Occupational Therapies for Essential Tremor

Occupational Therapies for Essential Tremor

Thursday, October 13, 2016 IETF hosted their third telephone conference call. The topic of this event was coping with essential tremor. Patrick McCartney, IETF Executive Director, facilitated the event. Kelli Reiling, Occupational Therapist and Clinical Assistant Professor at the University of Kansas Medical Center was the guest speaker. Professor Reiling provided information about different types of occupational therapies and also answered questions for one half hour.

Professor Reiling began by explaining what occupational therapy is. It is therapy that involves the whole person to help with activity engagement. Most people are probably familiar with occupational therapy for stroke patients learning to walk again but it is used in many more scenarios. The therapist collaborates with the patient to help the patient successfully achieve whatever activity they need help with.

Professor Reiling spoke about tremor suppressing orthotics like gloves with weights. While they may help some people with a reduction in tremor when worn, they do not provide any long lasting benefit. She then discussed several research projects:

  • Strength Training Program – only the index finger was worked with; the goal was to hold it steady for 1 minute and improve function such as holding a glass or drawing a spiral; after 4 weeks there was an improvement in strength but no reduction in tremor.
  • Limb Cooling – hands and forearms were cooled to 59 degrees fahrenheit for five minutes at a time; they were checked every five minutes for up to 30 minutes; short term was an improvement in tremor reduction; long term there was no reduction.
  • Electro Stimulation – electrodes were placed and current was applied; the goal was to interrupt the tremor; again no long term benefit found
  • Vibration Therapy – vibration was applied in two ways, either to backside of upper forearm or whole body through a vibrating chair; ten minutes of vibration was followed by ten minutes of rest; there was a short term reduction in tremor but no long term reduction.
  • Applying weights to wrists – Professor Reiling did not give the number of subjects in the study as a whole but said 12 subjects still were finding reduction in their tremor after six months of use but researchers found it did not work for everyone.
  • Bright Light Therapy – A type of mood light was used for 14 days consecutively to suppress melatonin production; a small effect was found for short term improvement.
  • Transcranial magnets – magnets are held over the head for four days; no improvement shown at all.
  • There are possibly more devices coming soon; participants encouraged to contact IETF for further information.

Professor Reiling noted that no single thing has been found to work for everyone and no therapy has been found to have true lasting effect.

Solutions proposed:

  • To modify the task instead of trying to make the person do something they cannot.
  • Stabilize objects by using non-stick surfaces or a clipboard when working with paper.
  • Reduce tremor by using weighted utensils.
  • Conserve energy.
  • Promote success by changing tasks, using covered bottles, straws and filling glasses only ½ full.
  • Use technology such as adaptable keyboards or voice activated software.

For home use, it was suggested to use washers to create weighted gloves, and use paper clips for zipper pulls. The best coping method is to raise awareness of what essential tremor is and to reduce stress.

The lines were open for questions with Mr. McCartney requesting people to only ask about what was discussed and not medication or other issues. Someone asked about the Readi-Steadi Glove and Mr. McCartney said it is getting closer to market release. One questioner wanted to know how to help voice tremor and they were referred to find a speech therapist. Someone mentioned Gyro Glove and Mr. McCartney said it is approaching the prototype state. At the end of the thirty minute question portion, Mr. McCartney stated that the call was recorded and will be available on IETF’s website within a few days.

TAN Blog Editor
Nannette Halliwell

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