Feasibility and preliminary efficacy of a wearable device that provides vibration in improving handwriting and hand function in individuals with action tremor (Preprint)

BACKGROUND Action tremor is a debilitating symptom of Parkinson’s Disease (PD) and there is a need for effective interventions. The Microsoft Emma Watch, a wristband with five vibrating motors, is a non-invasive, non-pharmaceutical intervention for tremor attenuation. OBJECTIVE This pilot study investigated the use of the Emma Watch device to attenuate action tremor in people with PD (PwPD). METHODS The sample included nine PwPD who were assessed on handwriting and hand function tasks. The tasks were completed with the Emma Watch at a high vibration intensity, a low intensity (sham), and compared these to their baseline (no vibration) to see if there were changes in performance. RESULTS Results indicated there were no significant differences found in the outcomes of interest measured with the tablet (duration, mean velocity, number of peaks, pause time, and number of pauses). Acceleration and jerk variables measured by APDM did not have significant differences between vibration intensities, except for normalized acceleration peaks, where a main effect of frequency was found. However, a post-hoc Tukey test revealed no pairwise differences between vibration intensities. CONCLUSIONS There were visually depicted and subjectively reported improvements in handwriting for a small subset of individuals. Our study did not indicate significant differences in any outcome measures. Future studies may benefit from a larger sample size and should focus on finding safe and effective ways to address Parkinson-induced action tremor and combining the Emma Watch with task specific training to study its effect on increasing hand function and/or writing ability.