Reliability of a new scale for essential tremor
Southern Illinois University School of Medicine, Springfield. Illinois, USA. . Movement Disorders
(Impact Factor: 5.68).
10/2012; 27(12):1567-9. DOI: 10.1002/mds.25162
The objective of this study was to determine the reliability of a new scale for the clinical assessment of essential tremor. The Essential Tremor Rating Assessment Scale contains 9 performance items that rate action tremor in the head, face, voice, limbs, and trunk from 0 to 4 in half-point intervals. Head and limb tremor ratings are defined by specific amplitude ranges in centimeters.
Videos of 44 patients and 6 controls were rated by 10 specialists on 2 occasions 1-2 months apart. Inter- and intrarater reliability was assessed with a 2-way random-effects intraclass correlation, using an absolute agreement definition.
Inter- and intrarater intraclass correlations for head and upper-limb tremor ranged from 0.86 to 0.96, and intraclass correlations for total score were 0.94 and 0.96. The intraclass correlations for voice, face, trunk, and leg were less robust.
This scale is an exceptionally reliable tool for the clinical assessment of essential tremor. © 2012 Movement Disorder Society.
Available from: Martin Heroux
- "No population norms, other than expectation of " normal " rating on all items; Not systematically used in any other neurological or other medical condition. Sum of items interpretable as lesser or greater evidence of tremor intruding on a variety of tasks TETRAS – ADL subscale (Elble et al., 2012) Reduction in ADL abilities, mostly self-care, that are typically compromised in ET Experienced clinician, as above 8–12 of 12 items, depending on how some items are interpreted; some tasks would typically be done with dominant hand, but scoring for some items includes the possibility of using both hands for stability; others would naturally be two-handed tasks Ordinal scale ratings Designed only for tremor. No population norms, other than expectation of " normal " rating on all items; Not systematically used in any other neurological or other medical condition. "
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ABSTRACT: People with Parkinson's disease, essential tremor, or other movement disorders involving tremor have changes in fine motor skills that are among the hallmarks of these diseases. Numerous measurement tools have been created and other methods devised to measure such changes in fine motor skills. Measurement tools may focus on specific features - e.g., motor skills or dexterity, slowness in movement execution associated with parkinsonian bradykinesia, or magnitude of tremor. Less obviously, some tools may be better suited than others for specific goals such as detecting subtle dysfunction early in disease, revealing aspects of brain function affected by disease, or tracking changes expected from treatment or disease progression. The purpose of this review is to describe and appraise selected measurement tools of fine motor skills appropriate for people with tremor disorders. In this context, we consider the tools' content - i.e., what movement features they focus on. In addition, we consider how measurement tools of fine motor skills relate to measures of a person's disease state or a person's function. These considerations affect how one should select and interpret the results of these tools in laboratory and clinical contexts.
Available from: Sophie M Coffeng
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ABSTRACT: Orthostatic tremor (OT) is a high-frequency tremor (13-18 Hz) present in the legs when standing. Underlying disease is found in one-third of OT patients.
We describe an 86-year-old man with progressive shaking of the legs while standing, which disappears immediately after sitting down or while walking. Polymyography confirmed a tremor of the legs (10-11 Hz) while standing. Magnetic resonance imaging (MRI) and neurologic examination showed no underlying disease.
Primary OT can appear at a lower frequency of 10-11 Hz.
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