# US 8,892,210 B2 · Devices, systems, and methods for automated optimization of energy delivery

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- Number: US 8,892,210 B2
- Document ID: US8892210B2
- Status: Granted
- Kind: B2
- Application number: 13/647,249
- Filed: 2012-10-08
- Published: 2013-01-31
- Granted: 2014-11-18
- Earliest claimed: 2008-07-02
- Assignees: Niveus Medical, Inc.
- Applicants: Niveus Medical, Inc.
- Inventors: Brian J. Fahey
- Web page: https://patentgrep.com/patent/US8892210B2

## CPC

- A61N 1/0492: {Patch electrodes (A61N1/0412, A61N1/0428 take precedence)}
- A61B 5/296: for electromyography [EMG]
- A61B 5/4523: {Tendons}
- A61B 5/4836: {Diagnosis combined with treatment in closed-loop systems or methods (A61B5/0036 takes precedence)}
- A61B 5/6828: {Leg}
- A61B 5/6841: {by using templates}
- A61B 90/39: {Markers, e.g. radio-opaque or breast lesions markers}
- A61H 39/002: {Using electric currents (electrotherapy A61N1/32)}
- A61N 1/0452: {Specially adapted for transcutaneous muscle stimulation [TMS]}
- A61N 1/0476: {Array electrodes (including any electrode arrangement with more than one electrode for at least one of the polarities)}
- A61N 1/36003: {of motor muscles, e.g. for walking assistance}
- A61N 1/3603: {Control systems}
- A61B 5/4585: {Evaluating the knee}
- A61B 2090/3904: {specially adapted for marking specified tissue}
- A61H 2201/165: Wearable interfaces
- A61H 2201/5005: for controlling frequency distribution, modulation or interference of a driving signal
- A61H 2201/5015: using specific interfaces or standards, e.g. USB, serial, parallel
- A61H 2201/5061: Force sensors
- A61H 2201/5084: Acceleration sensors
- A61H 2201/5092: Optical sensor
- A61H 2201/5097: wireless
- A61H 2205/10: Leg
- A61H 2205/104: Patella
- A61H 2230/045: used as a control parameter for the apparatus
- A61H 2230/655: used as a control parameter for the apparatus
- A61N: ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY (measurement of bioelectric currents A61B; surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body A61B18/00; anaesthetic apparatus in general A61M; incandescent lamps H01K; infrared radiators for heating H05B)
- A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D)
- A61H: PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY (electrotherapy, magnetotherapy, radiation therapy or ultrasound therapy A61N)

## Abstract

Devices, systems, and methods for automated optimization of muscle stimulation energy. In some embodiments the disclosure optimizes stimulation parameters and/or stimulation location.

## Claims

### Claim 1

A method of electrically stimulating a muscle of a patient, comprising:
sensing electrical energy delivered to a muscle from an external electrical energy source, wherein the sensing step comprises sensing electrical energy at a sensing region that is different than a stimulation region at which the electrical energy is delivered to the muscle;
applying an electrical muscle stimulating signal to the muscle to stimulate the muscle, wherein at least one parameter of the electrical muscle stimulating signal is based on the sensed electrical energy delivered from the external energy source.

### Claim 2 (depends on 1)

The method of claim 1 wherein the sensing step comprises sensing electrical energy at a sensing region that is outside of a stimulation region demarcated by boundaries of a plurality of stimulation electrodes placed proximate to the muscle being stimulated.

### Claim 3 (depends on 1)

The method of claim 1 wherein the sensing step comprises sensing electrical activity indicative of a state of a tendon coupled to the muscle.

### Claim 4 (depends on 1)

The method of claim 1 wherein the sensing step comprises sensing electrical activity that is indicative of a proximity to a dynamic structure.

### Claim 5 (depends on 1)

The method of claim 1 wherein the sensing step comprises sensing a change in the electrical energy that occurs between the stimulation region and the sensing region.

### Claim 6 (depends on 1)

The method of claim 1 wherein the sensing step comprises sensing a first electrical stimulating signal with a first parameter delivered to the muscle from the external electrical energy source, the method further comprises:
sensing a second electrical stimulating signal delivered to the muscle from the external electrical energy source, wherein the second electrical stimulating signal has a second parameter different than the first parameter; and
comparing the sensed first electrical stimulating signal with the sensed second electrical stimulating signal and determining whether the first electrical stimulating signal or the second electrical stimulating signal results in a more efficient muscle contraction,
wherein the applying step comprises applying the first or the second electrical stimulating signal depending on which signal results in a more efficient muscle contraction.

### Claim 7 (depends on 6)

The method of claim 6 wherein determining whether the first electrical stimulating signal or the second electrical stimulating signal results in a more efficient muscle contraction comprises analyzing how the peak voltage amplitude of individual pulses contained within the first and second signals change over time.

### Claim 8 (depends on 6)

The method of claim 6 wherein the first parameter is first energy intensity and the second parameter is a second energy intensity different than the first energy intensity.