture state. 
     
     
         23 : The method of  claim 20 , further comprising associating one or more therapy parameter values with the new posture state, wherein the one or more therapy parameter values were used to deliver the posture responsive therapy to the patient when the new posture state was defined. 
     
     
         24 : The method of  claim 20 , further comprising:
 associating a set of therapy parameter values with the new posture state;   subsequently detecting the new posture state; and   delivering the posture responsive therapy to the patient according to the set of therapy parameter values associated with the new posture state in response to the detection.   
     
     
         25 : The method of  claim 19 , wherein the posture state definition update request comprises a request to modify a definition of an existing posture state, the set of pre-established posture state definitions comprising the definition of the existing posture state, and wherein updating the set of posture state definitions comprises modifying the definition of the existing posture state in response to the request to modify the existing posture state. 
     
     
         26 : The method of  claim 25 , wherein modifying the definition of the existing posture state comprises at least one of modifying a location or a boundary of the existing posture state within a posture state space. 
     
     
         27 : The method of  claim 19 , wherein the external programmer comprises a patient programmer configured to be primarily used by the patient, wherein the patient programmer is different from a clinician programmer configured to be primarily used by a clinician. 
     
     
         28 : An external programmer comprising:
 a user interface configured to receive a posture state definition update request from a patient to update a set of pre-established posture state definitions for delivery of posture responsive neurostimulation therapy to the patient; and   a processor configured to update the set of pre-established posture state definitions in response to receiving the posture state definition update request.   
     
     
         29 : The external programmer of  claim 28 , wherein the set of pre-established posture state definitions defines one or more existing posture states, wherein the posture state definition update request comprises a request for a new posture state, and wherein the processor is configured to define, in response to the request for the new posture state, the new posture state, the new posture state being in addition to the one or more existing posture states. 
     
     
         30 : The external programmer of  claim 29 , wherein the user interface is configured to receive, from the patient, an indication of a location of the new posture state within a posture state space. 
     
     
         31 : The external programmer of  claim 30 , wherein the indication of the location comprises an indication that the patient is positioned in the new posture state. 
     
     
         32 : The external programmer of  claim 29 , wherein the processor is configured to associate one or more therapy parameter values with the new posture state, and wherein the one or more therapy parameter values were used to deliver the posture responsive therapy to the patient when the new posture state was defined. 
     
     
         33 : The external programmer of  claim 28 , wherein the posture state definition update request comprises a request to modify a definition of an existing posture state, the set of pre-established posture state definitions comprising the definition of the existing posture state, and wherein the processor is configured to modify the definition of the existing posture state in response to the request to modify the existing posture state. 
     
     
         34 : The external programmer of  claim 33 , wherein the processor is configured to modify at least one of a location or a boundary of the existing posture state within a posture state space. 
     
     
         35 : A system comprising:
 a memory configured to store a set of pre-established posture state definitions for delivery of posture state-responsive neurostimulation therapy to a patient;   an external programmer comprising a user interface configured to receive a posture state definition update request from the patient to update the set of pre-established posture state definitions; and   a processor configured to update the set of pre-established posture state definitions in response to receiving the posture state definition update request.   
     
     
         36 : The system of  claim 35 , wherein the set of pre-established posture state definitions define one or more existing posture states, wherein the posture state definition update request comprises a request for a new posture state, and wherein the processor is configured to define, in response to receiving the posture state definition update request, the new posture state, the new posture state being in addition to the one or more existing posture states. 
     
     
         37 : The system of  claim 36 , wherein the user interface is configured to receive, from the patient, a location of the new posture state within a posture state space. 
     
     
         38 : The system of  claim 37 , wherein the user interface is configured to receive an indication that the patient is positioned in the new posture state. 
     
     
         39 : The system of  claim 36 , further comprising a medical device configured to deliver the posture-responsive neurostimulation therapy to the patient according to a set of therapy parameter values, wherein the processor is configured to associate one or more therapy parameter values with the new posture state, and wherein the one or more therapy parameter values were used to deliver neurostimulation therapy to the patient when the new posture state was defined. 
     
     
         40 : The system of  claim 36 , wherein the processor is configured to:
 associate a set of therapy parameter values with the new posture state;   subsequently detect the new posture state; and   deliver the posture state-responsive neurostimulation therapy to the patient according to the set of therapy parameter values associated with the new posture state in response to the detection.   
     
     
         41 : The system of  claim 35 , wherein the posture state definition update request comprises a request to modify a definition of an existing posture state, the set of pre-established posture state definitions comprising the definition of the existing posture state, and wherein the processor is configured to modify the definition of the existing posture state in response to receiving the posture state definition update request. 
     
     
         42 : The system of  claim 41 , wherein the processor is configured to modify at least one of a location or a boundary of the existing posture state within a posture state space. 
     
     
         43 : The system of  claim 35 , wherein the external programmer comprises the processor. 
     
     
         44 : The system of  claim 35 , further comprising a medical device configured to deliver posture-responsive neurostimulation therapy to the patient, wherein the medical device comprises the processor. 
     
     
         45 : A non-transitory computer-readable medium comprising instructions that cause a programmable processor to:
 store a set of pre-established posture state definitions for delivery of posture responsive neurostimulation therapy to a patient;   receive a posture state definition update request from the patient to update the set of pre-established posture state definitions for delivery of posture responsive neurostimulation therapy to the patient; and   update the set of pre-established posture state definitions in response to receiving the posture state definition update request.   
     
     
         46 : An implantable medical device comprising:
 a housing configured to be implantable within a patient;   a memory that stores a set of pre-established posture state definitions for delivery of posture state-responsive neurostimulation therapy to the patient; and   a processor within the housing and configured to:
 receive a signal from an external programmer, the signal being representative of a posture state definition update request from the patient to update the set of pre-established posture state definitions; and 
 update the set of pre-established posture state definitions in response to receiving the signal. 
   
     
     
         47 : The implantable medical device of  claim 46 , wherein the set of pre-established posture state definitions define one or more existing posture states, wherein the signal is representative of a request for a new posture state, and wherein the processor, to update the set of pre-established posture state definitions, is configured to define, in response to the signal, the new posture state, the new posture state being in addition to the one or more existing posture states. 
     
     
         48 : The implantable medical device of  claim 47 , further comprising a stimulation generator, wherein:
 the processor is configured to associate a set of therapy parameter values with the new posture state and subsequently detect the new posture state; and   the stimulation generator is configured to deliver neurostimulation therapy to the patient according to the set of therapy parameter values associated with the new posture state in response to the detection.   
     
     
         49 : The implantable medical device of  claim 46 , wherein the signal is representative of a request to modify a definition of an existing posture state, the set of pre-established posture state definitions comprising the definition of the existing posture state, and wherein the processor is configured to modify the definition of the existing posture state in response to the signal. 
     
     
         50 : The implantable medical device of  claim 49 , wherein the processor is configured to modify at least one of a location or a boundary of the existing posture state.