Tremor during movement correlates well with disability in people with essential tremor

Essential tremor is the most common movement disorder, typically characterized by the presence of both postural and kinetic tremor of the hand. In recent studies, we described the effects of altering force and load conditions on tremor amplitude and power in people with essential tremor. In the same participants, we also measured tremor‐related functional disability. In this article we report on the current study on correlations of measures of tremor severity with those of tremor‐related functional disability. Twenty‐one participants with essential tremor had tremor measured in their more tremorous hand. Power spectral and amplitude measures of tremor were calculated for each of 16 conditions: force tremor at 4 submaximal force levels, postural tremor in unloaded and 3 submaximal load conditions, and kinetic tremor in unloaded and 3 submaximal load conditions for each of concentric and eccentric contractions of the wrist extensors. Participants were rated on the hand items of the Fahn‐Tolosa‐Marin rating scale and timed on the unilateral hand tasks of the Test Évaluant la Performance des Membres supérieurs des Personnes Âgées. The most consistently high and significant correlations were found between kinetic tremor measures and the hand task scores and tremor‐B scores (r = 0.548–0.780, P < .01). Postural tremor measures correlated with disability measures only in loaded conditions, most consistently with the hand task measures (r = 0.640–0.725, P < .01). Thus, measures of kinetic tremor and loaded postural tremor, but not unloaded postural tremor or force tremor, relate well to disability captured with dynamic tasks. © 2011 Movement Disorder Society

[1]  G. Pari,et al.  The effect of inertial loading on wrist kinetic tremor and rhythmic muscle activity in individuals with essential tremor , 2011, Clinical Neurophysiology.

[2]  J. Jankovic,et al.  Correlation between Kinesia system assessments and clinical tremor scores in patients with essential tremor , 2010, Movement disorders : official journal of the Movement Disorder Society.

[3]  G. Pari,et al.  The effect of contraction intensity on force fluctuations and motor unit entrainment in individuals with essential tremor , 2010, Clinical Neurophysiology.

[4]  K. Norman,et al.  The effect of inertial loading on wrist postural tremor in essential tremor , 2009, Clinical Neurophysiology.

[5]  M. Brin,et al.  Consensus Statement of the Movement Disorder Society on Tremor , 2008, Movement disorders : official journal of the Movement Disorder Society.

[6]  R. Elble,et al.  Assessment of interrater and intrarater reliability of the Fahn–Tolosa–Marin Tremor Rating Scale in essential tremor , 2007, Movement disorders : official journal of the Movement Disorder Society.

[7]  Jan Raethjen,et al.  Tremor amplitude is logarithmically related to 4- and 5-point tremor rating scales. , 2006, Brain : a journal of neurology.

[8]  Samay Jain,et al.  Common misdiagnosis of a common neurological disorder: how are we misdiagnosing essential tremor? , 2006, Archives of neurology.

[9]  K. Norman,et al.  Upper-extremity disability in essential tremor. , 2006, Archives of physical medicine and rehabilitation.

[10]  Thomas J. Armstrong,et al.  Observational Assessment of Forceful Exertion and the Perceived Force Demands of Daily Activities , 2004, Journal of Occupational Rehabilitation.

[11]  G. Deuschl,et al.  Tremor analysis in two normal cohorts , 2004, Clinical Neurophysiology.

[12]  Rajesh Pahwa,et al.  Validity of clinical and patient ratings of tremor disability among older adults. , 2003, Parkinsonism & related disorders.

[13]  R. Elble Characteristics of physiologic tremor in young and elderly adults , 2003, Clinical Neurophysiology.

[14]  L. Cote,et al.  Correlates of functional disability in essential tremor , 2001, Movement disorders : official journal of the Movement Disorder Society.

[15]  E D Louis,et al.  Validity and test–retest reliability of a disability questionnaire for essential tremor , 2000, Movement disorders : official journal of the Movement Disorder Society.

[16]  S. Albert,et al.  Validity of a performance-based test of function in essential tremor. , 1999, Archives of neurology.

[17]  J. Matsumoto,et al.  Three‐dimensional measurement of essential tremor , 1999, Movement disorders : official journal of the Movement Disorder Society.

[18]  R. Elble,et al.  Quantification of essential tremor in writing and drawing , 1996, Movement disorders : official journal of the Movement Disorder Society.

[19]  R. Hébert,et al.  Upper extremity performance test for the elderly (TEMPA): normative data and correlates with sensorimotor parameters. Test d'Evaluation des Membres Supérieurs de Personnes Agées. , 1995, Archives of physical medicine and rehabilitation.

[20]  Mazen Al-Hakim,et al.  Magnetic Resonance Imaging in Multiple Sclerosis , 1990, Neurology.

[21]  R. Elble,et al.  Diagnostic criteria for essential tremor and differential diagnosis. , 2000, Neurology.

[22]  E. Auff,et al.  Essential tremor: functional disability vs. subjective impairment. , 1991, Journal of neural transmission. Supplementum.