Presented at the 2012 AAPM Annual Meeting « Back

The Potential Value of Objective Patient Activity Data Recorded in an Implantable Neurostimulation Device in the Assessment of Therapy Efficacy

Dennis Skelton, BS, dennis.m.skelton@medtronic.com¹, Lisa Johanek, PhD¹, Nick Mairs, BS¹, Eric Panken, MS¹, (1) Medtronic, Inc., Minneapolis, Minnesota

Introduction: Pain often impacts a patient’s overall function including their level of physical activity. The RestoreSensor™ implantable neurostimulator (Medtronic, Inc., Minneapolis, MN) was designed to automatically collect information on patient activity. This objective data could prove useful in the evaluation of patient response to treatment. Patient activity data: The AdaptiveStim Diary™ feature included in the RestoreSensor device quantifies patient behaviors and graphically reports trending information including: a) Position Trend (Figure 1): average amount of time per day a patient spends in various postures over time; b) Resting Trend (Figure 2): average number of times per day a patient changes from one lying position to another lying position over time. Conclusions: Clinicians commonly rely on the patient’s reported perception of pain and quality of life when evaluating therapy efficacy. However, subjective reporting of pain can be problematic due to biased recall and variability in the experience of pain. Additionally, the possibility that activity impacts pain and vice-versa may confound assessment of therapy efficacy. Therefore, patient perception alone is not always enough for clinicians to evaluate therapy efficacy. Clinicians can use the patient postures and activity levels recorded in the RestoreSensor device to track patient behavior between visits. This type of objective data collection is new to the field of spinal cord stimulation and will build a scientific understanding of the utility of activity and posture trends in the ongoing assessment of therapy efficacy.

Funding: Development of the position-adaptive spinal cord stimulation technology described in the abstract was funded by Medtronic, Inc.