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

Abstract

This review discusses non-pharmacological, non-surgical interventions for action tremor, including essential tremor (ET). We review transcutaneous peripheral nerve stimulation (PNS), a variety of orthotic/mechanical devices, cooling and vibration strategies, and adaptive utensils, most of which are currently available. The PNS section discusses open loop (CALA-Trio) and closed loop systems (Felix™, NeuroAI™ and Motimove® systems). Orthotic devices which physically dampen tremor include Tremulo™, GyroGlove™, WOTAS exoskeleton, Magnetorheological Fluid-Based Exoskeleton System, Steadi-One® and Steadi-Two®, and Readi-Steady®. Adaptive devices include weighted spoons, deep cavity spoons, counter-balance utensils, and electrical actuator devices. Despite availability, most of these devices have limited to no published clinical trial data.

Keywords: Action tremor; adaptive device; cala trio; clinical trials; cooling therapy; device based interventions; essential tremor; mechanical device; neurostimulation; non-invasive; transcutaneous afferent patterned stimulation; tremor management; tremor research; vibration therapy; wearable device.