Peripheral electrical stimulation to reduce pathological tremor: a review.
Alejandro Pascual-Valdunciel, Grace W Hoo, Simon Avrillon and 4 others
PMID 33588841WHAT IT FOUND
Peripheral electrical stimulation, including functional electrical stimulation and nerve stimulation, sometimes reduced hand tremor in essential tremor and Parkinson disease trials.
Results varied widely across 27 studies, most with 20 or fewer participants, so this is not enough to change therapy on Monday.
Key findings
01Twenty-seven full-text journal articles on peripheral electrical stimulation for tremor in essential tremor or Parkinson disease were included.
02Tremor reduction was variable across studies, and sample sizes ranged from 1 to 263.
03All included studies tested a single stimulation session except one clinical trial that used two 40-minute sessions per day for three months.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
Many included studies had 20 or fewer participants, and some had one or two participants. Most studies tested only a single session, so long-term benefit is unclear. Only three studies included a sham group. Stimulation settings, electrode locations, and outcome measures varied widely. Studies are hard to compare. Some studies reported the best individual reductions rather than average results. Essential tremor and Parkinson disease were sometimes combined, even though tremor mechanisms differ. Some studies did not report motor threshold, demographics, or posture, so it is hard to know exactly what was stimulated or who benefited. The review excluded non-English papers and some conference proceedings, so it may not include all evidence.
The easy way to misread this
Do not conclude that peripheral electrical stimulation is an established treatment for tremor. Most included studies were small, single-session, and highly variable, and only one tested three months of daily use.