Upper limb intention tremor assessment: opportunities and challenges in wearable technology

• Published in: Journal of neuroengineering and rehabilitation Vol. 21; no. 1; pp. 8 - 17
• Main Authors: Paredes-Acuna, Natalia, Utpadel-Fischler, Daniel, Ding, Keqin, Thakor, Nitish V., Cheng, Gordon
• Format: Journal Article
• Language: English
• Published: London BioMed Central 13.01.2024; BioMed Central Ltd; Springer Nature B.V; BMC
• Subjects: Algorithms; Ataxia; Biomedical and Life Sciences; Biomedical Engineering and Bioengineering; Biomedicine; Body measurements; Care and treatment; Cerebellum; Complications and side effects; Diagnosis; Disease; Essential Tremor - diagnosis; Fourier transforms; Gravity; Health aspects; Humans; Intention tremor; Limbs; Motion capture; Movement; Movement - physiology; Movement disorders; Multiple sclerosis; Nervous system diseases; Neurodegenerative diseases; Neurological diseases; Neurology; Neurosciences; Parkinson Disease - complications; Parkinson Disease - diagnosis; Parkinson's disease; Physiology; Rehabilitation Medicine; Review; Sensors; Signal processing; Smartphones; Technology; Technology assessment; Tremor; Tremor (Muscular contraction); Tremor - diagnosis; Tremor assessment; Tremors; Upper Extremity; Wearable computers; Wearable Electronic Devices; Wearable sensors; Wearable technology; United States; Ataxia; Multiple sclerosis; Intention tremor; Wearable sensors; Tremor assessment
• ISSN: 1743-0003; 1743-0003
• DOI: 10.1186/s12984-023-01302-9

Background Tremors are involuntary rhythmic movements commonly present in neurological diseases such as Parkinson's disease, essential tremor, and multiple sclerosis. Intention tremor is a subtype associated with lesions in the cerebellum and its connected pathways, and it is a common symptom in diseases associated with cerebellar pathology. While clinicians traditionally use tests to identify tremor type and severity, recent advancements in wearable technology have provided quantifiable ways to measure movement and tremor using motion capture systems, app-based tasks and tools, and physiology-based measurements. However, quantifying intention tremor remains challenging due to its changing nature. Methodology & Results This review examines the current state of upper limb tremor assessment technology and discusses potential directions to further develop new and existing algorithms and sensors to better quantify tremor, specifically intention tremor. A comprehensive search using PubMed and Scopus was performed using keywords related to technologies for tremor assessment. Afterward, screened results were filtered for relevance and eligibility and further classified into technology type. A total of 243 publications were selected for this review and classified according to their type: body function level: movement-based, activity level: task and tool-based, and physiology-based. Furthermore, each publication's methods, purpose, and technology are summarized in the appendix table. Conclusions Our survey suggests a need for more targeted tasks to evaluate intention tremors, including digitized tasks related to intentional movements, neurological and physiological measurements targeting the cerebellum and its pathways, and signal processing techniques that differentiate voluntary from involuntary movement in motion capture systems.