Interventions for Upper-Limb Intention Tremor in Multiple Sclerosis

Abstract

Approximately 25% of people with multiple sclerosis (MS) experience upper-limb intention tremor (ULIT), which limits their ability to participate in daily activities. Little research has been conducted on the effectiveness of available treatments for ULIT. The objectives of this study were to investigate the use of occupational therapy interventions to improve eating and handwriting performance in adults with MS and ULIT and, based on these findings, to provide recommendations for the development of a treatment protocol for ULIT. Six adults with MS and ULIT were recruited from an MS clinic. Participants rated their pre- and post-intervention functional performance using the Multi-Dimensional Assessment of Tremor. Interventions included education about tremor, proximal stabilization, hand-over-hand technique, weighted tool, weighted wrist, and splinting. Participants evaluated the techniques using visual analogue scales (VASs). One month after the intervention, participants were interviewed to assess sustainability of the techniques. Pre- and post-intervention functional scores, VAS scores, and qualitative reports were used to evaluate the success of the techniques in improving participants' abilities in eating and handwriting. Preliminary evidence demonstrates the usefulness and sustainability of the behavioral strategies and the use of multiple techniques simultaneously in the treatment of ULIT. Further investigation is needed to support the use of weights and splints. Recommendations for the further development of a ULIT treatment protocol were provided.