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The effect of temperature on hand function in patients with tremor
C Cooper1, V G Evidente, J G Hentz
1Department of Physical Medicine and Rehabilitation, Mayo Clinic Scottsdale, Arizona, USA.
Summary
Limb cooling temporarily improved hand function in essential tremor (ET) patients, while warming showed minimal effect in Parkinson disease (PD) patients. This suggests cooling may be a therapeutic option for ET hand dysfunction.
Area of Science:
- Neurology
- Occupational Therapy
- Rehabilitation Medicine
Background:
- Essential tremor (ET) and Parkinson disease (PD) can cause hand tremors, impacting daily activities like dressing and eating.
- Hand therapists may observe tremors during routine patient care, highlighting the need for effective management strategies.
- Current therapeutic options for tremor-related hand dysfunction are limited, necessitating exploration of novel interventions.
Purpose of the Study:
- To investigate the hypothesis that limb cooling improves hand function in essential tremor (ET).
- To determine if limb warming improves hand function in Parkinson disease (PD) with resting tremor.
- To compare the effects of cold and warm water immersion on hand function in patients with ET and PD.
Main Methods:
- A single-blind randomized crossover study involving 20 patients with ET and 20 patients with PD.
- Participants underwent limb immersion in cold and warm water, with hand function assessed using various subtests.
- Scores were compared between cold water, warm water, and baseline conditions to evaluate treatment effects.
Main Results:
- Patients with ET showed statistically significant improvements in spiral drawing, simulated feeding, and checkers tasks after cold water exposure compared to warm water and baseline.
- Patients with PD exhibited no significant differences between treatments, except for a slight improvement in handling small objects with warm water exposure compared to baseline.
- The findings suggest that cooling is effective in temporarily reducing tremor and enhancing hand function in ET.
Conclusions:
- Limb cooling offers a temporary therapeutic benefit for improving hand function in individuals with essential tremor.
- Limb warming demonstrated limited efficacy in improving hand function for Parkinson disease patients in this study.
- Further research into non-pharmacological interventions like temperature manipulation could provide valuable adjunctive therapies for tremor management.