Archives of physical medicine and rehabilitation · 2013
Dexterity training improves manual precision in patients affected by essential tremor.
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Budini Francesco, Lowery Madeleine M, Hutchinson Michael, Bradley David, Conroy Luke, De Vito Giuseppe
Аннотация
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.
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.