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A Review on Wearable Technologies for Tremor Suppression

Journal

FRONTIERS IN NEUROLOGY
Volume 12, Issue -, Pages -

Publisher

FRONTIERS MEDIA SA
DOI: 10.3389/fneur.2021.700600

Keywords

neurorehabiliation; pathological tremor; essential tremor; Parkinson's disease; wearable device; assistive technology

Funding

  1. Spanish Ministry of Science and Innovation [PID2019-105110RBC31]
  2. Ministry of Universities of the Government of Spain [FPU16/01313]
  3. Secretaria Nacional de Educacion Superior, Ciencia, Tecnologia e Innovacion of Ecuador (SENESCYT)
  4. CSIC Open Access Publication Support Initiative through its Unit of Information Resources for Research (URICI)

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Pathological tremors can severely impact daily life activities and are currently managed through pharmacotherapy or surgery, which have associated drawbacks. However, recent research has shown the feasibility of treating upper limb tremors using wearable technologies.
Tremor is defined as a rhythmic, involuntary oscillatory movement of a body part. Although everyone exhibits a certain degree of tremor, some pathologies lead to very disabling tremors. These pathological tremors constitute the most prevalent movement disorder, and they imply severe difficulties in performing activities of daily living. Although tremors are currently managed through pharmacotherapy or surgery, these treatments present significant associated drawbacks: drugs often induce side effects and show decreased effectiveness over years of use, while surgery is a hazardous procedure for a very low percentage of eligible patients. In this context, recent research demonstrated the feasibility of managing upper limb tremors through wearable technologies that suppress tremors by modifying limb biomechanics or applying counteracting forces. Furthermore, recent experiments with transcutaneous afferent stimulation showed significant tremor attenuation. In this regard, this article reviews the devices developed following these tremor management paradigms, such as robotic exoskeletons, soft robotic exoskeletons, and transcutaneous neurostimulators. These works are presented, and their effectiveness is discussed. The article also evaluates the different metrics used for the validation of these devices and the lack of a standard validation procedure that allows the comparison among them.

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