Neuromodulation medical treatment device
The present disclosure provides a neuromodulation medical treatment device and a medical treatment neuromodulation method for stimulating peripheral nerves. The device comprises a pulse generator and at least one active electrode connected to the pulse generator. The at least one active electrode has an electrically conductive surface of less than or equal to 0.3100 square inch and the electrically conductive surface is attachable to a patient's skin in a proximity of branches of peripheral nerves. The at least one active electrode is adapted to stimulate via the electrically conductive surface the peripheral nerves by electrical pulses generated by the pulse generator. The control unit controls the pulse generator and sets at least one parameter of generated electrical pulses.
1. A neuromodulation device for a medical treatment of a low urinary tract dysfunction, the device comprising:
a pulse generator configured to generate electrical pulses;
a control unit configured to control the pulse generator and set at least one parameter of the generated electrical pulses;
at least one active electrode connected to the pulse generator, wherein the at least one active electrode has an electrically conductive surface of less than or equal to 0.3100 square inch and the electrically conductive surface is configured to be attached to a leg of a patient, wherein the at least one active electrode is adapted to stimulate via the electrically conductive surface a nerve of the leg of the patient by the electrical pulses generated by the pulse generator;
a response detector configured to detect a reflexive movement of the stimulated leg in a response to the nerve stimulation and provide a feedback on the detected reflexive movement to the control unit, wherein for the medical treatment the control unit is further configured to:
determine in a first phase a stimulation setting by varying an initial setting, of the at least one parameter of the generated electrical pulses until the detected reflexive movement of the stimulated leg is within a redetermined range, and
maintain in a second phe the determined stimulation setting for a predefined amount of stimulation time provided the detected reflexive movement of the stimulated leg remains within the predetermined range.
2. The neuromodulation device according to claim 1 , wherein the size of the electrically conductive surface is comprised between 0.3100 square inch and 0.0775 square inch or the size of the electrically conductive surface is less than 0.0775 square inch.
3. The neuromodulation device according to claim 1 further comprising a grounding electrode connected to the pulse generator and configured to be attached to the skin of the patient, wherein the at least one active electrode comprises at least two active electrodes and each of the at least two active electrodes has the electrically conductive surface adapted to stimulate the peroneal nerve by the electrical pulses generated by the pulse generator.
4. The neuromodulation device according to claim 3 , wherein the at least two active electrodes comprise a first active electrode configured to be attached to a first leg of the patient and a second active electrode configured to be attached to a second leg of the patient.
5. The neuromodulation device according to claim 1 , wherein the pulse generator generates electrical pulses with a frequency comprised between 2.5 Hz and 60 Hz and the electrical pulses have a pulse width comprised between 0.1 ms and 2.5 ms.
6. The neuromodulation device according to claim 1 , wherein the pulse generator generates electrical pulses with a frequency comprised between 1 Hz and 15 Hz or the pulse generator generates electrical pulses with a frequency comprised between 2 Hz and 6 Hz.
7. The neuromodulation device according to claim 1 or 2 , wherein the response detector comprises at least one of an electromyograph or an accelerometer sensor for sensing the reflexive movement.
8. The neuromodulation device according to claim 1 or 2 , wherein the nerve to be stimulated is a peroneal or a tibial nerve.
9. The neuromodulation device according to claim 8 , wherein the at least one active electrode is configured to be attached to an expected location of a branch of a peroneal nerve or a tibial nerve in the back of the knee area of the leg of the patient.
10. The neuromodulation device according to claim 1 , wherein the at least one parameter of the generated electrical pulses comprises a frequency or a pulse length or a current or a voltage or a combination thereof.
11. The neuromodulation device according to claim 1 , wherein when in the second phase the detected reflexive movement falls outside of the predetermined range the control unit is further configured to initiate back the first phase to determine a new stimulation setting.
12. The neuromodulation device according to claim 11 , wherein when the first phase is initiated back to determine a new stimulation setting the initial setting of the at least one parameter of the generated electrical pulses is set to be the previously determined setting.
13. A method for a neuromodulation medical treatment of a low urinary tract dysfunction, the method is carried out by the neuromodulation device according to claim 1 or 11 , the method comprising:
generating electrical pulses by the pulse generator;
attaching the electrically conductive surface of the at least one active electrode to the skin of a leg og a patient in an expected location of a nerve of the patient;
stimulating via the electrically conductive surface of the at least one active electrode the nerve by the electrical pulses generated by the pulse generator and detecting by a response detector a reflexive movement of the stimulated leg in a response to the nerve stimulation;
controlling the stimulation by the control unit in two phases:
in a first phase determining a stimulation setting by varying an initial setting of the at least one parameter of the generated electrical pulses until the detected reflexive movement of the stimulated leg is within a predetermined range, and
in a second phase maintaining the determined stimulation setting for a predefined amount of stimulation time provided the detected reflexive movement of the stimulated leg remains within the redetermined range.
14. The medical treatment neuromodulation method according to claim 13 , wherein the size of the electrically conductive surface is comprised between 0.3100 square inch and 0.0775 square inch.
15. The medical treatment neuromodulation method according to claim 13 , wherein the size of the electrically conductive surface is less than 0.0775 square inch.
16. The medical treatment neuromodulation method according to claim 13 , wherein the at least one active electrode comprises at least two active electrodes, wherein the attaching the electrically conductive surface of the at least one active electrode to the skin of the patient comprises:
attaching a first active electrode to a first leg of the patient; and
attaching a second active electrode to a second leg of the patient.
17. The medical treatment neuromodulation method according to claim 16 , wherein attaching the first active electrode to the first leg of the patient involves attaching the first active electrode to the back of the knee area in proximity of a peroneal nerve of the first leg and attaching the second active electrode involves attaching the second active electrode to the back of the knee area in proximity of a peroneal and/or a tibial nerve of the second leg.
18. The medical treatment neuromodulation method according to claim 16 , the method further comprising:
independently adjusting, by the control unit, timings of generated pulses to respectively the first and the second active electrodes so that an invoked reflex movement of the first and the second leg of the patient is synchronized.
19. The method according to claim 13 , wherein the controlling the stimulation comprising: initiating back the first phase to determine a new stimulation setting when in the second phase the detected reflexive movement falls outside of the predetermined range.
20. The method according to claim 19 , wherein the initiating back the first phase comprising changing the initial setting of the at least one parameter of the generated electrical pulses to be the previously determined setting.
21. The method according to claim 13 , wherein the response detector comprises at least one of an electromyograph or an accelerometer sensor for sensing the reflexive movement.
22. The method according to claim 13 , wherein the nerve to be stimulated is a peroneal or a tibial nerve.