Resistance Training Reduces Force Tremor and Improves Manual Dexterity in Older Individuals With Essential Tremor

Kavanagh, Justin J.; Wedderburn-Bisshop, Jacob; Keogh, Justin W L

doi:10.1080/00222895.2015.1028583

Cited by 20 publications

(16 citation statements)

References 40 publications

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“…47 There are a few studies on the effects of exercise (occupational therapy) in improving upper limb function in ET. 48,49,50 These studies implemented resistance training 49,50 or manual dexterity training 48 but did not examine balance and gait. Given the prevalence of balance and gait impairments in ET, and given their effect on functional limitations, exercise (physical and occupational therapy) intervention studies are needed.…”

Section: Resultsmentioning

confidence: 99%

Ataxic Gait in Essential Tremor: A Disease-Associated Feature?

Rao

Louis²

2019

Tremor and Other Hyperkinetic Movements

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BackgroundWhile accumulating evidence suggests that balance and gait impairments are commonly seen in patients with essential tremor (ET), questions remain regarding their prevalence, their relationship with normal aging, whether they are similar to the impairments seen in spinocerebellar ataxias, their functional consequences, and whether some ET patients carry greater susceptibility.MethodsWe conducted a literature search (until December 2018) on this topic.ResultsWe identified 23 articles on gait or balance impairments in ET. The prevalence of balance impairment (missteps on tandem walk test) was seven times higher in ET patients than controls. Gait impairments in ET included reduced speed, increased asymmetry, and impaired dynamic balance. While balance and gait problems worsened with age, ET patients were more impaired than controls, independent of age. The pattern of impairments seen in ET was qualitatively similar to that seen in spinocerebellar ataxias. Balance and gait impairments resulted in greater number of near falls in ET patients. Factors associated with balance and gait impairments in ET included age, presence of tremor in midline structures, and cognitive dysfunction.DiscussionAccumulating evidence suggests that balance and gait impairments are common in ET patients and occur to a greater extent in controls. Thus, they represent a disease-associated feature. These impairments, which are qualitatively similar to those seen in spinocerebellar ataxias, are not merely subclinical but result in difficulty performing functional tasks and increase falls risk. A subset of patients is more susceptible to balance and gait impairments. The full spectrum of impairments remains to be characterized.

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Section: Resultsmentioning

confidence: 99%

Ataxic Gait in Essential Tremor: A Disease-Associated Feature?

Rao

Louis²

2019

Tremor and Other Hyperkinetic Movements

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“…Notably, elbow flexion torque steadiness was relatively unaffected for the female group when each contraction protocol was performed, but the male group had progressively lower levels of steadiness during the prolonged isometric contractions. Although steadiness is a dimensionless measure where variability in torque is normalized to the torque amplitude (Kavanagh, Wedderburn‐Bisshop, Wedderburn‐Bisshop, & Keogh, 2016; Kenway et al, 2014), it cannot be discounted that enhanced strength in the male group caused some of the reductions in steadiness. In particular, numerical normalization does not account for the increased intramuscular pressure, increased mechanical occlusion of vasculature supplying the muscle, and decreased muscle perfusion potentially experienced by males when performing steady‐state contractions.…”

Section: Discussionmentioning

confidence: 99%

Sex differences in muscle activity emerge during sustained low‐intensity contractions but not during intermittent low‐intensity contractions

2020

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Sex differences in motor performance may arise depending on the mode of contraction being performed. In particular, contractions that are held for long durations, rather than contractions that are interspersed with rest periods, may induce greater levels of fatigue in men compared to women. The purpose of this study was to examine fatigue responses in a cohort of healthy men (n = 7, age [mean] = 21.6 ± [SD]1.1 year) and women (n = 7, age: 22.0 ± 2.0 year) during sustained isometric and intermittent isometric contractions. Two contraction protocols were matched for intensity (20% MVC) and total contraction time (600-s). Biceps brachii EMG and elbow flexion torque steadiness were examined throughout each protocol, and motor nerve stimulation was used to quantify central and peripheral fatigue. Overall, there were few sex-related differences in the fatigue responses during intermittent contractions. However, men exhibited progressively lower maximal torque generation (39% versus 27% decrease), progressively greater muscle activity (220% versus 144% increase), progressively greater declines in elbow flexion steadiness (354% versus 285% decrease), and progressively greater self-perception of fatigue (Borg scale:8.8 ± 1.2 versus 6.3 ± 1.1) throughout the sustained contractions. The mechanism underlying fatigue responses had a muscle component, as voluntary activation of the biceps brachii did not differ between sexes, but the amplitude of resting twitches decreased throughout the sustained contractions (m: 32%, w: 10% decrease). As generating large sustained forces causes a progressive increase in intramuscular pressure and mechanical occlusion-which has the effect of enhancing metabolite accumulation and peripheral fatigue-it is likely that the greater maximal strength of men contributed to their exacerbated levels of fatigue.

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“…Although the strength of contraction may differ-i.e. low magnitudes for postural tasks [14,15] and potentially higher magnitudes for force generating tasks [16,17]-there is still a need to regulate muscle activity to achieve a steady limb position.…”

Section: Introductionmentioning

confidence: 99%

Correlates Between Force and Postural Tremor in Older Individuals with Essential Tremor

Kavanagh

Keogh

2015

Cerebellum

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Essential tremor (ET) is commonly associated with kinetic tremor. However, other forms of tremor, such as force and postural tremor, may occur in ET with less severity. This study objectively assessed force and postural tremor characteristics in ET with the purpose of identifying the relationships between these tremors. Ten individuals with ET (age 71 ± 5 years) and ten healthy controls (age 70 ± 5 years) participated in the study. Force tremor was quantified as fluctuations in index finger abduction force during isometric contractions at 10 % maximum voluntary contraction (MVC) and 60 % MVC. Postural tremor was quantified as index finger acceleration when the subjects held their entire arm unsupported, and when their arm was supported so that only the index finger could move. Time- and frequency-domain parameters were extracted from tremor data, and then correlations within, and between, tremor subtypes were examined. ET force tremor was dependent on contraction intensity whereas postural tremor was unaffected by the level of limb support. Significant correlations existed between frequency components of postural tremor and force tremor amplitude. Force tremor amplitude normalised to the level of contraction intensity correlated to the proportion of power for postural tremor. These correlations were observed for both contraction intensities and both levels of postural support. The proportion of power represents the output of central oscillators in ET patients and therefore correlated well to force tremor. Given that significant relationships existed between spectral features of postural tremor and the overall force tremor amplitude, it is clear that these tremor modalities are not completely independent in older adults with ET.

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Resistance Training Reduces Force Tremor and Improves Manual Dexterity in Older Individuals With Essential Tremor

Cited by 20 publications

References 40 publications

Ataxic Gait in Essential Tremor: A Disease-Associated Feature?

Ataxic Gait in Essential Tremor: A Disease-Associated Feature?

Sex differences in muscle activity emerge during sustained low‐intensity contractions but not during intermittent low‐intensity contractions

Correlates Between Force and Postural Tremor in Older Individuals with Essential Tremor

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