Techniques for controlling therapy delivery based on the relative orientation and/or motion of a device accelerometer and a lead accelerometer are described. In one embodiment, a therapy system includes an electrical stimulator and a lead. The electrical stimulator comprises a processor that controls delivery of a therapy to a target stimulation site in a patient and a device accelerometer coupled to the electrical stimulator. The lead is coupled to the electrical stimulator to deliver the therapy from the electrical stimulator to the target stimulation site in the patient, and includes a lead accelerometer. The processor compares signals from the accelerometers, and controls delivery of the therapy to the patient based on the comparison. In this manner, the processor may adjust stimulation to, for example, address movement of electrodes relative to target tissue when a patient changes postures.

 
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