Abstract
Although tremor is the most common movement disorder, there exist few effective tremor-suppressing devices, in part because the characteristics of tremor throughout the upper limb are unknown. To clarify, optimally suppressing tremor requires a knowledge of the mechanical origin, propagation, and distribution of tremor throughout the upper limb. Here we present the first systematic investigation of how tremor propagates between the shoulder, elbow, forearm, and wrist. We simulated tremor propagation using a linear, time-invariant, lumped-parameter model relating joint torques and the resulting joint displacements. The model focused on the seven main degrees of freedom from the shoulder to the wrist and included coupled joint inertia, damping, and stiffness. We deliberately implemented a simple model to focus first on the most basic effects. Simulating tremorogenic joint torque as a sinusoidal input, we used the model to establish fundamental principles describing how input parameters (torque location and frequency) and joint impedance (inertia, damping, and stiffness) affect tremor propagation. We expect that the methods and principles presented here will serve as the groundwork for future refining studies to understand the origin, propagation, and distribution of tremor throughout the upper limb in order to enable the future development of optimal tremor-suppressing devices.
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Acknowledgments
SK Charles and AD Davidson received financial support from NIH Grant R15NS087447, Quantitative Characterization of Essential Tremor for Future Tremor Suppression.
Conflict of Interest
SK Charles is a scientific advisor to, and holds stock in, Vykon Technologies LLC. This company has licensed technology invented by SK Charles to develop markerless monitoring of movement disorders, including tremor.
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Associate Editor Sean S. Kohles oversaw the review of this article.
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Davidson, A.D., Charles, S.K. Fundamental Principles of Tremor Propagation in the Upper Limb. Ann Biomed Eng 45, 1133–1147 (2017). https://doi.org/10.1007/s10439-016-1765-5
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DOI: https://doi.org/10.1007/s10439-016-1765-5