Dexterity training improves manual precision in patients affected by essential tremor.

OBJECTIVE To 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). DESIGN Three testing sessions: baseline, after 4 weeks without any interventions (control), and after 4 weeks of dexterity-training carried out 3 times per week. SETTING Biomechanics research laboratory. PARTICIPANTS Patients (N=8) with a diagnosis of ET. INTERVENTION Training 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 MEASURES Testing included an ET-specific quality of life questionnaire and postural and kinetic tremor assessments. Each training session was scored to evaluate the performance. RESULTS After training, improvements were observed in the performance of the 2 goal-directed tasks (P<.01); however, postural and kinetic tremor did not change. CONCLUSIONS This 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.