Abstract: The invention is directed to controlling therapy delivery based on a relative motion between a first and second activity sensor. The relative motion between the activity sensors is representative of the relative motion between the locations of the body of the patient at which the respective activity sensors are located. The use of relative motion, however, may substantially remove motion experienced by both the activity sensors, e.g., motion caused by the environment in which patient is located, thus providing a new reference frame from which to analyze the motion measurements. The relative motion may be used to detect a condition of a movement disorder and/or control delivery of the therapy delivered to patient to treat or reduce the condition.

Abstract: A therapy program is modified to decompose an electrical stimulation signal defined by the therapy program into a plurality of sub-signals based on a comparison between an energy associated with the stimulation signal and a threshold value. An electrical stimulation signal defined by a therapy program may be decomposed into a plurality of subsignals when an electrical stimulation energy of the stimulation signal exceeds the maximum energy output of the medical device or of a channel of the medical device. The energy associated with each one of the subsignals may be less than the energy threshold value of the medical device.

Abstract: The invention is directed to controlling therapy delivery based on a relative motion between a first and second activity sensor. The relative motion between the activity sensors is representative of the relative motion between the locations of the body of the patient at which the respective activity sensors are located. The use of relative motion, however, may substantially remove motion experienced by both the activity sensors, e.g., motion caused by the environment in which patient is located, thus providing a new reference frame from which to analyze the motion measurements. The relative motion may be used to detect a condition of a movement disorder and/or control delivery of the therapy delivered to patient to treat or reduce the condition.

Abstract: The disclosure is directed to techniques for providing a visualization of efficacy ratings for a medical therapy. A graphical representation of weighted efficacy parameter values may be displayed to provide a visualization of efficacy for the patient. The graphical representation may include a boundary extending between the efficacy parameter values on multiple axes. If the representation includes three axes, the shape of the boundary may be substantially triangular. The graphical representation may simultaneously display multiple graphical representations. Each of the multiple multi-axis graphical representations corresponds to efficacy parameter values obtained for different sets of therapy parameters or to efficacy parameter values obtained at different times. The graphical representation may be modified so that the efficacy parameter values correspond to values relating to a time reference specified by a user.

Abstract: The disclosure describes an implantable stimulation system that guides programming with a therapeutic tree. All possible stimulation parameters are arranged on the therapeutic tree, with each level of the therapeutic tree containing a different stimulation parameter type. Each level includes nodes that are connected to nodes of adjacent levels. A program path is created by moving through nodes of lower levels. The stimulation parameter types are arranged so that coarse adjustments occur at higher levels of the tree and fine adjustments occur at lower levels of the tree. The nodes of the program path define the stimulation parameters of the delivered stimulation therapy. The user may provide information such as efficacy input and/or medication dosage information to the system for identifying the most efficacious program path in treating pain of the patient. Additionally or alternatively, efficacy feedback may be received from physiological parameter sensors.

Abstract: The disclosure is directed to techniques for providing a patient-individualized efficacy rating. Different stimulation parameters impact efficacy. For example, efficacy may be a function of parameters such as electrode combination, stimulation amplitude, pulse width, and pulse rate. Efficacy may vary from patient-to-patient. For example, efficacy may vary according to age, gender, physiology, disease state, activity level, or activity profile. Comparable stimulation programs may provide different efficacy levels for different patients, according to patient characteristics or desires. Patients may rank efficacy parameters differently. The efficacy parameters may include desirable therapeutic effects and undesirable side effects. For one patient, optimization of a particular efficacy parameter may be the paramount concern. Other patients may be willing to compromise the outcome of the same parameter in favor of better outcomes with other efficacy parameters.

