None listed
Conditions
Brief summary
Tremors are uncontrollable shaking movements. Organic tremors are usually the result of structural damage to the parts of the brain that coordinate muscular movement. Current treatments for organic tremors are mainly medication based. Up to 30% of tremor patients do not respond to medication and therefore need alternative treatment options. For some of these patients surgical treatment options can be considered. These treatments are invasive (with significant risks of complications), expensive and difficult to access for many patients. Also, many patients cannot undergo surgery for treatment of their tremors due to age or unacceptably high surgical risk. Functional Neurological Disorder (FND) is one of the most common diagnoses in general neurology clinic. Functional tremors are not caused by structural damage to the brain, but are due to a problem with communication between different brain areas. Functional tremors can often be treated by teaching patients strategies to retrain control over their movements. In this study we want to test if this approach can also work for patients with organic tremor disorders. Acute flares of organic tremors share many features with functional tremors. We hypothesized that it will be possible to use the physiotherapy-based treatment approaches that have been shown to be beneficial in patients with functional tremors to help patients with organic tremors to manage their acute tremor flares.
Interventions
Phase 2: Intervention phase: Patients will undergo a standardised 5-week program of weekly targeted physiotherapy sessions. The FND- informed will involve breathing exercises, grounding and distraction techniques.
The Physiotherapy sessions will be 30min each in duration and will focus on the following areas: 1) Education about principles of brain retraining, 2) Breathing and grounding techniques, 3) Distraction techniques, 4) Overriding abnormal movements, 5) Summary and development of patient-
Phase 2: Intervention phase: Patients will undergo a standardised 5-week program of weekly targeted physiotherapy sessions. The FND- informed will involve breathing exercises, grounding and distraction techniques. The Physiotherapy sessions will be 30min each in duration and will focus on the following areas: 1) Education about principles of brain retraining, 2) Breathing and grounding techniques, 3) Distraction techniques, 4) Overriding abnormal movements, 5) Summary and development of patient-specific management advice. Patients will be provided with written management advice for tremor flares. Patients will also be provided with exercise diaries by the study coordinator to monitor adherence. Phase 3: 'Washout' and Reassessment phase: Patients will again undergo a formal tremor assessment in clinic with the use of the 3D accelerometer devices. After that patients will again wear these 3D accelerometers at home for 1 week while performing their everyday activities. During this phase patients will also be asked to keep a written diary for tremor flares and activities related to them. The diary will be provided to the participants by the study coordinator.
Sponsors
Queensland University of Technology
Study design
Allocation
Non-randomised trial
Intervention model
Single group
Primary purpose
Prevention
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
1. Adults over the age of 18 years old and over. 2. Have received diagnosis of an organic tremor disorder affecting one or both upper limbs. 3. Able to read and write English. 4. Access to an Apple IOS device (iPhone or iPad
Exclusion criteria
None
Outcome results
None listed