Shaking Up Essential Tremor: Peripheral Devices and Mechanical Strategies to Reduce Tremor

Area of Science:

• Neurology
• Biomedical Engineering
• Rehabilitation Medicine

Background:

• Action tremor, including essential tremor (ET), significantly impacts daily activities.
• Current treatment options often involve pharmacological or surgical approaches with potential side effects.
• Non-pharmacological, non-surgical interventions offer alternative management strategies.

Purpose of the Study:

• To review available non-pharmacological, non-surgical interventions for action tremor.
• To assess the current state of devices and strategies for tremor management.
• To highlight the availability and evidence base for these interventions.

Main Methods:

• Systematic review of transcutaneous peripheral nerve stimulation (PNS) systems (open and closed loop).
• Review of various orthotic/mechanical devices designed to dampen tremor.
• Examination of adaptive utensils and other assistive devices.
• Inclusion of cooling and vibration strategies.

Main Results:

• Multiple interventions are currently available, including PNS (e.g., CALA-Trio, Felix™, NeuroAI™, Motimove®), orthotic devices (e.g., Tremulo™, GyroGlove™, Steadi-One®), and adaptive utensils.
• Most reviewed devices and strategies have limited to no published clinical trial data supporting their efficacy.
• The review categorizes interventions into PNS, orthotic/mechanical devices, and adaptive devices.

Conclusions:

• A range of non-pharmacological, non-surgical interventions for action tremor exist and are accessible.
• A significant gap in clinical trial data exists for most available tremor management devices.
• Further research and clinical validation are crucial to establish the effectiveness of these promising interventions.