Objective: Assess the efficacy of a novel anti-tremor orthosis in reducing hand and forearm tremor in patients with Essential Tremor in a clinical setting.

Background: Essential Tremor (ET) often causes substantial difficulties in performing activities of daily living (ADL). Existing therapies, such as medication and stereotactic surgery, are often ineffective or give side effects. Previous studies have suggested that biomechanical loading reduces tremor power in ET patients. Here, we used a clinical rating scale and an accelerometer to test whether tremor severity and power in ET were reduced using a novel anti-tremor orthosis.

Method: The randomized crossover trial compared 24 adult ET patients in three conditions: wearing no orthosis (baseline); wearing a sham device; and wearing the anti-tremor orthosis. The anti-tremor orthosis contained specialized dampers acting on the wrist flexion-extension and forearm pronation-supination, and prevented wrist radial-ulnar deviation. The sham device, though identical in terms of appearance and weight, did not restrict movements.

In each condition, subjects performed seven relevant tasks from the Tremor Research Group Essential Tremor Rating Assessment Scale (TETRAS) in a clinical setting: static posture, wingbeat posture, finger-to-nose, spiral drawing, pouring, drinking, and eating. Tremor severity was evaluated from video recordings and tremor power was calculated from readings of an accelerometer at the hand. Patient satisfaction was self-assessed using the Dutch Quebec User Evaluation of Satisfaction with assistive Technology (D-QUEST), and adverse events were monitored. Comparisons between conditions were analysed by the Wilcoxon signed rank test.

Results: Compared to baseline, the anti-tremor orthosis significantly reduced tremor power (>80%) as well as mean TETRAS scores (baseline: 19/28; orthosis: 8/28) across all seven tasks. Compared to the sham device, both outcome measures showed significantly more tremor reduction with the anti-tremor orthosis. The majority of participants were satisfied with the orthosis; only few minor adverse events were reported.

Conclusion: The novel anti-tremor orthosis significantly reduced both tremor severity and power of ET patients during the execution of seven tasks, performed in a clinical setting. This orthosis is a viable medical device that can complement existing therapies when treating ET patients.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/essential-tremor-suppression-using-a-novel-anti-tremor-orthosis/