Dexterity Training Improves Manual Precision in Patients Affected by Essential Tremor

ObjectiveTo 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).DesignThree testing sessions: baseline, after 4 weeks without any interventions (control), and after 4 weeks of dexterity-training carried out 3 times per week.SettingBiomechanics research laboratory.ParticipantsPatients (N=8) with a diagnosis of ET.InterventionTraining 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 MeasuresTesting included an ET-specific quality of life questionnaire and postural and kinetic tremor assessments. Each training session was scored to evaluate the performance.ResultsAfter training, improvements were observed in the performance of the 2 goal-directed tasks (P<.01); however, postural and kinetic tremor did not change.ConclusionsThis 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.