Abstract: An implantable medical lead includes at least one stimulation electrode and at least one sensor configured to generate an electrical signal that varies as a function of a parameter associated with a voiding event of a patient. In some embodiments, the sensor may be at least one of a microphone that captures sounds associated with voiding events, a pressure sensor, a flow sensor, a strain gauge, a physiological parameter sensing electrode or a temperature sensor. The electrical signal generated by the sensor may used to detect an occurrence of a voiding event. Thus, the lead may be coupled wirelessly or via a wired connection to a device that processes the electrical signal from the sensor, generates voiding information based on the electrical signal, and in some cases, records the voiding information for later retrieval and analysis.

Abstract: Systems and methods for determining a number of interruptions in a sleep state of a patient attributable to an urge or need to void during a sleep event include monitoring an activity level of the patient. The urge or need to void may be attributable to fecal or urinary incontinence. The patient activity level may be determined with one or more sensors that detect motion and/or one or more sensors that monitor a physiological parameter of the patient that varies as a function of patient activity. In one embodiment, a clinician selects a therapy parameter set for the patient based on the severity of the patient's incontinence. In another embodiment, the number of interruptions in the sleep state is associated with a therapy parameter set that was implemented during the sleep state in order to evaluate the efficacy of the therapy parameter set.

Abstract: System and method for estimating a time to recharge a rechargeable power source of an implantable medical device. A plurality of measured parameters relating to the implantable medical device and an external charging device are applied to a model of recharging performance and an estimate is provided to a patient, perhaps in advance of charging. Once charging has begun, updated estimates can be provided until charging is complete. Once charging is complete, the model may be updated to reflect any differences in the estimated time to complete charging and the actual time required to complete charging. The model may be based on limitations to the rate at which charge may be transferred to the rechargeable power source over a plurality of intervals.

Abstract: In general, the disclosure is directed to an implantable neurostimulator and system capable of providing adaptive neurostimulation therapy to alleviate urinary or fecal incontinence. The neurostimulator operates according to a set of stimulation parameters stored in memory. During operation, information is obtained from the patient, the implanted neurostimulator, one or more implanted sensors, or some combination thereof. A processor analyzes the information to automatically generate proposed adjustments to the stimulation parameters applied by the neurostimulator. The adjustments provide an adaptive neurostimulation therapy that supports or enhances therapeutic efficacy based on the information.

Abstract: The invention is directed to controlling therapy delivery based on a relative motion between a first and second activity sensor. The relative motion between the activity sensors is representative of the relative motion between the locations of the body of the patient at which the respective activity sensors are located. The use of relative motion, however, may substantially remove motion experienced by both the activity sensors, e.g., motion caused by the environment in which patient is located, thus providing a new reference frame from which to analyze the motion measurements. The relative motion may be used to detect a condition of a movement disorder and/or control delivery of the therapy delivered to patient to treat or reduce the condition.

Abstract: Systems and methods for adjusting a therapy delivered to a patient include detecting a value of at least one sensed patient parameter and adjusting a therapy parameter value to accommodate different patient parameter values. A data structure including a plurality of patient parameter values and associated therapy parameter values may be stored within a medical device or a programming device. Upon detecting a patient parameter value, an associated therapy parameter value from the data structure may be selected. If no therapy parameter value is associated with the detected patient parameter value, an intermediate therapy parameter value may be generated by interpolating between the most recently implemented therapy parameter value and a stored therapy parameter value. In some embodiments, the rate of shifting between parameters of two stored or interpolated therapy parameter values may be based on the rate of change of the patient parameter value over time.

Abstract: An implantable medical device (IMD) is configured to operate as an automatic voiding diary for logging urinary and/or fecal voiding events. The IMD detects urinary and/or fecal voiding events and generates data that identifies detected events as voluntary or involuntary events. In particular, the IMD generates the identification data based on a patient defined action. In one embodiment, the patient defined action is the patient tapping on the skin located above the IMD. The IMD may generate the identification data based on one or more characteristics of the tapping, e.g., the number, frequency, duration, or pattern of taps. The IMD may also generate the identification data based on a lack of input during a specific range of time after a detected voiding event. In some embodiments, the identification data may be used to identify a false positive, i.e., an event that was incorrectly detected by the IMD.

