Feasibility Pilot of the LaceUp Compression-Weight Sleeve for Essential Tremor

Essential tremor (ET) often remains disabling despite pharmacologic, surgical, and stimulation-based options. This feasibility study evaluated LaceUp, a passive wearable sleeve combining soft compression with distributed embedded weight. Ten adults with ET completed a single laboratory visit with a fixed task battery under baseline, unweighted compression sleeve, wrist weight, and LaceUp conditions. Outcomes included wrist inertial measurement unit (IMU) tremor-band power (4-12 Hz), root mean square (RMS) jerk, digitized Archimedes spirals, handwriting, satisfaction/preference surveys, and follow-up Canadian Occupational Performance Measure (COPM) ratings. On the more-affected limb, LaceUp was associated with the largest median tremor-band power reduction (-32.9%) versus wrist weights (-25.3%) and the unweighted sleeve (-19.5%), while RMS jerk reductions were similar across conditions. Spiral and handwriting measures were heterogeneous and appeared most informative in participants with greater baseline severity. Six of nine participants who completed the preference ranking selected LaceUp as preferred. At follow-up, two of six reported continued use, and one exceeded the commonly cited 2-point COPM satisfaction threshold. Because this small pilot used a fixed order, effects cannot be separated from period, learning, expectancy, fatigue, behavioral adaptation, or measurement effects. Findings support feasibility and identify candidate endpoints, severity-based enrollment considerations, and operational constraints for future studies.