Overview
This protocol outlines the systematic approach for evaluating and analyzing tremors in clinical settings.
Required Equipment
- Accelerometer (if available)
- Spiral drawing templates
- Writing samples template
- Cup with graduated marks
- EMG equipment (for advanced assessment)
Assessment Steps
1. Initial Observation
- Document tremor characteristics at rest
- Note affected body parts
- Record amplitude and frequency estimates
2. Postural Testing
- Arms outstretched (wing-beating position)
- Hands in prayer position
- Finger-nose-finger test
- Document duration: minimum 30 seconds per position
3. Action/Intention Testing
- Pour water between cups
- Draw Archimedes spiral
- Write standard sentence
- Perform finger tapping test
4. Specific Measurements
Rest Tremor
- Patient seated comfortably
- Arms relaxed on armrests
- Record for 60 seconds
Postural Tremor
- Arms held against gravity
- Record tremor characteristics
- Note fatigue effects
Documentation Requirements
Essential Parameters
- Frequency (Hz)
- Amplitude
- Anatomical distribution
- Activating factors
- Suppressing factors
Clinical Context
- Medication effects
- Diurnal variations
- Impact on ADLs
Scoring System
0: None
1: Slight
2: Moderate
3: Marked
4: Severe
Follow-up Protocol
- Document changes from baseline
- Compare spiral drawings
- Assess functional impact
- Update treatment plan
Red Flags
- Sudden onset
- Rapid progression
- Associated neurological symptoms
- Unilateral symptoms
Quality Assurance
- Calibrate equipment regularly
- Maintain consistent testing conditions
- Document environmental factors