Abstract: The invention is directed to controlling therapy delivery based on a relative motion between a first and second activity sensor. The relative motion between the activity sensors is representative of the relative motion between the locations of the body of the patient at which the respective activity sensors are located. The use of relative motion, however, may substantially remove motion experienced by both the activity sensors, e.g., motion caused by the environment in which patient is located, thus providing a new reference frame from which to analyze the motion measurements. The relative motion may be used to detect a condition of a movement disorder and/or control delivery of the therapy delivered to patient to treat or reduce the condition.

Abstract: The disclosure describes an external sensor attached to an undergarment worn by a patient that detects voiding information. The sensor stores the voiding information in a voiding log and transmits the voiding log to an external device. The external device includes a user interface that displays the voiding log to the patient for review. The patient may correct any incorrect voiding information that was logged in error or due to a non-voiding event. A user, such as a clinician or the patient, may use the voiding information to diagnose a condition of the patient. In addition, the voiding information of the voiding log may be used by the user to adjust a stimulation therapy or the external device to automatically adjust stimulation therapy. The undergarment may be disposable or washable after patient use.

Abstract: Systems and methods for adjusting a therapy delivered to a patient include detecting a value of at least one sensed patient parameter and adjusting a therapy parameter value to accommodate different patient parameter values. A data structure including a plurality of patient parameter values and associated therapy parameter values may be stored within a medical device or a programming device. Upon detecting a patient parameter value, an associated therapy parameter value from the data structure may be selected. If no therapy parameter value is associated with the detected patient parameter value, an intermediate therapy parameter value may be generated by interpolating between the most recently implemented therapy parameter value and a stored therapy parameter value. In some embodiments, the rate of shifting between parameters of two stored or interpolated therapy parameter values may be based on the rate of change of the patient parameter value over time.

Abstract: Techniques for modeling therapy fields for therapy delivered by medical devices are described. Each therapy field model is based on a set of therapy parameters and represents where therapy will propagate from the therapy system delivering therapy according to the set of therapy parameters. Therapy field models may be useful in guiding the modification of therapy parameters. As one example, a processor compares an algorithmic model of a therapy field to a reference therapy field and adjusts at least one therapy parameter based on the comparison. As another example, a processor adjusts at least one therapy parameter to increase an operating efficiency of the therapy system while substantially maintaining the modeled therapy field.

Abstract: Implantable medical devices include a sensor module capable of detecting an indicator of infection in proximity to the device. The sensor module is activated following a detection of an event associated with the device, such as, for example, refill of an implantable infusion device or implantation. The sensor module is deactivated two or more hours following activation. Methods include detecting a first event associated with an implanted medical device; activating a sensor module of the implanted medical device at or after the detection of the first event; deactivating the sensor module two hours or more after the sensor module is activated; and determining whether information regarding the indicator of infection is indicative of an infection.

Abstract: A therapy program may be generated based on an algorithmic model of a baseline therapy field, which may represent a therapy field resulting from therapy delivery via the first therapy system based on a first therapy program. A second therapy program that controls therapy delivery by a second therapy system may be generated based on the baseline therapy field model. For example, therapy parameter values of the second therapy program may be selected to maintain at least one field characteristic of the baseline therapy field model. In some examples, the second therapy system may result from a hardware modification to the first therapy system. In other examples, the first and second therapy systems may be associated with different patients. For example, the baseline therapy field model may be an efficacious therapy field for a patient class, and a second therapy program may be generated for a patient in the class.

Abstract: A therapy program is modified to decompose an electrical stimulation signal defined by the therapy program into a plurality of sub-signals based on a comparison between an energy associated with the stimulation signal and a threshold value. An electrical stimulation signal defined by a therapy program may be decomposed into a plurality of subsignals when an electrical stimulation energy of the stimulation signal exceeds the maximum energy output of the medical device or of a channel of the medical device. The energy associated with each one of the subsignals may be less than the energy threshold value of the medical device.