In adults, the most prevalent motor disorder is tremors characterized by involuntary shaky moments and rhythmic muscular contractions of different body parts.
Tremors are prominent symptoms of Parkinson's disease. Usually, tremors do not respond to the dopaminergic medicines compared to other signs of the disease. Deep brain stimulation can effectively relieve tremors. However, the placement of stimulating electrodes deep within the brain's material involves substantial hazards, including the possibility of hemorrhage.
Tremor is an accidental, periodic movement that is a common movement disorder that affects the arms, hands primarily in the elderly. It has a significant impact on patient's daily activities, like eating, writing, and typing. The prevalence rate of tremor disease in the elderly over 65 increases rapidly, and the global aging problem worsens. Therefore, it is becoming highly significant to research tremor suppression approaches. The mechanical suppression of the oscillation movement is effective noninvasive symptom management. Placement of medical tools in a specific position to fill the gap between lifestyle changes, pharmacotherapies, and surgical procedures to provide tremor suppression that proves to be both safe and effective.
Medical Devices for Tremor Suppression
Orthoses for the Upper Limb
Recently, non-invasive and effective approaches for tremor suppression have been developed, such as biomedical loading and functional electrical stimulation (FES) and biomechanical loading using worn orthoses have developed.
The EU TREMOR project, for example, intended to apply selected biomechanical stresses through multichannel array FES to compensate for tremors without hindering the user's voluntary motions. Depending on the suppression mechanism, biomechanical loading with worn orthoses for tremor suppression may be divided into three categories: passive, semi-active, and active systems.
Active Vibration Control Method
Another method used for tremor suppression includes active vibration control. It is composed of actuators, sensors, along with feedback controls. The mechanism of the active vibration control method is to control the tremors by applying equal and opposite forces. Tremors are detected through sensors and actuators with the help of feedback to counteract the tremor. There is no application of external forces in passive methods, as it is done by using biomechanical loads.
Using active control techniques, tremor suppression may be possible, including a piezoelectric actuator in specially constructed gloves. It was discovered that the actuator could function as a tremor resistive element by resisting the tremor force. The simulation findings show that the tremors can be controlled by using the actuator to provide feedback to the hand. In comparison to traditional techniques, this provides a platform for developing a prototype for delivering noninvasive and cost-effective tremor suppression. Tremor suppression in patients can be achieved by developing such anti-tremor tools.
Soft Exoskeleton for Tremor Suppression
The latest technique, called Soft exoskeleton for tremor suppression (SETS), is built on assistive technology. A controlled flexible semi active actuator based on the magnetorheological fluid is included in the SETS system. A soft semi active actuator that is a mix of cylinder-piston damper and elastic fluidic damper to address the limitations of standard fluidic semi active actuators. Solid construction, comfortable wearability, low mass, and real-time adjustment for tremor reduction with changing intensity are all features of the entire system. The SETS can help with wrist tremor suppression.
Drugs for Tremor Suppression
Long-term treatment is required for tremors suppression as tremors interfere with daily activities. The most common drugs used for tremor suppression include Propranolol (beta-blocker), Primidone, Topiramate, and Gabapentin. The effectiveness of Primidone is better than propranolol in suppressing tremors. Primidone is commonly administered to patients who cannot tolerate propranolol. Primidone can be used in conjunction with propranolol to relieve symptoms.
References