Abstract
Background:Long-term tremor recording is particularly useful for the assessment of overall severity and therapeutic interventions in tremor patients. The purpose of this paper is to investigate the optimal number of days needed to obtain reliable estimates of tremor percentage, tremor frequency variability and tremor intensity in tremor patients using long-term tremor recordings.Methods:Participants were 18 years or older and were diagnosed with tremor by a movement disorders specialist. Participants wore an accelerometer on the wrist of the most affected arm during 30 consecutive days. Tremor presence, frequency variability and intensity were calculated per day. We used reliability analysis to determine the minimum number of days needed to obtain reliable estimates of these tremor characteristics.Results:Data from 36 adult organic (OrgT) and functional tremor (FT) patients (24 males; mean age 63.9 ± 11.9 years; 15 FT) were analyzed. Using five hours per day, one day of measurement is enough, except for tremor frequency variability in the OrgT group, where three days are needed and for tremor intensity where two days are always needed.Discussion:Visual analysis suggested that reliability can be increased considerably by using data from three days instead of one day even when using six hours of data per day. Three days with at least three hours of tremor data provide estimates of tremor percentage, frequency variability and intensity with good to excellent reliability, both for organic and functional tremor.
Highlights
Tremor is the most common neurological movement disorder [1] and is defined as an involuntary, rhythmic and sinusoidal movement of one or more body parts [2]
Longer term tremor recordings might be relevant for the assessment of overall severity and therapeutic interventions [4], for evaluating functional tremor, which has been shown to be less stable over time than organic tremor [5]
It was concluded that long-term tremor recordings are needed to objectively quantify tremor presence, no information regarding the minimum number of days needed to quantify tremor in these patient groups was presented
Summary
Tremor is the most common neurological movement disorder [1] and is defined as an involuntary, rhythmic and sinusoidal movement of one or more body parts [2]. Longer term tremor recordings might be relevant for the assessment of overall severity and therapeutic interventions [4], for evaluating functional tremor, which has been shown to be less stable over time than organic tremor [5] In this respect, some studies have successfully quantified and differentiated between tremors [6, 7] with the use of long-time tremor recordings. Several researchers have proposed the use of longterm tremor recordings using EMG [6, 8,9,10], ACC [7, 11,12,13] or gyroscope [14] signals In those studies, the most common characteristics used for tremor quantification are tremor intensity, frequency and occurrence. The purpose of this paper is to investigate the optimal number of days needed to obtain reliable estimates of tremor percentage, tremor frequency variability and tremor intensity in tremor patients using long-term tremor recordings
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