Dexterity training improves manual precision in patients affected by essential tremor

OBJECTIVE:

To evaluate the effect of a short-term dexterity-training program on muscle tremor and the performance of hand precision tasks in patients with essential tremor (ET).

DESIGN:

Three testing sessions: baseline, after 4 weeks without any interventions (control), and after 4 weeks of dexterity-training carried out 3 times per week.

SETTING:

Biomechanics research laboratory.

PARTICIPANTS:

Patients (N=8) with a diagnosis of ET.

INTERVENTION:

Training program consisted of 12 dexterity training sessions where each session comprised 4 tasks involving both goal-directed manual movements and hand postural exercises.

MAIN OUTCOME MEASURES:

Testing included an ET-specific quality of life questionnaire and postural and kinetic tremor assessments. Each training session was scored to evaluate the performance.

RESULTS:

After training, improvements were observed in the performance of the 2 goal-directed tasks (P<.01); however, postural and kinetic tremor did not change.

CONCLUSIONS:

This study suggests that dexterity training could be effective in increasing fine manual control during goal-directed movements, which are known to be the most compromised in this pathology. The absence of a decrease in tremor severity highlights the necessity for developing this novel training technique further, perhaps over a longer period of time. This study could provide guidelines for the prescription of self-directed and personalized home-based exercises and will offer clinicians a treatment that might be used as an adjuvant or an alternative to the classical pharmacotherapy.