Diagnosis and Treatment of Tremor in Parkinson’s Disease Using Mechanical Devices

Abstract

Background: Parkinsonian tremors are sometimes confused with essential tremors or other conditions. Recently, researchers conducted several studies on tremor evaluation using wearable sensors and devices, which may support accurate diagnosis. Mechanical devices are also commonly used to treat tremors and have been actively researched and developed. Here, we aimed to review recent progress and the efficacy of the devices related to Parkinsonian tremors. Methods: The PubMed and Scopus databases were searched for articles. We searched for “Parkinson disease” and “tremor” and “device”. Results: Eighty-six articles were selected by our systematic approach. Many studies demonstrated that the diagnosis and evaluation of tremors in patients with PD can be done accurately by machine learning algorithms. Mechanical devices for tremor suppression include deep brain stimulation (DBS), electrical muscle stimulation, and orthosis. In recent years, adaptive DBS and optimization of stimulation parameters have been studied to further improve treatment efficacy. Conclusions: Due to developments using state-of-the-art techniques, effectiveness in diagnosing and evaluating tremor and suppressing it using these devices is satisfactorily high in many studies. However, other than DBS, no devices are in practical use. To acquire high-level evidence, large-scale studies and randomized controlled trials are needed for these devices.

An Internet of Things-Enabled Self-Stabilizing Spoon for Patients with Parkinson’s Disease

“…Two axes must be maintained by the spoon in a horizontal position. To construct a 2-DOF system, two servo motors are placed orthogonally to one another [10][11][12][13]. The spoon bowl is meant to stay in a horizontal posture with this configuration in place.…”

Accelerometric Classification of Resting and Postural Tremor Amplitude

“…Accelerometry has been applied in several clinical studies to assess the treatment effects of medication [16], DBS [17] or for intraoperative evaluation of tremor severity during thalamotomy surgery [18]. Recently, wearable accelerometers [12,19] and other portable devices such as smartwatches [20] and smartphones [21,22] have been used to detect and evaluate tremors with high precision [23]. Certain devices and solutions have even gained regulatory approval to monitor tremor in PD patients continuously [20].…”